Neurosurgery clinics of North America
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Neurosurg. Clin. N. Am. · Jul 1998
ReviewPerioperative and intensive care unit care of patients with aneurysmal subarachnoid hemorrhage.
Subarachnoid hemorrhage (SAH) is a complex pathophysiological event that results in a number of intracranial and systemic alterations. The effective management of SAH has its foundation in the prevention, early diagnosis, and correction of complications. Successful outcome in these compromised patients requires close monitoring and intensive care. This article will review the pathophysiology of SAH, identify the most common medical and neurological events that complicate SAH, examine the impact of secondary cerebral insults after aneurysm rupture, and outline current ICU care for SAH.
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Cerebral aneurysms and their treatment have numerous consequences for patients and society, including loss of life, permanent neurologic deficits, decreased functioning in daily life, vast expenditures of health care resources, and loss of economic productivity. By the use of administrative, clinical, functional, and economic data, outcomes research increases neuro-surgeons' understanding of aneurysmal disease, and consequently, our ability to provide more effective interventions.
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Surgical treatment of Parkinson's disease has become an important mode of therapy for advanced disease. Both ablative lesions and, more recently, deep brain stimulation have been employed. Various brain areas, including the thalamus, globus pallidus, and subthalamus, have been target sites.
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Neurosurg. Clin. N. Am. · Apr 1998
Historical ArticleThe history of surgery for movement disorders.
Treatment of movement disorders by interruption of pathways within the nervous system has been a goal of neurosurgeons for the past century. When human stereotactic surgery was introduced 50 years ago, a major advance was made in surgical treatment of Parkinson's disease and other disorders of the motor system. Since then, the field has experienced a period of progressive growth, then abrupt decline, and now is more active than ever before and continuing to grow rapidly. Recent progress in computer science, imaging techniques, neurophysiology, and stereotactic targeting has provided the fuel for future progress.
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Neurosurg. Clin. N. Am. · Jan 1998
ReviewAnesthetic considerations in neonatal neurosurgical patients.
Neonatal neurosurgery patients have specific considerations throughout the perioperative course in addition to the usual care of neonates undergoing other surgical procedures. Prematurity, with its associated comorbidity, temperature, and glucose control are important topics to consider in this age group. This article addresses practical aspects of preoperative assessment, intraoperative management, and postoperative care. Because CSF shunting and myelomeningocele repair are common neonatal procedures, these specific procedures are the focus of this article.