Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Aug 2013
Immediate coma and poor outcome in subarachnoid haemorrhage are independently associated with an aneurysmal origin.
Subarachnoid haemorrhage (SAH) may present with coma and this is known to be associated with aneurysmal origin and blood load. Aneurysmal origin is associated with increased blood load and existing data do not allow us to determine if the association between coma and aneurysmal SAH is wholly due to blood load or if aneurysmal origin has an additional independent effect. The objective of our study is to find if an aneurysmal origin is a predictor of acute onset of coma independent of blood load. ⋯ Immediate coma and poor outcome in SAH are associated with an aneurysmal origin and do not characterize naSAH.
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Clin Neurol Neurosurg · Aug 2013
Early superficial temporal artery to middle cerebral artery bypass in acute ischemic stroke.
To evaluate the effects and safety of superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in the early stage after an acute ischemic event and the improvement of present symptoms in patients with intracranial atherosclerotic occlusive disease with stroke/stroke in progress. ⋯ In this study, which consisted of 20 carefully selected patients with acute ischemic stroke, an early STA-MCA bypass was safely and effectively performed, and in some cases, an early STA-MCA bypass resulted in rapid neurological improvement. An early STA-MCA bypass was beneficial in select patients who had acute ischemic stroke with imaging evidence of a small infarction.
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Clin Neurol Neurosurg · Aug 2013
Hemorrhage rates of external ventricular drain (EVD), intracranial pressure gauge (ICP) or combined EVD and ICP gauge placement within 48 h of endovascular coil embolization of cerebral aneurysms.
In single patients with a cerebral aneurysm an external ventricular drain (EVD), an intracranial pressure (ICP) gauge or a combined EVD and ICP gauge placement is necessary after coil embolization and initiation of postprocedural anticoagulation. The aim of this study was to examine the hemorrhage rates of drain placement within 48 h after aneurysm coiling and under anticoagulation or antiplatelet therapy. ⋯ EVD, ICP gauge or combined EVD and ICP gauge placements within 48 h after cerebral aneurysm coiling and under different anticoagulation or antiplatelet regimens seem to have no increased risk of hemorrhages compared to literature.
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Clin Neurol Neurosurg · Aug 2013
Adolescent lumbar disc herniation: experience from a large minimally invasive treatment centre for lumbar degenerative disease in Chongqing, China.
This article discusses the aetiology, medical history, physical examination, imaging characteristics and treatment modalities relevant to this entity aiming to increase awareness among paediatricians regarding LDH (lumbar disc herniation) in young children. ⋯ Diagnosis of LDH in young children is usually delayed, but there were no risk factors for the delayed outpatient diagnosis of LDH. Awareness of LDH will help the paediatrician extract a relevant medical history, perform a directed physical examination and order appropriate imaging studies.
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In the majority of literature concerning age in TBI, specifically in subdural hematomas (SDH), the mean age of patients considered elderly is 55-65. Limited data in SDH patients>75 years suggest an increased mortality rate. The impact of medical decision making on these data is not well-documented. ⋯ This study examines mortality rates in patients>80 with SDHs who are managed surgically and non-surgically using a large administrative database and institutional data. It provides preliminary insight into medical decision making which make affect mortality rates of the very elderly.