Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2011
Review Historical ArticleA clinical review of cerebral vasospasm and delayed ischaemia following aneurysm rupture.
The continuation of a review of delayed vasospasm after aneurysmal subarachnoid haemorrhage, originally published in 1994 and partially updated at the ninth vasospasm conference in Turkey, is presented. Further online and physical searches have been made of the relevant literature. The incidence of delayed ischaemic deficit (DID) or symptomatic vasospasm reported in 1994 was 32.5% in over 30,000 reported cases. ⋯ It thus appears likely that delayed vasospasm is still common but less so, and that the overall outcome has improved. This may be due to the more widespread use of calcium antagonists and more effective fluid management. A number of other mechanical and drug treatments are also mentioned.
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Acta Neurochir. Suppl. · Jan 2011
O-arm guided balloon kyphoplasty: preliminary experience of 16 consecutive patients.
Balloon kyphoplasty is now widely used for the treatment of vertebral compression fractures. Excellent pain relief is achieved with cement injection, but the safety of the procedure relays on excellent radiological exposure. The balloon kyphoplasty technique is usually performed using one or two C-Arm devices to allow correct antero-posterior (AP) and lateral view throughout the surgical procedure. ⋯ We prospectively evaluate on 16 consecutive patients, the feasibility of the O-Arm guided kyphoplasty procedure with the original, usual tools, and we measured the fluoroscopy time and the X-ray exposure. We didn't experience any device related problem and demonstrated a significant reduction of X-ray exposure and time of fluoroscopy. We believe that using this new intraoperative system, the overall time of surgery and fluoroscopy could still be reduced in a near future.
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Acta Neurochir. Suppl. · Jan 2011
Case ReportsInformation-guided surgical management of gliomas using low-field-strength intraoperative MRI.
Contemporary technological developments revolutionized management of brain tumors. The experience with information-guided surgery of gliomas, based on the integration of the various intraoperative anatomical, functional, and histological data, is reported. ⋯ Information-guided management of gliomas using low-field-strength ioMRI provides a good opportunity for maximal possible tumor resection, and may result in survival advantage, particularly in patients with WHO grade III neoplasms.
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we focused on the recent management of aneurysmal subarachnoid hemorrhage (SAH) in patients over 70 years old (advanced age). ⋯ mean age and proportion of procedures in advanced age are increasing, but outcomes have improved. These results depend on radical surgery for aneurysm in the acute stage and aggressive prevention and treatment of vasospasm. Interventional treatment is necessary to improve the outcome in cases of advanced age.
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Acta Neurochir. Suppl. · Jan 2011
The prediction of 30-day mortality and functional outcome in spontaneous intracerebral hemorrhage with secondary ventricular hemorrhage: a score comparison.
The original ICH (oICH) score was tested in different populations and showed good accuracy in the prediction of outcome and 30-day mortality after spontaneous ICH. The oICH was developed to stratify patients with all types of spontaneous intracerebral hemorrhage (SICH). Several modifications of the oICH score exist in the literature. ⋯ The best AUC for functional outcome was observed for the mICH-B score (0.823). For the mICH-A and the IVH score, an AUC of 0.811 was calculated. The scores that include the quantification of IVH or the grading of hydrocephalus show good accuracy in the prediction of 30-day mortality and functional outcome at 6 months in SICH with secondary IVH.