Acta neurochirurgica
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Acta neurochirurgica · Jan 1995
The effect of nimodipine on autoregulation of cerebral blood flow after subarachnoid haemorrhage in rat.
Disturbance of the autoregulation of the cerebral blood flow (CBF) is frequently seen following subarachnoid haemorrhage (SAH) and is possibly partly caused by cerebral ischaemia. It is well-known, that the calcium channel blocker nimodipine reduces the incidence of cerebral infarction and ischaemic dysfunction after SAH. The aim of the present study was to investigate the effect of nimodipine on autoregulation of CBF in an experimental model of SAH. ⋯ In the control rats the autoregulation was severely disturbed, no plateau was found where CBF was independent of changes in the arterial blood pressure (MABP). In rats treated with intravenous nimodipine (0.03 mg/kg body weight/h), CBF was 33.0% higher and MABP 5.3% higher compared with the controls. CBF was found constant in the MABP interval between 60 and 100 mmHg which indicates, that nimodipine improves the autoregulation of CBF after SAH.
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Acta neurochirurgica · Jan 1995
Comparative Study Historical ArticleCharacter and behaviour of teachers in neurosurgery from a Japanese perspective.
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Acta neurochirurgica · Jan 1994
Clinical Trial Controlled Clinical TrialEffects of prophylactic intrathecal administrations of nicardipine on vasospasm in patients with severe aneurysmal subarachnoid haemorrhage.
Calcium antagonists are currently most widely used for chronic cerebral vasospasm after aneurysmal subarachnoid haemorrhage (SAH). However, the vasodilatory effects of systemically administered calcium antagonists can be limited secondary to hypotension. We previously compared intrathecal and intravenous routes of administration of nicardipine. ⋯ Nine patients complained of headache probably secondary to nicardipine induced vasodilation. Two patients suffered from meningitis, both were successfully treated. Intrathecal administration nicardipine appears to be effective in the treatment of vasospasm, but side effects were significant.
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Acta neurochirurgica · Jan 1994
Vasospasm diagnosis: theoretical sensitivity of transcranial Doppler evaluated using 135 angiograms demonstrating vasospasm. Practical consequences.
The authors inspected 135 angiograms (A zero) demonstrating vasospasm (VS) after aneurysm (An) rupture. There were 54 anterior communicating artery (ACoA), 38 internal carotid artery (ICA) and 43 middle cerebral artery (MCA) ruptured aneurysms. VS was searched for on each A zero in distal branches of MCA (M2) proximal MCA (M1), ICA, anterior cerebral artery (A1) and pericallosal artery (A2). ⋯ If M1 and ICA are insonated TCD sensitivity would be 61% after ACoA, 95% after ICA and 88% after MCA An rupture. TCD sensitivity would be almost perfect with a reliable and constant A1 insonation but that hypothesis is today purely speculative. An additional A zero appears to be necessary to establish VS diagnosis, mainly after ACoA An rupture when a discrepancy is observed between normal TCD data and delayed clinical worsening.
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Acta neurochirurgica · Jan 1994
Comparative Study Clinical Trial Controlled Clinical TrialFavourable influence of opening the lamina terminalis and Lilliequist's membrane on the outcome of ruptured intracranial aneurysms. A study of 197 consecutive cases.
Opening of the lamina terminalis and Lilliequist's membrane--by facilitating CSF circulation in the basal cisterns--favourably influences the outcome in patients with ruptured intracranial aneurysms. This has been demonstrated by the analysis of a series of 197 consecutive cases of ruptured intracranial aneurysms.