Acta neurochirurgica
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Acta neurochirurgica · Dec 2012
Unruptured non-branching site aneurysms located on the anterior (dorsal) wall of the supraclinoid internal carotid artery: aneurysmal characteristics and outcomes following endovascular treatment.
This study was undertaken to evaluate the aneurysmal characteristics and clinico-radiological outcomes of unruptured non-branching site aneurysms located on the anterior (dorsal) wall of the supraclinoid internal carotid artery (ICA). ⋯ Stent-assisted embolization is safe and effective for the treatment of unruptured ICA anterior wall aneurysms exhibiting unfavorable aneurysmal geometries and projections for coil embolization.
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Acta neurochirurgica · Dec 2012
Circulatory characteristics of normovolemia and normotension therapy after subarachnoid hemorrhage, focusing on pulmonary edema.
Cardiopulmonary complications are common after subarachnoid hemorrhage (SAH), and include pulmonary edema (PE). The purpose of this study was to investigate circulatory characteristics of normovolemia and normotension therapy after SAH using pulse contour analysis, and to reveal the mechanisms of PE after SAH. ⋯ The appropriate preload was kept despite negative net water balance and low CVP. PE after SAH was biphasic, with cardiogenic PE caused by low cardiac contractility immediately after SAH, and hydrostatic PE caused by low cardiac contractility and hypervolemia on and after day 7 of SAH. Pulse contour analysis was useful to monitor this unique circulatory change and effective for detecting cardiopulmonary complications after SAH.
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Acta neurochirurgica · Dec 2012
The role of catecholamines in the pathogenesis of neurogenic pulmonary edema associated with subarachnoid hemorrhage.
Neurogenic pulmonary edema (NPE) occurs frequently after aneurysmal subarachnoid hemorrhage (SAH), and excessive release of catecholamines (epinephrine/norepinephrine) has been suggested as its principal cause. The objective of this retrospective study is to evaluate the relative contribution of each catecholamine in the pathogenesis of NPE associated with SAH. ⋯ Elevated plasma norepinephrine may have more active role in the pathogenesis of SAH-induced NPE compared with epinephrine, although both catecholamines may be involved via multiple signaling pathways.
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Pituitary surgery is a continuous evolving specialty of neurosurgery, requiring precise anatomical knowledge, technical skills and integrated appreciation of the pathophysiology. ⋯ The endoscopic endonasal technique brings advantages to the patient (less nasal traumatism, less post-op pain), to the surgeon (wider and closer view of the surgical target area, increase of the scientific activity, smoothing of interdisciplinary cooperation), and to the institution (shorter post-op hospital stay, and increase of the case load).
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Acta neurochirurgica · Dec 2012
Historical ArticleOn the myth of the Edwin Smith papyrus: is it magic or science?