Neurological research
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Neurological research · Nov 2008
Doppler ultrasonography screening of poor-grade subarachnoid hemorrhage patients increases the diagnosis of deep venous thrombosis.
Prophylactic anticoagulation greatly decreases the prevalence of deep venous thrombosis (DVT) in neurosurgical patients. Using Doppler ultrasonography (USG), recent studies demonstrate a 1% DVT detection rate following microsurgery or endovascular treatment for aneurysmal subarachnoid hemorrhage (aSAH). We hypothesize that reported statistics underestimate the DVT detection rate in this high risk cohort by accounting for only symptomatic thromboses. This study utilizes Doppler USG to examine the prevalence of DVT in a large population of aSAH patients and attempts to identify a high-risk subgroup within this cohort. ⋯ These data suggest that while pharmacologic prophylaxis lowers the prevalence of symptomatic DVTs in aSAH patients, the number of asymptomatic DVTs remains significant, particularly in patients with formidable neurological deficits. While a formal cost-effective analysis is warranted, our data suggest that screening high-risk patients may increase the diagnosis of asymptomatic DVTs and potentially prevent serious medical complications.
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Neurological research · Nov 2008
A case control study of statin and magnesium administration in patients after aneurysmal subarachnoid hemorrhage: incidence of delayed cerebral ischemia and mortality.
To analyse the effect of the implementation of statin and magnesium treatment on delayed cerebral ischemia (DCI) and 14 day mortality in patients with subarachnoid hemorrhage (SAH). ⋯ A trend towards a lower mortality within 14 days in patients receiving solely simvastatin and those receiving statin and magnesium as compared with the control group was found. A higher incidence for DCI was found in the statin group, whereas patients without statin and magnesium tended to have less often DCI. None of the results was statistically significant.
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Neurological research · Nov 2008
The temporal correlation of dynamic contrast-enhanced magnetic resonance imaging with tumor angiogenesis in a murine glioblastoma model.
Glioblastoma multiforme (GBM) is a WHO grade IV malignant brain tumor with poor prognosis, despite advances in surgical and adjuvant therapy. GBM is characterized by areas of central necrosis and high levels of angiogenesis, during which increased vascular permeability allows for the extravasation of endothelial progenitor cells to support blood vessel and tumor growth. The purpose of this study was to characterize changes in tumor vascular permeability, vascular density and vessel morphology in vivo during angiogenesis. ⋯ In vivo changes of orthotopic glioma blood vessel permeability as shown by DCE-MRI correlates with histologic quantification of vascular density and vessel caliber as well as with the molecular expression of angiogenic factors. DCE-MRI is a useful tool for non-invasive in vivo monitoring of angiogenesis in pre-clinical tumor models.
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Neurological research · Oct 2008
Case ReportsRepetitive cortical spreading depolarizations in a case of severe brain trauma.
Cortical spreading depolarizations (CSD) are waves of mass tissue depolarization that mediate progressive development of cortical infarction in animal models and occur in approximately 50% of patients with acute brain injury. Here we performed multi-modal cerebral monitoring to investigate pathologies associated with CSD occurrence in a case of severe traumatic brain injury. ⋯ Repetitive mass tissue depolarizations accompanied a negative course of hemorrhagic lesion progression in the presence of ischemic conditions after traumatic brain injury. Whether as cause or effect, CSD may represent an inherent component of progressive metabolic failure leading to tissue death, and temperature appears to be an important factor influencing their occurrence. Continuous ECoG is a valuable tool for monitoring subclinical events such as CSD and seizures and for translational research in acute brain injury mechanisms and therapeutics.
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Neurological research · Sep 2008
Management of petrosal veins during microvascular decompression for trigeminal neuralgia.
Venous compression might be the main cause of incomplete decompression and symptom recurrence after microvascular decompression (MVD) in patients with trigeminal neuralgia. Although it can be killed in most cases, cutting the vein sometimes has the potential risk arising from venous congestion. To maneuver the vein safely, we introduced a temporary occlusion test of the vein. ⋯ This venous occlusion test could help the surgeon in making a right decision before manipulation of the petrosal veins during MVD.