Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2008
The predictive value of ICP as compared to magnetic resonance imaging in comatose patients after head injury.
While highly increased intracranial pressure (ICP) is of high predictive value indicating a fatal outcome, the predictive value of moderately increased ICP early after head injury remains uncertain. We compared the predictive value of ICP to the predictive value of magnetic resonance imaging (MRI) early after head injury. ⋯ Our current MRI findings suggest that the location of the initial brain injury lesion correlates with outcome at 6 months. No such correlation could be identified for intracranial pressure on the first day after head injury (p = 0.766).
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Acta Neurochir. Suppl. · Jan 2008
Simvastatin attenuates cerebral vasospasm and improves outcomes by upregulation of PI3K/Akt pathway in a rat model of subarachnoid hemorrhage.
Cerebral vasospasm is a common sequelae of subarachonoid hemorrhage (SAH), however, the mechanism of cerebral vasospasm is still unclear. Recently, statins have been shown to have efficacy in ameliorating cerebral vasospasm. The present study investigates whether simvastatin attenuates cerebral vasospasm after subarachnoid hemorrhage (SAH) via upregulation of the PI3K/Akt pathway. ⋯ The beneficial effects of high dose simvastatin in ameliorating cerebral vasospasm are likely mediated by upregulation of the PI3K/Akt pathway.
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Acta Neurochir. Suppl. · Jan 2008
Noninvasive estimation of intracranial compliance in idiopathic NPH using MRI.
The pathophysiology of idiopathic normal pressure hydrocephalus (I-NPH) is still unclear and the diagnosis is sometimes difficult. The aim of this study was to assess the biophysics of I-NPH by measuring intracranial compliance using cine MRI. ⋯ It is possible to estimate intracranial compliance as CI non-invasively using cine MRI. CI could become a useful method for the diagnosis of I-NPH.
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Intracerebral hemorrhage (ICH) is a subtype of stroke with very high mortality. Experiments have indicated that clot lysis and iron play an important role in ICH-induced brain injury. Iron overload occurs in the brain after ICH in rats. ⋯ Deferoxamine can rapidly penetrate the blood-brain barrier and accumulate in the brain tissue in significant concentration after systemic administration. We have demonstrated that deferoxamine reduces ICH-induced brain edema, neuronal death, brain atrophy, and neurological deficits. Iron chelation with deferoxamine could be a new therapy for ICH.
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Acta Neurochir. Suppl. · Jan 2008
Randomized Controlled Trial Clinical TrialPreliminary findings of the minimally-invasive surgery plus rtPA for intracerebral hemorrhage evacuation (MISTIE) clinical trial.
Compared to ischemic stroke, intracerebral hemorrhage (ICH) is easily and rapidly identified, occurs in younger patients, and produces relatively small initial injury to cerebral tissues--all factors suggesting that interventional amelioration is possible. Investigations from the last decade established that extent of ICH-mediated brain injury relates directly to blood clot volume and duration of blood exposure to brain tissue. Using minimally-invasive surgery plus recombinant tissue plasminogen activator (rtPA), MISTIE investigators explored aggressive avenues to treat ICH. ⋯ There is tentative indication that minimally-invasive surgery plus rtPA shows greater clot resolution than traditional medical management.