Abstract:
:The present study compares the clinical outcome, as expressed by the Glasgow outcome scale, of two groups of severely head injured patients treated before (49 patients) and after (72 patients) the establishment of a neurosurgical intensive care (NIC) unit at the department of neurosurgery. Uppsala University Hospital. The number of "good recoveries" increased significantly after the establishment of the NIC. This was confirmed by univariate analysis (p less than 0.05) and by multivariate analysis using the logistic regression model to adjust for differences between the two groups of patients (p less than 0.05, p less than 0.005). The most striking improvement was found in patients with a Glasgow coma motor score (GCSM) greater than or equal to 4 on admission. In this subgroup of patients the "good recoveries" increased from 15% to 52%. The object of NIC is basically to prevent or minimize secondary brain damage, and it seems logical that the effect of such care is most obvious in GCS M greater than or equal to 4 patients in whom a good outcome can be anticipated if secondary damage can be prevented or minimized. In conclusion, the present study shows that improved clinical outcome after severe head injury can be achieved by organizing an NIC unit with a well trained staff capable of providing this care 24 hours a day using established methods of surveillance and treatment.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Wärme PE,Bergström R,Persson Ldoi
10.1007/BF01402049subject
Has Abstractpub_date
1991-01-01 00:00:00pages
57-64issue
1-2eissn
0001-6268issn
0942-0940journal_volume
110pub_type
杂志文章abstract::In theory, lymphokine-activated killer (LAK) cells offer a potential method to treat cerebral gliomas, especially low-grade gliomas. LAK cells would be administered by repeated injections straight into the cavity of a subtotally removed tumour. However, brain-tumour cyst fluid has been shown to be immunosuppressive in...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400532
更新日期:1988-01-01 00:00:00
abstract::Forty-two patients with petroclival meningioma were operated upon by the middle fossa transpetrosal-transtentorial approaches since 1977. Half of those showed tumour extension into the middle fossa and one-third in the cavernous sinus. Seventeen (40%) had a large tumour of 40 mm in diameter or larger, and 8 of those h...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406489
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Spinal epidural arachnoid cysts (EAC) are rare and may present with myelopathy, which can be completely curable with surgery. The majority of investigators believe that the repairment of dural defect is important to treat EAC. However, the necessity of excising EACs remains controversial. The purpose of this...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-012-1356-7
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:We developed a new simple therapeutic method for the treatment of chronic subdural hematoma (CSDH) without irrigation and drainage. This method is characterized by replacement of the hematoma with oxygen. METHODS:Seventy patients (seventy-eight sides) with CSDH were treated with this method from May 1994 to...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0689-x
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Occluding a ruptured intracranial aneurysm as early as possible may entail certain periprocedural conditions that compromise the outcome. The aim of the present study was to evaluate the effectiveness, safety, and clinical outcome of endovascular coiling procedures performed on an emergency bas...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2106-9
更新日期:2014-07-01 00:00:00
abstract:PURPOSE:Complete yet safe resection close to motor areas in medically intractable epilepsy requires functional information. New deficit may occur despite preservation of motor cortex, e.g., through vascular compromise. Here, we explore for the first time the feasibility, safety, and the clinical value of continuous mot...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0675-9
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Impairment of cerebral autoregulation is known to adversely affect outcome following traumatic brain injury (TBI). The phase shift (PS) method of cerebral autoregulation (CA) assessment describes the time lag between fluctuations in arterial blood pressure (ABP) and cerebral blood flow velocity (CBFV) in the...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1447-z
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVES:A number of different image-guided surgical techniques have been developed during the past decade. None of these methods can provide the surgeon with information about the dynamic changes that occur intra-operatively. MATERIAL AND METHOD:The first vertical open 0.5T MRI-scanner for intra-operative MRI-guide...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050325
更新日期:1999-01-01 00:00:00
abstract::Patients with multiple intracranial aneurysms present a great challenge to neurosurgical practice. The presence of one or more additional aneurysms, whether recognized or unrecognized, along with the source of the haemorrhage profoundly changes the outcome. It also alters the timing and strategy of surgery. In this st...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01456314
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Surgical intervention for unruptured intracranial aneurysms (IAs) carries inherent health risks. The analysis of "patient-specific" IA geometric and computational fluid dynamics (CFD) simulated wall shear stress (WSS) data has been investigated to differentiate IAs at high and low risk of rupture to help cli...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04616-y
更新日期:2020-10-17 00:00:00
abstract:BACKGROUND:The rostral expanded endoscopic approach (EEA) to anterior cranial fossa (ACF) has several advantages over transcranial/craniofacial surgery, providing early access to the vascular supply of tumors and reducing morbidities of craniotomy especially that of brain retraction. This article presents endoscopic la...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04277-x
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Cerebral vasospasm following subarachnoid haemorrhage (SAH) remains one of the major factors contributing to poor overall patient outcome. Prostaglandin F2-alpha (PGF2a) induces vasoconstriction. After SAH, PGF2a leads to cerebral inflammation and enhanced vasoconstriction, resulting in cerebral vasospasm. L...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3419-2
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Evolving of a single centre by means of different transsphenoidal approaches during the survey of methodological advances in pituitary surgery is presented. MATERIALS AND METHODS:Ninety-three consecutive patients with pituitary adenomas underwent transphenoidal pituitary operations at Gulhane Military Medic...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-008-0135-y
更新日期:2008-11-01 00:00:00
abstract::We describe a patient with primary CNS lymphomas, awake despite an extreme ICP elevation. A 48-year-old woman presented with headache since 1 month, and bilateral papillary edema was observed. Magnetic resonance imaging revealed diffuse infiltration around the petrous bone. Following external ventricular drainage (EVD...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04231-x
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Most scales used to assess prognosis after subarachnoid haemorrhage (SAH) are based on the level of consciousness of the patient. Based on information from a logistic regression model, Ogilvy et al. developed a new grading scheme (Massachussetts General Hospital (MGH) Scale) which applied a simple scoring me...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-004-0417-y
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Transsphenoidal surgery has been well established as an effective primary treatment for tumours of the sellar region. During the dural opening, the prominent intercavernous sinus poses limitations for this approach and may contribute to incomplete tumour resections. METHOD:Based on our experience from 940 c...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0356-8
更新日期:2009-07-01 00:00:00
abstract::The introduction of transcranial Doppler ultrasonography (TCD) has made it possible to examine blood flow characteristics in carotid-cavernous sinus fistulae (CCSF) in a noninvasive, relatively simple, and reliable way. This study investigated the usefulness of TCD in the diagnosis and follow-up of various CCSF subtyp...
journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章
doi:10.1007/s007010100022
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Oculomotor cistern extension (OMCE) of pituitary adenoma through the oculomotor triangle may be one of the major characteristics of multi-lobulated adenoma. The OMCE may be hard to remove only through the endonasal approach. METHOD:We applied the simultaneous combined supra-infrasellar approach to remove pi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03869-6
更新日期:2019-05-01 00:00:00
abstract::Twenty operated cases of angiographically unrecognized microaneurysm (AUM) have been analysed with special reference to intra-operative observations and clipping-technique. Among the patients with intracranial aneurysms that the authors' facility has operated upon, the incidence of asymptomatic incidental AUM that was...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01808877
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:The practice of endoscopic endonasal surgery is still limited in children because of the relative rarity of sellar lesions in the paediatric population. However, such an approach is increasingly reported in the literature as an alternative option to standard sublabial microsurgery, and its surgical results a...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0929-6
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:In dealing with cases of oedematous brain, relaxation during the transsylvian approach to supratentorial aneurysms has been accomplished by ventricular drainage by using the anatomic point defined by Dr. Paine. However, we have experienced patient complications when using this point. We propose a novel anatom...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1281-3
更新日期:2007-10-01 00:00:00
abstract::Although intracranial cavernomas are known to cause haemorrhage, data concerning the frequency, severity and delay of recurrent bleedings are controversial. We report a series of 6 patients with histologically proven cavernoma, presenting with early clinical signs and radiological proof of rebleeding, that is occurrin...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/BF01411299
更新日期:1997-01-01 00:00:00
abstract::This case illustrates the correlation between Magnetic Resonance Imaging (MRI) and the pathological findings in a case of cavernous sinus (CS) aspergilloma. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-004-0449-3
更新日期:2005-03-01 00:00:00
abstract::The authors report a retrospective study of 15 patients with solitary vertebral plasmacytoma. 15 patients were considered in this study on the basis of the following characteristics: 1) histologically confirmed plasmacytoma following surgical removal; 2) existence of a single vertebral lesion, documented by skeletal a...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02187754
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:This study was aimed at the evaluation of the relationship between genetic polymorphisms of catechol-O-methyltransferase (COMT) (rs4680:A > G-Val158Met, rs6269:A > G, rs4633:C > T, rs4818:C > G) and pain sensitivity after lumbar discectomy. METHODS:All patients had one-level symptomatic disc herniation from...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1895-6
更新日期:2014-02-01 00:00:00
abstract::Early diagnosis of thoracic disc herniations has become more common with the advent of spinal magnetic resonance imaging (MRI). This early diagnosis combined with choosing the optimal surgical approach, to ensure adequate decompression without excessive cord and root manipulation, will achieve the optimum results. It ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01402509
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:van Gijn and co-workers identified "Perimesencephalic haemorrhage" (PM) as distinct, benign, non-aneurysmal subarachnoid haemorrhage. However, there is only one retrospective series of this entity outside the Netherlands. PURPOSE:to confirm (or not) the benign nature of perimesencephalic subarachnoid haemor...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01404842
更新日期:1995-01-01 00:00:00
abstract::The facial nerve may be damaged by trauma, surgical manipulation, inflammation or neoplastic disease. Current techniques for repair and regeneration of the damaged nerve produce suboptimal results. This review outlines the current knowledge of experimental facial nerve regeneration in vitro and in vivo to provide an i...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s007010170114
更新日期:2001-01-01 00:00:00
abstract:STUDY DESIGN:This report characterises a 25 year old male patient with a complete burst fracture of the fifth lumbar vertebra with dislocation. He was treated by posterior surgery with transpedicular instrumentation and an expandable cage from the posterior approach. OBJECTIVES:Burst fractures of the fifth lumbar vert...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-008-0149-5
更新日期:2008-12-01 00:00:00
abstract::The role of superficial temporal artery--middle cerebral artery (STA-MCA) anastomosis was investigated with an ultrasonic Doppler flowmeter in 3 patients with sphenoid ridge meningiomas and one with a parasellar malignant teratoma, all of which involved the intracranial internal carotid artery. The intraoperative Dopp...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406817
更新日期:1984-01-01 00:00:00