Clinical neurology and neurosurgery
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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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An awake craniotomy is a safe neurological surgical technique that minimizes the risk of brain damage. During the course of this surgery, the patient is asked to perform motor or cognitive tasks, but some patients exhibit severe sleepiness. Thus, the present study investigated the predictive value of a patient's preoperative neuropsychological background in terms of sleepiness during an awake craniotomy. ⋯ These results indicate that the preoperative cognitive functioning of patients was related to their sleepiness during the awake craniotomy procedure and that the patients who exhibited sleepiness during an awake craniotomy had previously experienced reduced functioning in the parietal lobe.
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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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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
Prediction of quality of life improvements in patients with lumbar stenosis following use of membrane stabilizing agents.
Membrane stabilizing agents (MSAs) improves function and reduces neuropathic pain in a subset of patients with LSS. No study has investigated the pre-treatment demographic and psychosocial factors associated with quality of life (QOL) outcomes following the use of MSAs. In this study we sought to create prediction models for post-treatment outcome. ⋯ MSA treatment provides improvements in quality of life for those individuals with LSS. Treatment effects of MSAs will be greatest in those with worse quality of life, less depression, married patients, and those of higher socio-economic status.