Acta neurochirurgica
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Acta neurochirurgica · Jan 2012
Chemokines as markers of local inflammation and angiogenesis in patients with chronic subdural hematoma: a prospective study.
The goal of this study was to investigate the chemokines CCL2, CXCL8, CXCL9 and CXCL10 as markers of the inflammatory responses in chronic subdural hematoma (CSDH). ⋯ Chemokines are elevated in the hematoma cavity of patients with CSDH. It is likely that these signaling modulators play an important role in promoting local inflammation. Furthermore, biological activity of CCL2 and CXCL8 may promote neovascularization within the outer CSDH membrane, and a compensatory angiostatic activity of CXCL9 and CXCL10 may contribute to repairing this disorder. This phenomenon was restricted to the hematoma site, and the systemic chemokine levels might not reflect local immune responses.
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Acta neurochirurgica · Jan 2012
Comparative StudyIs the use of antibiotic-impregnated external ventricular drainage beneficial in the management of iatrogenic ventriculitis?
Profound evidence substantiates significantly reduced risk of catheter-related infections with prophylactic use of rifampin- and clindamycin-impregnated silicone catheters (Bactiseal(®), Codman Johnson & Johnson, Raynham, MA, USA) for external ventricular drainage (EVD). However, whether Bactiseal(®)-EVD (B-EVD) influences the treatment of EVD-related ventriculitis remains controversial. ⋯ This retrospective pilot study indicates that B-EVD might have no major advantage in the management of EVD or VP-shunt-related ventriculitis. Based on published reports and the results of this study, data support only the prophylactic use of B-EVD for prevention of EVD-related infections. Prospective randomized clinical trials are warranted to further evaluate the role of B-EVD in the treatment of ventriculitis.
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Acta neurochirurgica · Jan 2012
Comparative StudyLong-term visual outcome and aneurysm obliteration rate for very large and giant ophthalmic segment aneurysms: assessment of surgical treatment.
Standard endovascular therapy has shown little success in treatment of very large and giant ophthalmic segment aneurysms. We hypothesize that surgical treatment of these aneurysms yields better results in terms of visual function and aneurysm obliteration. ⋯ There is considerable surgery-related risk for optic pathways during treatment of very large and giant ophthalmic segment aneurysms. Surgery, however, seems to be the treatment of choice in terms of overall visual outcome and aneurysm obliteration as compared to the current endovascular results in this subset of patients.
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External ventricular drainage (EVD) is a freehand neurosurgical procedure performed routinely using the anatomical landmarks. ⋯ Freehand placement of EVDs does not have sufficient accuracy and may lead to drainage dysfunctions. This data suggests that a guidance system for EVD's would be required.
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Acta neurochirurgica · Jan 2012
The usefulness of S100B, NSE, GFAP, NF-H, secretagogin and Hsp70 as a predictive biomarker of outcome in children with traumatic brain injury.
Predicting the long-term outcome after traumatic brain injury (TBI) is an important component of treatment strategy. Despite dramatically improved emergency management of TBI and apparent clinical recovery, most patients with TBI still may have long-term central nervous system (CNS) impairment. ⋯ Although further prospective study is warranted, these findings suggest that levels of biomarkers correlate with mortality and may be useful as predictors of outcome in children with TBI.