Acta neurochirurgica. Supplement
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we focused on the recent management of aneurysmal subarachnoid hemorrhage (SAH) in patients over 70 years old (advanced age). ⋯ mean age and proportion of procedures in advanced age are increasing, but outcomes have improved. These results depend on radical surgery for aneurysm in the acute stage and aggressive prevention and treatment of vasospasm. Interventional treatment is necessary to improve the outcome in cases of advanced age.
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Acta Neurochir. Suppl. · Jan 2011
O-arm guided balloon kyphoplasty: preliminary experience of 16 consecutive patients.
Balloon kyphoplasty is now widely used for the treatment of vertebral compression fractures. Excellent pain relief is achieved with cement injection, but the safety of the procedure relays on excellent radiological exposure. The balloon kyphoplasty technique is usually performed using one or two C-Arm devices to allow correct antero-posterior (AP) and lateral view throughout the surgical procedure. ⋯ We prospectively evaluate on 16 consecutive patients, the feasibility of the O-Arm guided kyphoplasty procedure with the original, usual tools, and we measured the fluoroscopy time and the X-ray exposure. We didn't experience any device related problem and demonstrated a significant reduction of X-ray exposure and time of fluoroscopy. We believe that using this new intraoperative system, the overall time of surgery and fluoroscopy could still be reduced in a near future.
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Acta Neurochir. Suppl. · Jan 2011
Comparative StudyComparison of nimodipine delivery routes in cerebral vasospasm after subarachnoid hemorrhage: an experimental study in rabbits.
nimodipine is the most widely preferred and administered calcium channel blocker in cerebral vasospasm prevention and treatment. There is no experimental or clinical study investigating the comparative effects of routine treatment modalities. ⋯ this is the first study to show the most effective drug delivery route in CVS after SAH. Nimodipine treatment in cerebral vasospasm is useful. This study showed that selective IA nimodipine treatment and IT nimodipine treatment must be preferred to IV and oral treatments of chronic vasospasm following SAH.
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Acta Neurochir. Suppl. · Jan 2011
Case ReportsA numerical approach to patient-specific cerebral vasospasm research.
cerebral vasospasm (CVS) is a devastating sequela of subarachnoid hemorrhage (SAH). Among the many factors that are associated with the pathogenesis of CVS, the cerebral blood flow (CBF) and underlying haemodynamics play an important role. In this paper we present an integrated clinical-engineering approach to CVS research. ⋯ a numerical approach to patient-specific CVS analysis has been established, and some initial results are achieved via application to an actual spasm case. The undergoing and future work include applying the approach to more CVS cases and incorporating computational models of different scales into the current framework for CVS and SAH research.
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Acta Neurochir. Suppl. · Jan 2011
The prediction of 30-day mortality and functional outcome in spontaneous intracerebral hemorrhage with secondary ventricular hemorrhage: a score comparison.
The original ICH (oICH) score was tested in different populations and showed good accuracy in the prediction of outcome and 30-day mortality after spontaneous ICH. The oICH was developed to stratify patients with all types of spontaneous intracerebral hemorrhage (SICH). Several modifications of the oICH score exist in the literature. ⋯ The best AUC for functional outcome was observed for the mICH-B score (0.823). For the mICH-A and the IVH score, an AUC of 0.811 was calculated. The scores that include the quantification of IVH or the grading of hydrocephalus show good accuracy in the prediction of 30-day mortality and functional outcome at 6 months in SICH with secondary IVH.