Acta neurochirurgica
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Acta neurochirurgica · May 2004
Clinical TrialTreatment of pain from osteoporotic vertebral collapse by percutaneous PMMA vertebroplasty.
Vertebral compression fractures are common complications in advanced osteoporosis. In general, this disease of the elderly patient is characterized by severe local back pain. Pathophysiologically, bony instability triggers local pain during body movement. Serious pain immobilizes the patients and forces them to bed rest. As a result, complications like thrombosis or pneumonia occur. Invasive treatment with surgical instrumentation for vertebral stabilization is not indicated in elderly patients especially with additional diseases. The purpose of this study was to test the hypothesis that percutaneous polymethylmethacrylate (PMMA) vertebroplasty significantly reduces pain due to vertebral collapse in osteoporotic patients and improves quality of life. ⋯ PMMA vertebroplasty is a useful and safe method of pain relief which rapidly regains quality of life for patients with osteoporotic vertebral compression.
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Acta neurochirurgica · May 2004
Discharge criteria from intensive care unit in brain injured patients.
We investigated the value of information on clinical features and intensity of treatment activity in the Intensive Care Unit (ICU) in predicting the need for further interventions after a patient is discharged from the Intensive Care Unit. Our aim was to assess if this could aid in making decisions about transfer to an Immediate Care Unit (sub-ICU). ⋯ Complications in Sub-ICU are less likely in patients younger than 50 and who have SAPS II and GCS scores within predetermined limits. These indices can help in making decisions about discharge of a patient from ICU to Sub-ICU.
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Lymphoma as primary infiltration of the skull base, especially the clivus, is unusual and rare. However, increasing incidence of atypical lymphoma manifestations have been reported. As cranial base surgery becomes more common, it is important to be aware of lymphoma as a possible differential diagnosis of clivus lesions. This case presents a primary malignant lymphoma of the clivus, histologically confirmed after intra-operative MRI-guided transnasal-transsphenoidal biopsy.
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Anterior clinoidectomy is useful in the surgical treatment of paraclinoid and parasellar lesions. Previously reported procedures require expertise in drilling, the alternative method reported here reduces the drilling procedure. ⋯ Intradural en-bloc removal of the ACP with fracture of the optic strut requires minimal drilling, resulting in decreased risk of injury to the optic nerve and a shortened time for clinoidectomy.