Abstract:
OBJECTIVES:Neurologists have continually led the assessment and management of Acute Ischemic Stroke(AIS) by use of IV-rtPA, anti-platelet therapy, antihypertensives, and other pharmacologic agents. Since the advent of mechanical thrombectomy(MT) and its proven efficacy, neurovascular surgeons(NS) are playing an increasingly important role in the management and overall care of AIS. We assessed outcomes of AIS patients managed by NS, who have been traditionally managed by neurologists. PATIENTS AND METHODS:Outcomes of AIS patients who presented to the telestroke system, over a 5-year period, were assessed. NIHSS and mRS stroke scales were used as outcome metrics. Multivariate analysis was conducted to compare outcomes of patients treated by neurovascular surgeons and those treated by neurologists. RESULTS:1353 AIS patients were identified. 21.6% received care from neurosurgeons and 78.4% received care from neurologists. Of the neurologist-managed group: 7.8% received MT and were followed by NS, 34% received IVrt-PA, average discharge NIHSS = 9.0 (SD = 8.42), latest follow-up mRS < 2 = 57.5% and mortality rate = 9.4%. Of the neurovascular surgeon-managed group: 7.4% patients received MT, 20% received IVrt-PA, average discharge NIHSS = 0.14(SD = 0.72), latest follow-up mRS ≤2 = 98.6% and mortality rate = 8.3%. There were no significant differences between groups in MT use (OR 1.22; CI95%, 0.971-2.09; p = 0.464), IVrt-PA administration (OR 0.98; CI95%, 0.70-1.38; p = 0.924), mortality rate (OR 1.21; 0.71-2.03; p = 0.483) and patients' latest mRS, p = 0.873. CONCLUSIONS:AIS requires multidisciplinary management. Care provided by neurosurgeons has similar efficacy and patient outcomes as the care provided by neurologists. These findings support the role and ability of neurosurgeons to manage and care for these patients.
journal_name
Clin Neurol Neurosurgjournal_title
Clinical neurology and neurosurgeryauthors
Atallah E,Bekelis K,Saad H,Chalouhi N,Dang S,Li J,Kumar A,Turpin J,Barsoom R,Tjoumakaris S,Hasan D,Deprince M,Labella G,Rosenwasser RH,Jabbour Pdoi
10.1016/j.clineuro.2018.02.033subject
Has Abstractpub_date
2018-05-01 00:00:00pages
67-71eissn
0303-8467issn
1872-6968pii
S0303-8467(18)30084-2journal_volume
168pub_type
杂志文章abstract:OBJECTIVE:Primary brachial plexus tumors are extremely rare and the treatment is challengeable. Our aim is to share the experiences in the treatment of primary brachial plexus tumors. METHODS:A retrospective analysis of 143 patients with primary brachial plexus tumors was made in our department from January 2001 to De...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2016.07.009
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVES:Intraoperative direct electrical stimulation (DES) is increasingly used in patients operated on for tumours in critical language areas. Although a positive impact of DES on postoperative linguistic outcome is generally advocated, the literature is only scantily documented with information about the linguisti...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2012.09.015
更新日期:2013-02-01 00:00:00
abstract::Tardive dyskinesia (TD) is a hyperkinetic movement disorder induced by dopamine receptor blocking drugs (DRBDs). TD typically presents with stereotypy or dystonia, but may also cause akathisia, myoclonus, or tremor. However, no detailed reports of gait abnormalities have been documented. We report three patients expos...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2007.09.013
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Cranioplasty is considered as a routine procedure in everyday neurosurgical practice for the patient with cranial defect, however, there is no established consensus on optimal surgical timing. OBJECTIVE:To compare the effect of early cranioplasty (1-3 months after DC) and late cranioplasty (3-6 months after...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2015.05.031
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:To investigate the impact of intensive blood pressure control on progressive intracerebral hemorrhage and outcome in patients with high blood pressure and intracerebral hemorrhage. PATIENTS AND METHODS:A retrospective study was conducted recruiting 659 patients with acute hemorrhagic stroke between Jan. 2012...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2019.02.021
更新日期:2019-05-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2013.09.036
更新日期:2013-12-01 00:00:00
abstract::Primary amoebic meningoencephalitis due to Naegleria fowleri was found in a 38-year-old Chinese man living in Hong Kong who presumably acquired the infection from swimming in a hot spring in neighbouring China. Amoebic cysts were identified in tissue taken from a brain abscess. The patient responded to surgical draina...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(93)90132-z
更新日期:1993-09-01 00:00:00
abstract::The case of a solitary cerebellar abscess in a 36-year-old Rwandese male is described. First it was considered to be tuberculosis, but at microscopal examination of the lesion after neurosurgical excision the true germ was found: Blastomyces dermatitidis. This solitary intracerebellar blastomycosis abscess is only the...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(86)80031-2
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVES:For patients with medically unresponsive trigeminal neuralgia (TN), surgical options include micro vascular decompression (MVD), radiofrequency rhizotomy (RF), and stereotactic radio surgery (SRS). Multiple sclerosis (MS) is a demyelinating condition that can be associated with TN, but is not amenable to tre...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2017.09.004
更新日期:2017-11-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2011.05.002
更新日期:2011-09-01 00:00:00
abstract::Rhabdomyolysis (lysis of skeletal muscle cells) is a potentially lethal syndrome with a broad spectrum of clinical and biochemical findings. Myalgia, pigmenturia and elevated activity of serum creatine kinase are the common features. Fulminant rhabdomyolysis may be associated with severe metabolic disturbances and inv...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/0303-8467(93)90122-w
更新日期:1993-09-01 00:00:00
abstract::The positive results of recent clinical trials examining endovascular treatment of acute stroke were the culmination of nearly two decades of studies of endovascular stroke treatment. We systematically reviewed this body of work, evaluated the strength of evidence, and performed a meta-analysis to define the clinical ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.clineuro.2017.03.005
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To obtain information on functional integrity of the facial nerve by transcranial electrical motor evoked potentials independent of nerve visualization and to improve prediction of postoperative function. PATIENTS AND METHODS:In a prospective clinical study, 68 patients with cerebello-pontine angle tumors an...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2011.06.011
更新日期:2011-12-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2016.08.005
更新日期:2016-10-01 00:00:00
abstract::To investigate the possible mechanism of neointimal formation in Moyamoya disease, we histologically examined the superficial temporal arteries and also investigated cultured smooth muscle cells (SMCs) from the arteries. Intimal thickening of the scalp arteries developed significantly at an early age in Moyamoya patie...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(97)00046-2
更新日期:1997-10-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2009.12.005
更新日期:2010-05-01 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.2011.09.010
更新日期:2012-02-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(94)90038-8
更新日期:1994-02-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2008.09.029
更新日期:2009-02-01 00:00:00
abstract::Syncope is a rare symptom of nasopharyngeal carcinoma, a common tumor in Taiwan. We describe two patients with nasopharyngeal carcinoma who presented with frequent syncopal attacks five months before the diagnosis was made. We postulate that the mechanism of syncope is involvement of the glossopharyngeal or vagal nerv...
journal_title:Clinical neurology and neurosurgery
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doi:10.1016/0303-8467(94)90051-5
更新日期:1994-05-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2012.04.005
更新日期:2013-01-01 00:00:00
abstract::Eumycetoma in the cerebellopontine angle region is extremely uncommon with no case being reported as per an extensive review of the literature by the authors. The authors report a case of cerebellopontine angle eumycetoma in a young female managed by subtotal decompression and antifungal treatment. The pre-operative d...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2007.03.003
更新日期:2007-07-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2011.12.033
更新日期:2012-07-01 00:00:00
abstract::True and false positive rates of auditory and visual evoked potentials, as well as multi-modal evoked potentials, were assessed in groups of 30 multiple sclerosis patients and 19 healthy age-matched subjects. Sensitivity (true positive rate) generally proved to be high confirming published reports. False positive rate...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(92)90058-b
更新日期:1992-01-01 00:00:00
abstract::We report a case of thalamic deep brain stimulation (DBS) for treatment of posttraumatic tremor. An 18-year-old right-handed man developed a disabling and medically refractory action tremor in the right upper extremity 9 months after sustaining diffuse axonal injury in a motor vehicle collision. DBS of the left ventra...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2003.12.004
更新日期:2004-09-01 00:00:00
abstract::Metallic implants used in neurosurgery, comprising vascular clips, shunt valves, and metallic surgical wire for spondylodesis, induce distortion of magnetic resonance images. The image deformation usually pertains to small areas of signal suppression in its immediate vicinity, when the implant is non-ferromagnetic. Th...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(89)80030-7
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:Information on the nature and relative frequency of diagnoses made in referrals to neurology outpatient clinics is an important guide to priorities in services, teaching and research. Previous studies of this topic have been limited by being of only single centres or lacking in detail. We aimed to describe th...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clineuro.2010.05.011
更新日期:2010-11-01 00:00:00
abstract::A case of pseudohypoxic brain swelling, a newly defined entity, is described. The patient experienced generalized seizures and did not awake initially after a seemingly uneventful elective craniotomy for clipping of an unruptured anterior communicating artery aneurysm. Neuroimaging findings demonstrated diffuse brain ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2009.08.007
更新日期:2009-12-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2013.06.003
更新日期:2013-10-01 00:00:00