Abstract:
:Intracisternal thrombolysis with recombinant tissue plasminogen activator (rtPA) was performed in 20 patients with aneurysmal subarachnoid hemorrhage. All patients had blood accumulations in the basal cisterns according to Fisher's Grade III, thus being at a high risk for the development of posthemorrhagic delayed ischemic deficits (DID). All patients underwent an operation within 72 hours after aneurysm rupture. After the aneurysm had been excluded from the cerebral circulation, a single bolus of 10 mg of rtPA was injected into the basal cisterns. Postoperatively, serial computed tomographic examinations demonstrated radical blood clot removal in all patients. Daily transcranial Doppler examinations revealed accelerated blood flow velocities in 16 of 20 patients. The postoperative results according to the Glasgow Outcome Scale were as follows: 16 patients were Grades I and II, 2 patients were Grade III. Two patients died postoperatively, 1 because of a bowel perforation, and 1 from DID attributable to the development of a cerebral vasospasm. No postoperative bleeding complications occurred. It is concluded that pharmacological removal of subarachnoid blood accumulations can be achieved in a safe and effective way by an intrathecal single bolus of 10 mg of rtPA instilled into the basal cisterns after aneurysm clipping. The acceleration of blood flow velocities in a number of patients indicated that posthemorrhagic arterial narrowing was not completely prevented by this treatment, but this remained asymptomatic in 19 of 20 patients. Although extensive blood clot removal can be achieved by a single bolus of rtPA, more radical or complete blood removal probably requires the use of higher drug concentrations or additional postoperative intracisternal or intraventricular rtPA injections, for which further studies are needed.(ABSTRACT TRUNCATED AT 250 WORDS)
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Stolke D,Seifert Vdoi
10.1227/00006123-199206000-00010keywords:
subject
Has Abstractpub_date
1992-06-01 00:00:00pages
877-81issue
6eissn
0148-396Xissn
1524-4040journal_volume
30pub_type
杂志文章相关文献
NEUROSURGERY文献大全abstract::The results of magnetic resonance (MR) evaluation in 18 patients with common neurosurgical problems, including cerebrovascular lesions, intracranial tumors, and craniovertebral junction pathological conditions, are presented. The results are compared with those of routine diagnostic studies. Overall, MR imaging was eq...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1985-04-01 00:00:00
abstract::To elucidate the factors associated with functional recovery after traumatic transtentorial herniation, we reviewed the records of 153 consecutive patients admitted with clinical signs of transtentorial herniation (altered level of consciousness, anisocoria or pupillary unresponsiveness, and abnormal motor findings). ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199108000-00010
更新日期:1991-08-01 00:00:00
abstract:BACKGROUND:Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) are promising biomarkers of traumatic brain injury (TBI). OBJECTIVE:We investigated the relation of the GFAP and UCH-L1 levels to the severity of TBI during the first week after injury. METHODS:Plasma UCH-L1 and GFAP were...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000001226
更新日期:2016-09-01 00:00:00
abstract::In our studies of the pathogenesis of cerebral vasospasm, we have been emphasizing that microthrombosis may play an important role in the induction of cerebral ischemic symptoms or cerebral infarction. In this report, multiple microthrombi are demonstrated histologically to be a major cause of cerebral infarction in t...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198308000-00018
更新日期:1983-08-01 00:00:00
abstract:BACKGROUND:Although injury to the lumbar arteries during anterior spinal approaches is often encountered, there are few published articles regarding the relationship between the lumbar arteries and spinal cord ischemia. OBJECTIVE:To examine the morphology of the lumbar arteries and to emphasize their clinical importan...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e318205e307
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Achieving seizure control in patients with low-grade temporal lobe gliomas or glioneuronal tumors remains highly underappreciated, because seizures are the most frequent presenting symptom and significantly impact patient quality-of-life. OBJECTIVE:To assess how the extent of temporal lobe resection influen...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/NEU.0b013e31823c3a30
更新日期:2012-04-01 00:00:00
abstract::A new technique for the diversion of the peritoneal end of a lumboperitoneal shunt into the right atrium through femoral vein catheterization is presented. As an alternative to a ventriculoatrial shunt, this is a promising technique for the treatment of patients with communicating hydrocephalus when the peritoneal cav...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198802000-00033
更新日期:1988-02-01 00:00:00
abstract::We studied the impairment of autoregulation of cerebral blood flow (CBF) and its effect on the electrical activity of the brain during the development of chronic cerebral vasospasm after subarachnoid hemorrhage, using a vasospasm model in primates. Fourteen animals were divided into two groups: a clot group (8) and a ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199101000-00007
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:Our goal was to increase the safety of anterior cervical discectomy, a routine surgery performed by neurosurgeons worldwide, in the face of vertebral artery (VA) anomalies. CLINICAL PRESENTATION:A 59-year-old woman had an intraoperative injury of the left VA during elective anterior cervical discectomy and f...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000374858.18717.33
更新日期:2010-09-01 00:00:00
abstract::Neuroendovascular embolization represents a critical component of the multidisciplinary management of cerebral arteriovenous malformations. Safe and effective embolization may be performed only in the context of a well-designed, rational treatment plan that is fundamentally based on a clear understanding of the natura...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/01.NEU.0000237544.20452.47
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:A piezo actuator-driven pulsed water jet (ADPJ) system is a novel surgical instrument that enables dissection of tissue without thermal damage. It can potentially resect intra-axial lesions while preserving neurological function. OBJECTIVE:To report our first experience of applying an ADPJ system to brain a...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000867
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:Meningiomas arising primarily within the internal auditory canal (IAC) are notably rare. By far the most common tumors that are encountered in this region are neuromas. We report a series of eight patients with meningiomas of the IAC, analyzing the clinical presentations, surgical management strategies, and c...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/01.neu.0000126887.55995.e7
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:We describe an easy and useful method for treating hemifacial spasm related to the vertebral artery. METHODS:The technique entails the manufacture of a dural belt harvested from the cerebellar convexity dura and a dural bridge made at the petrous dura combined with the use of an aneurysm clip. The dural belt...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199912000-00048
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:Y-stent-assisted coiling is one of the eligible techniques for the treatment of complex bifurcation aneurysms. In majority of previous literature, Y-stenting has been performed using stents that could be delivered through large profile microcatheters that are often difficult to manipulate during navigation t...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyz516
更新日期:2020-09-15 00:00:00
abstract:OBJECTIVE:During the past 15 years, the concept of dysembryoplastic neuroepithelial tumors has continued to evolve. We present an interesting case of dysembryoplastic neuroepithelial tumor that showed rapid growth during a short period of time. CLINICAL PRESENTATION:A 9-year-old boy had been experiencing intractable c...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000245621.62721.79
更新日期:2006-12-01 00:00:00
abstract::The objectives of this study were to evaluate the use of brain stem auditory evoked potentials (BAEPs) in 10 adult patients with vascular disorders of the posterior circulation that were treated surgically and to compare the BAEPs with the neurological findings. The vascular lesions included basilar artery stenosis in...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198305000-00003
更新日期:1983-05-01 00:00:00
abstract::OBJECTIVE: We developed a modified soft tissue retractor for preventing problems that occur outside of the microscopic view field during microsurgery. INSTRUMENTATION AND OPERATIVE PROCEDURE: The characteristics of the modified soft tissue retractor are detachable handgrips, which can be easily released and fixed with...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:Motor cortex stimulation (MCS) is routinely used for the treatment of chronic neuropathic pain but its effect on quality of life remains uncertain. OBEJCTIVE:To systematically review the published literature on MCS and quality of life and report the effects of this therapy in a series of patients prospectiv...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyy060
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:Conflicting reports have been published with regard to the relationship between the efficacy of p53 gene therapy and the p53 status of gliomas. In this study, we evaluated whether U-87MG glioma cells harboring wild-type p53 and U251 and U-373MG glioma cells harboring mutated p53 demonstrate different sensitiv...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200107000-00027
更新日期:2001-07-01 00:00:00
abstract::Two cases of very small trigeminal neurinomas arising proximal to Meckel's cave are presented. We believe that the overlap of the symptoms and signs of these tumors with those of atypical trigeminal neuralgia strengthens the concept of the latter entity also being due to compression of the trigeminal nerve solely with...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1980-03-01 00:00:00
abstract::Cerebral arterial vasospasm continues to be a major secondary medical complication of aneurysmal subarachnoid hemorrhage. Despite hypervolemic hemodilution, arterial hypertension, and pharmacological therapy, morbidity and mortality due to vasospasm remain high. The authors discuss a patient with vasospasm who did not...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199505000-00024
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVE:Internal carotid artery (ICA) injury during sellar dural opening is a potentially catastrophic complication of transsphenoidal surgery. We describe two ICA injuries that occurred early in our endonasal transsphenoidal experience. We then describe our subsequent protocol to prevent this complication in which w...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000255408.84269.A8
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:Sodium butyrate (SB), a differentiation-inducing agent, has been demonstrated to inhibit cellular proliferation in a number of human cell lines. Its precise mechanisms remain to be clarified, however. We investigated molecular mechanisms of SB-induced growth suppression as well as the effects of SB on the inv...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200108000-00031
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Spine stereotactic body radiotherapy (sSBRT) is commonly limited to 1 or 2 vertebral levels given a paucity of efficacy and toxicity data when more than 2 levels are treated. OBJECTIVE:To prove our hypothesis that multilevel sSBRT could provide similar rates of local control (LC) (primary endpoint) and toxi...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyz348
更新日期:2020-02-01 00:00:00
abstract::Computed tomography has proven useful in children with craniosynostosis for the evaluation of deformity of the skull base, calvarium, and parenchymal brain structures. A retrospective analysis of 24 children seen during a 4-year period who had adequate preoperative, postoperative, and follow-up scans was carried out. ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198110000-00003
更新日期:1981-10-01 00:00:00
abstract:OBJECTIVE:Ion transporters play pivotal roles in cancer cell migration in general and in glioblastomas (GBMs) in particular. However, the specific role of Na/K-ATPase (the sodium pump) and, in particular, its alpha1 subunit, has remained unexplored in GBMs. MATERIALS AND METHODS:The expression of Na+/K+ -ATPase alpha1...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000311080.43024.0E
更新日期:2008-01-01 00:00:00
abstract::Four cases of intracerebral hemorrhage remote from the site of the initial neurosurgical procedure are presented. Two of the four patients had preoperative hypertension. Possible mechanisms are discussed, and labile hypertension and unstable blood pressure during the perisurgical period may be contributory. Clinical a...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198312000-00008
更新日期:1983-12-01 00:00:00
abstract:OBJECTIVE:The management of patients with a Chiari I malformation who present with headaches alone remains unclear. We studied the cerebrospinal fluid (CSF) flow dynamics of Chiari I malformation patients presenting with headaches alone so as to identify headache types that are associated with CSF flow obstruction vers...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000156203.20659.14
更新日期:2005-04-01 00:00:00
abstract::Endovascular neurosurgical procedures are complex, requiring significant planning, foresight, and coordination. The neuroanesthetist is an integral part of these procedures, organizing efforts of the technicians and nurses and responding to the needs of the neurointerventionalist. The purpose of this article is to rev...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/01.NEU.0000237337.38375.90
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:We report our initial clinical experience with a new method for intraoperative blood flow assessment. The purposes of the study were to assess the use of indocyanine green (ICG) video angiography in neurovascular cases, to assess the handling and image quality, to compare the findings with postoperative angio...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200301000-00017
更新日期:2003-01-01 00:00:00