Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2005
Clinical TrialSurgical radio-frequency epiduroscopy technique (R-ResAblator) and FBSS treatment: preliminary evaluations.
Failed back surgery syndrome represents a heterogeneous situation that suggests a fibrosis or neuroinflammatory genesis. The social cost related to this issue are enormous. Several surgical techniques have been applied to FBSS patients with controversial effectiveness. In 1998 we evaluated the efficiency and limits of epiduroscopy treatment; it proved to be effective in 75% of cases, but in 45% of cases it needed to be repeated after 12 months. Therefore we subjected 14 patients, who had previously experienced a short temporary benefit by using a traditional epiduroscopic approach, to a new epiduroscopy fibrolysis using a radio-frequency device named "R-Resablator Epiduroscopy". Clinical evaluation was performed before myeloscopy and after 1-3-6 months. After myeloscopy, 93% of patients reported a general improvement. Among the latter, pain was reduced by 90% in 8 patients, by 60-70% in 5, and by less than 30% in 1. ⋯ It can be concluded that RF-Epiduroscopy offers greater therapeutic benefit than traditional epiduroscopy or other surgical techniques. Furthermore, RF-Epiduroscopy is more easily performed and repeated.
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Authors present a seven years retrospective study on 85 cases of severe brain injuries (SBI) in children (GCS = 8) treated in the Pediatric and ICU Departments of the Clinic Hospital "Bagdasar-Arseni" Bucharest, Romania. The relationship between ICP, GCS on admission, the CT-scan/MRI alteration and the outcome evaluated by the Glasgow Outcome Scale (GOS) were studied in order to highlight the most important factors to improve prognosis. ⋯ The politrauma context is an aggravating factor for SBI in this age group. Other factors which influence GCS on admission may have prognostic importance i.e.: prehospital care, transport time and adequate transport conditions.
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Acta Neurochir. Suppl. · Jan 2005
Accurate data collection for head injury monitoring studies: a data validation methodology.
BrainIT is a multi centre, European project, to collect high quality continuous data from severely head injured patients using a previously defined [6] core data set. This includes minute-by-minute physiological data and simultaneous treatment and management information. It is crucial that the data is correctly collected and validated. ⋯ Advances in patient care require an improved evidence base. For accurate, consistent and repeatable data collection, robust mechanisms are required which should enhance the reliability of clinical trials, assessment of management protocols and equipment evaluations.
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Acta Neurochir. Suppl. · Jan 2005
Clinical TrialImprovement of brain tissue oxygen and intracranial pressure during and after surgical decompression for diffuse brain oedema and space occupying infarction.
We evaluated the perioperative and intraoperative changes of intracranial pressure (ICP) and partial pressure of brain tissue oxygen (PtiO2) after decompressive craniectomy in patients with diffuse brain oedema and space occupying infarction. ⋯ Decompressive craniectomy seems to be a successful option in the treatment of intractable intracranial hypertension with associated cerebral hypoxia. These positive effects may last for several hours after the procedure irrespective of the underlying disease.
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Acta Neurochir. Suppl. · Jan 2005
Endovascular treatment of cerebral vasospasm following aneurysmal subarachnoid hemorrhage.
Endovascular treatment by balloon angioplasty or intra-arterial papaverine infusion has been established as a valuable treatment option in patients with cerebral vasospasm refractory to maximal medical therapy. A summary of the indications, applications and limitations is provided for microcatheter guided selective papaverine infusion and transluminal balloon angioplasty in patients who sustain cerebral vasospasm following subarachnoid haemorrhage. Structured neuro-intensive and endovascular treatment of imminent vasospasm integrate papaverine administration and balloon angioplasty as complimentary rather than alternative techniques.