Acta neurochirurgica. Supplement
-
Acta Neurochir. Suppl. · Jan 2006
Monitoring and interpretation of intracranial pressure after head injury.
To investigate the relationships between long-term computer-assisted monitoring of intracranial pressure (ICP) and indices derived from its waveform versus outcome, age, and sex. ⋯ High ICP and low PRx are strongly associated with fatal outcome. There is a considerable heterogeneity amongst patients; optimization of care depends upon observing the time-trends for the individual patient.
-
Acta Neurochir. Suppl. · Jan 2006
Case ReportsFifteen year experience of intrathecal baclofen treatment in Japan.
Intrathecal baclofen administration is a fully established treatment for severe spasticity. However, it is scarcely known that Baclofen, an agonist of GABA-B receptor, has other potential effects on pain, restoration coma, dystonia, tetanus, and hypothalamic storm. Sporadic episodes of dramatic recovery from persistent vegetative state are reported after intrathecal administration of baclofen. ⋯ On the other hand, epidural spinal cord stimulation has been used for pain, spasticity, dystonia, or attempt to improve deteriorated consciousness, though the effects seem variable and modest. Similarity between baclofen and spinal cord stimulation is interesting in that both involve the spinal GABAergic system. Based on the 15-year personal experience of intrathecal baclofen, I would stress importance of this treatment not only for spasticity but also for other difficult neurological disorders.
-
Acta Neurochir. Suppl. · Jan 2006
Clinical TrialImportance of cerebral perfusion pressure management using cerebrospinal drainage in severe traumatic brain injury.
To evaluate hemodynamics in patients with severe traumatic brain injury (TBI) after cerebral perfusion pressure (CPP) management using cerebrospinal fluid (CSF) drainage. ⋯ CPP management using CSF drainage decreases the total infusion volume of crystalloid and may reduce the risk of aggravated brain edema after excess fluid resuscitation.
-
Acta Neurochir. Suppl. · Jan 2006
Long term follow-up results of dorsal root entry zone lesions for intractable pain after brachial plexus avulsion injuries.
Brachial plexus avulsion injury is one of the major complications after traffic, especially motorcycle accidents and machine injuries. Intractable pain and paralysis of the affected limbs are the major neurological deficits. During the past 18 years, we have encountered and treated more than 500 cases with brachial plexus avulsion injuries. ⋯ The pain relief rate dropped to 60% in 5 year follow-up period and only 9 cases (50%) had excellent or good result in 10 year follow-up. Reconstructive procedures were performed in almost all patients in the last 10 years. Dorsal root entry zone lesion is an effective procedure for pain control after brachial plexus avulsion injuries.
-
Acta Neurochir. Suppl. · Jan 2006
Seizure control of Gamma Knife radiosurgery for non-hemorrhagic arteriovenous malformations.
Although radiosurgery has been found to be a safe and effective alternative treatment, seizure outcome of arteriovenous malformation (AVM) radiosurgery has not been documented in detail. We report the effect of Gamma Knife radiosurgery (GKRS) on seizures associated with AVMs and discuss the various factors that influence the prognosis. ⋯ Up to now, controversy about resective surgery or radiosurgery as treatment of seizure related to AVMs still remains. In this study, we experienced that Gamma Knife radiosurgery is commonly performed to treat AVMs and can improve symptomatic seizure associated with AVMs. To clarify the mechanism of seizure control in AVMs radiosurgery is difficult, but it seems to be closely related to hemodynamic effects after radiosurgery.