Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2013
Multicenter StudyClinical, transcranial Doppler ultrasound, radiological features and, prognostic significance of delayed cerebral ischemia.
We aimed to investigate the profiles and prognostic values of delayed cerebral ischemia (DCI) and delayed cerebral infarction. ⋯ Delayed cerebral ischemia and delayed cerebral infarction carried different prognostic values in aneurysmal subarachnoid hemorrhage.
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Acta Neurochir. Suppl. · Jan 2013
Hydrocephalus following decompressive craniectomy for ischemic stroke.
Numerous studies on hydrocephalus after decompressive craniectomy (DC) for severe traumatic brain injury have been reported, whereas there have been only two reports on DC for hemispheric cerebral infarction. Here, we present the clinical details of 23 patients who underwent DC for hemispheric cerebral infarction and the incidence of hydrocephalus following DC. Of the 23 patients, 13 were male and 10 were female, with an age range from 34 to 75 years (mean, 60.8 years). ⋯ Four patients who had precranioplasty hydrocephalus were transferred or died without cranioplasty, and post-cranioplasty hydrocephalus occurred in 7 (36.8 %). Only one patient underwent a shunt procedure after cranioplasty. We consider that the explanation for the discrepancies between our study and the previous studies might lie in the definition of hydrocephalus and the indications for shunting.
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Acta Neurochir. Suppl. · Jan 2013
ReviewThe roles of early brain injury in cerebral vasospasm following subarachnoid hemorrhage: from clinical and scientific aspects.
Cerebral vasospasm research has been focused on investigating the mechanisms of prolonged delayed vasoconstriction of cerebral arteries following subarachnoid hemorrhage (SAH). However, it has been clarified that induction of significant vasodilation of such arteries does not lead to better overall outcomes in SAH patients. ⋯ It is of utmost importance to investigate whether early brain injury and delayed cerebral vasospasm correlate with each other following SAH or are independent. Recent results of cerebral vasospasm research indicates future directions, and such investigations would lead to better outcome for SAH patients.
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Acta Neurochir. Suppl. · Jan 2013
Psychiatric side-effects of bilateral deep brain stimulation for movement disorders.
The effects of deep brain stimulation (DBS) on cognitive functions, and its psychiatric side-effects, are still controversial. The present study investigated psychiatric comorbidity and postoperative effects of DBS of different targets on mood and psychological functions in 81 patients with a mean follow-up of 37 months. ⋯ A wide range of behavioural changes may be seen following DBS. Depression was the most common side-effect after DBS, and occurred independently of the target. PD patients, in contrast to dystonia and tremor patients, developed complications in all tested subgroups, with varying frequencies. Preoperative evaluation for psychiatric and cognitive dysfunction is crucial to identify patients who are at specific risk for psychiatric complications.
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Acta Neurochir. Suppl. · Jan 2013
Cerebral hemodynamic and metabolic effects of remote ischemic preconditioning in patients with subarachnoid hemorrhage.
Remote ischemic preconditioning (RIPC) is a form of endogenous neuroprotection induced by transient, subcritical ischemia in a distant tissue. RIPC effects on cerebral hemodynamics and metabolism have not been explored in humans. This study evaluates hemodynamic and metabolic changes induced by RIPC in patients with aneurysmal subarachnoid hemorrhage (SAH). ⋯ This study demonstrated cerebrovascular effects induced by RIPC consistent with transient vasodilation. Cerebral metabolic effects suggest protection from ischemia and cell membrane preservation lasting up to 2 days following RIPC.