Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Review Meta Analysis
A meta analysis of treating subarachnoid hemorrhage with magnesium sulfate.
Despite the publication of several randomized controlled studies, there is still much debate on whether magnesium sulfate improves outcome in patients with aneurysmal subarachnoid hemorrhage. Here we present data to assess the clinical effectiveness of magnesium sulfate in the prevention of cerebral vasospasm in patients who have suffered from aneurysmal subarachnoid hemorrhage. The EMBASE and PubMed databases were searched using the following terms: "magnesium sulfate" or "MgSO(4)" with "subarachnoid hemorrhage" or "cerebral vasospasm". ⋯ The occurrence of poor outcome (death, vegetative state, or dependency) in patients treated with magnesium sulfate was less likely than control group patients (odds ratio [OR] 0.54 [95% confidence interval, CI 0.36-0.81]). Mortality rates did not differ between magnesium sulfate (14%) and control treated (12%) patients (OR 1.16 [95% CI 0.51-2.65]). Our results indicate that although there was reduced likelihood of a poor outcome for patients treated with magnesium sulfate after SAH, patient mortality was not improved.
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Randomized Controlled Trial Comparative Study
The treatment of first division idiopathic trigeminal neuralgia with radiofrequency thermocoagulation of the peripheral branches compared to conventional radiofrequency.
The aim of this study was to prospectively evaluate and compare the effects of radiofrequency thermocoagulation of the first division branches of the trigeminal nerve (trigeminal peripheral division radiofrequency thermocoagulation, PRT) versus conventional radiofrequency (CRF) in the treatment of first division idiopathic trigeminal neuralgia (ITN). Fifty patients with first division ITN were randomly divided into two groups. The 20 patients in group 1 were treated with CRF, while the remaining 30 patients in group 2 were treated using PRT. ⋯ The recurrence rates of ITN at the 3-year follow-up were 25% and 27% for group 1 and group 2, respectively, and 35% and 40%, respectively, 5 years after treatment. There were no significant differences between groups 1 and 2 at any time. Our study demonstrates that PRT is an effective way to treat first division ITN.
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The Glasgow Outcome Scale (GOS) score is widely used to assess outcome after a subarachnoid hemorrhage (SAH). Patients who have recovered fully or with a mild disability (GOS scores 4 and 5) frequently complain about difficulties in conducting their daily activities. The Short Form-36 (SF-36) Health Survey is a questionnaire that assesses outcomes in multiple categories. ⋯ We conclude that patients continue to suffer neuropsychological deficits years after a SAH. The GOS score is a rough outcome measure that primarily focuses on physical functioning. SF-36 is a useful tool to include in the neuropsychological outcome assessment of patients with SAH.
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Deep brain stimulation (DBS) of the ventral intermediate nucleus of the thalamus (VIM) is a powerful surgical option in the treatment of tremor-predominant Parkinson's disease. However, its therapeutic efficacy depends on the tremor distribution. ⋯ Also, it is generally thought that DBS of the VIM has no significant beneficial effects on other motor symptoms of Parkinson's disease. We report two hemiparkinsonian patients, in whom unilateral VIM DBS combined with posteroventral pallidotomy produced long-lasting suppression of not only hand tremor, but also leg or jaw tremor and other motor symptoms.