Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Dec 2015
Status epilepticus severity score (STESS): A useful tool to predict outcome of status epilepticus.
The treatment protocols for status epilepticus (SE) range from small doses of intravenous benzodiazepines to induction of coma. The pros and cons of more aggressive treatment regimen remain debatable. The importance of an index need not be overemphasized which can predict outcome of SE and guide the intensity of treatment. We tried to evaluate utility of one such index Status epilepticus severity score (STESS). ⋯ STESS can reliably predict the outcome of status epilepticus. Further studies on STESS based treatment approach may help in designing better therapeutic regimens for SE.
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Clin Neurol Neurosurg · Dec 2015
Antifibrinolytic therapy in aneurysmal subarachnoid hemorrhage increases the risk for deep venous thrombosis: A case-control study.
Aneurysm re-rupture is associated with significant morbidity and mortality in aneurysmal subarachnoid hemorrhage (aSAH). While antifibrinolytics reduce aneurysm re-rupture rates, they have been associated with hydrocephalus, delayed cerebral ischemia, and venous thrombosis. We performed a case-control study in patients enrolled in the Cerebral Aneurysm Renin Angiotensin System (CARAS) study to evaluate the impact of short course (<48 h) ɛ-aminocaproic acid (EACA) on deep venous thrombosis (DVT) rates. ⋯ Short course (<48 h) administration of EACA in patients with aneurysmal subarachnoid hemorrhage is associated with an 8.5 times greater risk of DVT formation.
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Deep brain stimulation is nowadays a frequently performed surgery in patients with movement disorders, intractable epilepsy, and severe psychiatric disorders. The most feared complication of this surgery is an intracerebral hemorrhage due to the electrode placement, either for intraoperative electrophysiology (microelectrode recording) and/or implantation of the final electrode (macroelectrode). Here, we have investigated the risk of developing an intracerebral hemorrhage in our cohort of deep brain stimulation patients over a period of 15 years. ⋯ We have found that the risk of developing an intracerebral hemorrhage due to deep brain stimulation surgery is low. The clinical course of the patients with an intracerebral hemorrhage was generally favorable.
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Clin Neurol Neurosurg · Dec 2015
Effects of minimally invasive decompression surgery on quality of life in older patients with spinal stenosis.
Lumbar spinal stenosis (LSS) in the elderly may result in a progressive narrowing of the spinal canal leading to compression of nerve roots in some individuals. The aim of this study was to evaluate the quality of life changes after minimally invasive decompression surgery without instrumentation in geriatric patients with lumbar spinal stenosis. ⋯ Minimally invasive decompression surgery, without instrumentation, for lumbar spinal stenosis in geriatric patients significantly improves the patients' quality of life.
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Clin Neurol Neurosurg · Dec 2015
A minimally invasive approach to defects of the pars interarticularis: Restoring function in competitive athletes.
To understand that young athletes have a higher incidence of pars interarticularis defects than the general population. This may be due to an immature spine put under higher stress loads at an early age. Traditionally, surgery was reserved for those who failed conservative therapy, and consisted of open exposure, bone grafting and placement of pedicle screws. This leads to a long recovery period and limited ability to return to competitive sport. ⋯ MIS advantages include less muscle tissue disruption and restoration of the natural anatomy. This leads to a more rapid recovery, decreased perioperative pain, minimal blood loss, earlier mobilization and decreased hospital length of stay. Overall this allows the athlete to start therapy earlier and return to competition sooner and at his/her pre-operative competitive level. The described MIS repair technique outcomes are similar to those that have been reported in the literature and have allowed a high rate of return to athletics in high performing patients; critical to their quality of life.