Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2011
Multicenter Study Clinical TrialClinical trial of nicardipine prolonged-release implants for preventing cerebral vasospasm: multicenter cooperative study in Tokyo.
since October 1999, nicardipine pellets (NP) have been used to prevent vasospasm in patients with subarachnoid hemorrhage (SAH). We started a multicenter cooperative study on Jan 1, 2007, and 136 patients in six hospitals were enrolled to this trial in 2 years. The incidence of cerebral vasospasm and outcome were examined in these patients. ⋯ the incidence of cerebral vasospasm in this multicenter trial is similar to that of our first trial performed in a single center.
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Acta Neurochir. Suppl. · Jan 2011
Randomized Controlled TrialLong term intrathecal infusion of opiates for treatment of failed back surgery syndrome.
Failed Back Surgery Syndrome (FBSS) is a multidimensional painful condition and its treatment remains a challenge for the surgeons. Prolonged intrathecal infusion of opiates for treatment of noncancer pain also remains a controversial issue. The authors present a prospective study about the long-term treatment of 30 patients with nonmalignant pain treated with intrathecal infusion of morphine from February, 1996 to May, 2004. ⋯ There was improvement of the quality of life measured by SF-36 (30.8-49.6) and in all dimensions of the Treatment of Pain Survey, except for working capacity. The follow-up period ranged from 18 to 98 months (mean = 46.7 months). It was concluded that intrathecal infusion of morphine is a useful and safe tool for long-term treatment of chronic nonmalignant pain.
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Subarachnoid hemorrhage (SAH) remains to be a devastating disease with high mortality and morbidity. Two major areas are becoming the focus of the research interest of SAH: these are cerebral vasospasm (CVS) and early brain injury (EBI). This mini review will provide a broad summary of the major advances in experimental SAH during the last 3 years. ⋯ Inflammation and oxidative stress contribute to the pathophysiology of both CVS and EBI. Apoptosis, a major component of EBI after SAH, also underlie the etiology of CVS. Since we recognize now that CVS and EBI are the two major contributors to the significant mortality and morbidity associated with SAH, ongoing research will continue to elucidate the underlying pathophysiological pathways and treatment strategies targeting both CVS and EBI may be more successful and improve outcome of patients with SAH.
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Acta Neurochir. Suppl. · Jan 2011
Multicenter StudyPercutaneous surgical treatment in lumbar spinal stenosis with Aperius-PercLID: indications, surgical technique and results.
Interspinous spacers have recently been used in the treatment of lumbar spinal stenosis. In vitro studies have demonstrated a reduction in facet joint forces by 68% and annulus pressures by 63%. MRI studies have demonstrated increased canal and neural foraminal area after implantation of these devices. ⋯ The average VAS pain score improved from 8.2 to 3.6 (scale of 1 to 10). The overall patient satisfaction rate was 76%. No complications were detected at 6 months' follow-up.
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Acta Neurochir. Suppl. · Jan 2011
Comparative StudyDecompressive hemi-craniectomy is not necessary to rescue supratentorial hypertensive intracerebral hemorrhage patients: consecutive single-center experience.
A consensus on decompressive surgery for hypertensive intracranial hemorrhage (ICH) has not been reached. We retrospectively analyzed our single-center experience with ICH. ⋯ Decompressive craniectomy is not necessary for rescue in ICH if the hematoma can be removed completely.