Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2011
Improving patient safety in the intra-operative MRI suite using an on-duty safety nurse, safety manual and checklist.
This paper describes the use of an on-duty safety nurse, a surgical safety manual and a checklist as an essential precursor to evaluating how these approaches affect surgical quality, communication in surgery crews and contribute to the safety of surgical care in the intra-operative magnetic resonance imaging (MRI) suite.
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Acta Neurochir. Suppl. · Jan 2011
Vasospasm after subarachnoid hemorrhage: a 3D rotational angiography study.
the purpose of this study was to investigate the clinical value of 3D rotational angiography (3DRA) for evaluation of cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage (SAH) by comparison with 2D digital subtraction angiography (DSA). ⋯ the pseudo-spasm phenomenon was frequently observed on 3DRA volume rendering images. 3DRA was less useful than 2D DSA for evaluation of vasospasm after SAH.
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Acta Neurochir. Suppl. · Jan 2011
Case ReportsIntraoperative MRI (ioMRI) in the setting of awake craniotomies for supratentorial glioma resection.
Both awake craniotomy under conscious sedation and use of intraoperative MRI can increase the efficiency and safety of glioma resections. In contrast to craniotomies under general anesthesia, neurosurgery under conscious sedation requires several changes to the routine operative setup when performed in the ioMRI environment. ⋯ Seven patients underwent awake-craniotomies for resection of supratentorial gliomas using ioMRI at the Ohio State University Medical Center and James Cancer Hospital by a single surgeon. ioMRI can be safely employed in patients who are undergoing craniotomies under conscious sedation. Particularly important is the evaluation by the anesthesiologist whether the patient is a good candidate to sustain a likely longer than average procedure in a setting where his active cooperation is not only required, but also the essential aspect of this procedure.
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Acta Neurochir. Suppl. · Jan 2011
Recurrent vasospasm after endovascular treatment in subarachnoid hemorrhage.
the frequency and predictors of recurrent symptomatic and angiographic vasospasm after angioplasty or intra-arterial chemical vasodilatation (IACV) in patients with subarachnoid hemorrhage (SAH) are not well characterized. ⋯ recurrent angiographic or symptomatic vasospasm is not uncommon after angioplasty + IACV, but appears to occur significantly less than after IACV alone, without any increase in procedural complications.
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Acta Neurochir. Suppl. · Jan 2011
Post-treatment with SR49059 improves outcomes following an intracerebral hemorrhagic stroke in mice.
Intracerebral hemorrhage (ICH) is a devastating stroke subtype characterized by severe brain edema formation leading to cerebral blood flow compromise and parenchymal damage. Arginine vasopressin (AVP), a non-peptide antidiuretic hormone, has recently been implicated as a modulator of brain edema following injury. In this study, we investigated the effects of SR49059, a highly specific AVP V1a receptor antagonist, on brain injury outcomes following ICH, specifically assessing the ability of SR49059 in reducing brain edema and improving neurobehavioral deficits. ⋯ The study found that SR49059 significantly reduced cerebral edema at 24 and 72 h post-ICH injury and improved neurobehavioral deficits at 72 h. Our study suggests that blockage of the AVP V1a receptor is a promising treatment target for improving ICH-induced brain injury. Further studies will be needed to confirm this relationship and determine future clinical direction.