Journal of neurosurgery
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Journal of neurosurgery · Feb 2004
Effectiveness of the head-shaking method combined with cisternal irrigation with urokinase in preventing cerebral vasospasm after subarachnoid hemorrhage.
The head-shaking method combined with cisternal irrigation has been proposed to be effective in preventing cerebral vasospasm after subarachnoid hemorrhage (SAH) by facilitating rapid washout of the clot from the subarachnoid space. This study was conducted to evaluate the effectiveness of this method. ⋯ The head-shaking method significantly reduced the incidence of symptomatic vasospasm, cerebral infarction, and permanent ischemic neurological deficit and improved the clinical outcomes in patients who underwent cisternal irrigation therapy after aneurysmal SAH.
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Journal of neurosurgery · Feb 2004
Randomized Controlled Trial Clinical TrialRapid and selective cerebral hypothermia achieved using a cooling helmet.
Hypothermia is by far the most potent neuroprotectant. Nevertheless, timely and safe delivery of hypothermia remains a clinical challenge. To maximize neuroprotection yet minimize systemic complications, ultra-early delivery of selective cerebral hypothermia by Emergency Medical Service (EMS) personnel in the field would be advantageous. The authors (W.E. and H.W.) have developed a cooling helmet by using National Aeronautics and Space Administration spinoff technology. In this study its effectiveness in lowering brain temperature in patients with severe stroke or head injury is examined. ⋯ This helmet delivers initial rapid and selective brain cooling and maintains a significant temperature gradient between the core and brain temperatures throughout the hypothermic period to provide sufficient regional hypothermia yet minimize systemic complications. It results in delayed systemic hypothermia, creating a safe window for possible ultra-early delivery of regional hypothermia by EMS personnel in the field.
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Journal of neurosurgery · Feb 2004
Clinical Trial Controlled Clinical TrialEfficacy of scheduled nonnarcotic analgesic medications in children after suboccipital craniectomy.
The authors performed a study to evaluate the efficacy of a regimen of scheduled minor analgesic medications in managing postoperative pain in children undergoing intracranial procedures. ⋯ A regimen of minor analgesic therapy, given in alternating doses every 2 hours immediately after craniotomy and throughout hospitalization, significantly reduced postoperative pain scores and LOS in children in whom suboccipital craniotomy was performed. Narcotic and antiemetic requirements were also decreased in association with this regimen. Application of this postoperative analgesia protocol may benefit children and adults in whom various similar neurosurgical procedures are required.