Abstract:
OBJECTIVE:The purpose of the study was to measure the effects of increased inspired oxygen on patients suffering severe head injury and consequent influences on the correlations between CPP and brain tissue oxygen (PtiO2) and the effects on brain microdialysate glucose and lactate. METHODS:In a prospective, observational study 20 patients suffering severe head injury (GCS< or =8) were studied between January 2000 and December 2001. Each patient received an intraparenchymal ICP device and an oxygen sensor and, in 17 patients brain microdialysis was performed at the cortical-subcortical junction. A 6 h 100% oxygen challenge (F IO2 1.0) ( Period A) was performed as early as possible in the first 24 hours after injury and compared with a similar 6 hour period following the challenge ( Period B). Statistics were performed using the linear correlation analysis, one sample t-test, as well as the Lorentzian peak correlation analysis. RESULTS:F IO2 was positively correlated with PtiO2 (p < 0.0001) over the whole study period. PtiO2 was significantly higher (p < 0.001) during Period A compared to Period B. CPP was positively correlated with PtiO2 (p < 0.001) during the whole study. PtiO2 peaked at a CPP value of 78 mmHg performing a Lorentzian peak correlation analysis of all patients over the whole study. During Period A the brain microdialysate lactate was significantly lower (p = 0.015) compared with Period B. However the brain microdialysate glucose remained unchanged. CONCLUSION:PtiO2 is significantly positively correlated with F IO2, meaning that PtiO2 can be improved by the simple manipulation of increasing F IO2 and ABGAO2. PtiO2 is positively correlated with CPP, peaking at a CPP value of 78 mmHg. Brain microdialysate lactate can be lowered by increasing PtiO2 values, as observed during the oxygen challenge, whereas microdialysate glucose is unchanged during this procedure. Extension of the oxygen challenge time and measurement of the intermediate energy metabolite pyruvate may clarify the metabolic effects of the intervention. Prospective comparative studies, including analysis of outcome on a larger multicenter basis, are necessary to assess the long term clinical benefits of this procedure.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Reinert M,Barth A,Rothen HU,Schaller B,Takala J,Seiler RWdoi
10.1007/s00701-003-0027-0subject
Has Abstractpub_date
2003-05-01 00:00:00pages
341-9; discussion 349-50issue
5eissn
0001-6268issn
0942-0940journal_volume
145pub_type
杂志文章abstract::Quantitative isotope ventriculography (QIV) has been suggested as a method for diagnosing hydrocephalus and predicting the results of CSF shunt insertion. However, the physiological significance of this and other tracer clearance studies is questionable. Using a simplified mathematical model for tracer clearance follo...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01808440
更新日期:1981-01-01 00:00:00
abstract::We report management and outcome data on 118 patients that presented to our emergency room over a 4 year interval (1990-1994) in poor neurological condition after subarachnoid hemorrhage. All patients were treated following a strict protocol. After initial evaluation, patients underwent a head computerized tomography ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01410974
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abstract:BACKGROUND:Burr hole surgery for moyamoya disease and moyamoya syndrome is known to be an effective, versatile, and relatively simple revascularization technique. We will focus on the technical operative aspects of multiple burr hole surgery as we perform it in our center. METHODS:Periosteal flaps are prepared and pla...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
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doi:10.1007/s00701-004-0289-1
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abstract::An association between fibromuscular dysplasia (FMD) and intracranial aneurysms has been proposed but the occurrence of multiple aneurysms on the trunk of basilar artery (BA) associated with FMD has not been previously reported. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-003-0163-6
更新日期:2004-01-01 00:00:00
abstract:AIM:Numerous materials have been used to replace defects in the dura mater as result of neurosurgical and spinal procedures. Tissudura is a biomatrix made of cross-linked equine collagen fibrils, mainly of the interstitial type I. The specially engineered dura-like layered structure provides a non porous primary water ...
journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s00701-009-0290-9
更新日期:2009-05-01 00:00:00
abstract::Selection of the approach and technique for surgical repair of aneurysm of the vertebrobasilar artery system is mainly based on angiographic features. This report emphasizes that planning the surgical procedure should also include preoperative evaluation of the individual skull base configuration, as well as the relat...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01428505
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:The wide variety of intraspinal cystic lesions necessitates different elaborate diagnostic procedures to choose the right therapeutic management in symptomatic patients. Based on the case reports of seven patients with symptomatic spinal arachnoid cysts we discuss the aetiology, diagnostic procedures and the...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010170102
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pub_type: 杂志文章
doi:10.1007/s00701-012-1473-3
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abstract:INTRODUCTION:Navigated transcranial magnetic stimulation (nTMS) is increasingly used for preoperative mapping of motor function, and clinical evidence for its benefit for brain tumor patients is accumulating. In respect to language mapping with repetitive nTMS, literature reports have yielded variable results, and it i...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-017-3187-z
更新日期:2017-07-01 00:00:00
abstract::It is critical that traumatic intracranial pseudoaneurysms should be removed completely from the parent artery because there is a possibility of significant morbidity and mortality from the high risk of rebleeding from any remnants of the pseudoaneurysm. However, the deconstruction of the parent artery has the risk of...
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pub_type: 杂志文章
doi:10.1007/s00701-011-1251-7
更新日期:2012-03-01 00:00:00
abstract::Aneurysms of the vertebro-basilar junction area have been considered the most difficult to be surgically treated because of their deep location, the proximity of the brain stem and the cranial nerves. However, at present, new endovascular techniques and new transbasal surgical approaches offer valuable management stra...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02747192
更新日期:1997-01-01 00:00:00
abstract::The brain-type isoenzyme of creatine kinase was determined in serum (S) and cerebrospinal fluid (CSF) in 37 patients with severe head injury, and a correlation was made with the Glasgow coma score and Glasgow outcome score. All patients with normal S-CKBB and CSF-CKBB activities had a coma score of 15, i.e., no neurol...
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pub_type: 杂志文章
doi:10.1007/BF01418476
更新日期:1985-01-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01808622
更新日期:1994-01-01 00:00:00
abstract::We present a rare fatal complication of an occipital condylar fracture. The patient was initially neurologically intact, but showed secondary clinical deterioration. Imaging revealed extensive extra-axial hemorrhage at the craniocervical junction and an acute obstructive hydrocephalus. MR imaging demonstrated a T2 hyp...
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pub_type: 杂志文章
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更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Accumulating results have disclosed that early brain injury (EBI) may play a major role in the determination of the outcome of aneurysmal subarachnoid hemorrhage (SAH) patients. This study is of interest to examine the efficacy of pitavastatin, a 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMG-CoA reductase) ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-015-2399-3
更新日期:2015-06-01 00:00:00
abstract::Ki-67 antigen is used as a marker of proliferative activity that is linked to growth rate, invasiveness and prognosis of pituitary adenomas. So far the distribution of Ki-67 index within an individual adenoma has not been investigated. If Ki-67 antigen expression differs significantly within an individual pituitary ad...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-004-0390-5
更新日期:2004-12-01 00:00:00
abstract::In order to further elucidate the pathogenesis of the direct carotid cavernous fistulas (dCCF) clinical, patho-anatomical, and physico-mechanical studies were performed. In 27 of 42 patients the dCCF were found to be localized in the segment C4 (according to Teufel, 12), in 13 patients in segment C2 and in only 2 pati...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
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更新日期:1994-01-01 00:00:00
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更新日期:2020-08-01 00:00:00
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doi:10.1007/s00701-010-0771-x
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pub_type: 杂志文章
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更新日期:2017-04-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-004-0460-8
更新日期:2005-03-01 00:00:00
abstract::Magnetic Resonance Imaging (MRI) scanning would prove useful for lesions that are not visualized on computed tomography (CT) scan or are better defined on MRI scan. The problem of reference marker visualization can be overcome by coating them with mineral oil or by placing paramagnetic fluid filled rods on them. The u...
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pub_type: 杂志文章
doi:10.1007/BF01456375
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Meticulous haemostasis is one of the most important factors during microneurosurgical resection of brain arteriovenous malformation (AVM). Controlling major arterial feeders and draining veins with clips and bipolar coagulation are well-established techniques, while managing with bleeding from deep tiny vess...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3138-8
更新日期:2017-05-01 00:00:00
abstract:INTRODUCTION:In low-grade glioma (LGG) surgery, intraoperative differentiation between tumor and most likely tumor-free brain tissue can be challenging. Intraoperative ultrasound can facilitate tumor resection. The aim of this study is to evaluate the accuracy of linear array ultrasound in comparison to conventional in...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2314-3
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:As the anatomical three-dimensional (3D) positional relationship around the anterior clinoid process (ACP) is complex, experience of many surgeries is necessary to understand anterior clinoidectomy (AC). We prepared a 3D synthetic image from computed tomographic angiography (CTA) and magnetic resonance imagi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3202-4
更新日期:2017-09-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s00701-013-1895-6
更新日期:2014-02-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03867-8
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:To determine cerebrospinal fluid (CSF) dynamics and morphology in Chiari I malformation (CMI) and assess the response to surgery of the posterior cranial fossa, we examined midsagittal imaging along with anterior cervical 2-3 (AC2-3), posterior cervical 2-3 (PC2-3), and aqueduct CSF flow hydrodynamics in axi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1958-8
更新日期:2014-04-01 00:00:00