Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Sep 2012
A clinical analysis on microvascular decompression surgery in a series of 3000 cases.
Despite the microvascular decompression (MVD) has become a definitive treatment for trigeminal neuralgia (TN) and hemifacial spasm (HFS), not all of the patients have been cured completely so far and this sort of operation is still with risk because of the critical operative area. In order to refine this surgery, we investigated thousands MVDs. ⋯ A prompt recognition of the conflict site leads to a successful MVD. To facilitate the approach, the craniotomy should be lateral enough to the sigmoid sinus. The whole intracranial nerve root should be examined and veins or arterioles should not be ignored. For TN, all the vessels contacting the nerve should be detached. For HFS, the exposure should be medial enough to the pontomedullary sulcus.
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Clin Neurol Neurosurg · Sep 2012
Elevated blood urea nitrogen/creatinine ratio is associated with poor outcome in patients with ischemic stroke.
Dehydration may impair cerebral oxygen delivery and worsen clinical outcome in patients with acute ischemic stroke (AIS). We evaluated if elevated blood urea nitrogen to creatinine ratio (BUN/Cr) as a marker of dehydration was associated with poor clinical outcome in emergency department (ED) patients presenting with AIS. ⋯ An elevated BUN/Cr ratio in patients with AIS is associated with poor outcome at 30 days. Further study is needed to see if acutely addressing hydration status in ED patients with AIS can alter outcome.
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Clin Neurol Neurosurg · Sep 2012
Review Meta AnalysisA systematic review of clinical outcomes, perioperative data and selective adverse events related to mild hypothermia in intracranial aneurysm surgery.
In the last two decades, mild intraoperative hypothermia has become widely accepted as a protective therapy in neurosurgery. However, its effect in intracranial aneurysm surgery remains unclear. ⋯ Based on available RCTs, especially involving surgery of low-grade aneurysms, intraoperative mild hypothermia showed no advantages compared with normothermia.
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Clin Neurol Neurosurg · Sep 2012
Case ReportsModified acrylic cranioplasty for large cranial defects.
To describe a novel technique for constructing polymethylmethacrylate (acrylic) cranioplasty to repair large cranial defects. ⋯ Our technique is quick and easy to perform, avoids thermal injury to the brain and produces a strong implant with excellent cosmesis even with large bony defects.