British journal of neurosurgery
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Randomized Controlled Trial
Role of simvastatin in prevention of vasospasm and improving functional outcome after aneurysmal sub-arachnoid hemorrhage: a prospective, randomized, double-blind, placebo-controlled pilot trial.
Vasospasm plays a major role in the morbidity and mortality after aneurysmal subarachnoid hemorrhage (aSAH). The preliminary studies suggest that statins protect against cerebral vasospasm. ⋯ There was benefit of simvastatin in terms of reduction in clinical vasospasm, mortality or improved functional outcome, however, this was not statistically significant.
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To propose a pinpointing method and to obtain technique parameters for puncture of the branches of the trigeminal nerve through anatomical radiological study. ⋯ The results showed that Distances from each branch of trigeminal nerve to the medial rim of foramen ovale vary on different individuals while the proportional relationship between each branch and 'FO-PC Distance' has regularity.
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The outcome in patients who present with an aneurysm related intracerebral haemorrhage (ICH) is poor. There are many treatment strategies now available to treat this group of patients. The management approach is dominated by a direct surgical approach for both aneurysm treatment and clot evacuation. It remains unclear, however, whether overall outcomes justify an aggressive treatment approach in this group of patients. We report our results of a pragmatic strategy based on availability of expertise and patient condition in patients presenting with an aneurysm related intracerebral haemorrhage. ⋯ The presence of an aneurysm related ICH does not justify a nihilistic approach, as aggressive treatment is associated with a favourable outcome in 46% of patients. In the post-ISAT era, management should be patient specific and consideration should be given to both endovascular and open surgical therapy.
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Patients with spinal deformities and nerve compression due to spinal tuberculosis often require surgical intervention. The objective of this study was to assess the long-term therapeutic effectiveness of one-stage anterior debridement, bone grafting, and internal fixation for lower cervical tuberculosis with kyphosis. ⋯ One-stage anterior debridement, bone grafting, and internal fixation can effectively remove lesions, decompress the nerve, reduce pain, and correct kyphosis in patients with cervical tuberculosis and associated kyphosis. Long-term postoperative outcomes were satisfactory.
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To evaluate patient and staff satisfaction with day of admission surgery in a neurosurgical unit and its effect on theatre start times. ⋯ Neurosurgical patients, appropriately selected, can be admitted on the day of surgery with high staff and patient satisfaction and without delaying theatre start times.