Acta neurochirurgica. Supplement
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Studies have shown that weekend admissions are associated with outcomes of patients with different diseases. Our aim is to evaluate the weekend effects in patients with intracerebral hemorrhage (ICH) in our hospital. A retrospective analysis of patients with ICH was performed. ⋯ Weekend admission was not a statistically significant predictive factor for in-hospital mortality (P=0.315) and functional outcomes (P=0.128) in patients with ICH. However, a significant correlation was found between the ICH score and the mortality (OR=6.819, 95%CI: 4.323-10.757; P=0.009). Our results suggest that compared with weekday admission, weekend admission is not significantly associated with increased short-term mortality and poorer functional outcome among patients hospitalized with ICH.
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Acta Neurochir. Suppl. · Jan 2011
Clinical requirements and possible applications of robot assisted endoscopy in skull base and sinus surgery.
Functional Endoscopic Surgery of Paranasal sinuses (FESS) and Skull Base surgery is one of the most frequent surgeries performed at the ENT department of the Bonn University, Germany. Beside of surgical Navigation Robotic is one of the upcoming fields of Computer assisted Surgery developments. This work presents novel research and concepts for Robot Assisted Endoscopic Sinus Surgery (RASS) of the Paranasal sinuses and the anterior Skull Base containing the analysis of surgical workflows, the segmentation and modelling of the Paranasal sinuses and the anterior Skull Base and the development of the robotic path planning. An interdisciplinary group of software engineers and surgeons in Braunschweig and Bonn, Germany are approximate to solutions by a clinical and technical research program financed through the DFG (Deutsche Forschungsgemeinschaft, German research Community).
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Intraoperative imaging technologies have improved surgical results in glioma and pituitary adenoma surgeries. With improvements and refinements 3T intraoperative MRI systems offer a potential of further improving these results. Hereby we describe the equipment and technique of a cost-effective shared-resource 3-T ultra-high field intraoperative magnetic resonance imaging system and report our continuing experience on surgical tumor resection. ⋯ Operation is performed using regular non-MRI compatible equipment and the patient is transferred to the MRI during the procedure using a custom designed floating table. Advanced sequences such as diffusion weighted and diffusion tensor imaging, MR angiography, MR venography, MR spectroscopy can be performed with no changes in the setup and result in image quality comparable to outpatient scans. The intraoperative 3-T ultra high field MRI unit with the twin room concept permits both diagnostic outpatient imaging and image guided surgery in the same setting and is a cost effective solution to afford a highly capable ioMRI system.
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Acta Neurochir. Suppl. · Jan 2011
Mechanism of action of oxygen ozone therapy in the treatment of disc herniation and low back pain.
In the low back syndrome the pain has a multifactorial origin and ozone can surprisingly display a number of beneficial effects ranging from the inhibition of inflammation, correction of ischemia and venous stasis, and finally inducing a reflex therapy effect by stimulating anti-nociceptor analgesic mechanisms. The intradiscal and intramuscular injection of oxygen-ozone is a successful approach comparable to other minimally invasive procedures, but the elucidation of the mechanisms of action remains elusive. This communication shortly reports the mechanisms of action of oxygen ozone therapy at the level of intervertebral disc and paravertebral muscles.
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Acta Neurochir. Suppl. · Jan 2011
Multiparametric characterisation of the perihemorrhagic zone in a porcine model of lobar ICH.
To describe early perihemorrhagic changes after lobar intracerebral hemorrhage (ICH) using multiparametric neuromonitoring [intracranial pressure (ICP), cerebral blood flow (CBF), tissue oxygenation (PbrO2), microdialysis (MD)]. ⋯ We established a reproducible cortical ICH model using multiparametric neuromonitoring. Subtle changes in ICP were observed. No evidence for the existence of a perihemorrhagic ischemic area was found, hypothetically because of the small hematoma size. Individual animals underwent critical PbrO2 and CBF decreases with consecutive metabolic derangement. The effect of larger hematoma volumes should be evaluated with this setup in future studies to study volume-dependent deterioration.