No shinkei geka. Neurological surgery
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Two thirds of patients suffer from moderate to severe pain after frontotemporal craniotomy. We think neurosurgeons must try to reduce the postoperative pain, which may induce postoperative hypertension, restlessness, and pathological pains. To investigate how preemptive analgesia effects postoperative pain, we assessed the pain in 20 consecutive patients who underwent neck clipping for non-ruptured cerebral aneurysms of anterior circulation systems by frontotemporal craniotomies. ⋯ Patients of the preemptive group had significantly less postoperative pain during the whole post-surgery period and required less administration of NSAID than the control group. Preemptive analgesia procedures No. 1, 2 and 4 reduced the postoperative pain and the total administration of NSAID. Postoperative pain may be reduced after other types of brain surgery, with proper nerve blocks like procedure No. 2, procedures No. 1, 3 and 4.
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Review Case Reports
[A ruptured distal aneurysm, thought to be a mycotic aneurysm, associated with acute subdural hematoma: case report and review of the literature].
A case is described of a ruptured intracranial mycotic aneurysm in the distal middle cerebral artery associated with an acute subdural hematoma. A 55-year-old woman, with a history of tuberculous meningitis at the age of 7, presented left hemiparesis. She was in a state of semi-coma. ⋯ The incidence of ruptured mycotic aneurysms presenting with acute subdural hematoma is extremely low. There have been only four previously reported cases as far as I can ascertain. This case and a review of the literature are discussed.