Journal of neurosurgery
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Journal of neurosurgery · Apr 2004
Comparative StudyEffect of human albumin administration on clinical outcome and hospital cost in patients with subarachnoid hemorrhage.
Human albumin is used to induce hypervolemia (central venous pressure [CVP] > 8 mm Hg) after subarachnoid hemorrhage (SAH). Unfortunately, human albumin may increase the mortality rate in critically ill patients; because of this, its use became restricted in the authors' hospital in May 1999. The goal of this study was to determine the effect of human albumin on outcome and cost in patients with SAH before and after this restriction was put into place. ⋯ Administration of human albumin after SAH may improve clinical outcome and reduce hospital cost.
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Journal of neurosurgery · Apr 2004
Case ReportsSubacute spinal subdural hematoma after spontaneous resolution of cranial subdural hematoma: causal relationship or coincidence? Case report.
The etiopathogenesis of traumatic spinal subdural hematoma (SSH) is uncertain. Unlike the supratentorial subdural space, no bridging veins traverse the spinal subdural space. The authors describe a case of subacute SSH that occurred after spontaneous resolution of traumatic intracranial SDH and suggest a causal relationship between the two. ⋯ Ten days after the original injury, bilateral L5-S1 laminotomy and drainage of the subacute spinal SDH were performed. The patient experienced immediate pain relief. The authors hypothesize that in some cases spinal SDH may be related to redistribution of blood from the supratentorial subdural space.
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Journal of neurosurgery · Apr 2004
Case ReportsDural arteriovenous fistula as a late complication of upper cervical spine fracture. Case report.
The authors report an unusual case of a dural arteriovenous fistula (DAVF) in the cervical spine after a C1-2 fracture. The patient presented with a delayed epidural hematoma and quadriparesis. The DAVF was successfully treated by coil embolization and the patient made a full recovery. The possibility of a DAVF as a late complication of an upper cervical spine fracture should be considered when a patient presents with a spinal epidural hematoma.
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Journal of neurosurgery · Apr 2004
Case ReportsDural arteriovenous fistula of the lumbar spine presenting with subarachnoid hemorrhage. Case report and review of the literature.
The authors report on a patient presenting with subarachnoid hemorrhage (SAH) that was initially attributed to an aneurysm of the right internal carotid artery. During surgical exploration and placement of a clip, however, it was observed that the aneurysm had not ruptured. Diagnostic workup including spinal magnetic resonance imaging revealed a vascular malformation of the lumbar spinal canal within a subarachnoid hematoma. ⋯ This is the first case of SAH that can be attributed to a lumbar DAVF. Although unusual even in cases of cervical DAVF, SAH as a presenting symptom may occur in spinal DAVF of any location. Nontraumatic SAH should not be prematurely attributed to the rupture of an intracranial aneurysm if the clinical findings and imaging results are inconclusive.
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Journal of neurosurgery · Apr 2004
Clinical TrialClosed reduction vertebroplasty for the treatment of osteoporotic vertebral compression fractures. Technical note.
The purpose of this study was to determine the efficacy and feasibility of closed reduction vertebroplasty for the treatment of osteoporotic vertebral compression fractures. Two hundred consecutive patients (183 women and 17 men) with single-level osteoporotic vertebral compression fracture were included in this study. After induction of general anesthesia, the patient was placed prone on an operating table. ⋯ In 141 (71.5%) of the compression fractures kyphosis was corrected by 12.5 +/- 3.8 degrees [mean 61.6 +/- 23.7%]). Closed reduction vertebroplasty is an efficacious and simple method in the treatment of osteoporotic vertebral compression fracture and was able to restore the VB height and kyphotic angle in postions of fractured vertebrae. Its associated, long-term effects on treated vertebrae, however, need further evaluation.