Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2012
The impact of silver nanoparticle-coated and antibiotic-impregnated external ventricular drainage catheters on the risk of infections: a clinical comparison of 95 patients.
Infection, i.e. meningitis or ventriculitis, is a major complication of external ventricular drainage (EVD). In order to prevent this complication rifampin-impregnated and clindamycin-impregnated silicone catheters and EVDs impregnated with nanoparticles of silver and an insoluble silver salt have been developed. Sparse data are published concerning the efficacy of these catheters in reducing bacterial colonization. ⋯ Rifampin-impregnated and clindamycin-impregnated EVDs as well as silver-impregnated EVDs decreased the infection rate. Randomized studies are needed to assess the advantage of these catheters compared with standard polyurethane catheters.
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Acta Neurochir. Suppl. · Jan 2012
Association between ICP pulse waveform morphology and ICP B waves.
The study aimed to investigate changes in the shape of ICP pulses associated with different patterns of the ICP slow waves (0.5-2.0 cycles/min) during ICP overnight monitoring in hydrocephalus. Four patterns of ICP slow waves were characterized in 44 overnight ICP recordings (no waves - NW, slow symmetrical waves - SW, slow asymmetrical waves - AS, slow waves with plateau phase - PW). The morphological clustering and analysis of ICP pulse (MOCAIP) algorithm was utilized to calculate a set of metrics describing ICP pulse morphology based on the location of three sub-peaks in an ICP pulse: systolic peak (P(1)), tidal peak (P(2)) and dicrotic peak (P(3)). ⋯ Based on relative changes in variability of amplitudes of P(2) and P(3) we were able to distinguish between the combined groups NW + SW and AS + PW (p < 0.000001). The AS pattern can be differentiated from PW based on respective changes in the mean curvature of P(2) and P(3) (p < 0.000001); however, none of the MOCAIP feature separates between NW and SW. The investigation of ICP pulse morphology associated with different ICP B waves may provide additional information for analysing recordings of overnight ICP.
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Acta Neurochir. Suppl. · Jan 2012
Is P(br)O (2) pressure reactivity index (ORx) dependent on the type of oxygen probe? An in vivo study.
To evaluate if ORx is dependent on the type of brain tissue O(2) (P(br)O(2)) probe in an in vivo setting. ⋯ Despite this significant difference in absolute values of P(br)O(2) the derived mean ORx values were not different. Similar to the established Licox system, the Raumedic system seems to enable a valid ORx recording.
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Acta Neurochir. Suppl. · Jan 2012
Quantification of pulsatile cerebrospinal fluid flow within the prepontine cistern.
Phase-contrast MRI (PC-MRI) has previously been used for the quantification of CSF and blood flow throughout the body. We propose a new method of semi-automated segmentation for the prepontine cistern based on anatomical and pulsatility information. ⋯ Reliable quantification of volumetric CSF flow in complex cisternal spaces is possible using a methodology combining known anatomical features with the pulsatile nature of CSF flow.
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Acta Neurochir. Suppl. · Jan 2012
Quantification of normal CSF flow through the aqueduct using PC-cine MRI at 3T.
Quantification of cerebrospinal fluid (CSF) flow through the cerebral aqueduct is of paramount importance in patients with hydrocephalus. The purpose of this study was to evaluate the normal CSF flow measurements at three different anatomical levels of the aqueduct utilizing 3-Tesla (3 T) magnetic resonance imaging. ⋯ CSF peak positive velocity, peak negative velocity, and mean flow through the aqueduct were calculated in 22 young healthy volunteers performed at 3 T. Our measurements did not show significant difference compared with the reported measurements obtained at 1.5 T. Slight differences were observed in the CSF hydrodynamic measurements, depending on the anatomical level of the aqueduct; however, they did not vary significantly.