Journal of neurosurgery
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Journal of neurosurgery · Feb 2002
Brain edema after experimental intracerebral hemorrhage: role of hemoglobin degradation products.
The mechanisms involved in brain edema formation following intracerebral hemorrhage (ICH) have not been fully elucidated. The authors have found that red blood cell lysis plays an important role in edema development after ICH. In the present study, they sought to determine whether degradation products of hemoglobin cause brain edema. ⋯ Hemoglobin causes brain edema, at least in part, through its degradation products. Limiting hemoglobin degradation coupled with the use of iron chelators may be a novel therapeutic approach to limit brain edema after ICH.
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Journal of neurosurgery · Feb 2002
Evaluation of the healing process after dural reconstruction achieved using a free fascial graft.
This study was undertaken to investigate the healing process and to delineate factors important for the survival of free fascial grafts used for dural repair. ⋯ Fascial grafts tolerated extraordinary intracranial pressures at 1 week postoperatively. Free fascial grafts can heal with durable fibrous tissue without the presence of a blood supply from an overlying vascularized flap.
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Journal of neurosurgery · Jan 2002
Outcome prediction with serum intercellular adhesion molecule-1 levels after aneurysmal subarachnoid hemorrhage.
Although upregulated adhesion molecule expression has been demonstrated in experimental models of subarachnoid hemorrhage (SAH) and in the cerebrospinal fluid of patients with aneurysmal SAH, the clinical significance of these proinflammatory findings remains unclear. The authors hypothesize that 1) serum levels of soluble intercellular adhesion molecule-l (ICAM-1) are increased in all patients with aneurysmal SAH shortly after the hemorrhagic event, and 2) elevated soluble ICAM-1 values are associated with poor patient outcome, even when controlling for the severity of the initial hemorrhagic insult. ⋯ These data demonstrate a correlation between soluble ICAM-1 levels and functional outcome following aneurysmal SAH that appears to be, at least in part, independent of the initial hemorrhage.
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Journal of neurosurgery · Jan 2002
Prospective multiple outcomes study of outpatient lumbar microdiscectomy: should 75 to 80% success rates be the norm?
The authors assessed the efficacy and outcomes of lumbar microdiscectomy performed on an outpatient basis by administering six questionnaires before and at five time points after surgery. The results were compared with those reported in literature in which the success rates vary between 70% and 80% and in excess of 90%. The authors use the methodology and data derived from their study to evaluate critically the relevance of these two categories of success rates. ⋯ The findings of this study support the evidence that lumbar microdiscectomy performed on an outpatient basis is a very safe and effective means of treating sciatic pain due to disc herniation. The authors believe that their outcome success rates of 75 to 80% are more realistic than those of 90% or more found in some reports.
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Journal of neurosurgery · Jan 2002
Bilateral open-door cervical expansive laminoplasty with hydroxyapatite spacers and titanium screws.
The authors report a simple method for bilateral open-door cervical expansive laminoplasty in which hydroxyapatite (HA) spacers are secured by titanium screws. A biomechanical study was also conducted to confirm the strength of the screw fixation. ⋯ Bilateral open-door cervical expansive laminoplasty in which HA spacers are secured by titanium screws is a simple and quick method that yields sufficient fixation strength.