Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · May 2014
Patency of the posterior communicating artery after flow diversion treatment of internal carotid artery aneurysms.
Cerebral aneurysm treatment with the Pipeline Embolization Device (PED) often mandates device placement across the ostia of arteries of the Circle of Willis. We determined the patency rates of the posterior communicating artery (Pcomm) after placement across its ostium a PED and studied neurologic outcomes in these patients. ⋯ Approximately one half of Pcomm arteries demonstrated occlusion or decreased flow at follow-up if the ostia are covered with a flow diversion device. Covering the Pcomm ostium in patients with a P1 did not result in any neurologic deficits.
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Clin Neurol Neurosurg · May 2014
Clinical experience with telemetric intracranial pressure monitoring in a Danish neurosurgical center.
Monitoring of intracranial pressure (ICP) is important in the optimal treatment of various neurological and neurosurgical diseases. Telemetric ICP monitoring allows long-term measurements in the patient's everyday life and the possibility to perform additional measurements without the procedure related risks of repeated transducer insertions. ⋯ Telemetric ICP monitoring is useful in patients with complicated CSF dynamic disturbances who would otherwise require repeated invasive pressure monitoring. It seems to be a feasible method to guide adjustment of programmable valve settings and to identify patients with chronic or repeated shunt problems.
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Clin Neurol Neurosurg · May 2014
Prediction parameters of bone flap resorption following cranioplasty with autologous bone.
The number of patients who need cranioplasty after decompressive craniectomy has increased. In most cases, autologous bone flaps are used for cranioplasty, and there have been reports of the complication of bone flap resorption. Based on these facts, we analysed patients who underwent cranioplasty in our institution to learn about potential risk factors of cranioplasty. ⋯ Patients with delayed reimplantation and a defect size >120cm(2) show a tendency of aseptic bone flap resorption. In these cases, a patient-specific implant (PSI) could be the first choice material for this procedure to reduce the rate of this complication.
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Clin Neurol Neurosurg · May 2014
Lower complication rates for cranioplasty with peri-operative bundle.
The overall benefits of craniectomy must include procedural risks from cranioplasty. Cranioplasty carries a high risk of surgical site infections (SSI) particularly with antibiotic resistant bacteria. The goal of this study was to measure the effect of a cranioplasty bundle on peri-operative complications. ⋯ The cranioplasty bundle was associated with reduced SSI rates and the need for re-do cranioplasties.