Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Seventy-one patients from northern Sweden were diagnosed with chronic subdural haematomas (CSDH) and treated at the Department of Neurosurgery at Umeå University Hospital over 12 months. Fifty-four patients with CSDH had a history of head trauma (trauma group), while 17 patients had no previous head trauma (non-trauma group). In the non-trauma group 71% of patients were treated with anticoagulants or antiplatelet aggregation agents (AAA) compared to 18% in the trauma group. ⋯ The recurrence rate for all patients was 17%. These findings confirm that the use of anticoagulants and AAA is over-represented in patients with non-traumatic CSDH. In our study, recurrence was not associated with previous use of anticoagulants or AAA.
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The past decade (1999-2009) has witnessed a dramatic increase in the use of electrical stimulation to treat chronic, intractable pain. The implantation of electrodes in close proximity to peripheral nerves, known as peripheral nerve stimulation, has been enthusiastically adopted by neurosurgeons and interventional pain specialists. ⋯ The potential application of peripheral neuromodulation to relatively common and frequently disabling conditions such as migraine and lower back pain represents an exciting phase in the evolution of contemporary pain surgery. We review the available evidence relating to the use of peripheral nerve stimulation for the treatment of medically refractory, chronic non-cancer pain in a variety of clinical situations, highlight the absence of randomised controlled studies, and emphasise the need for scientifically sound research in this field.
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Dolichoectasia is an angiopathy characterized by dilatation, elongation, and tortuosity of the brain arteries. It most frequently involves the vertebral and basilar arteries; involvement of both the vertebrobasilar and carotid systems is rare. We present a patient with fatal dolichoectasia involving both the vertebrobasilar and carotid artery systems.