Acta neurochirurgica
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Acta neurochirurgica · Jun 2007
Predictive value of initial clinical status, intracranial pressure and transcranial Doppler pulsatility after subarachnoid haemorrhage.
We examined the predictive value of initial clinical status, mean arterial blood pressure (MABP), intracranial pressure (ICP) and transcranial Doppler (TCD)-derived pulsatility and resistance indices for outcome and quality of life one year following aneurysmal subarachnoid haemorrhage (SAH). ⋯ Mortality and morbidity following SAH remains high, especially in poor-grade patients. Outcome is mainly correlated with initial clinical status, mean arterial blood pressure, intracranial pressure, pulsatility and resistance indices. Those factors seem to be stronger than the influence of vasospasm.
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Acta neurochirurgica · Jun 2007
Case ReportsCraniocervical instability in an infant with partial sacral agenesis.
Sacral agenesis is an uncommon condition characterised by total or partial absence of the sacrum. The association of this condition with craniocervical junction abnormalities is extremely rare. ⋯ The authors describe this extremely rare association and discuss the difficulties faced while deciding the optimum surgical strategy for managing such young children with craniocervical instability.
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Acta neurochirurgica · Jun 2007
Dynamic cerebral autoregulation: should intracranial pressure be taken into account?
Although the inclusion of cerebral perfusion pressure (CPP) is a standard feature in static testing of autoregulation after head injury, controversy surrounds the use of CPP versus arterial blood pressure (ABP) in dynamic tests. The aim of our project was to assess the discrepancies between methods of dynamic autoregulation testing based on CPP or ABP, and study possible differences in their prognostic value. ⋯ Although relatively similar in a large group of patients, the differences between these two methods of assessment of dynamic autoregulation may be considerable in individual cases. When ICP is monitored, CPP rather than ABP should be included in the calculation of the autoregulatory index.