Abstract:
OBJECTIVE:To review the changes in the management of aneurysmal subarachnoid haemorrhage (SAH) in a single neurosurgical unit in the UK, following the publication of the international subarachnoid aneurysm trial (ISAT). METHODS:The presentation, investigations, treatments and outcome data of all patients admitted with SAH to the neurosurgical unit between February 2001 and May 2003 were prospectively recorded in a database. The total period studied was split in to three blocks, around the time of publication of the ISAT in October 2002 (period 1=February-December, 2001; period 2=January-September, 2002 and period 3=October 2002 to May 2003). RESULTS:Of the 177 patients admitted with presumed SAH, 130 patients with evidence of an aneurysm on angiograms were included in the study. The mean age was 53+/-1 years, 92 (71%) patients were WFNS grade 1 or 2 and 77 (60%) were Fischer grade 2 or 3. These parameters were unchanged over the study period. Overall, 60 patients (46%) underwent a craniotomy for clipping or wrapping of aneurysm, 60 (46%) underwent endovascular embolisation of the aneurysm and 10 patients (8%) were managed conservatively. Over the study periods 1-3, the proportion of patients undergoing open surgery decreased (from 51 to 31%) while endovascular treatment of aneurysms increased (35-68%; p<0.01). Over the same time points there was a non-significant trend towards better Glasgow outcome scores at 6 months follow-up. The management mortality for all WFNS grades of patients with SAH was eight deaths (14%). The mortality in the surgical group was 3 patients (5%) and there were no deaths in the endovascular group. Over the study periods 1-3, there was a decrease in the mean total duration of hospital stay (from 23.6 to 15.5 days; p<0.05) in WFNS grade 1 and 2 patients and this was related to a shorter duration of hospital stay in the endovascular than surgical group of patients (p<0.05). The mean delay in obtaining an angiogram increased over the study periods 1-3 (1.1-2.3 days; p<0.05). CONCLUSIONS:This observational study highlights the changing pattern of management of SAH and the potential difficulties that could be encountered. The proportion of patients undergoing endovascular treatment of aneurysms has increased following the publication of the ISAT study. The associated increase in the delay in obtaining an angiogram may reflect the increased workload encountered by the neuroradiologists.
journal_name
Clin Neurol Neurosurgjournal_title
Clinical neurology and neurosurgeryauthors
Gnanalingham KK,Apostolopoulos V,Barazi S,O'Neill Kdoi
10.1016/j.clineuro.2005.11.001keywords:
subject
Has Abstractpub_date
2006-02-01 00:00:00pages
117-23issue
2eissn
0303-8467issn
1872-6968pii
S0303-8467(05)00188-5journal_volume
108pub_type
杂志文章abstract::Two siblings suffering from acro-osteolysis, a rare disorder, are discussed. Although three distinct types of acro-osteolysis, namely familial, idiopathic, and due to vinyl-chloride, are clearly defined, these patients did not fit into any category. They had intact nails, preserved tactile and sensory system, plantar ...
journal_title:Clinical neurology and neurosurgery
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doi:10.1016/0303-8467(80)90059-1
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journal_title:Clinical neurology and neurosurgery
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(81)90001-9
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(84)90070-2
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(89)80016-2
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abstract::Tanycytic ependymoma is an uncommon but well-recognized variant of ependymoma. Here we report a case of tanycytic ependymoma occurring at the region of filum terminale in a 44-year male who presented with low backache, bilateral lower limb weakness and urinary incontinence. MR imaging in this patient showed a lesion t...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2011.09.017
更新日期:2012-02-01 00:00:00
abstract::Behcet's disease (BD) is a rare condition, more commonly seen in Turkey, the Middle East, the Mediterranean, and the Far Eastern countries. It is a multifaced disease involving the central nervous system (CNS), skin, joints, intestines and blood vessels. CNS involvement occurs in 10-25% of the patients with BD. We rep...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2004.07.002
更新日期:2005-06-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2014.04.010
更新日期:2014-08-01 00:00:00
abstract::This study assessed the added effect of 6 months of erythropoietin (EPO) administration in patients suffering from diabetic neuropathy with mild to moderate chronic kidney disease (CKD) managed with gabapentin. Twenty diabetic patients with mild to moderate CKD were included; 12 in gabapentin and 8 in EPO+gabapentin g...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2012.01.007
更新日期:2012-07-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.105732
更新日期:2020-05-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2011.02.014
更新日期:2011-09-01 00:00:00
abstract::Focal task-specific dystonia affects one part of the body, occurring only during the performance of a specific task. It usually affects the hand, though it can rarely affect the orofacial region. Treatment with oral medications and botulinum toxin (BTX) usually produces only modest benefit, owing to the complexity of ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2009.09.003
更新日期:2010-01-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2016.09.007
更新日期:2016-11-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2009.08.027
更新日期:2010-01-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2008.05.020
更新日期:2008-09-01 00:00:00
abstract::Progressive multifocal leukoencephalopathy (PML) is a severe demyelinating disease of the central nervous system caused by the JC virus; the mortality rate is high and it is usually refractory to treatment. In non-HIV patients, PML occurs as a late consequence of hematologic malignancies or during prolonged immunosupp...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2009.10.005
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:The postoperative change in cervical sagittal alignment has an impact on health-related quality of life in adolescent idiopathic scoliosis (AIS) patients who have undergone deformity correction. However, the effect of deformity correction on sagittal cervical profile is still controversial in the literatures....
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2018.04.019
更新日期:2018-08-01 00:00:00
abstract::Percutaneous treatments for trigeminal neuralgia (TN) include glycerol rhizotomy (GR), radiofrequency thermocoagulation (RF), and balloon compression (BC), which aim to provide pain relief by targeted injury to the trigeminal nerve pain fibers. All three techniques are well established and can provide immediate pain r...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.clineuro.2019.05.011
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:A lack of visualization of the proximal internal carotid artery (ICA) on computed tomography angiography (CTA) in acute ischemic stroke may be caused by an atherosclerotic occlusion or a pseudo-occlusion by a massive thrombus in the ICA. Pseudo-occlusion of the proximal ICA is caused by stagnant flow from a d...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2019.105495
更新日期:2019-10-01 00:00:00
abstract:INTRODUCTION:MS is associated with structural and functional brain alterations leading to cognitive impairments across multiple domains including attention, memory, and speed of information processing. Here, we analyzed the white matter damage and topological organization of white matter tracts in specific brain region...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.106424
更新日期:2020-12-08 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.106348
更新日期:2021-01-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2018.06.015
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:It is well established that smoking has a myriad of negative effects on varies aspects of bodily health. The aim of this study was to examine the effects of the smoking status at time of surgery on the postoperative subjective pain course and health related quality of life (HRQoL) until 1 year after surgery ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2014.04.015
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:External ventricular drain (EVD) placement is a common neurosurgical procedure performed in both the intensive care unit (ICU) and operating room (OR). The optimal setting for EVD placement in regard to safety and accuracy of placement is poorly defined. METHODS:A retrospective chart review was performed on ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2014.09.026
更新日期:2015-01-01 00:00:00