Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2015
Risk factors for vasospasm-induced cerebral infarct when both clipping and coiling are equally available.
Vasospasm-induced cerebral infarct is still a significant cause of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). ⋯ New treatment strategies for vasospasm-induced cerebral infarct are needed, especially for ruptured middle cerebral artery aneurysm cases associated with massive SAH.
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Acta Neurochir. Suppl. · Jan 2015
Detection of delayed cerebral ischemia (DCI) in subarachnoid haemorrhage applying near-infrared spectroscopy: elimination of the extracerebral signal by transcutaneous and intraparenchymatous measurements in parallel.
Detection of delayed cerebral ischemia (DCI) in high-grade subarachnoid haemorrhage (SAH) is an unsolved issue. Conventional near-infrared spectroscopy (NIRS) with optodes applied over the skin is controversial because the NIRS signal is contaminated by extracerebral tissue. The objective is to quantify and subtract the contribution from extracerebral tissue from the signal by using measurements in parallel with a NIRS brain tissue probe and conventional NIRS. ⋯ Blood flow values obtained with conventional NIRS correlated significantly with absolute CBF values obtained directly within the brain tissue. Simultaneous measurements with the NeMo Probe and NeMo Patch allow quantification and subtraction of the contribution from extracerebral tissues from the signal obtained with conventional NIRS.
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Acta Neurochir. Suppl. · Jan 2015
Impaired cerebrovascular reactivity in the early phase of subarachnoid hemorrhage in good clinical grade patients does not predict vasospasm.
Subarachnoid hemorrhage (SAH) alters cerebrovascular reactivity (CVR) to carbon dioxide (CO2), which may be related to an increased risk of delayed ischemic neurological deficits (DINDs). We report the results of bedside CVR testing in the acute phase of SAH in good clinical grade patients without established vasospasm or signs of DIND. ⋯ Patients with SAH had significantly lower CVR indexes compared with healthy controls. Although impaired CVR was present in 50 % of the patients early after SAH, no correlation with later occurrence of DINDs was found.
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Acta Neurochir. Suppl. · Jan 2013
Multicenter StudyEffect of aneurysm treatment modalities on cerebral vasospasm after aneurysmal subarachnoid hemorrhage.
It is still controversial if the selection of treatment modality (clip or coil) affects cerebral vasospasm development following aneurysmal subarachnoid hemorrhage (SAH). ⋯ Treatment modalities (clip or coil) may not significantly affect the incidence of vasospasm.
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Acta Neurochir. Suppl. · Jan 2013
Deep brain stimulation of the ventrolateral thalamic base and posterior subthalamic area in dystonic head tremor.
Dystonic head tremor (DHT) is characterized by head tremor associated with cervical dystonia (CD). Deep brain stimulation (DBS) can be considered when local treatment with botulinum toxin or oral medication has failed. However, there is lack of data regarding the optimal target structure for surgery in DHT. ⋯ Based on these observations, we performed DBS in three patients with DHT, placing the proximal contacts of the electrodes into the inferior base of VL thalamic nuclei and the distal contacts into the adjacent PSA. Chronic stimulation improved not only head tremor but also CD. These findings suggest that DBS at the base of VL thalamus and the adjacent PSA should undergo further investigation as a potential target for patients with DHT.