Acta neurochirurgica. Supplement
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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.
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Acta Neurochir. Suppl. · Jan 2011
Subarachnoid hemorrhage causes pulmonary endothelial cell apoptosis and neurogenic pulmonary edema in mice.
Neurogenic pulmonary edema (NPE) is a well-known complication of subarachnoid hemorrhage (SAH), which potentially causes a poor outcome. The aim of this study was to examine if NPE occurs in the endovascular perforation model of SAH in mice and if apoptosis contributes to NPE development after SAH in mice. ⋯ Pulmonary endothelial cell apoptosis contributes to the pathophysiology of NPE after SAH in mice.
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The lack of radiation, high soft tissue contrast and capacity for multiplanar and three-dimensional imaging have made magnetic resonance imaging (MRI) the imaging modality of choice for evaluating spinal cord diseases. In diagnostic imaging of the spine, MRI is clearly superior to both conventional radiography (CR) and computed tomography (CT) and it should be preferred as first diagnostic examination when degenerative spine pathologies are suspected. ⋯ Both "container" and "contents" of the spine should be primly evaluated. Finally, a correlation between clinical and radiological features seems to be mandatory for selecting the correct therapeutic choice, since the reliability of the MRI as potential prognostic indicator has been demonstrated.