Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2011
Clinical TrialIntravascular hypothermia for acute hemorrhagic stroke: a pilot study.
The use of intravascular hypothermia in the treatment of hemorrhagic stroke is currently still being researched. The exact therapeutic properties and effect of hypothermia on the natural progression of the disease are not known, and a only small number of papers has been published with results from these studies. Mild hypothermia at 34°C was induced in six patients with hemorrhagic stroke in the first 48 h after presentation, using an intravascular catheter placed in the inferior vena cava. ⋯ The patients were then followed up using the modified Rankin Scale (mRS) for 6 months and 1 year. There was a statistically significant improvement at 6 months and 1 year follow-up using the mRS score in the hypothermia group, indicating a possible beneficial effect of early therapeutic hypothermia in the management of acute hemorrhagic stroke. However, a larger study is needed in order to confirm our finding.
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Acta Neurochir. Suppl. · Jan 2011
ReviewHypoperfusion in the acute phase of subarachnoid hemorrhage.
Acute disruption of cerebral perfusion and metabolism is a well-established hallmark of the immediate phase after subarachnoid hemorrhage (SAH). It is thought to contribute significantly to acute brain injury, but despite its prognostic importance, the exact mechanism and time course is largely unknown and remains to be characterized. ⋯ Acute vasospasm, cytotoxic edema and a general metabolic stress response occur immediately after experimental SAH. Prophylactic treatment with hypothermia or ET-A antagonists can correct these disturbances in the experimental setting. Clinically, prolonged and ICP-independent hypoperfusion was also confirmed. As the initial phase is of particular importance regarding the neurological outcome and is amenable to beneficial intervention, the acute stage after SAH demands further investigation and warrants the exploration of measures to improve the immediate management of SAH patients.
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Acta Neurochir. Suppl. · Jan 2011
Percutaneous coblation nucleoplasty in patients with contained lumbar disc prolapse: 1 year follow-up in a prospective case series.
Nucleoplasty appears a successful minimally-invasive treatment for symptomatic contained disc herniation (protrusion). The purpose of this prospective study was to assess the effectiveness of nucleoplasty for alleviating pain and dysfunction in our patients. ⋯ This disc decompression procedure was a safe and effective treatment option for carefully selected patients affected by low back and leg pain due to contained disc herniation.
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Acta Neurochir. Suppl. · Jan 2011
Delayed intracranial hemorrhage associated with antiplatelet therapy in stent-assisted coil embolized cerebral aneurysms.
Administration of oral clopidogrel plus aspirin is the most important regimen to reduce thromboembolic complications in stent-assisted coil embolization of cerebral aneurysm. However, such therapy may increase the risk of hemorrhage. The purpose of this study is to analyze the effect of two different antiplatelet regimens on hemorrhagic and thromboembolic complication rates around the stent-assisted coil embolization period. ⋯ The thromboembolic complication rates were not significantly different between the two groups. Oral administration of routine antiplatelet drugs for 3 days before stent-assisted coil embolization possibly increases the risk of delayed intracranial hemorrhage, compared to loading group. Symptomatic thromboembolic complications have no significant difference in the two different regimens.
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Acta Neurochir. Suppl. · Jan 2011
Vasospasm after subarachnoid hemorrhage: a 3D rotational angiography study.
the purpose of this study was to investigate the clinical value of 3D rotational angiography (3DRA) for evaluation of cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage (SAH) by comparison with 2D digital subtraction angiography (DSA). ⋯ the pseudo-spasm phenomenon was frequently observed on 3DRA volume rendering images. 3DRA was less useful than 2D DSA for evaluation of vasospasm after SAH.