Journal of neurosurgery
-
Journal of neurosurgery · Oct 2018
Founder of modern hydrocephalus diagnosis and therapy: Walter Dandy at the Johns Hopkins Hospital.
Because of his exceptional and pioneering contributions to the understanding and treatment of neurosurgical conditions, Walter Dandy is considered to be one of the founders of both neurosurgery and neuroradiology. In the field of hydrocephalus, Dandy developed revolutionary research models, imaging modalities, and operative procedures. ⋯ His operative experience with hydrocephalus spanned 1915-1946 and comprised 381 surgeries. From this clinical experience, Dandy created much of the framework for modern diagnostic imaging and treatment of hydrocephalus.
-
Journal of neurosurgery · Oct 2018
Association between vasoactive peptide urotensin II in plasma and cerebral vasospasm after aneurysmal subarachnoid hemorrhage: a potential therapeutic target.
OBJECTIVECerebral vasospasm (VS) is a severe complication of aneurysmal subarachnoid hemorrhage (SAH). Urotensin II (UII) is a potent vasoactive peptide activating the urotensin (UT) receptor, potentially involved in brain vascular pathologies. The authors hypothesized that UII/UT system antagonism with the UT receptor antagonist/biased ligand urantide may be associated with post-SAH VS. ⋯ Concerning daily measures of plasma UII levels in VS, non-VS patients, and healthy volunteers, we found a significant difference between SAH patients with VS (median 66 pg/ml [IQR 30-110 pg/ml]) and SAH patients without VS (27 pg/ml [IQR 15-46 pg/ml], p < 0.001) but no significant difference between VS patients and healthy volunteers (44 pg/ml [IQR 27-51 pg/ml]) or between non-VS patients and healthy volunteers. CONCLUSIONSThe results of this study suggest that UT receptor antagonism with urantide prevents VS and improves neurological outcome after SAH in mice and that an increase in plasma UII is associated with cerebral VS subsequent to SAH in humans. The causality link between circulating UII and VS after SAH remains to be established, but according to our data the UT receptor is a potential therapeutic target in SAH.