Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2005
Randomized Controlled TrialMagnesium sulfate for brain protection during temporary cerebral artery occlusion.
We evaluated the effects of magnesium sulfate on brain tissue oxygen (PtO2) tension, carbon dioxide (PtCO2) tension and pH (pHt) in patients undergoing temporary artery occlusion for clipping of cerebral aneurysm. We studied 18 patients with aneurysmal subarachnoid hemorrhage. All patients received standard anesthetics using target controlled infusion of propofol (3 microg/ml) and remifentanil (10 ng/ml). ⋯ Following temporary artery occlusion, PtO2 and pHt decreased and PtCO2 increased in both groups. However, tissue hypoxia was less severe and the rate of PtO2 decline was slower in the magnesium group. Our data suggested that magnesium enhances tissue oxygenation and attenuates hypoxia during temporary artery occlusion.
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Acta Neurochir. Suppl. · Jan 2005
Clinical TrialPlateau waves: changes of cerebrovascular pressure transmission.
To test the validity of the hypothesis that active vasodilatation and vasoconstriction underlie the occurrence of intracranial pressure (ICP) plateau waves by evaluating corresponding changes of cerebrovascular pressure transmission of arterial blood pressure (ABP) to ICP. ⋯ The findings that HMF increased at onset and decreased at the termination of plateau wave support the validity of the vasodilatatory/constriction cascade model that postulates active vasodilation at the onset and active vasoconstriction of the cerebrovascular bed at the termination of a plateau wave.
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Acta Neurochir. Suppl. · Jan 2005
Randomized Controlled Trial Clinical TrialPercutaneous cervical nucleoplasty using coblation technology. Clinical results in fifty consecutive cases.
Conventional open cervical discectomy, with or without bony fusion, in common neurosurgical knowledge is considered the standard treatment for cervical disc herniation. Percutaneous procedures are minimally invasive and offer decreased morbidity, require no bone graft and promise shorter recuperation time. Nevertheless, candidates for a percutaneous procedure as inclusion criteria must complain of symptoms related to contained herniated disc or focal protrusion. ⋯ In the nucleoplasty group results were complete resolution of symptoms in 80% of cases, only 10% referred some residual cervical or radicular pain and are still under follow-up with a wait-and-see prospective. Patients who did not have a clinical resolution were treated with alternative traditional methods (10%). Despite the relative low cases number and the limited follow-up the encouraging results induce us to utilize this technique in well-selected cases.
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Acta Neurochir. Suppl. · Jan 2005
Clinical TrialConcept of "true ICP" in monitoring and prognostication in head trauma.
To propose a new coefficient, which contains information about both the absolute ICP and the position of the 'working point' on the pressure-volume curve. ⋯ The proposed variable is a powerful predictor of fatal outcome following head injury. It is sensitive to both the rising absolute ICP and the critical loss of cerebrovascular regulation.
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In recent years the general trend in spinal surgery has been reduction and minimalization. In general, all these have shown a moderate or good clinical result but they have been associated with serious sequelae. Plasma-mediated electrosurgery, widely used in other medical fields, has demonstrated to be well suited for this new indication. ⋯ Results indicate that Nucleoplasty may be an efficacious minimally invasive technique for the treatment of symptoms associated with contained herniated disc. However, randomized controlled studies are required to know with more precision the role of this procedure. CAM procedure (13 cases) is an excellent method in cases of root compression that needs liberation or in spine stenosis.