Journal of neurosurgery
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Journal of neurosurgery · Jul 1980
Case ReportsElective extracranial-intracranial arterial bypass in the treatment of inoperable giant aneurysms of the internal carotid artery.
Thirteen patients with giant aneurysms of the internal carotid artery (ICA) were treated with ICA ligation and an extracranial-intracranial arterial bypass. A method for establishing a proper superficial temporal artery to middle cerebral artery pressure gradient while maintaining partial flow through the ICA is presented. This procedure allows the anastomosis to become established before full occlusion of the cervical ICA. None of these patients suffered any immediate or delayed ischemic or rebleed complications over an average follow-up period of 18 months.
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Journal of neurosurgery · Jun 1980
Relationship of cerebral blood flow to cardiac output, mean arterial pressure, blood volume, and alpha and beta blockade in cats.
The relationship among cerebral blood flow (CBF), blood volume, cardiac output (CO), and mean arterial blood pressure (MABP) at varying levels of arterial CO2 tensions (PaCO2) were studied in 70 normal cats. The CBF was measured from the clearance curve of xenon-133 and CO with a thermal dilution catheter placed in the pulmonary artery. The CBF, CO, and MABP values varied appropriately with changes in PaCO2, confirming the reliability of the preparations and the presence of normal autoregulatory responses. ⋯ The ability of the brain to resist increases in MABP and CO and maintain normal CBF is explained by normal cerebral autoregulation. However, its vulnerability to modest decreases in blood volume, which cannot be attributed to variations in perfusion pressure, is unexplained but obviously has important therapeutic implications. This may be related to reduction in CO, changes in autonomic activity, or a decrease in the size of the perfused capillary bed.
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Journal of neurosurgery · May 1980
Case ReportsCongenital inclusion dermoid cyst located over the region of the anterior fontanel in adult Nigerians: report of two cases.
Two cases of a congenital inclusion dermoid cyst located over the region of the anterior fontanel are described in adult Nigerians, aged 28 and 32 years. In both cases, the cystic lesion was noticed at birth over the anterior fontanel as a small soft lump, and was carried on the head from infancy into adult life. ⋯ The two lesions were histologically verified as dermoid cysts. Surgical excision was curative.
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Journal of neurosurgery · Apr 1980
Comparative StudyPreoperative treatment of ruptured intracranial aneurysms with tranexamic acid and monitoring of fibrinolytic activity.
The fibrinolytic activity in cerebrospinal fluid has been monitored by determination of levels of fibrin split products (FSP) in 23 patients with ruptured intracranial aneurysms. In 20 of these 23, FSP was found in the cerebrospinal fluid (CSF), with levels ranging from 10 to 80 micrograms/ml. ⋯ These results suggest that there exists a localized fibrinolytic activity, and monitoring the FSP levels in the CSF may be a simple and accurate method for controlling the efficiency of antifibrinolytic therapy. Thus, treatment could be begun with a lower dose, which could be increased later as deemed necessary from the results of careful monitoring.
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Journal of neurosurgery · Apr 1980
Retrospective analysis of 22 patients with chronic pain treated by peripheral nerve stimulation.
Twenty-two patients with chronic pain, chiefly from posttraumatic neuropathy, were treated by implanted peripheral nerve stimulators located proximal to the pain. Thirteen of these (62%) have experienced pain control for an average of 25 months. ⋯ There are theoretical and practical advantages to electrical stimulation and proximal portions of the peripheral nervous system. The surgical technique for implantation is described and the necessity for reoperation in some patients is explained.