Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Apr 2019
Early management of poor-grade aneurysmal subarachnoid hemorrhage: A prognostic analysis of 104 patients.
This study aimed to investigate the efficacy of early management for poor-grade aneurysmal subarachnoid hemorrhage (aSAH; WFNS grade IV and V), and analyze the prognostic factors. ⋯ The treatment of aSAH at the early stage by microsurgical clipping or endovascular coiling should be highlighted, especially for patients with WFNS grade IV. CT Fisher grade I-II, WFNS grade IV and endovascular coiling may predict a favorable prognosis, and the CT low-density area appeared to be a possible risk factor for poor prognosis.
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Clin Neurol Neurosurg · Mar 2019
The relationship between preoperative factors and the presence of intramedullary increased signal intensity on T2-weighted magnetic resonance imaging in patients with cervical spondylotic myelopathy.
To investigate preoperative factors affecting the presence of intramedullary increased signal intensity (ISI) on T2-weighted magnetic resonance imaging (MRI) in patients with cervical spondylotic myelopathy (CSM) and the impact of ISI on clinical manifestations. ⋯ Multilevel spinal cord compression, lower preoperative JOA score and greater MSCC are independent preoperative risk factors related to the presence of ISI on T2-weighted MRI in patients with CSM. Patients with ISI tend to have more clinical symptoms and signs, especially in lower limb manifestations and motor deficits.
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Clin Neurol Neurosurg · Mar 2019
CT-guided percutaneous radiofrequency thermocoagulation for glossopharyngeal neuralgia: A retrospective clinical study of 117 cases.
Glossopharyngeal neuralgia (GPN) is a rare disorder of the ninth cranial nerve. Percutaneous radiofrequency thermocoagulation (PRT) is an established treatment for neuropathic pain. Since PRT was first applied with GPN, only a few studies have provided detailed reports on its clinical outcomes and complications, and the number of cases was small. The aim of this study was to investigate the effects, incidence rates, and severity of adverse events of computed tomography (CT)-guided PRT in 117 patients with GPN. ⋯ This study indicates that PRT is a minimally invasive procedure that leads to minor complications and is proven to have immediate and long-term effectiveness for managing GPN. It is especially suitable for patients with contraindication to surgery and patients who require recurrent treatment. We provide a detailed report of the adverse events experienced by GPN patients who underwent PRT.
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Falls from standing are common, particularly amongst the aging population, due to declining mobility, proprioception and vision. They are often complicated by fragility fractures, including vertebral fractures, that are associated with significant morbidity and may represent a pre-terminal condition with high one-year mortality rates. ⋯ Spinal fractures due to a fall from standing height represent one sixth of the fracture workload of the emergency spinal service at a major trauma centre. Whilst the majority of patients can be managed conservatively there are still considerable implications for hospital bed usage and patient mortality.