Articles: postoperative-complications.
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A hypothesis of the pathophysiology of midcervical quadriplegia after posterior fossa operation with the patient in the sitting position under general anesthesia is presented. Observations and experimental evidence are presented to support the theory that stretch of the cervical spinal cord associated with neck flexion may be sufficient to impair the autoregulation of spinal cord blood flow enough so that the reduced, but otherwise acceptable, hemodynamic parameters associated with general anesthesia in the sitting position contribute to the risk of spinal cord infarction.
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Journal of neurosurgery · Jun 1982
Results and complications of surgical management of 809 intracranial aneurysms in 722 cases. Related and unrelated to grade of patient, type of aneurysm, and timing of surgery.
Data from 722 consecutive causes with intracranial aneurysms were stored in a computer and later retrieved for analysis. Results and complications (including preoperative death and morbidity) of the surgical management of these patients were correlated with the Botterell grade of the patient in individuals with a recent subarachnoid hemorrhage (SAH), with the type of aneurysm, and with the timing of the surgical procedure. Patients with no SAH within 30 days prior to hospital admission were classified as "no SAH." Approximately 30% of all patients had sustained more than one hemorrhage. ⋯ Intraoperative complications were related both to the size of the aneurysm and to its location. Repair of multiple aneurysms did not adversely affect the result. The surgical approach, the importance of using a self-retaining brain retractor, and the technical complications in these cases are discussed.