Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2011
Case ReportsA numerical approach to patient-specific cerebral vasospasm research.
cerebral vasospasm (CVS) is a devastating sequela of subarachnoid hemorrhage (SAH). Among the many factors that are associated with the pathogenesis of CVS, the cerebral blood flow (CBF) and underlying haemodynamics play an important role. In this paper we present an integrated clinical-engineering approach to CVS research. ⋯ a numerical approach to patient-specific CVS analysis has been established, and some initial results are achieved via application to an actual spasm case. The undergoing and future work include applying the approach to more CVS cases and incorporating computational models of different scales into the current framework for CVS and SAH research.
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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.
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Studying discovertebral complex anatomy is extremely important for the understanding of the pathophysiology of disc degeneration which leads to vertebral endplates signal changes, also known as Modic changes. The sequelae of disc degeneration are among the leading causes of functional incapacity in both sexes and are one of the most common sources of chronic disability in the working years. Even if the presence of degenerative changes in MRI of the spine is by no means an indicator of symptoms, we are concordant in a positive association between Modic changes and low back pain, above all as a relatively specific but insensitive sign of discogenic low back pain.
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Acta Neurochir. Suppl. · Jan 2011
Evidenced Based Guidelines for the Management of Good Grade Subarachnoid Haemorrhage Patients in Leeds, UK.
Aneurysmal Subarachnoid Haemorrhage (SAH) is a common neurosurgical condition with high morbidity and mortality, with our trust treating over 120 patients annually. Although there are recommendations for the management of some aspects of subarachnoid haemorrhage, a comprehensive guideline document has not been produced. Our guidelines seek to address all aspects of acute patient care in our neurosurgical unit, using evidence based medicine with a multi-disciplinary team to produce care pathways establishing a standard of care for our patients.
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Acta Neurochir. Suppl. · Jan 2011
Predictors analysis of symptomatic cerebral vasospasm after subarachnoid hemorrhage.
symptomatic cerebral vasospasm (SCVS) is still lacking in reliable early warning methods and often diagnosed after clinical deterioration of neurological function, making prevention and treatment extremely passive. This study investigates the risk factors relevant to SCVS after subarachnoid hemorrhage (SAH) in order to provide useful information for clinical work. ⋯ SCVS is the final result of multiple factors acting together. Age and modified Fisher grades are independent risk factors to SCVS.