Acta neurochirurgica. Supplement
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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
Systemic interleukin-6 levels reflect illness course and prognosis of patients with spontaneous nonaneurysmal subarachnoid hemorrhage.
Patients with nonaneurysmal -subarachnoid hemorrhage (SAH) show either perimesencephal (pm)SAH or nonperimesencephalic (non-pm)SAH, with hemorrhage extending into adjacent cisterns. Patients with non-pmSAH have higher risk for a complicated clinical course with cerebral vasospasm (CVS) and worse outcome. Systemic inflammatory response has been linked to CVS occurrence and worse outcome in aneurysmal SAH. We analyzed whether levels of interleukin (IL)-6, a proinflammatory cytokine, differ in patients with pmSAH compared with non-pmSAH. ⋯ Higher IL-6 levels in patients with non-pmSAH supports the common observation of more complicated illness course with higher incidence of CVS compared to patients with pmSAH.
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Acta Neurochir. Suppl. · Jan 2013
Neuromonitoring with microdialysis in severe traumatic brain injury patients.
Neuromonitoring with microdialysis has the potential for early detection of metabolic derangements associated with TBI. ⋯ After craniotomy extracellular glucose and lactate were good "biomarkers" of cerebral damage in TBI patients. We consider that high extracellular lactate and low glucose is an indicator of severe neurological damage and poor outcome, because of impaired brain metabolism.
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Acta Neurochir. Suppl. · Jan 2013
Cerebral hemodynamic changes after wartime traumatic brain injury.
Traumatic brain injury (TBI) is associated with the severest casualties from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). From October 1, 2008, the U. S. ⋯ TCD signs of mild, moderate, and severe vasospasms were observed in 37%, 22%, and 12% of patients, respectively. TCD signs of intracranial hypertension were recorded in 62.2%; 5 patients (4.5%) underwent transluminal angioplasty for post-traumatic clinical vasospasm treatment, and 16 (14.4%) had cranioplasty. These findings demonstrate that cerebral arterial spasm and intracranial hypertension are frequent and significant complications of combat TBI; therefore, daily TCD monitoring is recommended for their recognition and subsequent management.
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Acta Neurochir. Suppl. · Jan 2013
Effect of lumbar puncture in patients with aneurysmal subarachnoid hemorrhage treated microsurgically or endovascularly.
The aim of this study was to evaluate the effect of treatment modality (surgical clipping vs. endovascular coiling) and lumbar puncture (LP) in patients with aneurysmal subarachnoid hemorrhage (SAH) based on neurologic status on admission and clinical outcome. ⋯ Surgical clipping might improve clinical outcome better than endovascular coiling, although a more confident conclusion requires absolute randomization of patients for both treatments. LP could also improve clinical outcome in patients with high initial SAH evaluation scores.