World Neurosurg
-
Randomized Controlled Trial
Effect of Tranexamic Acid on Prevention of Hemorrhagic Mass Growth in Patients with Traumatic Brain Injury.
Intracranial hemorrhage is a common complication of traumatic brain injury (TBI). The purpose of this study is evaluation of the effect of tranexamic acid (TXA) on hemorrhagic mass growth in TBI patients. ⋯ Administration of a short dose of TXA does not lead to significant prevention of growth of posttraumatic hemorrhagic lesion or improvement of clinical outcomes.
-
Review Case Reports
Spinal cavernous angioma associated with Klippel-Trenaunay-Weber syndrome: a case report and literature review.
Klippel-Trenaunay-Weber syndrome (KTWS) is a rare congenital vascular disorder characterized by the classic triad of cutaneous nevi, venous varicosities, and osseous and soft tissue hypertrophy of the affected limb. Various vascular anomalies of the central nervous system have also been described in patients with KTWS. The English language literature to date contains 6 reports of associations between KTWS and spinal cord cavernous angioma (CA), but management of these patients has not been well described. ⋯ This is the first report to provide a detailed pathologic description of the features of spinal CA in a patient with KTWS. Assessment of the clinical features and management of CA associated with KTWS are discussed. This syndrome is rare, and further experience in the treatment of these patients is needed. However, considering that the pathologic findings of spinal CA in patients with KTWS include the typical features of CA, the management of CA in patients with KTWS may be identical to management of isolated CA.
-
Multicenter Study Comparative Study
Two-Year Results of the Prospective Spine Treatment Outcomes Study: Analysis of Post-Operative Clinical Outcomes between Patients With and Without a History of Prior Cervical Spine Surgery.
History of previous cervical spine surgery is a frequently cited cause of worse outcomes after cervical spine surgery. The purpose of this study was to determine any differences in clinical outcomes after cervical spine surgery between patients with and without a history of previous cervical spine surgery. ⋯ Patients with a history of previous cervical spine surgery had inferior improvement in quality of life outcome scores. Patients with a history of previous surgical intervention who elect to undergo subsequent surgeries should be appropriately counseled about expected results.
-
Randomized Controlled Trial
Postoperative Intravenous Acetaminophen for Craniotomy Patients: A Randomized Controlled Trial.
To determine whether opioids during the first 24 postoperative hours were significantly altered when receiving intravenous (IV) acetaminophen during that time compared with those receiving placebo (normal saline). ⋯ The opioid requirements within the first 24 postoperative hours were similar in the placebo and acetaminophen groups. This study is informative for the design and planning of future studies investigating the management of postoperative pain in patients undergoing craniotomies.
-
Surgical treatment of patients with atlantoaxial instability caused by pathologic changes of the skull base and craniovertebral junction combined with anterior compression of the brain stem is still associated with substantial technical difficulties and remains a matter of debate. Currently, anterior stabilization of the atlantoaxial junction is a promising approach that allows for the resection of the pathologic lesion of the skull base and craniovertebral junction with subsequent stabilization of C1-C2 or C1-C3 in 1 stage. ⋯ The first experience of anterior fixation using individually manufactured C1-C2 and C1-C3 systems demonstrated their effectiveness. This approach can be safely used as an alternative or in combination with standard posterior stabilization methods. An innovative surgical technology developed and implemented in our surgical practice allows for optimization of the surgical technique, reduces the number of perioperative complications, eliminates movement restrictions in the cervical spine, improves motor activity, and makes earlier patient rehabilitation possible.