World Neurosurg
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Randomized Controlled Trial
Effect of Ondansetron on post-operative shivering after craniotomy.
Postoperative shivering (POS) is an early complication after craniotomy. Preventive pharmacologic drugs are the mainstay of treatment. Meperidine is the drug of choice but with increased risk of apnea, nausea, and increased intracranial pressure. Some reports have suggested that ondansetron and meperidine have similar anti-shivering effects. ⋯ Ondansetron can effectively decrease POS after craniotomy. This effect is not mediated through maintenance of the core or peripheral temperature. Ondansetron probably acts by a central inhibitory mechanism on POS through 5-hydroxytryptaminergic pathways, not by changing thermoregulatory set points.
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Magnesium (Mg) is an essential element for the body's normal physiological functioning. It has a major role in modulating vascular smooth muscle tone and peripheral arterial resistance. A low serum Mg level on admission (HMg0) has been associated with more severe presentation in patients with subarachnoid hemorrhage. However, data on HMg0 specifically in relation to intracerebral hemorrhage (ICH) are scarce. We sought to determine the incidence and clinical significance of HMg0 in patients with ICH. ⋯ HMg0 occurs in one third of patients with ICH and is associated with more severe presentation and intraventricular hemorrhage. Mg levels on admission correlate inversely with systolic BP and directly with GCS scores at presentation. HMg0 does not influence outcomes at discharge.
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Comparative Study
Assessment of Cerebral Blood Flow Using Microdoppler Vascular Reduces the Risk of Ischemic Stroke during the Clipping of Intracranial Aneurysms.
To analyze the impact of the introduction of Micro-Doppler vascular (MDV) as a method of cerebral blood flow analysis during microsurgical clipping of intracranial aneurysms to check the partial occlusion of the aneurysm and the occurrence of stenosis by comparing these results with those provided by the postoperative digital subtraction angiography (DSA) scan as well as the occurrence of ischemic infarction on the postoperative computed tomography (CT) images. ⋯ MDV is an excellent method for cerebral blood flow assessment during the microsurgical clipping of intracranial aneurysms, reducing the unexpected angiographic results (residual aneurysms, stenosis, and arterial occlusion), as well as reducing the incidence of ischemic infarction on postoperative CT images, evidence of the positive impact of this method in the microsurgical treatment of intracranial aneurysms.
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Comparative Study
Different Surgical Approaches for the Spinal Schwannoma: A Single Surgeon's Experience with 49 Consecutive Cases.
Comparing different surgical approaches for spinal schwannoma, the safety and efficacy of the minimally invasive surgery (MIS) approach were demonstrated, and a suitable indication for each surgical approach was analyzed. ⋯ Safe and complete resection of intradural extramedullary schwannoma was obtained through the MIS approach. Regardless of sagittal extension of the tumor, a schwannoma with an axial diameter of 16 mm located in the lumbar spine can be effectively treated with the MIS approach, including foraminal extension.