Neurological research
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We studied the trigeminal nerve in the middle cranial fossa in 20 cadaveric specimens (10 fixed skull base). Specifically, we analysed the relationships among the gasserion or trigeminal ganglion (herein referred to as the gasserion ganglion), the internal carotid artery, and the petrous bone. ⋯ Our paper compares our study to previous studies and the measurements taken in those studies. The lesions affecting the ganglion and the nerves are discussed and the surgical approaches to the middle cranial fossa, the petrous bone, and the upper clivus are also reviewed.
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Neurological research · Apr 1994
Long term outcome after treatment of the ruptured intracranial aneurysm: 73 cases admitted from day 0 to day 3 after subarachnoid haemorrhage.
73 patients admitted from day 0 to day 3 (D0 to D3) after a subarachnoid haemorrhage and being in Hunt and Hess grades I to IV after aneurysm rupture, were studied. All admitted patients were operated upon. The timing of surgery was neither systematic early nor systematic late surgery, but modulated surgery. ⋯ The long term ability to work in 63 followed-up surviving patients was: normal activity--57%, reduced level of activity--16%, no resumption of activity--27%. This rate of activity resumption was not improved in patients operated on early. Among patients with a good long term neurological outcome, only 67% resumed their previous activity at the same level.(ABSTRACT TRUNCATED AT 250 WORDS)
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Neurological research · Feb 1994
Case ReportsAcute vasoparalysis after subarachnoid haemorrhage and cerebral trauma: general reflex phenomenon?
In patients with head trauma and consecutive acute diffuse cerebral swelling the sudden initial rise in intracranial pressure with subsequent impairment of cerebral blood flow is explained by engorgement due to vasoparalysis. How quickly hyperaemic brain swelling can occur is shown by a case report. The review of clinical and experimental data shows strong evidence that a general reflex phenomenon could be the result of this initial vasoparalysis in acute diffuse cerebral swelling in head trauma and acute aneurysmal subarachnoid haemorrhage.
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Neurological research · Jan 1992
Metabolic derangement in viable periinfarct tissue in the course of acute ischaemic infarction: a multitracer positron emission tomography (PET) study.
We used a multitracer positron emission tomography (PET) approach to assess metabolic changes in infarcted and periinfarct tissue in acute ischaemic stroke. 16 patients were studied within 6-48 hours (mean, 23 h) after onset of symptoms from a first hemispheric stroke and again 13-25 days later (mean, 15.6 days). Regional cerebral metabolic rates of oxygen (CMRO2) and glucose (CMRGlc), blood flow (CBF) and blood volume (CBV) were measured and oxygen extraction (OEF) as well as glucose extraction (GEF) and microvascular transit time were calculated. PET images were three-dimensionally aligned using serial CT or MRI scans. ⋯ In the infarction core CBF, CMRO2 and CMRGlc were significantly lower than on the contralateral side and did not change during time. In the periinfarct regions there was a decreased CMRO2 with progressive deterioration over time while CBF slightly increased. Only in a few ischaemic regions with initially increased OEF oxygen metabolism was preserved during the course of time.
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Neurological research · Dec 1991
Case ReportsTranscranial Doppler ultrasound in brain death: experience in 140 patients.
The interpretation of clinical tests for brain death is often complicated by the presence of facial trauma, or the use of barbiturate therapy for reduction of intracranial pressure. We propose a non-invasive technique--transcranial Doppler (TCD) sonography for the diagnosis of brain death. One hundred and forty comatose patients, 111 of whom were believed to be brain dead underwent TCD examinations. ⋯ In nine BD patients no MCA signals could be obtained while good quality signals were recorded from the basilar artery. The TCD results agreed essentially with 100% accuracy with clinical testing and four vessel cerebral angiography. This paper illustrates the usefulness of TCD examination of the MCAs and especially the basilar artery in the diagnosis of brain death.