British journal of neurosurgery
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Clinical Trial
Application of a new method of revealing foramen ovale under X-ray in radiofrequency ablation in the treatment of trigeminal neuralgia.
This study is to apply a new method of revealing foramen ovale guided by digital X-ray imaging for precise puncture in radiofrequency ablation (RFA) in the treatment of trigeminal neuralgia. ⋯ By observing the bony mark 'mid-cranial fossa arc', foramen ovale can be clearly displayed in lateral cranial position and under the guidance of X-ray real time imaging this method can be applied successfully in precise puncture of foramen ovale in trigeminal neuralgia radiofrequency ablation.
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An adequate response of hypothalamic-pituitary-adrenal (HPA) axis is important for survival and recovery after a severe disease. The hypothalamus and the pituitary glands are at risk of damage after subarachnoid haemorrhage (SAH). A better understanding of the hormonal changes would be valuable for optimising care in the acute phase of SAH. ⋯ There was an HPA response acutely after SAH with an increase in P-ACTH and S-cortisol. Higher U-cortisol in patients in a better clinical grade may indicate a more robust response of the HPA system. Global cerebral oedema was associated with higher S-cortisol at admission and was a predictor of S-cortisol concentrations. Global cerebral oedema may be the result of the stress response initiated by the brain injury. Periods of suppressed P-ACTH occurred particularly in periods of brain ischaemia, indicating a possible connection between brain ischaemia and ACTH suppression.
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Little is known about the roles that lifetime psychiatric disorders play in psychiatric and vocational outcomes of aneurysmal subarachnoid haemorrhage (SAH). ⋯ Depression and PTSD are present in a substantial proportion of patients 7 months after SAH. Those with a history of psychiatric morbidity, any time before the SAH, are more at risk and also constitute a risk group for difficulties in returning to work.
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Case Reports
An association between cerebral aneurysm re-bleed and CT angiography--more than a coincidence?
Rupture of cerebral aneurysm during CT angiogram is a rare occurrence. Here we present such a case where an aneurysmal re-rupture during CT angiogram was demonstrated.
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We describe the case of a 29-year-old farmer who developed upper limb radiculopathy followed by myelopathy in his lower limbs. MRI findings suggested cervical disc prolapse with cord changes. Despite a successful anterior cervical decompression and fusion his symptoms rapidly returned. Further investigations ultimately diagnosed underlying neurosarcoidosis.