Journal of neurosurgery
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Journal of neurosurgery · Sep 2002
Randomized Controlled Trial Clinical TrialEffects of decreasing endotracheal tube cuff pressures during neck retraction for anterior cervical spine surgery.
The authors' goal was to determine whether the incidence of postoperative sore throat, hoarseness, and dysphagia associated with anterior spine surgery is reduced by maintaining endotracheal tube cuff pressure (ETCP) at 20 mm Hg during the period of neck retraction. ⋯ The results of this study suggest the following three predictors of postoperative throat discomfort following anterior cervical spine surgery in which neck retraction is performed: increased ETCP during neck retraction (sore throat), neck retraction time (dysphagia), and female sex (sore throat and hoarseness). The simple maneuver of decreasing ETCP to 20 mm Hg may be helpful in improving patient comfort following anterior cervical spine surgery.
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Journal of neurosurgery · Sep 2002
Review Case ReportsNeurological deterioration after coil embolization of a giant basilar apex aneurysm with resolution following parent artery clip ligation. Case report and review of the literature.
The authors present the case of a patient who suffered from progressive cranial nerve dysfunction, radiographically documented brainstem compression, and peduncular hallucinosis after undergoing endosaccular coil placement in a giant basilar apex aneurysm. Symptom resolution was achieved following clip ligation of the basilar artery. The pathogenesis of aneurysm mass effect due to coil placement is discussed and the pertinent literature is reviewed.
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Journal of neurosurgery · Sep 2002
Rise in serum soluble intercellular adhesion molecule-1 levels with vasospasm following aneurysmal subarachnoid hemorrhage.
Proinflammatory adhesion molecule expression has been demonstrated to be elevated in patients with aneurysmal subarachnoid hemorrhage (SAH). Recent studies have shown that elevations in soluble intercellular adhesion molecule-1 (ICAM-1) may be predictive of poor outcome in patients with good grade (Hunt and Hess Grades 1-2) aneurysmal SAH at delayed time points that correspond with the risk period for cerebral vasospasm. In addition, ICAM-1 is upregulated in experimental models of vasospasm. Unfortunately, the relationship of adhesion molecule expression to human vasospasm remains unclear. The authors hypothesized that the delayed elevation of soluble ICAM-1 in patients with aneurysmal SAH is associated with the development of cerebral vasospasm. ⋯ These data suggest a role for ICAM-1 in the pathophysiology of cerebral vasospasm or its ischemic sequelae. As this relationship is further elucidated, adhesion molecules such as ICAM-1 may provide novel therapeutic targets in the prevention of vasospasm or its ischemic consequences.
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Journal of neurosurgery · Sep 2002
Validity and reliability of the Short Form-36 in cervical spondylotic myelopathy.
Validity (the extent to which a test measures what it is intended to measure) and reliability (the stability and reproducibility of measures of the same concept over time or across methods of gathering data) are important characteristics of any outcomes instrument. Generic outcomes instruments are designed for use in any population; however, their validity and reliability in particular diseases should be verified to ensure their appropriateness for use in that disease. In this study the authors assessed the validity and reliability of the Medical Outcomes Study Short Form-36 (SF-36), a generic outcomes instrument, in a population of patients with cervical spondylotic myelopathy (CSM). ⋯ The SF-36 provides valid and reliable data on patients with CSM.
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The aim of this study was to determine if subthalamotomy is effective in treating advanced Parkinson disease (PD). ⋯ These findings indicate that subthalamotomy can ameliorate the cardinal symptoms of PD, reduce the dosage of levodopa, diminish complications of the drug therapy, and improve the quality of life.