British journal of neurosurgery
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Review Case Reports
Depressed skull fracture overlying the superior sagittal sinus causing benign intracranial hypertension. Description of two cases and review of the literature.
The purpose of this report is to describe successful surgical treatment of benign intracranial hypertension (BIH) in two patients presenting with depressed skull fractures over the superior sagittal sinus (SSS). The first case involved a 22-year-old patient who presented with depressed skull fracture overlying the posterior third of the SSS. Symptoms of BIH developed within 48 h. ⋯ Retrograde venous catheterization with pressure measurement can be a useful diagnostic adjunct. Surgical treatment is indicated in symptomatic patients. Based on the two cases reported, we now propose MRI venography in all patients presenting with symptoms of BIH and arteriography with retrograde venous catheterization when venous sinus stenosis exists.
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Case Reports
Bedside monitoring of CBF with xenon-CT and a mobile scanner: a novel method in neurointensive care.
Combining previously independently established techniques our objective was to develop and evaluate a method for bedside qualitative assessment of cerebral blood flow in neurointensive care (NICU) patients. The CT-protocol was optimized using phantoms and comparing a mobile CT-scanner (Tomoscan-M, Philips) with two stationary CT scanners. Thirty-two per cent xenon was delivered with standard equipment (Enhancer 3000). ⋯ The potential clinical usefulness was illustrated in three patients with vasospasm following subarachnoid haemorrhage. Our conclusion is that quantitative bedside measurements of CBF can be repeatedly performed in an easy and safe way in a standard NICU-setting, using xenon-inhalation and a mobile CT-scanner. The method is useful for the decision-making, and is a good example of how the quality of multi-modality monitoring in the NICU can be developed and further diversified.