Abstract:
BACKGROUND:Nicardipine prolonged release implants (NPRI) have been shown to decrease the incidence of cerebral vasospasm and infarcts significantly in patients after aneurysmal subarachnoid haemorrhage (SAH) following microsurgical clipping. Yet, the comparison with results after endovascular coiling is lacking. This study was conducted to determine the differences in the incidence of cerebral vasospasm and infarctions between those two treatment modalities METHODS:The design of this investigation reflects a case-control study; 27 patients suffering from acute SAH were treated by microsurgical clipping and received an intracisternal implantation of NPRI. Twenty-seven matching consecutive patients after microsurgical treatment without implantation of NPRI or endovascular treatment, respectively, served as controls. The incidence of angiographic vasospasm and cerebral infarctions were documented. RESULTS:All groups were comparable concerning demographics and severity of SAH. Twenty-four of 81 patients developed angiographic vasospasm (>33% constriction). The incidence of vasospasm was 48%, 44% and 11% for patients after endovascular treatment, microsurgical clipping without NPRI and microsurgical clipping with NPRI, respectively. New cerebral infarctions occurred in 28%, 22% and 7% of the treated patients, respectively. A good clinical recovery 1 year after the initial bleeding (modified Rankin scale 0-2) was seen in 48%, 50% and 77% of the treated patients, respectively. CONCLUSION:The use of NPRI during microsurgical clipping was confirmed to be safe and effective. Patients who received intracisternally implanted NPRI during clipping after aneurysmal SAH yielded significantly lower vasospasm and infarction rates, and showed a better clinical outcome when compared with clipping without NPRI and also when compared with endovascular coiling.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Schneider UC,Dreher S,Hoffmann KT,Schmiedek P,Kasuya H,Vajkoczy Pdoi
10.1007/s00701-011-1129-8subject
Has Abstractpub_date
2011-11-01 00:00:00pages
2119-25issue
11eissn
0001-6268issn
0942-0940journal_volume
153pub_type
杂志文章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::The purpose of this study was to evaluate the high resolution magnetic resonance angiography (MRA) as pre-operative angiography for the detection of ruptured cerebral aneurysms. MRA was performed on 1.5 tesla system using the 3-dimensional time of flight (3D-TOF) method. The field of view was 16 cm or 20 cm and matrix...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400663
更新日期:1994-01-01 00:00:00
abstract::Considerable positive experience in functional radiosurgery has been reported since Leksell's first experience in 1951, but the development of frameless radiosurgery was been limited because of the difficulty of identifying invisible functional targets. In this paper we report on two cases of bilateral parkinsonian tr...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-0962-0
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abstract:BACKGROUND:Separation of the posterior ring apophysis of an adjacent vertebral body can sometimes accompany lumbar intervertebral disc herniation. The condition can be both difficult to detect in conventional radiographs and is somewhat controversial to treat. Although there is general agreement on the frequent need fo...
journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章
doi:10.1007/s00701-003-0044-z
更新日期:2003-06-01 00:00:00
abstract::The clinico-pathological findings are reported in a case with persistent vegetative state after multiple cerebral lesions. The lesions are small in size, and are situated at different levels of the CNS, some of them being important in the maintenance of wakefulness and motor initiative. The differential diagnosis and ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01411190
更新日期:1981-01-01 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::Twiddler syndrome occurs when a patient intentionally or unintentionally manipulates an implantable generator (usually a pacemaker) and dislodges the pacing leads, causing malfunction of the device. Though the syndrome has been described in patients with pacemakers, to our knowledge only one spontaneous case has been ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0366-6
更新日期:2010-03-01 00:00:00
abstract::A new atraumatic method for patency and blood flow control of microvascular anastomoses has been developed. Sounds proximal and distal to a suture line are separately detected by means of two specially modified miniature microphones built together as an auscultation unit and named a diplo-microphone. Transmission of t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02074518
更新日期:1980-01-01 00:00:00
abstract::The clinical features of 6 children who are probable sufferers of "unilateral" Moyamoya disease are here reported. They showed angiographic findings which were compatible with those of Moyamoya disease, albeit only on one side. They did not, however, show any basic aetiologic factors. The age of onset, the clinical sy...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01808612
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Although endoscopic septostomy is widely adopted in the treatment of unilateral or specific types of hydrocephalus, there is no consensus on surgical indications, technical aspects and postoperative outcome. In particular, the choice of the ventricular access has been recently debated. We investigated the re...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-012-1381-6
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:Lately, morphological parameters of the surrounding vasculature aside from aneurysm size, specific for the aneurysm location, e.g., posterior cerebral artery angle for basilar artery tip aneurysms, could be identified to correlate with the risk of rupture. We examined further image-based morphological paramet...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04593-2
更新日期:2020-10-06 00:00:00
abstract::A method based on growth of cells from glioma biopsies in a triple layer agarose system has been used to test the sensitivity of the tumour cells to different chemotherapeutic and immunotherapeutic agents. A special agarose that could be melted at 65 degrees C, enabled registration of proliferation by an easy and prec...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400530
更新日期:1988-01-01 00:00:00
abstract::The growth of a small arteriovenous angioma over a period of almost 18 years in a 20 year old patient has been proved by arteriography. This case is added to 29 cases previously published in the literature. The authors do not readily accept the theory of autochthonous growth, but prefer secondary or "pseudo-growth". I...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405394
更新日期:1977-01-01 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::A modification of the previous methods of producing cerebral ischaemia in rats (Koizumi et al., Longa et al.), using an intraluminal thread technique, is described. The middle cerebral artery is occluded by introducing a simple 3-0 nylon thread (0.20-0.249 mm in diameter) through the internal carotid artery in the nec...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01403007
更新日期:1991-01-01 00:00:00
abstract::Two-hundred seven patients who were operated on consecutively between January 1983 and December 1990 to relieve disabling positional vertigo (DPV) using the microvascular decompression (MVD) procedure were studied. Selection of the patients for MVD operations was based on both case history and the results of otoneurol...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401831
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:There is no universal management protocol concerning invasive malignant tumors of the scalp with bone and dura mater invasion. The aims of this study were to report and discuss our experience in the management of these forms of tumors. METHODS:We retrospectively reviewed all consecutive patients of microsur...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04525-0
更新日期:2020-12-01 00:00:00
abstract::The objective of this study is to investigate the effect at the season of the time of surgery on the survival of brain tumor patients. The population studied consisted of 101 patients (39 males and 62 females), gathered from a geographically large area in northern Finland (from 64 degrees N to 70 degrees N), aged betw...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0438-7
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Fever occurs frequently in acute brain injury patients, and its occurrence is associated with poorer outcomes. Paracetamol, an antipyretic frequently employed in patients with cerebral damage, may cause hypotension. We evaluated the cerebral and hemodynamic effects of intravenous (IV) paracetamol for the con...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2129-2
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:To study an effective method for surgical management of vertebral and basilar artery aneurysms. METHODS:Forty-one patients with 43 aneurysms of the vertebral and basilar arteries were managed by microsurgical clipping. Cerebral angiography revealed basilar apex aneurysms in 17 patients, basilar trunk in six ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1007/s00701-016-2733-4
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journal_title:Acta neurochirurgica
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doi:10.1007/s00701-008-1512-2
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Intraoperative vessel visualization is highly desirable, especially when the target is related to or close to main vessels, such as in the skull base and vascular surgery. Contrast-enhanced ultrasound (CEUS) is an imaging technique that allows visualization of tissue perfusion and vascularization through the...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-015-2412-x
更新日期:2015-06-01 00:00:00
abstract:INTRODUCTION:Titanium fixation plates are routinely used for rigid fixation of bone flaps after craniotomy. In craniofacial surgery or after craniotomy involving orbitozygomatic osteotomies, these plates are occasionally removed because of infection, pain, protrusion, soft tissue erosion, and plate malfunction. However...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2929-7
更新日期:2016-10-01 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:BACKGROUND:Within the realm of neurosurgery, petroclival meningiomas are regarded as probably the most difficult tumour to be treated by microsurgery. This is due to the not infrequently large size of the tumours which, although predominantly located in the posterior fossa, may occupy more than one cranial compartment,...
journal_title:Acta neurochirurgica
pub_type: 历史文章,杂志文章
doi:10.1007/s00701-010-0633-6
更新日期:2010-07-01 00:00:00
abstract::A case of cauda equina paraganglioma is described; subsequent intracranial and intraspinal metastases occurred after partial resection and adjunctive radiotherapy. Cerebrospinal fluid dissemination is a rare complication of spinal paragangliomas. Factors predictive of this unusual biological behaviour are discussed. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01420312
更新日期:1996-01-01 00:00:00
abstract::Indirect carotid-cavernous sinus dural arterio-venous fistulae (cDAVF) can be treated by transarterial and/or transvenous embolisation. This study evaluated patients with cDAVF who underwent transvenous embolisation using the direct superior ophthalmic vein (SOV) approach. Between January 2004 and October 2006, eight ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-008-1573-2
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Major artery aneurysms may be found incidentally while evaluating moyamoya disease (MMD). The purpose of this study was to delineate the prevalence and characteristics of these uncommon aneurysms with a brief mention of their management and outcomes. METHODS:We conducted a retrospective review of 249 adult ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-0948-y
更新日期:2011-06-01 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