Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 1995
Severe peripheral ischemia after vasospasm may be prevented by spinal cord stimulation. A preliminary report of a study in a free-flap animal model.
Electric spinal cord stimulation (SCS) is at present used in many centers to treat ischemic pain and ischemia in peripheral vascular disease. The most promising results have been obtained in cases where a vasospastic component is dominating. The knowledge concerning the mechanisms behind these effects has been scanty, but recent experimental studies indicate that suppression of sympathetic activity and the release of vasoactive substances may be important. ⋯ Some few trials with pharmacologically induced spasm by topical application of noradrenaline onto the feeding vessel also followed the same pattern. In conclusion, SCS seems to be able to reduce vasospasm, especially if the treatment is given before the ischemic period. This approach may supply an animal model for further studies of possible mechanisms behind the microcirculatory effects of SCS.
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The results of endofiberscopic removal of traumatic intracranial haematomas and hygromas in 180 patients are analysed. Peculiarities of the surgical techniques using flexiscopes and original devices in epidural, subdural, intracerebral, intraventricular haemorrhages of various consistencies, size and location are reported. A technique of the trephination access and delayed cranioplasty for endoscopic removal of extensive subdural and intracerebral haematomas is presented. Indications, contra-indications for endoscopic haematoma surgery, advantages, disadvantages, failures of the techniques are discussed.