Acta neurologica Belgica
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Acta neurologica Belgica · Jun 2016
Treatment of cauda equina syndrome caused by lumbar disc herniation with percutaneous endoscopic lumbar discectomy.
To evaluate the feasibility and clinical efficacy of percutaneous endoscopic lumbar discectomy (PELD) for cauda equina syndrome (CES) caused by disc herniation. 16 patients with CES caused by LDH at the early and middle stages of Shi's classification were selected as the objects of study, who underwent PELD. Clinical outcomes were assessed using the Macnab criteria and the visual analogue scale (VAS). ⋯ Complications included one patient of motor weakness, and one patient developed an ipsilateral recurrent herniation who finally acquired satisfactory result after reoperation. Hence, PELD could be used as an alternative surgical method for the treatment of CES in properly selected cases and appropriate patient selection and a reasonable surgical approach will give rise to better outcomes.
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Acta neurologica Belgica · Jun 2016
ReviewSpontaneous intracranial hypotension: diagnosis to management.
Spontaneous Intracranial Hypotension typically occurs from spontaneous CSF leak. CSF volume depletion rather than decrease in CSF pressure is thought to be the main causative feature for intracranial hypotension. More and more cases of intracranial hypotension are getting diagnosed with the advances in the imaging. ⋯ To localize the location of the CSF leak-CT myelography is the modality of choice. CSF cysternography may provide additional confirmation in uncertain cases and also MRI spine imaging may be of significant help in some cases. Spontaneous intracranial hypotension continues to be a diagnostic dilemma and our effort was to consolidate available information on the clinical features, diagnostics, and management for a practicing neurologist for a "15-20 min quick update of the topic".
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Acta neurologica Belgica · Mar 2016
Clinical analysis of hemifacial spasm patients with delay symptom relief after microvascular decompression of distinct offending vessels.
This study investigates symptom relief in patients whose hemifacial spasms (HFS) were completely relieved following microvascular decompression (MVD). Patients with HFS who were operated on from January 2007 to May 2011, at our department, were studied. The medical records and operation videos of each patient were reviewed. ⋯ While in the vertebral artery compression cohort, 52 (52/133, 39.1 %) HFS patients experienced relief with delayed healing. There was significant difference between these two cohorts (P < 0.05). 93.75% of delayed healing patients were cured and experienced spasm relief within 6 months. Surgeons should be aware that delayed symptom relief after MVD for HFS is more common than has been reported, and time course of symptom relief is various as well as unpredictable; however, most HFS patients are cured, and experience spasm relief within 6 months.
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Acta neurologica Belgica · Mar 2016
Role of admission serum albumin levels in patients with intracerebral hemorrhage.
Low serum albumin levels have been reported to be an independent predictor of increased morbidity and mortality in multiple disease conditions. The aim of our study was to identify the impact of low serum albumin levels on mortality and outcomes at discharge in patients with intracerebral hemorrhage. We retrospectively reviewed our prospective database of patients with intracerebral hemorrhage from January 2010 to December 2011. ⋯ Although admission hypoalbuminemia did not impact in-hospital mortality (28 vs 24 %, p = 0.635), there was a significant increase in poor outcomes at discharge (59 vs 31 %, p = 0.009) (OR 1.8; 95 % CI; 1.2-2.8). Similar to other diseases, hypoalbuminemia was associated with poor functional outcomes in patients with intracerebral hemorrhage. This will need to be confirmed in larger prospective studies before adopting therapeutic and preventive strategies in future.