Abstract:
BACKGROUND:Peripheral nerve lesions usually are associated with neuropathic pain. In the present paper, we describe a simple scale to quantify pain after brachial plexus injuries and apply this scale to a series of patients to determine initial outcomes after reconstructive surgery. METHODS:Fifty-one patients with traumatic brachial plexus avulsion injuries were treated over the period of one calendar year at one center by the same surgical team. Of these, 28 patients who were available for follow-up reported some degree of neuropathic pain radiating towards the hand or forearm and underwent reconstructive microsurgery and direct pain management, including trunk and nerve neurolysis and repair. A special pain severity rating scale was developed and used to assess patients' pain before and after surgery, over a minimum follow-up of 6 months. An independent researcher, not part of the surgical team, performed all pre- and postoperative evaluations. FINDINGS:Of the 28 patients with brachial plexus traction injuries who met eligibility criteria, 93% were male, and most were young (mean age, 27.6 years). The mean preoperative severity of pain using our scale was 30.9 out of a maximum of 37 (± 0.76 SD), which fell to a mean of 6.9 (± 0.68 SD) 6 months post-procedure. On average, pain declined by 78% across the whole series, a decline that was statistically significant (p < .001). Subset analysis revealed similar improvements across all the different parameters of pain. CONCLUSIONS:We have designed and tested a simple and reliable method by which to quantify neuropathic pain after traumatic brachial plexus injuries. Initial surgical treatment of the paralysis--including nerve, trunk and root reconstruction, and neurolysis--comprises an effective means by which to initially treat neuropathic pain. Ablative or neuromodulative procedures, like dorsal root entry zone, should be reserved for refractory cases.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Bonilla G,Di Masi G,Battaglia D,Otero JM,Socolovsky Mdoi
10.1007/s00701-010-0709-3subject
Has Abstractpub_date
2011-01-01 00:00:00pages
171-6issue
1eissn
0001-6268issn
0942-0940journal_volume
153pub_type
杂志文章abstract::In human brain tumours the extension of peritumoural brain oedema may vary considerably. 37 brain tumours of various pathology and 2 abscesses were examined to identify the factors and mechanisms responsible for the oedema spreading. Peritumoural oedema profiles were determined towards the white matter and ventricle b...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01793077
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:As there are many collateral pathways between venous systems, intraoperative venous injury rarely induces venous infarction. In some patients, however, venous injury during microsurgical manipulation may cause acute and/or delayed serious complications. Although intraoperative evaluation using indocyanine gr...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04617-x
更新日期:2020-10-21 00:00:00
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....
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01402049
更新日期:1991-01-01 00:00:00
abstract::Cervicocephalic fibromuscular dysplasia (FMD) is an idiopathic, non-inflammatory and non-atherosclerotic arteriopathy which usually affects small- and medium-sized cervical arteries distributed at the atlas and axis interspace. Few cervicocephalic FMD patients are associated with multiple intracranial aneurysms which ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0778-3
更新日期:2010-12-01 00:00:00
abstract::The use of cold as a therapeutic agent has a long and colorful history. The Edwin Smith Papyrus, the most ancient medical text known, dated 3500 B.C., made numerous references to the use of cold as therapy. Baron de Larrey, a French army surgeon during Napoleon's Russian campaign, packed the limbs in ice prior to ampu...
journal_title:Acta neurochirurgica
pub_type: 历史文章,杂志文章
doi:10.1007/s00701-006-0747-z
更新日期:2006-05-01 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: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::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::Arachnoid cysts are frequent anomalies of the CNS. They are benign lesions within the arachnoid membrane and have been reported to occur in virtually all locations where arachnoid is present. An intraventricular location, however, is rare and occurrence within the fourth ventricle is particularly uncommon. The first r...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-009-0309-2
更新日期:2010-01-01 00:00:00
abstract::An adjustable telescopic suction tube has been developed for microsurgery. Owing to this innovation, the surgeon can easily set the suction tube to a suitable length by gently pulling the end of the telescopic tube out or in. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401302
更新日期:1992-01-01 00:00:00
abstract::12 patients, 10 women and 2 men, were operated on for removal of a jugular foramen neurinoma. Removal was total in 11 cases and operative mortality was 16.6%. As there are no clinical or instrumental signs that permit sure distinction between these tumours and those of the cerebellopontine angle, only a thorough radio...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406293
更新日期:1975-01-01 00:00:00
abstract::Four cases of primary intraosseous meningiomas were seen among 373 cases of intracranial meningiomas operated upon in the Neurosurgical Clinic of the Krankenhaus Nordstadt, Hannover, FRG between January 1978 and December 1988. These 4 cases represent 1% of all intracranial meningiomas. Patients' age ranged between 21 ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01402613
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Multicentric WHO grade II gliomas constitute a rare entity. Their pathogenesis and treatment are still a matter of debate. OBJECTIVE:We present a 23 year-old female with two synchronous but separate WHO grade II oligodendrogliomas in the temporal and frontal lobes. CLINICAL FEATURES:The two lesions showed ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0306-5
更新日期:2009-12-01 00:00:00
abstract::A simple technique of stereotactic craniotomy and intraoperative lesion localisation that uses the Brown-Robert-Wells (BRW) stereotactic frame is presented. The method optimises craniotomy placement and facilitates localisation of small intracerebral lesions. Using the system, 16 patients have had resection of intracr...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405428
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Marshall computed tomographic (CT) classification is widely used as a predictor of outcome. However, this grading system lacks the following variables, which are found to be useful predictors: subarachnoid/intraventricular hemorrhage, extradural hematoma, and extent of basal cistern compression. A new classi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-015-2575-5
更新日期:2015-11-01 00:00:00
abstract::The management of vestibular schwannomata is controversial. Surveillance remains an acceptable option for elderly patients or those with small lesions. Stereoradiosurgery is also an option, while surgery is often preferred in younger patients with larger lesions. In elderly patients with lesions causing brainstem comp...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0493-0
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:The visualization of any morphological volume (i.e. CT, MRI) together with an additional second morphological volume (i.e. CT, MRI) or functional data set, which may come from SPECT or PET, is a new method for treatment planning, verification and follow-up of interstitial irradiation. METHOD:The authors pre...
journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章
doi:10.1007/s007010070022
更新日期:2000-01-01 00:00:00
abstract:PURPOSE:Post-traumatic fistulas between the middle meningeal artery and the cranial venous system are extremely rare. We describe clinical presentation and successful endovascular management of a case of post-traumatic fistula between the middle meningeal artery and the sphenoparietal sinus. METHODS:A 53-year-old man ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0251-3
更新日期:2009-10-01 00:00:00
abstract::Although disorders of cerebral autoregulation are commonly seen in neurosurgical disease, there is currently no test of autoregulation in widespread use that may be performed safely at the bedside. The presence of autoregulation, however, can be seen in the brief hyperemic response in the middle cerebral artery distri...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01407660
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:To present a patient with a cervico-thoracic ventrally located epidural hematoma caused by dissection and subsequent bleeding of the cervical portion of the vertebral artery. SUMMARY AND BACKGROUND DATA:Non traumatic epidural hematoma is a rare entity. The etiology usually is not clarified: a venous origin i...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0223-7
更新日期:2009-10-01 00:00:00
abstract::Rats were inoculated with staphylococcus aureus to produce cerebral abscesses and treated with either antibiotic or dexamethasone and with antibiotic plus dexamethasone at sequential stages of abscess formation. Antibiotic alone shortened the cerebritis stage, accelerated the encapsulation and affected the bacterial c...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01456174
更新日期:1989-01-01 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:OBJECT:The aim of this study was to document the possible role of Gamma Knife radiosurgery, suitable for the treatment of deep and well limited tumors, in the management of pineal parenchymal tumors (PPT). POPULATION AND METHODS:We reviewed retrospectively a series of 13 patients with PPT treated by Gamma Knife radios...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0626-z
更新日期:2006-01-01 00:00:00
abstract::First described on pre-B leukemia cells, the common acute lymphoblastic leukemia antigen (cALLa) is also expressed on glioma cells in vitro. Its identity to neutral endopeptidase (NEP) (E.C.3.24.11) was corroborated by our finding that cALLa positive glioma cells had NEP activity. To study cALLa/NEP distribution on gl...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401105
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:High-frequency deep brain stimulation (DBS) of the subthalamic nucleus (STN) has become an established therapeutic approach for the management of patients with late-stage idiopathic Parkinson's disease (PD). The aim of the present study was to assess regional cerebral blood flow (rCBF) changes related to mot...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-012-1610-z
更新日期:2013-03-01 00:00:00
abstract::Anterior spinal decompression and fusion was used as the primary treatment for thoracolumbar fractures in eleven patients with neurological deficits. Each patient achieved stability by interbody fusion. Significant progressive kyphosis did not occur. No patients with a complete neurological deficit was improved by ope...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01664845
更新日期:1981-01-01 00:00:00
abstract:INTRODUCTION:Radiosurgery (RS) and fractionated radiotherapy (FRT) are part of the therapeutic armamentarium for the management of cavernous sinus meningiomas. We propose a systematic review of the local tumor control and clinical outcomes after monofractionated radiosurgical treatment, including gamma knife radiosurge...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,meta分析
doi:10.1007/s00701-018-3711-9
更新日期:2018-12-01 00:00:00
abstract::An experience with surgical management of 30 giant pituitary tumours is analysed in this report. The clinical features, anatomical spread and relationship of these tumours with the cavernous sinus and other parasellar and basal forebrain structures is analysed. The problem encountered in the surgical treatment are rev...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01412306
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Tarlov cysts (TCs) are expanded nerve root sheaths that occur near the dorsal root ganglion and result from increased intraspinal hydrostatic pressure. TCs most frequently affect the lumbosacral plexus and therefore may cause specific symptoms such as perineal pain and neurogenic bladder, bowel, and sphincte...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-018-3494-z
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Z-L response (ZLR) has been suggested to a new electromyographic (EMG) potential recorded from the facial muscle of patient with hemifacial spasm (HFS) during microvascular decompression (MVD). Although ZLR has been suggested to be useful, experience of ZLR monitoring is limited and its significance during M...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3462-z
更新日期:2018-05-01 00:00:00