Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2005
Accurate data collection for head injury monitoring studies: a data validation methodology.
BrainIT is a multi centre, European project, to collect high quality continuous data from severely head injured patients using a previously defined [6] core data set. This includes minute-by-minute physiological data and simultaneous treatment and management information. It is crucial that the data is correctly collected and validated. ⋯ Advances in patient care require an improved evidence base. For accurate, consistent and repeatable data collection, robust mechanisms are required which should enhance the reliability of clinical trials, assessment of management protocols and equipment evaluations.
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Acta Neurochir. Suppl. · Jan 2005
Subtemporal approach to basilar bifurcation aneurysms: advanced technique and clinical experience.
The surgical treatment of basilar bifurcation aneurysms is challenging, and many of these aneurysms are currently treated by endovascular means. However, the complete closure of the aneurysm by surgical clipping still remains the best and most permanent cure for the aneurysm. The "gold standard", subtemporal approach was established and introduced by Drake and it has been adapted by the senior author Hernesniemi. We describe our present modified technique of this approach based on clinical experience. ⋯ The subtemporal approach is simple and safe in experienced hands, and should be considered the standard method to approach most basilar bifurcation aneurysms.
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Acta Neurochir. Suppl. · Jan 2005
Clinical TrialImprovement of brain tissue oxygen and intracranial pressure during and after surgical decompression for diffuse brain oedema and space occupying infarction.
We evaluated the perioperative and intraoperative changes of intracranial pressure (ICP) and partial pressure of brain tissue oxygen (PtiO2) after decompressive craniectomy in patients with diffuse brain oedema and space occupying infarction. ⋯ Decompressive craniectomy seems to be a successful option in the treatment of intractable intracranial hypertension with associated cerebral hypoxia. These positive effects may last for several hours after the procedure irrespective of the underlying disease.
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Authors present a seven years retrospective study on 85 cases of severe brain injuries (SBI) in children (GCS
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The optimal therapy of sustained increase in intracranial pressure (ICP) is still controversial. The "Lund concept" is based on the physiological volume regulation of the intracranial compartments. In addition to its other functions the blood-brain barrier (BBB) is the most important regulator of brain volume. ⋯ Reduction of cerebral blood volume. The efficacy of the treatment protocol has been evaluated in experimental and clinical studies regarding the physiological and biochemical (utilizing intracerebral microdialysis) effects. The clinical experiences have been favourable.