Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Feb 2016
Microparticle derived proteins as potential biomarkers for cerebral vasospasm post subarachnoid hemorrhage. A preliminary study.
Cerebral vasospasm (CV) and associated secondary brain injury are major contributors to death and disability after aneurysmal subarachnoid hemorrhage (aSAH). Microparticles (MP) are small vesicular micro-molecules released by red and white blood cells, platelets and endothelial cells that can change rapidly and specifically depending on the type of cellular insult. They may serve as useful tools to target a specific pool of proteins associated with the development of CV post aSAH. In these studies, our goal was to use targeted MP-derived protein isolation to find reliable biomarkers indicating increased risk for the development of CV. We hypothesize that there are specific early changes in MP-derived protein expression in CV patients. These proteins may be useful as biomarkers for CV and may help us to further understand the mechanism for the development of CV. Patients Adult male and female patients with angiographically confirmed aSAH and an external ventricular drain (EVD) placed for medical or surgical needs were included in this study. Patients were closely monitored for CV development. Cerebrospinal fluid (CSF) was collected daily until EVD was removed. ⋯ This is the first preliminary demonstration that there is differential protein expression in CSF microparticles from CV patients. Alone or in combination, these and other proteins may be useful as reliable biomarkers to guide in stratifying patients into categories of risk to develop CV post aSAH. These results will deepen our understanding of the mechanisms of cerebral vasospasm and potentially facilitate the development of safer and more effective therapies therapies for cerebral vasospasm.
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Clin Neurol Neurosurg · Feb 2016
Observational StudyDevelopment, validation and psychometric properties of a diagnostic/prognostic tool for breakthrough pain in mixed chronic-pain patients.
Breakthrough pain (BTP) shows variable prevalence in different clinical contexts of cancer and non-cancer patients. BTP diagnostic tools with demonstrated reliability, validation and prognostic capability are lacking. We report the development, psychometric and validation properties of a diagnostic/prognostic tool, the IQ-BTP, for BTP recognition, its likelihood and clinical features among chronic-pain (CP) patients. ⋯ The IQ-BTP showed satisfactory psychometric and validation properties. With adequate feasibility it enabled the allocating of cancer/non-cancer CP patients in three prognostic classes. Results are sufficient to warrant a subsequent impact study of the IQ-BTP as prognostic model and screening tool for BTP in both CP populations.
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Clin Neurol Neurosurg · Feb 2016
WHO grade 1 meningioma recurrence: Are location and Simpson grade still relevant?
To examine whether Simpson grade and pathology location are still predictors of recurrence/progression free survival (RPFS) in WHO grade 1 cranial meningiomas. ⋯ Simpson grade remains a significant predictor of RPFS in WHO grade 1 meningioma surgery. However, tumour location was not significant in this series. We advocate different post-operative imaging surveillance protocols depending on gross total or sub total surgical resection.
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Clin Neurol Neurosurg · Feb 2016
The diagnostic performance of ultrasonographic optic nerve sheath diameter and color Doppler indices of the ophthalmic arteries in detecting elevated intracranial pressure.
To assess the diagnostic accuracy of ultrasonographic optic nerve sheath diameter (ONSD) measurement and color Doppler indices of the ophthalmic arteries in detecting elevated intracranial pressure (ICP). ⋯ While the ultrasonographic mean binocular ONSD (>4.53 mm) was completely accurate in detecting elevated ICP, color Doppler indices of the ophthalmic arteries were of limited value.