Neurological research
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Neurological research · Dec 2009
Management and outcome of patients with acute traumatic subdural hematomas and pre-injury oral anticoagulation therapy.
Acute subdural hematomas (aSDHs) are found in up to one-third of patients with severe traumatic brain injury and are associated with an unfavorable outcome in the majority of cases. Mortality ranges between 40 and 60%, but was reported to be even higher in patients undergoing oral anticoagulation therapy (OAT) at the time of injury. The objective of this study is to specifically report on the peri-operative management and outcome of patients with aSDH and pre-injury OAT. ⋯ A large number of patients with aSDH are on pre-injury OAT. Specific replacement therapy facilitates successful clot evacuation without bleeding complications. The overall outcome of these patients does not seem to differ from historical cohorts with aSDH without OAT, but a large prospective multicenter study is warranted to answer that question.
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Neurological research · Dec 2009
Surgical management of cervical spondylotic myelopathy with laminectomy and instrumented fusion.
The indications for treating cervical spondylotic myelopathy (CSM) with laminectomy and instrumented fusion remain ill-defined. Cervical laminectomy without instrumented fusion has been associated with suboptimal outcomes, particularly in the setting of cervical kyphosis. This work's purpose is to retrospectively review our experience in patients who underwent laminectomy with instrumented fusion for CSM and to assess the neurological and radiological outcomes of patients treated with this technique. ⋯ Multilevel cervical laminectomy with instrumented fusion for patients with CSM resulted in an improvement in myelopathy in the majority of cases. Efficacy was similar for patients who may not have tolerated an anterior decompression, such as elderly patients with significant medical comorbidities. Hardware-related complication rates were relatively low.
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The objective of this work was to understand how the baseball bat is a silent weapon. The baseball bat has been utilized illegally in different areas of the world. In the past, several case reports are known for their lethal effect. In this paper, we analyse the outcome of the utilization of baseball bat for illegal purposes as well as review the principal injury and the utilization of baseball bat as explained by an engineer. ⋯ Baseball bat-related injury is an endemic problem in Detroit. This urban use of the baseball bat as a weapon is getting severe. A team approach to this type of injury is recommended.
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Neurological research · Dec 2009
Clinical value of computed tomography perfusion source images in acute stroke.
Computed tomography perfusion (CTP) map can sensitively and accurately distinguish between infarct core and ischemic penumbra. However, CTP mapping software might not generate a perfusion map because of head movement; thus, analysing CTP source images (CTP-SI) is necessary in this situation to provide information for stroke diagnosis and therapy. ⋯ Using follow-up imaging ASPECTS as the final infarct size, our results suggests that the ASPECTS of both CTP-SI and CTA-SI effectively predict final infarct core in the group without delayed perfusion, whereas CTP-SI has a potential advantage over CTA-SI in being able to predict final infarct core in the group with delayed perfusion. In conclusion, CTP-SI provides useful complementary information when CTP map software could not generate perfusion maps.
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Neurological research · Dec 2009
Activation of extracellular signal-regulated protein kinases 5 in the spinal cord contributes to the neuropathic pain behaviors induced by CCI in rats.
To investigate whether activation and translocation of extracellular signal-regulated kinase 5 (ERK5) is involved in the induction and maintenance of neuropathic pain and observe the effects of activation and translocation of ERK5 on the expression of phosphorylated cAMP response element binding (pCREB) in the chronic neuropathic pain. ⋯ The activation of ERK5 pathways contributes to neuropathic pain in CCI rats, and the function of pERK5 may partly be accomplished via the CREB protein-dependent gene expression.