Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Reliable outcome measurement is needed for spinal cord injury research to critically evaluate the severity of injury and recovery thereafter. However, such measurements can sometimes be affected by minor, injury to the spinal cord during surgical procedures, including laminectomy. The open-field Basso, Beattie and Bresnahan (BBB) behavior motor scores are subjective and prone to human error. ⋯ However, there was no change in the BBB scores for the same animals over the same period. This highlights the sensitivity of SEP to minor insult as compared to BBB. These differences may be beneficial in accurate evaluation of the severity and progression of spinal cord injury, and subsequent recovery.
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This retrospective study evaluated the recovery of ankle dorsiflexion (ADF) weakness following decompressive surgery in order to identify factors indicative of a better outcome. Fifty-six consecutive patients with ADF weakness secondary to nerve root compression underwent lumbar decompressive surgery. The demographic features, duration and severity of preoperative ADF weakness, associated radicular pain, as well as the radiological and intraoperative findings were recorded. ⋯ Only small improvements take place beyond 6 weeks following surgery. The degree of deficit at presentation is predictive of the extent of recovery. Recovery in ADF strength is more evident in younger patients.
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Most recent studies on the effectiveness of cerebral revascularization have focused on the treatment of atherosclerotic internal carotid artery occlusive disease. The goal of the present study was to assess neurological function in 11 severe atherosclerotic middle cerebral artery (MCA) disease patients with transient ischemic attacks (TIAs) and hemodynamic compromise and determine the efficacy of superficial temporal artery-middle cerebral artery (STA-MCA) bypass. ⋯ Surgical revascularization increased regional cerebral blood flow (mL/100g/min) from a mean of (+/- standard deviation) 25.9+/-7.39 preoperatively to 32.3+/-7.72 postoperatively, and improved regional cerebrovascular reactivity from -6.42%+/-14.61% to 30.14%+/-23.93% (p = 0.014) in the eight patients with atherosclerotic MCA occlusion. Our findings demonstrated the benefit of STA-MCA bypass for patients with medically refractory and symptomatic atherosclerotic MCA occlusion with hemodynamic compromise.