Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Jul 2013
Comparative StudyComparison of lumbar drainage and external ventricular drainage for clearance of subarachnoid clots after Guglielmi detachable coil embolization for aneurysmal subarachnoid hemorrhage.
Subarachnoid clots play an important role in development of delayed vasospasm after subarachnoid hemorrhage (SAH). The purpose of this study was to compare clearance of subarachnoid clots using external ventricular drainage (EVD) or lumbar drainage (LD) after Guglielmi detachable coil (GDC) embolization for aneurysmal SAH. ⋯ GDC embolization followed by lumbar drainage accelerates the reduction of subarachnoid clots, but EVD may contribute to stasis of hemorrhage within subarachnoid spaces.
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Clin Neurol Neurosurg · Jul 2013
Endoscopic third ventriculostomy associated 3D-construcive inference steady state MRI for obstructed hydrocephalus: a retrospective study.
Endoscopic third ventriculostomy (ETV) is a developing therapeutic stratagem for obstructive hydrocephalus (OH). The aim of this study was to determine the relevance of third ventricle diagnostic imaging by three-dimensional constructive inference in steady state (3D CISS) MRI in patients with OH and to access the preoperative and postoperative values of this technique in patients undergoing endoscopic third ventriculostomy (ETV). ⋯ Images of the 3D-CISS sequence on MRI can visualize the third ventricle accurately and provide a reliable method for the evaluation of ETV pre- and postoperatively. The degree of enlargement of the third ventricle in patients with obstructive hydrocephalus is associated with the thickness of third ventricle floor and allows a prediction of the difficulty to puncture in ETV.
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Clin Neurol Neurosurg · Jul 2013
Comparative StudyComparison of catheter-related large vein thrombosis in centrally inserted versus peripherally inserted central venous lines in the neurological intensive care unit.
To compare cumulative complication rates of peripherally (PICC) and centrally (CICVC) inserted central venous catheters, including catheter-related large vein thrombosis (CRLVT), central line-associated bloodstream infection (CLABSI), and line insertion-related complications in neurological intensive care patients. ⋯ In neurological critical care patients, CICVCs appear to have a better risk profile compared to PICCs, with a decreased risk of CRLVT. As use of PICCs in critical care patients increases, a prospective randomized trial comparing PICCs and CICVCs in neurological critical care patients is necessary to assist in choosing the appropriate catheter and to minimize risks of morbidity and mortality associated with central venous access.
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Clin Neurol Neurosurg · Jul 2013
Brain white matter hyperintensities in migraine: clinical and radiological correlates.
Migraine is a recognised cause of brain white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI). However radiological characteristics of those in migraine are not well defined. We sought to study the radiological characteristics and factors associated with WMH in migraine. ⋯ There are characteristic radiological features and clinical associations of WMH in migraine.
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Clin Neurol Neurosurg · Jul 2013
Clinical characteristics and outcomes of neurogenic stress cadiomyopathy in aneurysmal subarachnoid hemorrhage.
Aneurysmal subarachnoid hemorrhage (aSAH) is an often devastating form of stroke. Aside from the initial hemorrhage, cardiac complications can occur resulting in neurogenic stress cardiomyopathy (NCM), leading to impaired cardiac function. We investigated whether aSAH patients with NCM had poorer long term functional outcomes than patients without NCM. Mortality, vasospasm, and delayed ischemic complications were also evaluated. ⋯ NCM is seen in a substantial number of aSAH patients and when present, it is associated with higher mortality and poorer long-term functional outcomes. This finding may guide further prospective studies in order to determine if early recognition of NCM as well as optimization of cardiac output would improve mortality.