Journal of neurosurgery
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Journal of neurosurgery · May 2000
Significant reduction in brain swelling by administration of nonpeptide kinin B2 receptor antagonist LF 16-0687Ms after controlled cortical impact injury in rats.
Identification of new therapeutic agents aimed at attenuating posttraumatic brain edema formation remains an unresolved challenge. Among others, activation of bradykinin B2 receptors is known to mediate the formation of brain edema. The purpose of this study was to investigate the protective effect of the novel nonpeptide B2 receptor antagonist, LF 16-0687Ms, in brain-injured rats. ⋯ Using the present study design, a single administration of LF 16-0687Ms successfully reduced posttraumatic brain swelling. The decreased levels of taurine, hypoxanthine, and xanthine may reflect reduced posttraumatic brain edema, whereas the increased level of glutamate could account for the elevated water content observed in the nontraumatized hemisphere.
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Journal of neurosurgery · May 2000
Comparative StudyUsefulness of postischemic thrombolysis with or without neuroprotection in a focal embolic model of cerebral ischemia.
Recent studies have shown that the use of thrombolysis in the setting of acute stroke is associated with an increased risk of cerebral hemorrhage. The time of onset of symptoms to initiation of medication and the dose levels of the thrombolytic agents are important determinants for the risk of cerebral hemorrhage. The authors evaluated the time course of thrombolysis-related hemorrhages in experimental settings and tested whether the addition of neuroprotective medication augments the efficacy of thrombolysis and reduces the incidence of hemorrhages. ⋯ In this study the authors show that the volume of the infarct can be significantly decreased with 2 to 6-hour delayed intraarterial thrombolysis with urokinase and that the efficacy of thrombolysis may be enhanced by combining neuroprotective agents like TPM. It is also shown that low-dose combination therapy may decrease the likelihood of cerebral hemorrhage.
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Journal of neurosurgery · Apr 2000
Review Case ReportsSomatosensory evoked potential monitoring in anterior thoracic vertebrectomy.
Spine surgeons have used intraoperative cortical and subcortical somatosensory evoked potential (SSEP) monitoring to detect changes in spinal cord function when intraoperative procedures can be performed to prevent neurological deterioration. However, the reliability of SSEP monitoring as applied to anterior thoracic vertebral body resections has not been rigorously assessed. ⋯ It is important to recognize high false-negative rates and low sensitivity of SSEP monitoring when it is used to record spinal cord function during anterior approaches for thoracic vertebrectomies. The insensitivity of SSEPs for motor deterioration during anterior thoracic vertebrectomies is likely due to the limitation of SSEPs, which monitor only posterior column function whereas motor paths are conveyed in the anterior and anterolateral spinal cord. The authors believe that SSEPs can not be relied on to detect reversible spinal damage during anterior thoracic vertebrectomies.
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Journal of neurosurgery · Apr 2000
Segmental cervical spine motion during orotracheal intubation of the intact and injured spine with and without external stabilization.
The purpose of this study was to establish a cadaveric model for evaluating cervical spine motion in both the intact and injured states and to examine the efficacy of commonly used stabilization techniques in limiting that motion. ⋯ Cadaveric cervical spine motion accurately reflected previously reported motion in living, anesthetized patients. Traction was the most effective method of reducing motion at the occipitocervical junction, but none of the interventions significantly reduced movement at the subaxial site of injury. These findings should be considered when treating injured patients requiring orotracheal intubation.