Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Jul 2012
Terson haemorrhage in patients suffering aneurysmal subarachnoid haemorrhage: a prospective analysis of 60 consecutive patients.
The concomitance of vitreous/subhyaloid haemorrhage (Terson syndrome; TS) and aneurysmal subarachnoid haemorrhage (aSAH) is commonly underestimated. The aim of this study was to determine the incidence of TS and to identify parameters that predispose its development, indicate the severity of the underlying disease, and predict outcome. ⋯ Terson syndrome is likely to occur in severe aSAH with poor admission scores and indicates a worse functional outcome. An ophthalmological examination is strongly recommended in aSAH patients with poor admission scores.
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Clin Neurol Neurosurg · Jul 2012
Hydrocephalus following decompressive craniectomy for malignant middle cerebral artery infarction.
The aim of this study was to evaluate the incidence of hydrocephalus and understand the influence of hydrocephalus on the functional outcome of patients undergoing decompressive craniectomy for malignant middle cerebral artery (MCA) infarction. ⋯ Persistent hydrocephalus is common in patients who receive decompressive craniectomy for malignant MCA infarction. However, the shunt procedure does not significantly improve the patient's clinical condition. The timing of operation in relation to the functional outcome may be critical.
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Clin Neurol Neurosurg · Jul 2012
Distribution of delayed ischemic neurological deficits after aneurysmal subarachnoid hemorrhage and implications for regional neuromonitoring.
Many neuromonitoring devices provide data applicable to a limited region of the brain. Risk of DIND is common after aSAH and may occur near or remote from the ruptured aneurysm. The aim of this study is to determine the distribution of DIND after aneurysms rupture as it relates to the potential value of regional monitoring in detection of vasospasm. ⋯ Vasospasm related infarction occurs most commonly ipsilateral to or in the same distribution of the ruptured aneurysm. Less anatomical correlation is seen with midline aneurysms. Rupture of posterior circulation aneurysms infrequently results in supratentorial infarction. Decisions regarding placement of regional monitors for the purpose of vasospasm detection should consider this distribution of ischemic risk.
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Clin Neurol Neurosurg · Jul 2012
ReviewIntrathecal granuloma formation as result of opioid delivery: systematic literature review of case reports and analysis against a control group.
To investigate the existence of an association between formation of catheter tip intrathecal inflammatory masses with opioid dose and/or concentration. ⋯ Opioid dose and concentration were significantly associated with the development of catheter tip granulomas. A correlation with opioid concentration was confirmed for the first time.