Acta neurochirurgica
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Acta neurochirurgica · Jul 2002
Comparative StudyEffects of iso- and hypervolemic hemodilution on regional cerebral blood flow and oxygen delivery for patients with vasospasm after aneurysmal subarachnoid hemorrhage.
Arterial vasospasm after subarachnoid hemorrhage may cause cerebral ischemia. Treatment with hemodilution, reducing blood viscosity, and hypervolemia, increasing cardiac performance and distending the vasospastic artery, are clinically established methods to improve blood flow through the vasospastic arterial bed. ⋯ The present study of controlled isovolemic hemodilution demonstrated increased global CBF, but there was a pronounced reduction in oxygen delivery capacity. Both CBF and CDRO(2) remained decreased during further hypervolemic hemodilution. We conclude that hemodilution to hematocrit 0.28 is not beneficial for patients with cerebral vasospasm after SAH.
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Acta neurochirurgica · Jul 2002
Microsurgical anterior cervical foraminotomy (uncoforaminotomy) for unilateral radiculopathy: clinical results of a new technique.
The authors report the clinical application of a new microsurgical technique. The cervical anterior foraminotomy (uncoforaminotomy), which is used for the surgical treatment of unilateral cervical radiculopathy secondary to posterolateral disc herniations or spondylotic foraminal stenoses. ⋯ The results indicate that this new microsurgical technique is an attractive treatment option for adequate anterior decompression of the cervical nerve root via a minimized approach. It was associated with excellent clinical outcome and a less painful postoperative course, allowing patients an almost immediate return to unrestricted full activity.
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Acta neurochirurgica · Jul 2002
Comparative StudyMulti-slice 3D-CTA - an improvement over single slice helical CTA for cerebral aneurysms.
The aim of this study was to demonstrate the utility of volume rendered multi-slice helical three-dimensional CT angiography in patients with cerebral aneurysm when compared with single slice CT angiography and formal digital subtraction angiography. ⋯ Multi-slice CTA is a significant improvement over single slice CTA for cerebral aneurysms. It is our experience the superior and precise images produced by multi-slice technology displays anatomical information not readily available from standard DSA. Multislice 3D-CTA is relatively non-invasive and provides better and adequate detail for surgical planning. The basis of multi-slice CT angiography is described. Multi slice CTA is changing the way cerebral aneurysms are being managed nowadays. New advances in the technology of multi-slice CTA resulting in increased image resolution are outlined.
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Acta neurochirurgica · Jul 2002
Comparative StudyThe effects of 10 degrees reverse trendelenburg position on ICP and CPP in prone positioned patients subjected to craniotomy for occipital or cerebellar tumours.
Control of ICP-hypertension is of utmost importance during craniotomy. The effects of reverse Trendelenburg position (RTP) upon ICP and CPP have recently been studied in supine positioned patients. ⋯ In prone positioned patients 10 degrees RTP significantly reduces ICP, JPB and MABP within one minute, while CPP is unchanged.