Surg Neurol
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Increasing evidence indicates that inflammatory responses are implicated in the pathogenesis of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH). However, the role of adhesion molecules in SAH-induced vasospasm is less clear. This study was designed to examine the effect of a highly specific antibody, monoclonal anti-E-selectin antibody, on cerebral vasospasm in a new murine SAH model. ⋯ These findings provide the first evidence that anti-E-selectin antibody was effective in prevention of SAH-induced vasospasm and imply a possible role of E selectin in the pathogenesis of vasospasm after SAH.
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Comparative Study Clinical Trial
Preoperative evaluation of venous systems with 3-dimensional contrast-enhanced magnetic resonance venography in brain tumors: comparison with time-of-flight magnetic resonance venography and digital subtraction angiography.
Recent developments in magnetic resonance (MR) technology now enable the use of MR venography, providing 3-dimensional (3D) images of intracranial venous structures. The purpose of this study was to assess the usefulness of 3D contrast-enhanced MR venography (CE MRV) in the evaluation of intracranial venous system for surgical planning of brain tumors. ⋯ Although we do not yet advocate MR venography to replace conventional angiography as the imaging standard for brain tumors, 3D CE MRV can be regarded as a valuable diagnostic method just in evaluating the status of major sinuses and localization of the cortical draining veins.
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Trans-cranial Doppler (TCD) studies after head injury have been done in the first 24 hours after injury and do not specify the exact interval between injury and time of recordings. We have studied cerebral blood flow changes in patients with severe head injury using serial TCD starting within 6 hours after trauma, and present our findings and its correlation with clinical outcome. ⋯ Oligemia is the most common change within 6 hours of head injury. Persistence of oligemia beyond 24 hours is associated with poor outcome. Early (within 24 hours posttrauma) onset of vasospasm is associated with poor outcome; however, delayed (>24 hours after trauma) vasospasm is not associated with poor outcome.
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Malignant middle cerebral artery (MCA) infarction is characterized by mortality rate of up to 80%. The aim of this study was to determine the value of decompressive craniectomy in patients who present with malignant MCA territory infarction and to compare functional outcome in elderly patients with younger patients. ⋯ Decompressive craniectomy in younger patients with malignant MCA territory infarction improves both survival rates and functional outcomes. Although survival rates were improved after surgery in elderly patients, functional outcome and level of independence were poor.
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Comparative Study
The Oxiplex/SP gel-morphine compound after lumbar microdiscectomy in the management of postoperative pain. Report of 20 cases.
Morphine-based compounds are used epidurally after lumbar microdiscectomy to minimize postoperative pain. After the withdrawal of ADCON-L we started to use Oxiplex (Oxiplex/SP Gel) as a barrier against epidural fibrosis and as a vehicle for morphine delivery. ⋯ The epidural application of Oxiplex-morphine compound after lumbar microdiscectomy was found to be safe. Regarding postoperative pain control, it was found to be effective only during the first 36 hours.