Acta neurochirurgica
-
Acta neurochirurgica · Jan 1984
The cause of failure in high cervical percutaneous cordotomy: an analysis.
Factors that might have contributed to failure of high cervical percutaneous cordotomy in 23 patients with intractable pain were investigated. Cordotomy failed in 3 patients, 20 had initially good pain relief (87%). ⋯ There was no influence of age, sex, type of cancer or previous medication on the result of percutaneous cordotomy. Patients with plexus involvement did better than those with bone metastasis.
-
Acta neurochirurgica · Jan 1984
Prediction of cerebral vasospasm value of fibrinogen degradation products (FDP) in the cerebro-spinal fluid (CSF) for prediction of vasospasm following subarachnoid haemorrhage due to a ruptured aneurysm.
In a new treatment regimen with antifibrinolytic drugs in patients with aneurysmal subarachnoid haemorrhages, we have systematically controlled the level of fibrinogen degradation products (FDP) in the cerebrospinal fluid (CSF). The frequency of severe vasospasm with clinical ischaemia has been compared with the patient's initial level of FDP. Fifty patients have been included in this study. (All in Hunt and Hess's grades I or II on their arrival.) Patients with a secondary deterioration unrelated to vasospasm were excluded. ⋯ Furthermore, two different groups may be discriminated by their initial FDP level: FDP greater than 80 mcg/ml; n = 23, 65% severe vasospasm; FDP less than 80 mcg/ml; n = 27.8% no severe vasospasm (p less than 0.001). These results do not imply a direct role of FDP in pathophysiological mechanisms of vasospasm, but they suggest a relationship between the clot lysis and the appearance of vasospasm with clinical ischaemia. To our knowledge this is the first time that such a predictive role can be attributed to the initial FDP level in the prognosis of vasospasm.
-
Fourteen cases of gunshot wounds of the brain, evaluated by CT scanning are presented. The results indicate that CT scanning is superior to other diagnostic tests in missile wounds of the brain. ⋯ Visualization of the missile track is of particular importance; this cannot be achieved by any other diagnostic method. It is essential for the planning of the surgical approach in these lesions.