Neurol Neurochir Pol
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Neurol Neurochir Pol · Jan 2014
Review Meta AnalysisRisk factors for re-bleeding of aneurysmal subarachnoid hemorrhage: meta-analysis of observational studies.
The mortality of re-bleeding following aneurysmal subarachnoid hemorrhage is high, and surviving patients often have poor clinical condition and worse outcome than patients with a single bleed. In this study, we performed an updated systematic review and meta-analysis to determine the most common risk factors for re-bleeding in this patient population, with the goal of providing neurologists, neurosurgeons, neuro-interventionalists with a simple and fast method to evaluate the re-bleeding risk for aneurysmal subarachnoid hemorrhage. ⋯ Sex, high SBP, high Fisher grade, aneurysm size larger than 10mm, and poor clinical condition were independent risk factors for aneurysmal re-bleeding. The importance of early aneurysm intervention and careful consideration of patient risk factors should be emphasized to eliminate the risk of re-bleeding and poor outcome.
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Neurol Neurochir Pol · Jan 2014
ReviewDiagnosis and management of neuropathic pain: review of literature and recommendations of the Polish Association for the Study of Pain and the Polish Neurological Society - Part Two.
Neuropathic pain may be caused by a variety of lesions or diseases of both the peripheral and central nervous system. The most common and best known syndromes of peripheral neuropathic pain are painful diabetic neuropathy, trigeminal and post-herpetic neuralgia, persistent post-operative and post-traumatic pain, complex regional pain syndrome, cancer-related neuropathic pain, HIV-related neuropathic pain and pain after amputation. ⋯ A multidisciplinary team of Polish experts, commissioned by the Polish Association for the Study of Pain and the Polish Neurological Society, has reviewed the literature on various types of neuropathic pain, with special focus on the available international guidelines, and has formulated recommendations on their diagnosis and treatment, in accordance with the principles of evidence-based medicine (EBM). High quality studies on the efficacy of various medicines and medical procedures in many neuropathic pain syndromes are scarce, which makes the recommendations less robust.
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Neurol Neurochir Pol · Jan 2014
ReviewDiagnosis and management of neuropathic pain: review of literature and recommendations of the Polish Association for the study of pain and the Polish Neurological Society - part one.
Neuropathic pain still present a major diagnostic and therapeutic challenge despite considerable progress in understanding of its mechanisms and publication of number of studies which assessed the efficacy and safety of drugs used in the symptomatic treatment. In practice, it is diagnosed less frequently than recognised in the epidemiological studies, and many patients do not achieve satisfactory outcomes of treatment. ⋯ The diagnosis of neuropathic pain may be established based on medical history and physical examination including special assessment of the somatosensory system. First-line drugs used in pharmacological management of neuropathic pain are: tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors, gabapentin, pregabalin, opioids and lidocaine patches.
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Neurol Neurochir Pol · Jan 2014
Randomized Controlled TrialPerioperative outcome and cost-effectiveness of spinal versus general anesthesia for lumbar spine surgery.
General anesthesia (GA) is the most commonly used anesthetic technique for spinal surgery. This study aimed to compare spinal anesthesia (SA) and GA in patients undergoing spinal surgery, in terms of perioperative outcome and cost effectiveness. ⋯ SA could be considered a reliable alternative to GA in patients undergoing lumber spine surgery, as it is clinically as effective as GA, but more cost effective.
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Neurol Neurochir Pol · Jan 2014
ReviewPhantom phenomena and body scheme after limb amputation: a literature review.
Phantom phenomena are subject of various, often inconsistent, descriptions, and new concepts and treatment approaches emerge. The aim of the study is to describe contemporary terminology and developments in the field, and to share personal experience. ⋯ The terminology and classification of phantom phenomena sensations, relations between intensity and character of phantom pain to the etiology and level of amputations, as well as the influence of presence and intensity of pre-operative limb pain and post-operative stump pain on phantom phenomena are described. The benefits of mirror therapy and early introduction of prosthesis and applying functional prosthesis are also presented, with a glance at other conservative and surgical treatment approaches.