Abstract:
:Ten patients with severe spasticity were evaluated according to a standardized protocol in order to be treated by intraspinal baclofen. Entry criteria in the protocol were the following: 1) Stable central nervous system lesion, 2) Severe spasticity and/or flexo-extensor spasms not controllable by oral treatment, 3) Normal CSF circulation and 4) Informed consent. All patients received a test dose of twenty-five micrograms of baclofen injected intrathecally. At intervals of at least one day, doses were increased in 10-25 microgram steps until total abolition of spontaneous spasms was achieved in complete spinal cord lesions. In patients with residual motor function, doses were titrated until the optimal dose was found that reduced spasms and enabled performance of maximum daily life activities according to the patient's neurological level. In nine patients a multidose reservoir was implanted to deliver intrathecal baclofen. Effective dosage was 60 +/- 31 micrograms in the entire group. Ashworth score was reduced from 4.6 +/- 0.7 to 1.2 +/- 0.4 (mean +/- SD) (p less than 0.0001) and spasms from 3.2 +/- 0.8 to 0.2 +/- 0.4 (p less than 0.0001). Follow-up of the nine patients in whom a reservoir was implanted has been 18 +/- 9 months. Initial dosage requirements and tolerance were significantly different in complete (Frankel's A grade) or incomplete lesions (Frankel's B, C and D grades). Complete spinal cord lesions required a greater initial dose (156 +/- 43) than incomplete lesions (44 +/- 24), these differences being statistically significant (Student's t-test, p less than 0.05). Tolerance was observed only in patients with complete motor and complete sensory lesions. In incomplete lesions, dose increase was insignificant.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Sahuquillo J,Muxi T,Noguer M,Jodar R,Closa C,Rubio E,Garcia-Fernandez L,Guitart JMdoi
10.1007/BF01400686subject
Has Abstractpub_date
1991-01-01 00:00:00pages
166-73issue
3-4eissn
0001-6268issn
0942-0940journal_volume
110pub_type
杂志文章abstract:BACKGROUND:Early detection of residual disease may benefit management strategies in patients undergoing transsphenoidal surgery for acromegaly. This requires establishing objective thresholds for early postoperative growth hormone (GH) assays, and incorporating these parameters into a scale for outcome prediction. MET...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2098-5
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Hyponatremia generally occurs after transsphenoidal surgery (TSS) in a delayed fashion. Most patients with delayed postoperative hyponatremia (DPH) are asymptomatic or only express non-specific symptoms; consequently, DPH is associated with prolonged hospitalization. No consensus has been reached on which pa...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03818-3
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:To investigate whether patients with critical emergency conditions are seeking or receiving the medical care that they require, we characterized the reality of care for patients presenting with neuro-emergencies during the first phase of the COVID-19 pandemic. METHODS:In this observational, longitudinal coh...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04437-z
更新日期:2020-08-01 00:00:00
abstract::We present a case of dissection of the extracranial vertebral artery with prominent occipital pain and elements of the lateral medullary syndrome. Arteriography showed a string and pearl sign. Magnetic resonance imaging allowed visualization of an intramural thrombus associated with a narrow vascular lumen. The distal...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401852
更新日期:1993-01-01 00:00:00
abstract::A case of bilateral internal carotid artery thrombosis after blunt injury to the head in a 54 years old male is described. The literature is reviewed and comment is made on the causes. Unilateral thrombosis of the internal carotid artery after closed or blunt injury to the head and neck is well known but not common. T...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401637
更新日期:1978-01-01 00:00:00
abstract:PURPOSE:Patients with oligodendrogliomas with allelic loss of chromosomal arm 1p and 19q have been shown, especially with anaplastic oligodendrogliomas, to have both a better initial and long-term response to chemotherapy as well as an improved overall survival. Effective treatment of patients with brain tumors require...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0743-1
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:In patients with a vestibular schwannoma, some studies have reported that useful hearing preserved initially after surgery deteriorates gradually in the long term. Studies with more patients are needed to clarify the maintenance rate of postoperative hearing function and to identify prognostic of hearing fun...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04523-2
更新日期:2020-11-01 00:00:00
abstract::During intracranial tumor resection, the delayed kinking of a major encased vessel has never been described in literature. We present a case which required urgent endovascular treatment performed through a stent positioning. A patient was hospitalized with symptomatic sphenoid meningioma in the left middle cranial fos...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03822-7
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:The ventro-lateral thalamus is the stereotactic target of choice for severe intention tremor. Nevertheless, the optimal target area has remained controversial, and targeting of the subthalamic area has been suggested to be superior. PATIENTS AND METHODS:Eleven patients with disabling intention tremor of dif...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1230-1
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Meningoencephalitis may sometimes cause medically refractory intracranial hypertension and brain herniation. In such patients death is common. There are a limited number of reports on the use of decompressive craniectomy as a life saving measure in these circumstances with some good results. The aim of the s...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-008-0019-1
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Although the majority of patients with minimal acute subdural hematomas (aSDHs) can be managed conservatively, some require delayed aSDH evacuation due to hematoma enlargement. This study was designed to determine the risk factors associated with delayed hematoma enlargement leading to surgery in patients wi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2151-4
更新日期:2014-08-01 00:00:00
abstract:PURPOSE:Malignant gliomas are highly infiltrative tumours with a fatal prognosis. F18-fluoroethyl-tyrosine (FET)-positron emission tomography (PET) often reveals a broader extension of these tumours compared with contrast-enhanced magnetic resonance imaging (MRI). Complete resection of the contrast-enhancing lesion is ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0462-7
更新日期:2009-11-01 00:00:00
abstract::BAK-C is a new autostabilizing interbody cage which is implanted during an anterior cervical procedure to provide stability to the motion segment and allow fusion to occur. Special instrumentation is provided with a bone collecting reamer. The system utilizes surgical site bone graft as the osteo-inductive material wi...
journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章
doi:10.1007/s007010050049
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Neuroprotective effects of recombinant human activated Protein C (rhAPC) in models of Spinal Cord Injury (SCI) and ischemic stroke have been reported in rodents. To rule out immunogenicity of rhAPC and to possibly maintain the physiological PC/thrombin balance the use of zymogen PC in SCI might be preferable...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-006-0784-7
更新日期:2006-07-01 00:00:00
abstract::Therapy for vasogenic brain oedema (VBE) is still an unsolved problem. Experimental work with the aim of establishing an oncotherapeutic option is presented. VBE is performed by focal freeze injury in rats. Using a stereotactic head holder hypo- or hyperosmolar human serum albumin is administered via the intraventricu...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01412002
更新日期:1997-01-01 00:00:00
abstract::Intraoperative real-time ultrasound imaging (US) was used in over 500 patients to investigate which of the previously considered applications are of practical use in everyday neurosurgery. During all intraoperative applications for a wide variety of pathological conditions, small deep-seated as well as subcortically l...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01664851
更新日期:1990-01-01 00:00:00
abstract::During a period of 10 years (1977-1986) 40 cases of tumour of the pineal region have been treated at the Istituto Neurologico "C. Besta"-of Milan. Out of these 40 cases, 27 (67.5%) were in the paediatric (10-15 years) or juvenile (15-20 years) age at the time of operation. Since 1983 a specific diagnostic and therapeu...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01403491
更新日期:1989-01-01 00:00:00
abstract::The Glasgow Coma Scale, based upon eye opening, verbal and motor responses has proved a practical and consistent means of monitoring the state of head injured patients. Observations made in the early stages after injury define the depth and duration of coma and, when combined with clinical features such as a patient's...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405862
更新日期:1976-01-01 00:00:00
abstract:INTRODUCTION:Gamma knife radiosurgery (GKRS) has for the last decades been an established treatment option for patients with small- or medium-sized vestibular schwannomas (VS), although little data is reported on long-term outcome regarding quality of life (QOL) and tumour control in this patient category. The objectiv...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1924-5
更新日期:2014-02-01 00:00:00
abstract::Over the past 5 years 9 patients underwent partial or complete corpus callosotomy for treatment of medically intractable epileptic seizures. A beneficial effect of the procedure was observed in 8 patients. Criteria for performance of the procedure included CT evidence of unilateral cerebral damage and non-localized ep...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406608
更新日期:1988-01-01 00:00:00
abstract:OBJECT:In the past, the accuracy of surface matching has been shown to be disappointing. We aimed to determine whether this had improved over the years by assessing application accuracy of current navigation systems, using either surface matching or point-pair matching. METHODS:Eleven patients, scheduled for intracran...
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:Adipose lesions of nerve primarily include intra- and extraneural lipomas and lipomatosis of nerve (LN). This paper will summarize the advances that have been made in the past decade, particularly related to LN and nerve territory overgrowth that have improved our understanding of the natural history, geneti...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-020-04620-2
更新日期:2020-10-22 00:00:00
abstract::Cell-mediated cytotoxicity (CTX) of meningioma patients towards meningioma cells and fibroblasts was studied in vitro before and after surgery, using the 3H-proline microcytotoxicity test. When incubated with allogeneic target cells before surgery, lymphocytes from three out of seven donors showed a specific destructi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01808518
更新日期:1979-01-01 00:00:00
abstract::Results of measurements in vivo of intracranial pressure obtained with a new telemetric epidural pressure transducer are described. The relations of epidural pressure to ventricular fluid pressure are studied in acute experiments and found to be linear, but variable. The functioning of 18 transducers was studied over ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01769143
更新日期:1979-01-01 00:00:00
abstract::Without mortality, 31 patients underwent conservative treatment for traumatic supratentorial acute subdural haematoma (SDH). Later on six of them had the haematoma surgically evacuated mainly because of a deterioration of the Glasgow Coma Scale (GCS) scores. It was found that patients with a midline shift of less than...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02307412
更新日期:1995-01-01 00:00:00
abstract::The purpose of the present study is to evaluate retrospectively the effects of several intra-operative manipulations on the results of foramen magnum decompression (FMD) in patients having syringomyelia associated with type I Chiari malformation. Seventy-five patients having syringomyelia associated with Chiari I malf...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050175
更新日期:1998-01-01 00:00:00
abstract::Postoperative recovery of patients with chronic subdural haematoma (CSH) was investigated by comparing pre- and postoperative coagulant and fibrinolytic activity in the haematoma contents of 15 patients with SCH. Patients in this study were treated draining the haematoma cavity without irrigation, a procedure dubbed t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050283
更新日期:1999-01-01 00:00:00
abstract::The effects of the new spasmolytic agent HA1077, which belongs to the calciumantagonists but acts by mechanisms different from those of conventional calcium channel blockers, on the cerebral microcirculation were studied in rats using isolated and cannulated intracerebral (parenchymal) arterioles of 50 microns average...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01420194
更新日期:1990-01-01 00:00:00
abstract::The radiological aspect, pathology, treatment and results of 132 subdural haematomas observed in 100 patients, are discussed. The majority of these cases were characterized by a nonhomogenous CT scan picture, resulting from repeated bleeding in a previous subdural haematoma evolving to chronicity, or in a pre-existent...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02188772
更新日期:1995-01-01 00:00:00
abstract::Twenty-one patients with various types of pituitary macroadenomas underwent hypophysectomy at the Chaim Sheba Medical Centre between 1985 to 1987. Intraoperative fine needle aspiration of the tumoural content was attempted prior to tumour excision. Although none of the patients had a history compatible with pituitary ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405275
更新日期:1989-01-01 00:00:00