Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2012
Randomized Controlled TrialOn the method of a randomised comparison of programmable valves with and without gravitational units: the SVASONA study.
The supremacy of low-pressure valves (LPV) in the therapy of patients with idiopathic normal pressure hydrocephalus (iNPH) has been proven by the Dutch NPH study. The downside of LPVs is the high rate of overdrainage complications. In the meantime gravitational units have been developed with the objective of minimising overdrainage complications. Do these gravitational units allow the same favourable outcomes as in the Dutch NPH study without overdrainage complications? The goal of this prospective randomised controlled multicentre trial is to compare the rate of overdrainage complications after shunt surgery with programmable valves with or without a gravitational unit. ⋯ The design of the SVASONA study was developed to be able to confirm the primary hypothesis. Thus, the method of the study should solve the dilemma of the Dutch NPH study by the randomised comparison of LPVs with and without gravitational units.
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Acta Neurochir. Suppl. · Jan 2012
Comparative StudyExperimental comparison of the measurement accuracy of the Licox(®) and Raumedic (®) Neurovent-PTO brain tissue oxygen monitors.
Only a few experimental reports are available on the direct comparison of Licox(®) and Raumedic(®)-Neurovent-PTO brain tissue oxygen pressure (P(br)O(2)) monitors. We compared the two systems regarding their measurement properties under experimental in vitro and in vivo conditions. ⋯ Raumedic(®) sensors measured higher P(br)O(2) values. There was no significant difference regarding overall measurement of in vitro accuracy between the two probes, which proved to be robust when used consecutively for longer periods and in different environments.
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Acta Neurochir. Suppl. · Jan 2012
Intracranial pressure telemetry: first experience of an experimental in vivo study using a new device.
To test two new telemetric intracranial pressure (ICP) probes (NEUROVENT(®)-P-tel, NEUROVENT(®)-S-tel) in a porcine model. We aimed to intraoperatively correlate the telemetric probes to parenchymal ICP probes and study their reliability in the first hours after implantation. The experimental set-up, new telemetric technology and first data will be presented. ⋯ We present a new telemetric technology that was experimentally compared with a parenchymal ICP probe. We provide data that the new telemetric probes will comparably measure ICP vs an external ICP probe. This stand-alone ICP tool may allow permanent measurement of ICP in hydrocephalus patients. Further continuation of our study will demonstrate whether this system guarantees acceptable long-term reliability.
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Acta Neurochir. Suppl. · Jan 2012
Randomized Controlled TrialThe effect of intraventricular thrombolysis in combination with low-frequency head motion after severe subarachnoid hemorrhage: interim analysis of safety, clot clearance rate and delayed cerebral ischemia.
The current clinical prospective randomized phase II study was initiated in order to analyze the effect of enhanced washout by discontinuous intraventricular thrombolysis in combination with low-frequency head-motion therapy on side effects, clot clearance rate, cerebral vasospasm and clinical outcome after severe subarachnoid hemorrhage (SAH). ⋯ The present study demonstrates that a combination of intraventricular thrombolysis and lateral rotational therapy is not associated with a higher complication rate. Furthermore, the therapy leads to a significant acceleration of the clot clearance rate.
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Acta Neurochir. Suppl. · Jan 2012
Randomized Controlled TrialConservative versus surgical management of idiopathic normal pressure hydrocephalus: a prospective double-blind randomized controlled trial: study protocol.
There is no level I evidence to indicate whether placement of a shunt is effective in the management of idiopathic normal pressure hydrocephalus (INPH), because no trial has as yet compared the placement of a shunt versus no shunt in a randomized controlled manner. We started recruiting patients into a prospective double-blind randomized controlled study aiming to provide class I evidence supporting or refuting the role of surgical management in INPH. Inclusion criterion was the diagnosis of probable INPH plus objective improvement of walking speed following 72 h of extended lumbar drainage. ⋯ Primary end point was to be an improvement in gait. Secondary end points were improvement in mental function or urinary function and incidence of complications. Final results are expected mid 2011.