Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Randomized Controlled Trial Clinical Trial
A randomized crossover comparative study of aspirin, cilostazol and clopidogrel in normal controls: analysis with quantitative bleeding time and platelet aggregation test.
The effects of three antiplatelet drugs, aspirin, clopidogrel and cilostazol, were examined and compared using a quantitative bleeding time (QBT) test apparatus. In 12 healthy adult male subjects, a QBT test and platelet aggregation test were performed before and after medication. ⋯ In contrast, none of these QBT parameters were altered by the cilostazol treatment. This suggests that cilostazol has potent efficacy in inhibiting platelet aggregation without prolonging the bleeding time and changing the bleeding pattern.
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Case Reports
Stent-graft placement in a traumatic internal carotid-internal jugular fistula and pseudoaneurysm.
Traumatic arteriovenous fistulas following carotid artery injuries are rare. Treatment of carotid artery-to-jugular vein fistula requires direct closure of the fistula or occlusion of the carotid artery above and below the level of the fistula, by a surgical or endovascular approach. A 32-year-old man presented with a right-sided pulsatile neck swelling 2 days following a stab wound. ⋯ A balloon-expandable stent-graft was delivered and successfully positioned across the fistula. The arteriovenous fistula and pseudoaneurysm completely disappeared and the right internal carotid artery was well preserved. The stent-graft is a promising technology to obliterate fistulae and preserve the parent artery with relative safety.
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The pathogenesis and localization of neuronal dysfunction in transient global amnesia (TGA) is still disputed more than 40 years after the first description of this clinical entity. Previous studies have indicated that structural abnormality is rare in TGA. ⋯ This provides evidence in support of an ischemic hypothesis as the possible etiology of TGA. The role of caudate nucleus in human memory is also reviewed.
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Clinical Trial
Early electroencephalographic findings in patients with anoxic encephalopathy after cardiopulmonary arrest and successful resusitation.
This study investigated whether or not early electroencephalographic (EEG) findings and brain computed tomographic (CT) features reflect the prognosis of comatose patients for 48 h after cardiopulmonary resuscitation (CPR). EEGs and brain CT scans were collected from 21 patients within 72 h after CPR. The EEG findings were classified according to the five Hockaday grades. ⋯ Of the eight patients with grade 4 and 5 EEGs, seven had a poor outcome (three died and four remained in a persistent vegetative state). On the other hand, there was no correlation between early CT features and prognosis except for two severe cases, one whose gray/white matter interface had disappeared and the other with relatively increased density of the thalami, brain stem and cerebellum. These findings suggest that EEG is more useful than CT scan as a diagnostic tool for anoxic encephalopathy after CPR.