Journal of neurosurgery
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Journal of neurosurgery · Aug 1998
Selection of severely head injured patients for mild hypothermia therapy.
The authors have analyzed the efficacy of inducing mild hypothermia (34 degrees C) in 62 severely head injured patients to control fulminant intracranial hypertension. ⋯ The authors conclude that mild hypothermia is effective for preventing ICP elevation in patients without diffuse brain swelling in whom ICP remains higher than 20 mm Hg but less than 40 mm Hg after conventional therapies.
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Journal of neurosurgery · Aug 1998
Comparative StudyPosttraumatic hypothermia in the treatment of axonal damage in an animal model of traumatic axonal injury.
Many investigators have demonstrated the protective effects of hypothermia following traumatic brain injury (TBI) in both animals and humans. Typically, this protection has been evaluated in relation to the preservation of neurons and/or the blunting of behavioral abnormalities. However, little consideration has been given to any potential protection afforded in regard to TBI-induced axonal injury, a feature of human TBI. In this study, the authors evaluated the protective effects of hypothermia on axonal injury after TBI in rats. ⋯ The authors infer from these findings that early as well as delayed posttraumatic hypothermia results in substantial protection in TBI, at least in terms of the injured axons.
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Journal of neurosurgery · Jul 1998
Multicenter Study Comparative Study Clinical TrialEndovascular embolization of 150 basilar tip aneurysms with Guglielmi detachable coils: results of the Food and Drug Administration multicenter clinical trial.
To assess the safety and efficacy of aneurysm embolization performed using Guglielmi detachable coils (GDCs), the authors reviewed the results of a cohort of 150 patients with either ruptured (83 patients) or unruptured (67 patients) basilar tip aneurysms treated with these detachable platinum coil devices in the early part of the United States multicenter GDC clinical trial that led to Food and Drug Administration approval for the device. ⋯ Detachable platinum coil embolization is a promising treatment for ruptured basilar tip aneurysms that are not surgically clippable; in selected patients it offers lower incidences of morbidity and mortality compared with conservative medical management. The role of this procedure in unruptured basilar tip aneurysms is unclear with less supportive results. More long-term follow-up evaluation is necessary and results are expected to improve.
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Journal of neurosurgery · Jul 1998
Long-term follow-up review of patients who underwent laminectomy for lumbar stenosis: a prospective study.
Decompressive laminectomy for stenosis is the most common operation performed in the lumbar spine in older patients. This prospective study was designed to evaluate long-term results in patients with symptomatic lumbar stenosis. ⋯ In conclusion, long-term improvement after laminectomy was maintained in two-thirds of these patients.
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Journal of neurosurgery · Jul 1998
Management and results of sciatic nerve injuries: a 24-year experience.
The purpose of this retrospective clinical study was to present results and provide management guidelines for various types of sciatic injuries. ⋯ Surgical exploration and, when necessary, repair of sciatic nerve injuries is worthwhile in selected cases.