摘要:

&NA;Delayed traumatic intracerebral hematomas found after an initially unrevealing computerized tomographic scan have been reported occasionally. Such hemorrhage may occur in an area of brain contusion with cerebral vessel injury. Four cases of intracerebral hematoma appearing after evacuation of a different traumatic intracranial mass lesion are reported. This suggests that an intracranial mass lesion may tamponade cerebral venous oozing in an area of brain contusion and delay the accumulation of intracerebral blood, accounting for the late discovery of a parenchymal hematoma. (Neurosurgery,5: 653‐655, 1979)

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;Experimental vasogenic cerebral edema was created in rabbits with a cold‐induced left occipital cortical lesion. Intracranial pressure (ICP), intracranial elastance (Em), water content, hemispheric brain tissue volume, electrolytes, electroencephalograms, behavior, and gross pathology were studied. Various therapeutic modalities were employed alone or in combination to reduce ICP acutely: acetazolamide, furosemide, mannitol, pentobarbital, lorazepam, and dexamethasone. All therapies except dexamethasone were effective in reducing ICP. Peak ICP reduction occurred at 27 ± 9.8 (SD) minutes with mannitol and at 71.4 ± 15.5 minutes with acetazolamide, with the remaining agents and combinations falling between these two extreme values. Emimproved by 31.7 ± 17.02% in all therapeutic trials except those employing acetazolamide and lorazepam. With therapy, there was a reduction in the water content of the hemispheres, but the difference from that in the untreated, lesioned animals was not statistically significant. In the lesioned left hemisphere, sodium content was increased by acetazolamide (p< 0.005), furosemide (p< 0.025), pentobarbital (p< 0.05), and the combination of dexamethasone, pentobarbital, and mannitol (p< 0.005), Significant reduction was noted in the lesioned group for the potassium content of the left hemisphere in the dexamethasone (p< 0.05), pentobarbital (p< 0.025), and combination groups containing these agents (p< 0.005 to 0.025), (Neurosurgery,5: 656‐665, 1979)

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;A number of reliable methods are available for the short term monitoring of intracranial pressure (ICP). However, the danger of infection and the need for external connections make the use of these methods for extended periods inappropriate. Most previously described devices for chronic monitoring of ICP are of limited value because of uncertain drift from zeropoint readings. The Hittman‐Meyer ICP sensor approaches the ideal for a long term monitoring device. It is fully implantable and is accurate over a wide range of pressures and for extended periods. It is designed so that in vivo calibration may be performed in a noninvasive fashion. We report the use of this device in eight patients with pseudotumor cerebri. It has functioned accurately for periods ranging up to 14 months after implantation and has proven to be a valuable aid in the management of these patients. (Neurosurgery,5: 666‐670, 1979)

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;Thirteen patients with intracranial lesions were submitted to a twist drill needle biopsy under computerized tomographic (CT) control, with sedation and local anesthesia. (The patients' ages ranged from 12 to 81 years.) The final diagnoses were glioblastoma in 7 patients and 1 case each of anaplastic astrocytoma, low grade astrocytoma, thrombosed arteriovenous malformation, cerebral infarct, 3rd ventricular epidermoid, and degenerative disease of the brain. Definitive diagnosis was obtained in all but 2 patients with this technique. Appropriate therapy was subsequently instituted in 11 patients without further operation. Transiently increased weakness of the previously affected limbs was the only untoward effect (4 patients). Intracranial hematoma after this procedure was seen in 1 patient in this series, as detected by the postprocedure CT scan, but there was no change in the clinical course. All patients were treated with dexamethasone for 24 to 48 hours before and for several days after the procedure to avoid decompensation of intracranial dynamics because of edema. The procedure, including appropriate level CT scans of the lesion area, was performed in approximately 1 hour in all patients. (Neurosurgery,5: 671‐674, 1979)

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;This is a prospective study of cardiac arrhythmias in patients with acute subarachnoid hemorrhage (SAH) secondary to ruptured aneurysm. Twenty per cent of the patients had serious, life‐threatening arrhythmias. However, 100% of the patients had some kind of cardiac arrhythmia. The arrhythmias occurred during the first 48 hours after SAH. Such arrhythmias occur in patients without overt, pre‐existing heart disease, hypoxemia, or electrolyte imbalance. A prolonged Q‐T interval is frequently observed in patients with SAH who develop serious ventricular arrhythmias. (Neurosurgery,5: 675‐680, 1979)

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;Matrix support materials for brain surface electrodes used in neuroprosthetic applications were evaluated after chronic subdural implantation over the parietal cortex of the cat. Four types of array fabricated with Silastic, Dacron mesh, or platinum wire annuli were implanted for periods ranging from 5 weeks to 1 year. We evaluated the arrays by access resistance measurements and gross and histological observations of the tissue beneath both nonstimulated and stimulated electrodes. A porous type matrix constructed of Dacron mesh proved to be the superior design because of its minimal compression of the cortical surface, facility of handling during implantation and autopsy, and satisfactory electrical characteristics provided by a good electrode‐brain interface. (Neurosurgery,5: 681‐686, 1979)

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;The object of this investigation was to study the effects of intermittent, low dose mannitol therapy on conscious cats after acute left middle cerebral artery (MCA) occlusion. A simple implanted device was applied to the proximal left MCA of 40 adult cats using microsurgical techniques. In the acute experiments, 10 cats were untreated and 10 cats received mannitol (0.5 g/kg intravenously) immediately before occlusion and again 3, 6, and 9 hours later. They subsequently underwent intra‐arterial perfusion with colloidal carbon and buffered paraformaldehyde 12 hours after occlusion. The plasma osmolality immediately before perfusion was 316 ± 2 (SD) milliosmoles in untreated cats and 331 ± 5 milliosmoles in treated cats. Gross swelling, impaired carbon filling, and breakdown of the blood‐brain barrier (BBB) to fluorescein were seen in the left MCA territory of 8 untreated cats and 1 treated cat. The mean percentage of gray matter cross sectional area where severe ischemic neuronal alterations predominated was 45 ± 12% in untreated and 14 ± 16% in treated cats (p< 0.01). The mean capillary luminal diameter in the left sylvian cortex was 4.5 ± 1.0 μ in untreated cats (control, 6.5 ± 1.0 μ) and 5.5 ± 1.0 μ in treated cats. In the subacute experiments, 10 cats were not treated and 10 cats received mannitol as in the acute experiments. The cats were killed with a large bolus of sodium pentobarbital 48 hours after left MCA occlusion. Gross swelling and breakdown of the BBB were less severe in treated cats. The mean cross sectional area of infarcted tissue was 55 ± 12% in untreated cats and 33 ± 21% in treated cats (p< 1.0). The findings of this study indicate that intermittent, low dose mannitol therapy delays the onset of ischemic cerebral injury and may reduce the size of the eventual infarct or convert a potential infarct into a so‐called “transient ischemic attack.” (Neurosurgery,5: 687‐691, 1979)

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;A simple device is described for monitoring intracranial pressure by an extradural method. It is installed easily under local anesthesia and eliminates certain complications of other monitoring methods. It has been used in 70 patients for as long as 15 days without adverse effects. (Neurosurgery,5: 692‐694, 1979)

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;A case of saccular aneurysm associated with a fenestrated proximal basilar artery is presented. The aneurysm projected anteriorly, superiorly, and slightly to the left. Via a right suboccipital approach, the aneurysm was clipped with preservation of all vessels. The only postoperative deficit is a resolving dysphonia. (Neurosurgery,5: 695‐697, 1979)

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;The author reports a case of intracerebral and subdural hematomas of acute onset secondary to rupture of an aneurysm. The patient was in a state of advanced decerebration and was breathing spontaneously although irregularly. There was a gratifying response to prompt neurosurgical intervention. (Neurosurgery,5: 698‐700)

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID