Turk Neurosurg
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In traumatic brain injury (TBI) patients, to overcome the secondary insults, cerebral perfusion pressure (CPP) oriented therapy is recommended. The study is assigned to estimate CPP values with middle cerebral artery (MCA) flow velocities measured noninvasively using transcranial Doppler ultrasonography (TCD). ⋯ With ICP monitoring systems, CPP is calculated and the therapy is guided according to these values. As it is recognized that brain perfusion can be assessed with TCD waveforms, noninvasive CPP estimation with MCA flow velocities may help to observe the trends in CPP values.
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Non-missile intracranial injuries caused by foreign bodies are quite uncommon in civilian practice. Nails, knives, screwdrivers and sewing needles are the most commonly reported agents. ⋯ The foreign body was safely removed by a right parietal craniectomy as a result of detailed radiological evaluation and preoperative planning. To the best of authors' knowledge, the successful surgical treatment of a penetrating brain injury caused by a rebar has not been reported previously.
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We report a rare case of simultaneous cranial subarachnoid and spinal subdural hematoma (SDH) in a 42-year-old man who was on Warfarin therapy after cardiac bypass surgery. Computed tomography at presentation revealed a cranial subarachnoid hemorrhage, and spinal Magnetic Resonance Imaging (MRI) showed a spinal SDH extending from the T6 to L5 segments. ⋯ The patient was managed conservatively due to his poor general condition and was infused with intravenous steroid therapy, but he experienced sudden cardiac arrest 5 hours later after being admitted to the hospital. This case is of interest because of its first presentation of spinal subdural hematoma and cranial subarachnoid hemorrhage simultaneously and it is also the second longest vertebral segmental spread in the literature.
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Electrical stimulation of the dorsal column of the spinal cord stands out as a major method of neuromodulation. Its popularity stems from the long lasting support to the "gate theory" in which electrical stimulation of the gate prevents passage of nociceptive impulses and reduces pain sensation. There is little known about the effect of the duration of intraoperative stimulation (IOS) trial on the success of the spinal cord stimulation trial. MATERIAL and ⋯ The duration of IOS seems to influence the result of the initial trial of SCS. IOS should be between 30-60 minutes to optimize the placement of the lead for better correlation with the SCS trial.
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Our goal was to investigate the long-term results of anterior lumbar interbody fusion combined with percutaneous pedicle screw fixation for degenerative lumbar instability. ⋯ Anterior lumbar interbody fusion combined with percutaneous pedicle screws fixation in patients with degenerative lumbar instability results in good clinical and radiographic outcomes at long-term follow-up.