Acta neurochirurgica
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Acta neurochirurgica · Mar 2010
Intracranial pressure pulse amplitude during changes in head elevation: a new parameter for determining optimum cerebral perfusion pressure?
During short-term postural changes, the factors determining the amplitude of intracranial pulse pressure (ICPPA) remain constant, except for cerebrovascular resistance (CVR). Therefore, it may be possible to draw conclusions from the ICPPA onto the cerebrovascular resistance (CVR) and thus the relative change in cerebral perfusion pressure (CPP). ⋯ Head elevation is an important part of the ICP and CPP therapy in neurointensive care. When searching for the patient-specific optimum upper body position, ICPPA may provide additional information. Providing that the cerebral autoregulation is intact, the lowest ICPPA of a patient corresponds to the individual upper body position with the highest CPP.
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Acta neurochirurgica · Mar 2010
Outcome correlates with blood distribution in subarachnoid hemorrhage of unknown origin.
Between 15 and 30 % of patients with subarachnoid hemorrhage (SAH) have no bleeding source and usually have a benign clinical course and outcome. The objectives of this study were to classify the pattern of blood distribution on initial computed tomography (CT) and to correlate it with clinical outcome in aneurysmal (ASAH) and SAH of unknown origin (SAHuO). ⋯ In SAH of unknown origin, a new classification allows to predict outcome based on the extent of blood on CT.
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Acta neurochirurgica · Feb 2010
Review Case ReportsPostoperative intracranial seeding of craniopharyngiomas--report of three cases and review of the literature.
Seeding of craniopharyngioma has been rarely reported. We present three cases that ectopically recurred with seeding along the surgical route and CSF spaces. ⋯ Although craniopharyngiomas exhibit a benign histopathological pattern, cerebrospinal fluid seeding along the surgical route or along the CSF pathways has been observed. Ectopic recurrence of craniopharyngioma suggests that meticulous protection of the whole surgical field and careful handling of the tumor during the operation are required. It should be emphasized that long-term follow-up is mandatory, even in patients undergoing a total removal.