Acta neurochirurgica
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Acta neurochirurgica · Dec 2008
Analysis of intracranial pressure changes during early versus late percutaneous tracheostomy in a neuro-intensive care unit.
We aimed to investigate intracranial pressure (ICP) changes during early versus late bedside percutaneous tracheostomy (PT) in a neuro-intensive care unit (NICU). ⋯ In patients with decreased intracranial compliance, a relatively minimally invasive procedure such as PT may lead to significant increases in ICP. The timing of PT does not seem to influence ICP, mortality, pneumonia or early complications. During the PT procedure, ICP should be closely monitored and preventive strategies should be instituted in an attempt to prevent secondary insult to an already severely injured brain.
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Acta neurochirurgica · Dec 2008
Cerebral microdialysis of interleukin (IL)-1beta and IL-6: extraction efficiency and production in the acute phase after severe traumatic brain injury in rats.
As a research tool, cerebral microdialysis might be a useful technique in monitoring the release of cytokines into the extracellular fluid (ECF) following traumatic brain injury (TBI). We established extraction efficiency of Interleukin(IL)-1ss and Interleukin(IL)-6 by an in vitro microdialysis-perfusion system, followed by in vivo determination of the temporal profile of extracellular fluid cytokines after severe TBI in rats. ⋯ Cerebral microdialysis allows measurement of cytokine secretion in the ECF of brain tissue in rats.
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Acta neurochirurgica · Nov 2008
High incidence of optic canal involvement in clinoidal meningiomas: rationale for aggressive skull base approach.
Literature specifically focusing on clinoidal meningiomas is scant, particularly with regards to the postoperative visual outcome. In this study, we aimed to document the incidence of optic canal involvement (OCI) by the tumor, its management using a skull base technique, and its significance with relation to the visual outcome. ⋯ OCI is observed in 36% of clinoidal meningiomas, and it correlates well with pre-operative visual status. With the use of the skull base technique, without which the tumor in the optic canal could not have been removed completely and safely, visual improvement of 77% and stability of 23% was achieved.
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Acta neurochirurgica · Nov 2008
Changes in intracranial pulse pressure amplitudes after shunt implantation and adjustment of shunt valve opening pressure in normal pressure hydrocephalus.
We have previously reported that the intracranial pulse pressure amplitudes were elevated in idiopathic normal pressure hydrocephalus (NPH) patients responding to shunt surgery. Whether or not shunt implantation or adjustment of the shunt valve opening pressure modifies the intracranial pulse pressure amplitudes in NPH patients remains to be established. This report summarises our observations. ⋯ The present observations in 13 NPH patients indicate that shunt implantation reduces mean ICP wave amplitudes. Moreover, the level of reduction can be tailored by adjustment of the shunt valve opening pressure.