Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2011
Treatment of discogenic low back pain with Intradiscal Electrothermal Therapy (IDET): 24 months follow-up in 50 consecutive patients.
Degeneration of the intervertebral disc can be the source of severe low back pain. Intradiscal electrothermal therapy (IDET) is a minimally invasive treatment option for patients with symptomatic internal disc disruption nonresponsive to conservative medical care. ⋯ The findings of this study suggest that durable clinical improvements can be realized after IDET in highly selected patients with mild disc degeneration, confirmatory imaging evidence of annular disruption and concordant pain provocation by low pressure discography.
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Acta Neurochir. Suppl. · Jan 2011
High-field iMRI in glioblastoma surgery: improvement of resection radicality and survival for the patient?
Since the first patients underwent intracranial tumor removal with the radicality control of intraoperative MRI (ioMRI) in September 2005 in our department, the majority of operations performed in the ioMRI room have been indicated for high grade gliomas. In order to elucidate the role of ioMRI scanning in patients harboring high-grade gliomas (HGG) on their survival, one hundred ninety three patients with gliomas WHO grades III and IV were operated either in a standard microsurgical neuronavigated fashion or using additionally ioMRI and were included in a follow-up study. The series started with surgeries from September 2005 until October 2007. ⋯ Patients were followed in regular intervals mostly until death. Statistical analysis showed a median survival time for patients in whom ioMRI had been used of 20, 37 months compared to 10, 3 months in the cohort who had undergone conventional microsurgical removal. Major influencing concomitants were WHO grades and age which were balanced in both groups.
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Acta Neurochir. Suppl. · Jan 2011
Recurrent vasospasm after endovascular treatment in subarachnoid hemorrhage.
the frequency and predictors of recurrent symptomatic and angiographic vasospasm after angioplasty or intra-arterial chemical vasodilatation (IACV) in patients with subarachnoid hemorrhage (SAH) are not well characterized. ⋯ recurrent angiographic or symptomatic vasospasm is not uncommon after angioplasty + IACV, but appears to occur significantly less than after IACV alone, without any increase in procedural complications.
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Acta Neurochir. Suppl. · Jan 2011
Case ReportsA numerical approach to patient-specific cerebral vasospasm research.
cerebral vasospasm (CVS) is a devastating sequela of subarachnoid hemorrhage (SAH). Among the many factors that are associated with the pathogenesis of CVS, the cerebral blood flow (CBF) and underlying haemodynamics play an important role. In this paper we present an integrated clinical-engineering approach to CVS research. ⋯ a numerical approach to patient-specific CVS analysis has been established, and some initial results are achieved via application to an actual spasm case. The undergoing and future work include applying the approach to more CVS cases and incorporating computational models of different scales into the current framework for CVS and SAH research.
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Studying discovertebral complex anatomy is extremely important for the understanding of the pathophysiology of disc degeneration which leads to vertebral endplates signal changes, also known as Modic changes. The sequelae of disc degeneration are among the leading causes of functional incapacity in both sexes and are one of the most common sources of chronic disability in the working years. Even if the presence of degenerative changes in MRI of the spine is by no means an indicator of symptoms, we are concordant in a positive association between Modic changes and low back pain, above all as a relatively specific but insensitive sign of discogenic low back pain.