Neurological research
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Neurological research · Sep 1986
Outcome of ruptured intra-cranial aneurysm treated by a deferred operation. Review of 345 consecutive cases treated over a period of 12 years.
This paper reports experience with 345 patients admitted to a neurosurgical department after an aneurysm rupture. At the time of admission, patients were separated into two groups: the patients unsuitable for planned surgery and called 'unoperable'; the patients planned for surgery and called 'operable patients' (328 patients). The general management attitude consisted of deferred surgery according to the clinical status of the patients and the risk of vasospasm and ischaemia. ⋯ The cause of death was vasospasm and ischaemia in 10 cases and recurrence of haemorrhage in 8 cases. 310 patients were actually operated upon. Their final outcome was: good 70%, fair 9.6%, poor 7.7%, death 12.5%. This paper discusses the risk of SAH recurrence and the risk of vasospasm and ischaemia during the waiting time before surgery, in the attitude of deferred surgery which was elected in most cases of this series and compares the outcome with other published series.
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Neurological research · Sep 1986
Clinical Trial Controlled Clinical TrialChronic pain treatment with intravenous lidocaine.
In a few uncontrolled studies intravenous lidocaine has been used in the treatment of chronic pain. In a controlled study we used intravenous lidocaine in 18 patients with severe chronic pain states due to various but mainly neurological diseases. ⋯ There was no significant effect of placebo infusion with isotonic saline. The mechanism of the pain relieving ability of intravenous lidocaine is unknown.
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In cases of brachial plexus spinal root avulsions the only possibility for surgical treatment is reinnervation of plexus by cross-anastomosis with intact nerves. As donor nerves for reinnervation the adjoining (upper intercostal and spinal accessory) or regional intact nerves can be used. In this paper an analysis of these nerves on histological preparation from 15 autopsies and analysis of surgical results from 13 operated patients with total or partial spinal root avulsions are presented. The advantages of pure motor, especially regional, nerves and possibility of combined use of all donor nerves are emphasized.
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Neurological research · Dec 1984
Autoregulation of cortical blood flow and oxygen tension in the rabbit.
The relationship between cerebral blood flow autoregulation and oxygen tension of cerebral tissue is not fully known. We have examined the autoregulation of local cortical blood flow (CoBF) and cortical oxygen tension (bPO2) in the rabbit. CoBF was measured continuously by using the heated thermocouple technique and bPo2 was monitored by the polarographic method. ⋯ On the other hand, bPO2 was maintained constant in the range between 75 and 110 mmHg. This range is significantly wider than that of CoBF. We conclude that autoregulation of CoBF limits changes in local CoBF to maintain constant oxygen tension in brain tissue.