Acta neurochirurgica
-
Acta neurochirurgica · Jan 1999
Brain death and organ donation in Germany: analysis of procurement in a neurosurgical unit and review of press reports.
A prospective study was undertaken to determine the number of potential organ donors in a neurosurgical intensive care unit and to record the actual number of organ donations. The reasons for refusal of organ donations were analysed with respect to the controversial public discussion of the brain death concept and the transplantation law in Germany. ⋯ In Germany, the relatives refusal rate in organ donation is continuously high, presumable due to a depressing 39% of press reports rejecting the brain death concept, and resulting in a very low number of organ donations. There is hope that the transplantation law which has finally passed German parliament in 1997, confirming the brain death concept as well as the legal principle of prior consent by the donor or consent by the relatives will eventually result in an increase of organ donation especially when supported by an educational campaign which is embodied in the transplantation law.
-
Acta neurochirurgica · Jan 1999
Disturbance of cerebral blood flow autoregulation in hypertension is attributable to ischaemia following subarachnoid haemorrhage in rats: A PET study.
The effects of subarachnoid haemorrhage (SAH) on cerebral blood flow (CBF) autoregulation during induced hypertension were studied by positron emission tomography (PET) during chronic vasospasm in anaesthetized Sprague-Dawley rats. SAH was induced by intracisternal injection of autologous blood. In the control animals saline was injected instead. ⋯ AI (%/10-mmHg) was 13.5+/-2.4 in the control group (n=24). In the SAH group, AI decreased (p<0.05) to 4.5+/-2.5 in non-ischaemic areas (n=15), while in the ischaemic areas (n=5) AI increased (p<0.05) to 25.2+/-4.1. Since the spastic artery is intrinsically resistant to hypertension, the marked increase in CBF during hypertension can be attributable to ischaemia following SAH.
-
Acta neurochirurgica · Jan 1998
Case ReportsHerniated thoracic discs mimic cardiac disease: three case reports.
The authors report three patients (two males and one female) with herniated thoracic discs whose symptoms mimicked cardiac disease (severe intense stabbing pain beginning in the back and radiating to the lateral wall of the chest). They were evaluated for cardiac disease and angina, but the workup of the heart was negative. Magnetic resonance imaging and computed tomography myelography revealed the herniated thoracic discs. All patients underwent video-assisted endoscopic thoracic discectomy and recovered completely.
-
Acta neurochirurgica · Jan 1998
The effect of peripheral glycerol on trigeminal neuropathic pain examined by quantitative assessment of abnormal pain and sensory perception.
In nine patients with trigeminal neuropathic pain after nerve injury, we examined prospectively the effect of peripheral glycerol neurolysis on abnormal pain and sensory perception. In the painful facial skin area of these patients, we found increased temperature and tactile thresholds and the presence of abnormal temporal summation of pain. In seven patients, neuropathic pain was peripheral and disappeared after application of local anaesthesia at or proximal to the site of nerve injury. ⋯ We suggest that glycerol-induced reduction of primary afferent hyperactivity may secondarily result in down-regulation of central neuronal hyperexcitability. The efficacy of application of glycerol at the site of nerve injury in patients with peripheral trigeminal neuropathic pain may warrant further investigation. However, this prospective study does not provide evidence that application of glycerol proximal to the site of nerve injury has a place in the treatment of trigeminal neuropathic pain.