Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Most recent studies on the effectiveness of cerebral revascularization have focused on the treatment of atherosclerotic internal carotid artery occlusive disease. The goal of the present study was to assess neurological function in 11 severe atherosclerotic middle cerebral artery (MCA) disease patients with transient ischemic attacks (TIAs) and hemodynamic compromise and determine the efficacy of superficial temporal artery-middle cerebral artery (STA-MCA) bypass. ⋯ Surgical revascularization increased regional cerebral blood flow (mL/100g/min) from a mean of (+/- standard deviation) 25.9+/-7.39 preoperatively to 32.3+/-7.72 postoperatively, and improved regional cerebrovascular reactivity from -6.42%+/-14.61% to 30.14%+/-23.93% (p = 0.014) in the eight patients with atherosclerotic MCA occlusion. Our findings demonstrated the benefit of STA-MCA bypass for patients with medically refractory and symptomatic atherosclerotic MCA occlusion with hemodynamic compromise.
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Various clinical signs have been used for assessing difficult intubation in patients with acromegaly. These signs include the modified Mallampati classification, measurement of thyromental distance and head and neck movements. Some authors have also tried to establish a relationship between growth hormone levels and difficult intubation. ⋯ The incidence of Mallampati III and IV grades was higher in patients with acromegaly. Increased thyromental distance was noted in patients with a long duration of disease. However, increased thyromental distance was not associated with difficult laryngoscopy.
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Motor complications induced by levodopa (L-dopa) treatment in Parkinson's disease (PD) are not well documented in patients of Chinese ethnicity. We performed a cross-sectional study to investigate the prevalence of dyskinesias and motor fluctuations, and the factors determining their development, in a population of Chinese patients with PD. Among 137 patients with PD, 98 (71.5%) had received a L-dopa preparation. ⋯ Patients with dyskinesias and motor fluctuations had significantly longer duration of PD and L-dopa treatment, higher daily doses of L-dopa, and higher scores in the 39-item Parkinson's Disease Questionnaire (PDQ-39), when compared to patients without motor complications. Among these factors, motor fluctuations were best predicted by duration of L-dopa treatment and dyskinesias by disease duration. We conclude that motor complications are closely related to disease and treatment parameters, especially the treatment and disease duration.
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The human sacrum is the target of lumbosacral instrumentation and decompression procedures. Such surgical interventions require detailed knowledge of the anatomy of the human sacrum. The aim of this study was to measure surgically relevant parameters. ⋯ Thus, this study describes anatomical specifications of the sacrum. These defined morphometric details should be taken into consideration during surgical procedures. This study also describes anatomical landmarks which will allow injury of the sacrum during surgery to be avoided.