Acta neurochirurgica
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A survey is given of the development and actual state of the prediction of outcome in severe head injury. Thanks to the data collection in some large databanks it has become possible, in a relatively large number of cases, to estimate reliably the chances of survival and the chance of developing an intracranial haematoma base on clinical data and CT obtained during the first 24 hours. Later during the posttraumatic course prediction is possible of the degree of remaining disability in survivors, and the chances of developing epilepsy and neuro-behavioural sequelae. Due to changing management-regimens further data collection in international databanks is necessary.
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The number of papers published in European neurosurgical journals during the last decade (1980-90) was analysed using online databases. Thirteen journals devoted to neurosurgery were published in Europe at that time. In five of them neurosurgery appears together with other specialties. ⋯ Of the East-European countries Polish neurosurgeons contributed with 782 publications, followed by Czechoslovakia (568), Hungary (501), USSR (470) and East Germany (452). The proportion of papers published in neurosurgical journals by European neurosurgeons to those in the journals devoted to other neurosciences varied from 99% in the USSR to 12% in Austria with an average of 38%. Citation analysis indicates that only a few of the journals have a large impact on neurosurgical publications, while the others have a rather limited influence.
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Acta neurochirurgica · Jan 1992
Haemodynamic, intracranial pressure and electrocardiographic changes following subarachnoid haemorrhage in rats.
Experimental induction of subarachnoid haemorrhage in rats resulted in acute haemodynamic changes. Heart rate decreased concomitantly with a rise in arterial blood pressure. Intracranial pressure increased and consequently cerebral perfusion pressure dropped. ⋯ The haemodynamic and electrocardiographic changes, which result from subarachnoid haemorrhage, may even become aggravated, when repetitive injections of blood or saline are given into the cisterna magna and when cerebral angiography is performed prior to induction of the subarachnoid haemorrhage. Chronic intracranial pressure monitoring during the 48 hours following subarachnoid haemorrhage revealed no significant rise in pressure. A thorough control of the experimental conditions is thus of utmost importance in order to give a valid interpretation of the observed anomalies.
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Acta neurochirurgica · Jan 1992
Cerebral blood flow and intracranial pressure during experimental subarachnoid haemorrhage.
The relationships of intracranial pressure (ICP), systemic blood pressure (SBP) and cerebral blood flow (CBF) during experimental subarachnoid haemorrhage were investigated in cats. Continuous monitoring of regional cerebral blood flow (rCBF) was done by a thermal diffusion method using a Peltier stack. During haemorrhage ICP rose within 5.4 +/- 0.97 minutes from 10.5 +/- 4.9 to 176.1 +/- 27.8 mmHg. ⋯ The Cushing response during the haemorrhage could not improve the cerebral circulation, but in contrast caused a further increase of ICP. After the haemorrhage the cerebral blood flow normalised within minutes. It is concluded, that the Cushing response during a subarachnoid haemorrhage should be regarded as a deleterious rather than a beneficial mechanism.