Steroids in severe head injury: A prospective randomized clinical trial.

Abstract:

:This is a prospective randomized study of the efficacy of steroid therapy in patients with severe head injury. One hundred patients were randomized into two equal groups: the steroid group received 5 mg/kg/day of methylprednisolone, and the nonsteroid group received no drug. The groups were similar in their clinical features. All patients received a standardized therapeutic regimen. The patients were also classified as early responders or nonresponders to the overall treatment protocol without regard to steroid administration, on the basis of change in Glasgow Coma Scale score during the first 3 days of admission. There was no statistically significant difference in the outcome of the steroid and nonsteroid group at 6 months. Of the responders who were on steroids, 74% had good outcomes or were disabled, compared with 56% of the responders who did not receive steroids. In the nonresponder group, the patients on steroids were actually associated with a worse outcome than those who did not receive steroids: 75% of the nonresponders who received steroids were dead or vegetative, compared to 56% of those who were not receiving steroids. The data suggest that: 1) the effect of steroids may be different for different patient groups; 2) in order to identify these patients, a sensitive coma scale is needed; and 3) a rational approach to steroid therapy in head-injured patients may be to start all patients on steroids, but to discontinue their use in patients identified as not benefiting from steroid therapy.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Saul TG,Ducker TB,Salcman M,Carro E

doi

10.3171/jns.1981.54.5.0596

subject

Has Abstract

pub_date

1981-05-01 00:00:00

pages

596-600

issue

5

eissn

0022-3085

issn

1933-0693

journal_volume

54

pub_type

临床试验,杂志文章,随机对照试验
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    abstract::The authors demonstrate the use of cottonoid as a marker for ultrasound localization of a subcortical tumor. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1984.60.2.0438

    authors: Voorhies RM,Bell WO,Patterson RH Jr,Gamache FW Jr

    更新日期:1984-02-01 00:00:00

  • Spontaneous resolution of epidural hematomas. Report of two cases.

    abstract::Two cases of traumatic epidural hematomas are presented. Both patients were minimally symptomatic, and neither required surgical intervention. It is suggested that the use of computerized tomography in head trauma will reveal a new class of epidural hematoma patients who may be treated conservatively. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1981.54.2.0248

    authors: Weaver D,Pobereskin L,Jane JA

    更新日期:1981-02-01 00:00:00

  • Regional cerebral ischemia by occlusion of the posterior communicating artery and the middle cerebral artery in gerbils.

    abstract::The authors have created an experimental model of regional cerebral ischemia in gerbils that is reproducible and has a low mortality rate. In gerbils, either the posterior communicating artery (PCoA) or the middle cerebral artery (MCA) was occluded, and the distribution of cerebral ischemia from each surgical procedur...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1983.58.3.0362

    authors: Yoshimine T,Yanagihara T

    更新日期:1983-03-01 00:00:00

  • Multicenter study of the feasibility and safety of using the memotherm carotid arterial stent for extracranial carotid artery stenosis.

    abstract:OBJECT:Carotid artery (CA) angioplasty with stent placement has been proposed as an alternative technique for revascularization in cases of CA stenosis. In this report the authors review the results of a multicenter Phase I study in which they evaluated the safety and feasibility of using a new self-expanding nitinol s...

    journal_title:Journal of neurosurgery

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.3171/jns.2002.96.5.0830

    authors: Qureshi AI,Suri MF,New G,Wadsworth DC Jr,Dulin J,Hopkins LN

    更新日期:2002-05-01 00:00:00

  • Diffusion-tensor imaging of white matter tracts in patients with cerebral neoplasm.

    abstract:OBJECT:Preserving vital cerebral function while maximizing tumor resection is a principal goal in surgical neurooncology. Although functional magnetic resonance imaging has been useful in the localization of eloquent cerebral cortex, this method does not provide information about the white matter tracts that may be inv...

    journal_title:Journal of neurosurgery

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    doi:10.3171/jns.2002.97.3.0568

    authors: Witwer BP,Moftakhar R,Hasan KM,Deshmukh P,Haughton V,Field A,Arfanakis K,Noyes J,Moritz CH,Meyerand ME,Rowley HA,Alexander AL,Badie B

    更新日期:2002-09-01 00:00:00

  • Recurrent idiopathic perimesencephalic subarachnoid hemorrhage.

    abstract::Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) is a benign variant of SAH defined by clinical symptoms of SAH, a characteristic pattern of extravasated blood on noncontrast CT, and negative findings on cerebral angiography. This syndrome carries a favorable prognosis with reportedly no risk of recurre...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2011.5.JNS102020

    authors: Reynolds MR,Blackburn SL,Zipfel GJ

    更新日期:2011-09-01 00:00:00

  • Symptomatic C1-2 fusion failure due to a fracture of the lateral C-1 posterior arch in a patient with rheumatoid arthritis. Case report and review of the literature.

    abstract::The authors report a case in which the lateral C-1 arch fractured in a patient with rheumatoid arthritis and an intact fusion mass; this patient had previously undergone a C1-2 Brooks-type fusion. This unique complication occurred secondary to continued resorption of the C1-2 rheumatoid pannus. Two years after occipit...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/spi.2001.94.1.0137

    authors: Ecker RD,Dekutoski MB,Ebersold MJ

    更新日期:2001-01-01 00:00:00

  • Microendoscopic stereotactic-guided percutaneous radiofrequency trigeminal nucleotractotomy.

    abstract:OBJECT:Over the past few decades, various authors have performed open or stereotactic trigeminal nucleotractotomy for the treatment of neuropathic facial pain resistant to medical treatment. Stereotactic procedures can be performed percutaneously under local anesthesia, allowing intraoperative neurological examination ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2011.8.JNS11618

    authors: Teixeira MJ,de Almeida FF,de Oliveira YS,Fonoff ET

    更新日期:2012-02-01 00:00:00

  • A flow-regulating device to control differential pressure in CSF shunt systems. Technical note.

    abstract::A method of regulating flow rate through cerebrospinal fluid (CSF) shunts with the addition of a flow-regulating device (FRD) is reported. The FRD consists of a small-caliber (0.4 mm) Teflon tube placed in the usual connector. This device has the advantage of converting the original shunt valves to valves for higher-r...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1982.57.4.0570

    authors: Yamada H

    更新日期:1982-10-01 00:00:00

  • Massive cerebral involvement in fat embolism syndrome and intracranial pressure management.

    abstract::Fat embolism syndrome (FES) is a common clinical entity that can occasionally have significant neurological sequelae. The authors report a case of cerebral fat embolism and FES that required surgical management of intracranial pressure (ICP). They also discuss the literature as well as the potential need for neurosurg...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.3171/2013.7.JNS13363

    authors: Kellogg RG,Fontes RB,Lopes DK

    更新日期:2013-11-01 00:00:00

  • Clinical and radiological outcomes following traumatic Grade 3 and 4 vertebral artery injuries: a 10-year retrospective analysis from a Level I trauma center. The Parkland Carotid and Vertebral Artery Injury Survey.

    abstract:OBJECT:Grade 3 and 4 blunt vertebral artery (VA) injuries may carry a different natural course from that of lower-grade blunt VA injuries. Proper screening, management, and follow-up of these injuries remain controversial. Grade 3 and 4 blunt VA injuries were analyzed to define their natural history and establish a rat...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2014.9.JNS1461

    authors: Scott WW,Sharp S,Figueroa SA,Eastman AL,Hatchette CV,Madden CJ,Rickert KL

    更新日期:2015-05-01 00:00:00

  • Distal posterior inferior cerebellar artery aneurysms: clinical features and management.

    abstract:OBJECT:Aneurysms located on the distal portion of the posterior inferior cerebellar artery (PICA) are uncommon, and their underlying pathology, natural history, and clinical management are poorly understood. To clarify these lesions more fully, the authors undertook a retrospective analysis of the clinical features and...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2002.97.4.0756

    authors: Lewis SB,Chang DJ,Peace DA,Lafrentz PJ,Day AL

    更新日期:2002-10-01 00:00:00

  • Disc herniation at T1-2. Report of four cases and literature review.

    abstract::In preparing this paper, the authors reviewed their experiences with four cases of T1-2 disc herniation as well as the medical literature on the subject. Intervertebral thoracic disc herniations are uncommon and high thoracic disc herniations are rare. In the upper third of the thoracic spine, T1-2 is the most common ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.3171/jns.1998.88.1.0148

    authors: Morgan H,Abood C

    更新日期:1998-01-01 00:00:00

  • Effect of intracisternal antithrombin III on subarachnoid hemorrhage-induced arterial narrowing.

    abstract::The ability of antithrombin III, an endogenous plasma glycoprotein, to reverse the arterial narrowing in a rabbit model of cerebral vasospasm was evaluated. The vasodilator activity of antithrombin III on rabbit arteries was first assessed in vitro using a myograph-arterial ring preparation. Antithrombin III (10 IU/ml...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1989.70.4.0599

    authors: Vollmer DG,Hongo K,Kassell NF,Ogawa H,Tsukahara T,Lehman RM

    更新日期:1989-04-01 00:00:00

  • Vestibular schwannoma management. Part I. Failed microsurgery and the role of delayed stereotactic radiosurgery.

    abstract:OBJECT:The purpose of this study was to analyze patient outcomes and to define the role of radiosurgery in patients who have undergone prior microsurgical resection of their vestibular schwannoma. METHODS:The authors evaluated the pre- and postoperative clinical and neuroimaging characteristics of 76 consecutive patie...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1998.89.6.0944

    authors: Pollock BE,Lunsford LD,Flickinger JC,Clyde BL,Kondziolka D

    更新日期:1998-12-01 00:00:00

  • Long-term outcome after removal of spinal schwannoma: a clinicopathological study of 187 cases.

    abstract::Are spinal schwannomas as benign as we think? To what extent do patients recover? Are patients prone to develop late complications such as cystic myelopathy or symptomatic spinal deformity? Is their life expectancy compromised? In an effort to answer these questions, the authors analyzed the long-term outcome for 187 ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1995.83.4.0621

    authors: Seppälä MT,Haltia MJ,Sankila RJ,Jääskeläinen JE,Heiskanen O

    更新日期:1995-10-01 00:00:00

  • Moyamoya disease in monovular twins: case report.

    abstract::The first reported instance of identical twins with moyamoya disease is presented. The involved portions of the main intracranial arteries were similar, but the formation of the moyamoya vessels was somewhat different. The cause fo obstructive changes in large intracranial arteries remains obscure, but the frequent fa...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1980.53.1.0109

    authors: Yamada H,Nakamura S,Kageyama N

    更新日期:1980-07-01 00:00:00

  • Hemostasis activation in patients undergoing brain tumor surgery.

    abstract::Patients undergoing brain tumor surgery are at high risk for the occurrence of a thromboembolic event. To identify a laboratory marker suitable for risk estimation the authors studied the perioperative time pattern of routine coagulation parameters and the specific hemostasis activation marker D-dimer in 28 consecutiv...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1997.87.4.0508

    authors: Vukovich TC,Gabriel A,Schaeffer B,Veitl M,Matula C,Spiss CK

    更新日期:1997-10-01 00:00:00

  • Stereotaxic implantation of dispersed cell suspensions into brain. A systematic appraisal of cell placement and survival.

    abstract::The application of several recent advances in cell biology, brain implantation, and cell-mediated tumor immunotherapy requires successful and reproducible placement of viable cell suspensions into brain. Stereotaxic implantation is being used to inject cytotoxic lymphocytes into gliomas and to replace dopaminergic cel...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1988.69.2.0228

    authors: Plunkett RJ,Weber RJ,Oldfield EH

    更新日期:1988-08-01 00:00:00

  • Characterization of periventricular edema in normal-pressure hydrocephalus by measurement of water proton relaxation times.

    abstract::The magnetic resonance longitudinal relaxation time (T1) and transverse relaxation time (T2) of the water proton of the periventricular white and cortical gray matter were measured for 17 control patients and 21 patients with suspected normal-pressure hydrocephalus (NPH). Of the latter group, 14 showed good response t...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1990.73.6.0864

    authors: Tamaki N,Shirakuni T,Ehara K,Matsumoto S

    更新日期:1990-12-01 00:00:00

  • Delineating gray and white matter involvement in brain lesions: three-dimensional alignment of functional magnetic resonance and diffusion-tensor imaging.

    abstract:OBJECT:The role of functional magnetic resonance (fMR) imaging has become increasingly important in the presurgical mapping of gray matter. Neurosurgical interventions often involve fiber bundles that connect critical functional areas. Recently, diffusion-tensor (DT) imaging has enabled the visualization of fiber bundl...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2003.99.6.1018

    authors: Hendler T,Pianka P,Sigal M,Kafri M,Ben-Bashat D,Constantini S,Graif M,Fried I,Assaf Y

    更新日期:2003-12-01 00:00:00

  • Speech changes induced by deep brain stimulation of the subthalamic nucleus in Parkinson disease: involvement of the dentatorubrothalamic tract.

    abstract::OBJECTIVE Patients with Parkinson disease (PD) who undergo subthalamic nucleus (STN) deep brain stimulation (DBS) often develop a deterioration in speech performance, but there is no clear consensus on the specific effects seen or the mechanism involved and little description of the impact of DBS on conversational spe...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2016.5.JNS16243

    authors: Fenoy AJ,McHenry MA,Schiess MC

    更新日期:2017-06-01 00:00:00

  • Neurosurgical correction of upper brachial plexus birth injuries.

    abstract::The authors review the cases of 116 infants treated consecutively for birth-related brachial plexus injuries. Twenty-eight infants with upper brachial plexus lesions who showed no neurological improvement by 4 months of age were selected for early surgical reconstruction (at a mean age of 5 months). Neurological impro...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1993.79.2.0197

    authors: Laurent JP,Lee R,Shenaq S,Parke JT,Solis IS,Kowalik L

    更新日期:1993-08-01 00:00:00

  • Cerebral amyloid angiopathy presenting as transient ischemic attacks. Case report.

    abstract::Cerebral amyloid angiography can cause ischemic stroke and transient ischemic attacks (TIA's), as illustrated by this case report and literature review. It is possible that the use of anticoagulant or platelet-antiaggregant drugs in elderly patients with TIA's but no angiographic abnormalities may increase the risk of...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1985.63.6.0963

    authors: Smith DB,Hitchcock M,Philpott PJ

    更新日期:1985-12-01 00:00:00

  • Minimally invasive superficial temporal artery to middle cerebral artery bypass through an enlarged bur hole: the use of computed tomography angiography neuronavigation in surgical planning.

    abstract::The authors describe their minimally invasive technique for performing a superficial temporal artery (STA) to middle cerebral artery (MCA) bypass, which relies on an enlarged bur hole (2-2.5 cm) rather than the standard craniotomy. They perform this procedure in a minimally invasive fashion, using CT angiography for i...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/JNS/2008/109/9/0553

    authors: Coppens JR,Cantando JD,Abdulrauf SI

    更新日期:2008-09-01 00:00:00

  • Vestibular schwannoma surgery in the elderly: a matched cohort study.

    abstract:OBJECT:The authors' objective was 2-fold: 1) to compare outcomes of microsurgical resection for vestibular schwannoma (VS) between patients aged 70 years or older and patients younger than 70 years and 2) to test the hypothesis that symptomatic tumors in elderly patients represent a more aggressive variant of VS than t...

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  • Reliability assessment of the Biffl Scale for blunt traumatic cerebrovascular injury as detected on computer tomography angiography.

    abstract::OBJECTIVE Blunt traumatic cerebrovascular injury (TCVI) represents structural injury to a vessel due to high-energy trauma. The Biffl Scale is a widely accepted grading scheme for these injuries that was developed using digital subtraction angiography. In recent years, screening CT angiography (CTA) has been used to i...

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    pub_type: 杂志文章

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  • Isolation and partial purification of growth factors with TGF-like activity from human malignant gliomas.

    abstract::The effect of concentrated conditioned medium from each of eight human malignant glioma cell lines on the growth of indicator cells (normal rat kidney fibroblasts (NRK), clone 14) was determined in monolayer and in soft agar assay systems. The conditioned medium from all cell lines was mitogenic in the monolayer assay...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1989.71.6.0875

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    更新日期:1989-12-01 00:00:00

  • Emergency balloon occlusion for massive epistaxis due to traumatic carotid-cavernous aneurysm. Case report.

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    pub_type: 杂志文章

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    更新日期:1988-01-01 00:00:00

  • Vascularized temporoparietal fascial flap for the treatment of a traumatic cerebrospinal fluid fistula in the middle cranial fossa. Technical note.

    abstract::The temporoparietal fascial flap (TPFF) is a vascularized pedicle flap commonly used in head and neck reconstructions. The authors describe the use of a TPFF in repairing a large traumatic middle cranial fossa CSF fistula via a middle cranial fossa approach. During the 18-month follow-up, the patient had no further CS...

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    doi:10.3171/2008.9.17662

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    更新日期:2009-08-01 00:00:00