Abstract:
BACKGROUND:The antithrombotic agents are usually interrupted in fear of bleeding complications before neurosurgery. However, the optimal schematic regimen of substitutive medication to prevent thromboembolic events after surgery is unsettled. METHODS:We report five complex neurosurgical cases with high risk for thromboembolism requiring thromboprophylaxis during craniotomy. CLINICAL FEATURE:In one patient with coronary bare metal stent and antiplatelet therapy, acetylsalicylic acid and clopidogrel was discontinued 5 and 11 days prior to surgery, respectively. Four other patients were on regular warfarin therapy due to previous deep venous thrombosis, pulmonary embolism, or mechanical aortic valve. Adjusted bridging therapy with low-molecular-weight heparin was applied in all cases. The patient with the coronary stent who was managed with reduced-dose dalteparin developed postoperative intracranial hemorrhage despite having platelet and fresh-frozen plasma transfusions, and the patient did not survive. Another patient with a history of lower-extremity deep venous thrombosis developed a postoperative intracranial hematoma but also a recurrence of left lower extremity deep venous thrombosis and had a delayed recovery. The other two patients with history of pulmonary embolism, and one patient having mechanical aortic valve and atrial fibrillation, recovered uneventfully when reduced doses of low molecular weight heparin bridging therapy were administered. CONCLUSION:Our observations confirm the complexity of balancing the risks of bleeding and thrombosis in neurosurgical patients on antithrombotic medication. In these patients, the individual bleeding risk is likely minimized by the administration of reduced doses of LMWH relatively late after craniotomy and by delaying the start of warfarin after surgery.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Niemi T,Silvasti-Lundell M,Armstrong E,Hernesniemi Jdoi
10.1007/s00701-009-0419-xsubject
Has Abstractpub_date
2009-10-01 00:00:00pages
1289-94issue
10eissn
0001-6268issn
0942-0940journal_volume
151pub_type
杂志文章abstract::We retrospectively analysed 13 patients (pts.) treated at the University of Tübingen from 1985 to 1993 to evaluate the results of radiation therapy (XRT) given as an adjuvant to totally or subtotally resected meningiomas. The overall survival was 38% at five years with a probability of relapse of 50% at this time. Rec...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02187764
更新日期:1995-01-01 00:00:00
abstract::A paraganglioma of cauda equina region is extremely rare and except for secreting tumour, the pre-operative diagnosis of paraganglioma is very difficult. Two cases of non-functional paragangliomas of the cauda equina region are reported, one was attached to the filum terminale and the other to a rootlet looking very m...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s007010050269
更新日期:1999-01-01 00:00:00
abstract::Extravasation of Onyx is a rare complication during embolization of arteriovenous malformations (AVM). We present a case of embolization that was complicated by leakage of Onyx into the cerebellum which was later encountered during surgical excision of the AVM. Our goal is to report this rare event and to outline succ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-019-04199-3
更新日期:2020-04-01 00:00:00
abstract::The feline infusion model of brain edema was used to evaluate the pathophysiological effects of 0.6 ml infusions of autologous serum protein (66%), human serum protein (66%), human glioma cyst fluid and a tissue culture medium (TCM) on the structure and function of the forebrain white matter. These infusions increased...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02112037
更新日期:1993-01-01 00:00:00
abstract:STUDY DESIGN:Retrospective analysis of 357 cases of degenerative disc disease treated by interbody fusion with threaded titanium cages. OBJECTIVE:To determine the safety and efficiency of cervical and lumbar interbody fusions using threaded titanium cages and autogenous bone. SUMMARY OF BACKGROUND DATA:Stabilizing th...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050453
更新日期:2000-01-01 00:00:00
abstract::Intracranial clear-cell meningioma (CCM) is rarely reported in the literature since it has to be distinguished from other subtypes of meningioma. Most of the CCMs are intraspinal, according to the related literature. We report a case of occipital parietal CCM in a 6-year-old child, review all the 35 intracranial CCMs ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-009-0236-2
更新日期:2009-04-01 00:00:00
abstract::1. The use of rapid sequential gamma camera scintigraphy in conjunction with computer aided storage and evaluation of data has been shown to be a promising method for the analysis of CSF dynamics in man. 2. Using this method rapid flow of CSF in the basal cisterns can be studied. The further course of tracer activity ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405983
更新日期:1977-01-01 00:00:00
abstract:INTRODUCTION:The gold-standard treatment for symptomatic anterior skull base meningiomas is surgical resection. The endoscope-assisted supraorbital "keyhole" approach (eSKA) is a promising technique for surgical resection of olfactory groove (OGM) and tuberculum sellae meningioma (TSM) but has yet to be compared with t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04544-x
更新日期:2020-09-05 00:00:00
abstract:INTRODUCTION:An open collaborative international network has been established which aims to improve inter-centre standards for collection of high-resolution, neurointensive care data on patients with traumatic brain injury. The group is also working towards the creation of an open access, detailed and validated databas...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,多中心研究
doi:10.1007/s00701-003-0066-6
更新日期:2003-08-01 00:00:00
abstract::The pharmacological action of a leukotriene antagonist FPL 55712 was studied on canine cerebral arterial segments. FPL 55712 at concentrations of 10(-6)M and 10)-5)M showed dose-dependent inhibition of the constrictor responses of the artery to prostaglandin F2 alpha. The constrictor responses of the artery to either ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01413283
更新日期:1985-01-01 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...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01418476
更新日期:1985-01-01 00:00:00
abstract::Technological developments in neuroendoscopy are leading to an expansion of applications into the realm of microneurosurgical procedures. The new dimension that using an endoscope provides requires insight into different neuroanatomical aspects and a new kind of strategy in planning a microneurosurgical procedure. To ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01417688
更新日期:1995-01-01 00:00:00
abstract::Superficial siderosis (SS) of the central nervous system is an insidious, progressive, irreversible and debilitating neurological disorder caused by recurrent haemorrhage within the subarachnoid space. The subsequent deposition of haemorrhagic breakdown products in the spinal cord and nervous tissues leads to the loss...
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:OBJECTIVES:Ballistic injuries to peripheral nerves pose special challenges in terms of indications, timing and type of surgical intervention. The aim of the present work was to analyze our experience in the surgical treatment of peripheral nerve ballistic injuries with respect to the mechanism of injury (gunshot versus...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2139-0
更新日期:2014-08-01 00:00:00
abstract::Unstable fracture dislocations due to torn ligaments, fractures of both articular processes, or detachments of entire vertebral arches from vertebral bodies still pose the problem of fixation after anterior fusion. The application of internal metal plate fixation--using the small AO (ASFI) fragment equipment--is descr...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405907
更新日期:1975-01-01 00:00:00
abstract:BACKGROUND:Cavernous angiomas are vascular malformations which rarely involve the cavities of the lateral ventricles. Knowledge of the specific clinical and neuroradiological features displayed by these lesions is limited by the scarcity of patients included in the reported series. OBJECTIVE AND METHODS:The aim of thi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-009-0186-8
更新日期:2009-02-01 00:00:00
abstract::Three hundred and sixty-four patients who suffered a subarachnoid haemorrhage from an aneurysm at either the anterior (ACA) or posterior (PCA) communicating artery location and who were not surgically treated have been followed for up to 21 years in order to study the late morbidity and mortality. For the 213 patients...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01728858
更新日期:1982-01-01 00:00:00
abstract::Myelocystoceles are rare lesions. Rarer still are thoracic myelocystoceles. Two patients with thoracic myelocystoceles are being reported. The first patient presented with swelling in the thoracic region with paraplegia and incontinence. MR with MR myelography revealed the malformation to be a thoracic myelocystocele....
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-006-0734-4
更新日期:2006-07-01 00:00:00
abstract::In the present study the variation of the localisation and the course of the coronal suture (CS) was examined on the lateral skull X-ray. The study shows a variation of the localisation and course of the CS from the average position within +/- 4 mm in 65-77% and extreme differences between minimum and maximum values b...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01560378
更新日期:1987-01-01 00:00:00
abstract::We previously showed that a canine basilar artery manifested tonic and potent, protein kinase C (PKC)-dependent contractions when nitric oxide (NO) was inhibited. We also reported a linear correlation between chronological changes in the angiographic severity of vasospasm, enhanced PKC, and attenuated guanosine, 13',1...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050215
更新日期:1998-01-01 00:00:00
abstract::We report three cases of ischaemic complications following direct surgery of unruptured cerebral aneurysms having necks with atherosclerotic or calcified walls. Among 30 patients we treated directly for unruptured aneurysm over the last 4 years, 6 had 8 such aneurysms. Atherosclerotic or calcified neck was a major con...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050364
更新日期:1999-01-01 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::This article will look at how one female neurosurgeon in Turkey made her mark in the field. In 1954, Dr. Aysima Altinok began her residency training in neurosurgery at Haydarpaşa Numune Hospital where the first official department of neurosurgery in Turkey had been founded five years earlier. On November 22, 1959, she...
journal_title:Acta neurochirurgica
pub_type: 传,历史文章,杂志文章
doi:10.1007/s00701-007-1252-8
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Usual management of peripheral nerve tumors is to avoid biopsy in those that are likely benign; the risk of biopsy outweighs the benefit of definitive tissue diagnosis. Biopsy of presumed malignant lesions is performed widely. There is a subset of peripheral nerve tumors that are not easily categorized as be...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04257-1
更新日期:2020-06-01 00:00:00
abstract::Renal cell carcinoma has a complex and variable natural history. We report a case underlining this who presented concomitant renal cell carcinoma metastasis with pituitary and adrenocortical adenomas. A 62-year-old woman presented with visual loss. Imaging revealed a large sellar mass with suprasellar extension. Four ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-002-1060-0
更新日期:2003-03-01 00:00:00
abstract::The occurrence of abdominal aortic aneurysms (AAAs) and intracranial aneurysms (IAs) in the same patient and in the same family was studied among 89 patients with AAAs and 485 patients with IAs. Among the AAA-patients two had IAs themselves and five had IAs in the family, whereas three IA-patients had AAAs themselves ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02076012
更新日期:1987-01-01 00:00:00
abstract::The article presents an autosomal dominant Currarino syndrome with incomplete penetrance in three out of four members of the same family. The mother had only a bony sacral defect and no other signs. In the older daughter, the syndrome was completely developed with presacral cystic teratoma, a sacral defect and abdomin...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0220-x
更新日期:2009-09-01 00:00:00
abstract::Ventricular shunting has dramatically improved the care of children with hydrocephalus. Yet shunt malfunctions are extremely common and cause significant morbidity. To document shunt problems in children with a neural tube defect and hydrocephalus, 67 children born since 1973 were studied via life-table analysis. 28% ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01418798
更新日期:1985-01-01 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:BACKGROUND:The use of distal filter protection alone is associated with a high risk of ischemic complications when vulnerable carotid stenosis is treated by carotid artery stenting (CAS). Double balloon protection, a combination of distal balloon protection and proximal balloon occlusion, can be utilized. We assessed t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2816-2
更新日期:2016-07-01 00:00:00