Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Sep 2002
Clinical TrialMild hypothermia therapy for patients with severe brain injury.
The authors present a group of patients with severe head injuries in which deliberate mild hypothermia was carried out together with the standard treatment protocol according to the European Brain Injury Consortium. Thirty patients with severe head injuries with Glasgow Coma Scale (GCS) score of 3-8 were enrolled into the study. The subjects were divided into two groups. ⋯ Mean normothermia CPP value of 72+/-3 mmHg significantly increased (P value 0.0007) during this time to 80+/-4 mmHg with unchanged systolic arterial pressure (P value 0.9013). There were no cardiac or coagulopathy-related complications. Our results showed that mild therapeutic hypothermia could be useful in improving the outcome and neurological recovery in patients with severe head injuries.
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Clin Neurol Neurosurg · May 2002
Surgical management of aneurysms of the bifurcation of the internal carotid artery.
Internal carotid artery (ICA) bifurcation aneurysms are rare and easily bleed in younger patients, but are difficult to treat surgically, due to perforators surrounding and adherent to the aneurysm. A series of 25 patients treated by clipping under the operating microscope are analyzed and compared with previous cases. Twenty-five patients, 11 men and 14 women (mean age 51 years), were treated by the same neurosurgeon. ⋯ Poor clinical grade and vasospasm are the causative factors of poor outcome in patients with ruptured ICA bifurcation aneurysm. Preservation of perforators is crucial in cases of giant aneurysm. Clipping of unruptured ICA bifurcation aneurysms is recommended since they tend to bleed at a lower age than other aneurysms.
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We report the case of a 43-year-old patient with neuralgic shoulder amyotrophy who developed abducens palsy on the left 4 days after diagnostic lumbar puncture (LP), which recovered completely within 4 months. ⋯ The presented case emphasizes the use of atraumatic small-size needles for lumbar puncture.
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Clin Neurol Neurosurg · Dec 2001
Case ReportsEpisodic cervical dystonia associated with gastro-oesophageal reflux. A case of adult-onset Sandifer syndrome.
Sandifer syndrome is a dystonic movement disorder described in children with severe gastro-oesophageal reflux. We now report a patient who had the features of Sandifer syndrome first developing in adult life. ⋯ Successful symptomatic treatment of gastro-oesophageal reflux was accompanied by cessation of the dystonic episodes. Possible pathophysiological mechanisms of the abnormal movements in Sandifer syndrome are discussed.