摘要:

Summary:Significant advances in our understanding of vasospasm include the definition of the time course of vasospasm, the ability to predict the location and severity of vasospasm based on a computed tomography scan obtained within five days of subarachnoid hemorrhage and the recognition of vasospasm as a significant adverse prognostic factor for outcome following aneurysmal subarachnoid hemorrhage. It is also recognized that the most important factor in the etiology of vasospasm is subarachnoid clot that causes vasospasm by hemolysis and release of spasmogenic compounds from the erythrocytes. The recent advances that have substantially reduced the morbidity and mortality from vasospasm include calcium channel antagonists such as nimodipine, hemodynamic therapy to improve cerebral blood flow, and transluminal angioplasty. Numerous therapies continue to be evaluated including subarachnoid clot lysis with tissue plasminogen activator, superselective intraarterial infusions of papaverine, and drugs such as tirilazad.

ISSN:1050-6438    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Summary:Spinal cord stimulation is the most widespread application of neurostimulation, which includes electrical stimulation of the sensory-motor cortex, thalamus, spinal cord, sacral roots, peripheral nerves, and vagus nerve. Its popularity, although with variable acceptance over the past two decades, has steadily increased and is now a well-established part of the pain specialist's armamentarium. Several published studies (none of which, however, is prospective) have consistently shown a 50% efficacy in producing a satisfactory degree of long-term pain relief in a variety of chronic pain conditions. In Europe the most widely accepted application is for the management of peripheral vascular disease in the lower extremities. The effects on ischemic pain have been reported consistently to be very positive. Intractable pain due to angina pectoris is also showing promising results. The role of spinal cord stimulation in the management of hypertonic motor disorders has been controversial and has recently been overshadowed by the development of intrathecal baclofen infusion. In the author's experience, spinal cord stimulation remains the procedure of choice for athetosis or dystonia. Some evidence also exists that spinal cord stimulation might have a role in regulating the blood flow to the brain. This has been confirmed by animal experimental studies. Isolated reports have also shown some beneficial effects in persistent vegetative status due to brain injury or stroke.

ISSN:1050-6438    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Summary:Few areas of surgical management stimulate more controversy than the selection of patients for fusion of the lumbar spine. Selection, evaluation, and management of patients with degenerative spinal conditions that may benefit from lumbar stabilization are reviewed.

ISSN:1050-6438    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1050-6438    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1050-6438    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1050-6438    

出版商:OVID    

年代:1995

数据来源: OVID