摘要:

&NA;The clinical and pathological effects of nimodipine on cerebral infarction were investigated in 12 male baboons. In randomized/blind trials, six animals given intravenous nimodipine (2 &mgr;g/kg/min load, 1 &mgr;g/kg/min maintenance) for 96 hours starting 50 minutes before 6‐hour double‐clip occlusion of the middle cerebral artery were compared to 6 control animals. Standardized neurological examinations were performed by examiners blinded to the animals' therapy on Day 7 and Day 14 after stroke. On Day 14 the animals were killed. The brains were studied pathologically, and the relative areas of infarction were quantified. Intracranial pressure was lower in nimodipine‐treated animals; however, the range of intracranial pressure values in each group was broad. Two control animals with high intracranial pressure died. There were no deaths among the nimodipine‐treated animals. The neurological scores on Days 7 (P≤ 0.01) and 14 (P≤ 0.05) were significantly different between the two groups. The nimodipine‐treated animals had less clinical evidence of infarction compared to controls. Nimodipine‐treated animals tended to have smaller areas of infarction; however, the difference between the two groups was not statistically significant. The infusion of nimodipine in the treatment of focal cerebral ischemia is safe and does not appear to aggravate the extent of infarction or to exacerbate intracranial hypertension. The clinical neurological evaluations indicate that nimodipine may improve or preserve neurological outcome after stroke. (Neurosurgery25:63‐70, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Previous studies have indicated that the application of electrical fields to the contused rat spinal cord could result in a partial return of function within 3 weeks after injury/treatment. Whether similar functional recovery could be established after a delay in the treatment was investigated. Rat spinal cords were contused and allowed to recover untreated for 10 days. At that time, a stimulator delivering 3 &mgr;A of direct current was applied to the dorsal portion of the cord such that the cathode was oriented either rostral or caudal to the lesion. Inactive stimulators were also used as controls. Rats were then assessed behaviorally and clinically at weekly intervals up to 3 weeks on an inclined plane and then killed for histological assessments. The results indicate that both the “cathode rostral” and “anode rostral” groups performed statistically significantly better on the inclined plane than the “no current” group. The cathode rostral and anode rostral group animals also demonstrated superior motor abilities. The number of axons in the dorsal funiculi rostral to the lesion in the actively treated groups were also statistically significantly greater than no current controls. The cathode rostral group animals demonstrated a greater number of viable neuronal cell bodies near the site of the lesion. These data suggest that electric fields may facilitate functional recovery and regeneration in the mammalian spinal cord, even after a delay in such treatment. (Neurosurgery25:71‐75, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;CSF TRAP (Transport and Rapid Accessioning for Additional Procedures) is a procedure that provides storage of and rapid access to cerebrospinal fluid (CSF) specimens and allows clinicians to review initial findings before ordering low‐yield CSF studies. The cost‐effectiveness of routinely using the CSF TRAP procedure with myelography is examined in a study group of 819 patients, 74% with disc diseases, spinal stenosis, spondylolisthesis, or pain syndromes, 10% with cancer, and 16% with neuropathies and miscellaneous conditions. Routine studies on CSF obtained during myelography provided little additional clinical information, except for patients with cancer (of 80 patients with cancer, the results of cytological examination of the CSF were positive in 12) and patients with multiple sclerosis, for whom oligoclonal band and lgG analysis provided supportive diagnostic data. The utilization of the CSF TRAP procedure with elimination of unnecessary culture and cytological studies on patients with disc diseases, spinal stenosis, spondylolisthesis, and pain syndromes, reduces myelographic CSF procedures by 20%, for a savings exceeding $14,000. The CSF TRAP procedure allows for a more cost‐efficient analysis of CSF obtained using myelography, while providing fluid for analysis in patients with unexpected findings. (Neurosurgery25:76‐80, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Saccular intracranial aneurysms occur infrequently in children, and the incidence of pediatric giant aneurysms is statistically in the same proportion as in adults. The management of these giant aneurysms can be treacherous. This paper presents a case of a 9‐year‐old boy with a giant aneurysm of the right middle cerebral artery that was successfully managed by ligation of the middle cerebral artery using a Drake tourniquet with the patient awake and by augmentation of the middle cerebral artery circulation with superficial temporal artery‐middle cerebral artery anastomosis without excision of the lesion. (Neurosurgery25:81‐85, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;We report a case of luxury perfusion syndrome with temporary neurological deterioration after extracranial to intracranial bypass surgery. A preoperative computed tomographic scan showed no detectable infarct, and the measurement of regional cerebral blood flow showed severe depression of ipsilateral hemispheric perfusion. The patient developed temporary neurological deterioration after bypass surgery, with no recognizable pathological signs on postoperative computed tomographic and angiographic studies. Regional cerebral blood flow and volume were more elevated during the period of neurological deterioration than after the subsequent recovery. This strongly suggests that excessive blood flow directed into chronically ischemic brain through a graft may induce a luxury perfusion syndrome resulting in neurological deterioration. (Neurosurgery25:85‐89, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Ligation of the cervical internal carotid artery resulted in an acute neurological deficit in the dominant hemisphere of a 35‐year‐old man who suffered a penetrating injury to the neck. Regional cerebral hypoperfusion was suspected because the ischemic symptoms occurred while the patient was fully heparinized. Immediate institution of a barbiturate coma, volume expansion, and placement of a high‐flow extracranial‐intracranial arterial bypass graft led to rapid recovery of hemispheric function. High‐flow extracranial‐intracranial bypass grafts appear to be indicated for the treatment of symptomatic cerebral ischemia in selected cases of acute ligation or occlusion of the extracranial carotid artery. (Neurosurgery25:90‐92, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;The natural history of cavernous angiomas is poorly understood, and their growth has rarely been documented. We report three cases of cavernous angiomas that grew to large size in 6 years, 2 years, and 2 months, respectively. An initial computed tomographic scan disclosed no abnormalities in one patient and demonstrated two “minimal” lesions in the other two. The mechanisms of growth of these lesions are discussed; subsequent hemorrhages and capsule formation played a major role in their enlargement. (Neurosurgery25:92‐97, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;A case of intramedullary cavernous angioma of the upper cervical spinal cord, initially associated with trigeminal neuralgia, is reported. Magnetic resonance imaging precisely depicted the entire extent of the lesion. The angioma was totally removed and the operation was successful in relieving the patient of neuralgia. The previously reported 23 cases of intramedullary cavernous angiomas are reviewed, and the clinical symptoms, diagnosis, and treatment of this rare condition are discussed. (Neurosurgery25:97‐101, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;We report the case of a young girl who suffered bilateral upper extremity paralysis after minor head trauma. Her clinical picture, as well as radiographic evidence of a fracture at C1, led to the diagnosis of Bell's cruciate paralysis, caused by a small lesion in the rostral part of the pyramidal decussation. Magnetic resonance images showed, in addition to a Chiari Type I malformation, an abnormality in the medulla. All previous cases of cruciate paralysis lack both pathological and radiographic supporting evidence. (Neurosurgery25:102‐105, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Diagnosis and treatment of acute aortic thrombosis utilizing magnetic resonance imaging is reported. The patient had known thoracolumbar spinal metastases and sudden onset paraplegia. MRI critically shortened the time to emergent surgery and obviated the need for two invasive tests (myelogram and angiogram). (Neurosurgery25:105‐109, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID