Neurological research
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Neurological research · Sep 1998
Intracranial pressure waveform analysis: computation of pressure transmission and waveform shape indicators.
We studied transmission of arterial blood pressure to intracranial pressure by observing how the two pressure waveforms varied from baseline conditions to after postural change or jugular compression. Such experiments may lead to pressure waveform-based estimates of intracranial compliance. Using a single database of arterial blood pressure, central venous pressure, and intracranial pressure waveforms collected during baseline, jugular compresison, and head-elevated conditions from six Yucatan minipigs, we computed several numerical indicators of waveform shape to find an estimator of intracranial compliance. ⋯ The lack of statistically significant results may be due to the nature of the composites and/or the small sample size (n = 6). However, we hope this study stimulates further investigation of both central venous pressure-to-intracranial pressure (in addition to arterial blood pressure-to-intracranial pressure) transfer and automated computation of intracranial pressure waveform systolic slope. Such research may lead to noninvasively determined estimators of intracranial compliance.
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Neurological research · Jul 1998
Clinical Trial Controlled Clinical TrialSpinal cord stimulation revisited.
The proportion of patients with intractable pain successfully managed with spinal cord stimulation (SCS) remains disputed. We analyze 27 consecutive patients with intractable pain treated with SCS using identical hardware (Itrel II System; Medtronic Neurological, Inc Minneapolis, MN, USA) by a single satisfactory diagnosis 1992 through 1995. A rigid selection protocol was used: 1. ⋯ We conclude that rigid selection protocol can maximize the proportion of patients with intractable pain who are successfully treated with SCS. Strict neurosurgical technique eliminates infection risk. Hardware selection minimizes incidence of malfunction.
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Neurological research · Jun 1998
Review Case ReportsCutaneous T-cell lymphoma with intracerebral and bilateral intraocular spread.
Brain metastasis from systemic or cutaneous lymphoma is infrequently encountered. We present a case report of cutaneous T-cell lymphoma (CTCL) that metastasized to the brain. ⋯ This report focuses attention on the typical presentation and markedly poor prognosis that characterize this rare problem. It also emphasizes the suspicion with which a brain mass in a lymphoma patient with neurological changes should be regarded.
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Neurological research · Apr 1998
Case ReportsPial arteriovenous malformation with massive perinidal edema.
It is generally considered that perinidal edema in an arteriovenous malformation (AVM) is caused by a concomitant intracerebral hematoma. We report a rare case of AVM with perinidal massive edema which was possibly not due to hemorrhage, and discuss the pathophysiological mechanisms of such edema development. A 60-year-old woman presented with a sudden onset severe headache. ⋯ MR images 3 months after the operation showed marked reduction of perinidal edema. The time course of the perinidal edema suggests that its development was unrelated to the hemorrhage. The findings indicate that increased venous pressure secondary to severe stenosis of the draining vein may possibly contribute to the development of perinidal edema.
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Neurological research · Apr 1998
Correlation between intracranial pressure (ICP) and changes in CT images of cerebral hemorrhage.
The relationship between intracranial pressure and CT images was investigated in 80 cases of cerebral hemorrhage that occurred between 1984 and 1990. In traumatic intracerebral hematoma, positive correlation was found between intracranial pressure and both shift of midline structures and volume of hematoma except in the occipital lobe or at the base of the frontal lobe. ⋯ In nontraumatic subarachnoid hemorrhage, positive correlation existed between increased intracranial pressure and intraventricular hemorrhage as well as Evans' ratio calculated using repeat CT images that were obtained due to disturbances in cerebrospinal fluid circulation. These results suggest that the degree by which intracranial pressure increases in patients with cerebral hemorrhage can be estimated by the changes in CT images.