Acta neurochirurgica
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Acta neurochirurgica · Nov 2003
Secondary growth of a cortical necrosis: effect of NOS inhibition by aminoguanidine post insult.
A cortical tissue necrosis from a focal freezing injury expands to 140% of its initial volume within 24 hrs in rats. Previous studies of our laboratory have shown that administration of the NOS inhibitor aminoguanidine (AG) prior to trauma attenuates this process of secondary brain damage. Objective of the present study was to analyse whether this agent is also protective when treatment commences after the insult. ⋯ The findings demonstrate that AG retains its neuroprotective potential against secondary brain damage from trauma even when administration begins after trauma.
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Acta neurochirurgica · Nov 2003
Effects of intravascular perfusion of cooled crystalloid solution on cold-induced brain injury using an extracorporeal cooling-filtration system.
We evaluated cerebral metabolic change during brain hypothermia with intravascular perfusion of cooled crystalloid solution using an extracorporeal cooling-filtration system and cerebroprotective effects of this hypothermia on brain injury in an animal model. ⋯ Occlusion of three main arteries induced ischaemia under critical threshold in canine brains. Under this condition, intravascular cooling with crystalloid solution suppressed accumulation of extracellular glutamate and reduced tissue damage in the early phase after cold-induced brain injury, as cerebroprotective effects. This information suggests that a method employing brain hypothermia via intra-arterial cooling with an extracorporeal cooling-filtration system has potential to achieve successful, safe, selective brain cooling.
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Acta neurochirurgica · Oct 2003
Gamma knife radiosurgical management of petroclival meningiomas results and indications.
Surgical treatment of petroclival meningiomas remains challenging. In order to refine indications for the use of stereotactic radiosurgery in the treatment of these tumours, we retrospectively evaluated our experience in this field. ⋯ Stereotactic radiosurgery with a Gamma knife provides effective management of small to middle sized petroclival meningiomas and is an alternative to microsurgery. Careful selection of patients and use of major technical refinements should improve the safety of this treatment.
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Acta neurochirurgica · Oct 2003
Clinical TrialNeuropsychological assessment after microsurgical clipping or endovascular treatment for anterior communicating artery aneurysm.
After open surgery for ruptured ACoA aneurysms, several patients who have achieved a favourable neurological outcome still exhibit significant cognitive deficits. The aim of this study was to investigate the cognitive performances in patients with ACoA aneurysms submitted to different therapeutic options such as endovascular treatment and surgical clipping. ⋯ Investigation of neuropsychological deficits can show an impairment, even in patients classified as good outcome by Glasgow Outcome Scale (GOS). The frontal lobe functions and language are impaired especially in surgically treated in comparison with controls, but no significant difference was found respect to the endovascular and no treated patients (group C).