Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2002
Comparative Study Clinical Trial Controlled Clinical TrialEffect of early induction of hypothermia on severe head injury.
Although therapeutic hypothermia for patients with head injury has improved the outcome, the results in the most severe cases (GCS 3-6) have not been satisfactory so far. We induced hypothermia in head injury patients within 3 hours after the trauma, and compared the outcome of the treatment without hypothermia. Fourteen patients with GCS less than 6 were entered into this study (age range 13 to 58, mean 27.0 years). ⋯ Four patients including these 3 showed a favorable outcome (good or moderate disability) and 3 died in the hypothermia group. In the conventional treatment group, only 1 patient was moderately disabled and 6 exhibited an unfavorable outcome (severely disabled, vegetative, or death). Early induction of hypothermia can improve the outcome in patients with severe head injury by reducing the severe brain swelling.
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Acta Neurochir. Suppl. · Jan 2002
Comparative Study Clinical Trial Controlled Clinical TrialICP is lower during propofol anaesthesia compared to isoflurane and sevoflurane.
Propofol is a cerebral vasoconstrictor while inhalation anaesthetics like isoflurane and sevoflurane act as cerebral vasodilators in both animal and human studies. This difference of action upon cerebral vessels might implicate a lower ICP during propofol anaesthesia. Cerebral metabolism is decreased by all three anaesthetics. In a prospective, randomised multicenter study ICP was compared during anaesthesia with propofol, isoflurane and sevoflurane. ⋯ Subdural ICP is significantly lower during propofol anaesthesia compared to isoflurane and sevoflurane anaesthesia. CPP and AVDO2 are significantly higher during propofol anaesthesia compared to isoflurane and sevoflurane anaesthesia.
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Function of the nervous system has been the main domain of interest of an elite group of philosophers, scientists and physicians. This topic may only be understood within a historical perspective, since the progression of knowledge of the function of the nervous system has always paralleled the expansion of our understanding of the outer world and of biological organisms observed. ⋯ This article summarizes the basic principles and methods used in neurological function-based research. In order to elucidate the topic, the text was practically divided into three main sections: (1) historical perspective regarding functional research models in clinical and experimental neuroscience; (2) neurological function-based clinical studies in humans; and (3) experimental research models on animals.
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Acta Neurochir. Suppl. · Jan 2002
Case ReportsIs the rupture of cerebral berry aneurysms influenced by the perianeurysmal environment?
To evaluate contact between cerebral berry aneurysms and the perianeurysmal environment and to study the influence this contact has on aneurysm rupture. ⋯ Aneurysms exhibit contact with their perianeurysmal environment as soon as they reach a size that exceeds their allowance given by the local subarachnoid space. The contact with the environment was found to be an additional determinant parameter in the evolution of cerebral berry aneurysms and their risk to rupture.