Neurological research
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Neurological research · Jun 2005
Comparative StudyAccuracy of frameless and frame-based image-guided stereotactic brain biopsy in the diagnosis of glioma: comparison of biopsy and open resection specimen.
Tissue heterogeneity and rapid tumor progression may decrease the accuracy a prognostic value of stereotactic brain biopsy in the diagnosis of gliomas. Correct tumor grading is therefore dependent on the accuracy of biopsy needle placement. There has been a dramatic increase in the utilization of frameless image-guided stereotactic brain biopsy; however, its accuracy in the diagnosis of glioma remains unstudied. ⋯ Both frameless and frame-based MRI-guided stereotactic brain biopsy are safe and accurately represent the larger glioma mass sufficiently to guide subsequent therapy. Large tumor volume had a higher incidence of non-concordance. Increasing the number of specimens taken through the long dimension of large tumors may improve diagnostic accuracy.
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Neurological research · Jun 2005
Comparative Study Clinical TrialCerebral salt wasting syndrome in patients with aneurysmal subarachnoid hemorrhage.
Hydroelectrolytic disturbances are part of the complications of subarachnoid hemorrhage. Cerebral salt wasting syndrome (CSWS) must be considered when hyponatremia is associated with a decrease in circulating volume. We performed this study to determine the clinical characteristics and management paradigm of patients with serum sodium concentration abnormalities and aneurysmatic subarachnoid hemorrhage. ⋯ Cerebral salt wasting syndrome, occurring in some patients with subarachnoid hemorrhage, is more commonly related to certain specific anatomic locations of the ruptured aneurysm, responds to sodium replacement therapy and fluids and can be diagnosed and treated based on the clinical, hydroelectrolytic and hemodynamic course of the patient. Further studies are needed to define the underlying mechanism of this condition.
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Neurological research · Jun 2005
Comparative Study Clinical TrialChanges in hemodynamics during isoflurane and propofol anesthesia: a comparison study.
Volatile anesthetics are thought to impair cerebral autoregulation more than i.v. anesthetics. However, few comparative studies have been carried out in humans. The aim of our study was to evaluate the differences in cerebral hemodynamic changes after introduction of isoflurane (a volatile anesthetic) and propofol (an i.v. anesthetic). ⋯ Propofol but not isoflurane decreased cerebral blood velocity thus restoring cerebral autoregulation and the coupling between cerebral blood flow and cerebral metabolism.
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Neurological research · Jun 2005
Case Reports Comparative StudyAn NIRS matrix for detecting and correcting cerebral oxygen desaturation events during surgery and neuroendovascular procedures.
Transcranial cerebral oximetry was developed for early detection of cerebral hypoxia and to avoid cerebral dysfunctions. However, near infrared spectroscopy (NIRS) data obtained during surgery are subject to intrinsic and extrinsic influences that have to be accounted for when interpreting the recordings. ⋯ The modular expandable NIRS matrix we describe has promise for clinical use in surgical, neurointerventional, and anaesthesiological contexts.
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Neurological research · Jun 2005
Comparative StudySecondary spinal cord hypoperfusion of circumscribed areas after injury in rats.
The evaluation of the spatial spread of ischemia following spinal cord injury (SCI) is important for planning therapeutic strategies for secondary injury. The purpose of this study was to investigate in detail the change in regional spinal cord blood flow (rSCBF) after SCI. ⋯ This study found that SCBF is significantly decreased not only at the injured myelomere but also at the circumferent myelomeres. Circumferentially extending ischemia after SCI is related to secondary injury after SCI. The improvement in SCBF after SCI, therefore, can be attributed to the treatment of SCI.