Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Oct 2014
Blood pressure changes after aneurysmal subarachnoid hemorrhage and their relationship to cerebral vasospasm and clinical outcome.
Cerebral vasospasm (VS) and resulting delayed ischemic brain injury constitute the most severe secondary complication after subarachnoid hemorrhage (SAH). Identification of early clinical predictors of developing vasospasm and poor outcome has remained a major challenge in neurointensive care medicine. Aim of the present study was analyze the relevance of spontaneous changes in blood pressures and their predictive value for predicting vasospasm as well as adverse clinical outcome. ⋯ SAH leads to spontaneous and progressive elevations in mean arterial blood pressure. Vasospasm might be anticipated by identifying early elevations of mean arterial blood pressure. Finally, spontaneous elevations of mean arterial blood pressure correlate with poorer outcomes.
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Clin Neurol Neurosurg · Oct 2014
Relevance of gamma knife radiosurgery alone for the treatment of non-small cell lung cancer brain metastases.
Stereotactic radiosurgery (SRS) followed by close follow-up is becoming a popular strategy for the management of brain metastases as cancer patients live longer and late adverse effects of whole brain radiotherapy (WBRT) are increasingly reported. The authors report their experience in consecutively treated patients with limited brain metastases from non-small cell lung cancer (NSCLC), who underwent SRS alone followed by a close follow-up. ⋯ In patients with limited brain metastases from NSCLC, SRS is an effective treatment associated with high local control rate with low morbidity. When performed in isolation, close follow-up is mandatory and radiosurgery can be renewed as salvage treatment for distant brain progression, limiting the use of WBRT.