当前位置： SCI文献检索 > BRITISH JOURNAL OF NEUROSURGERY期刊下所有文献 > Guidelines for cauda equina syndrome. Red flags and white flags. Systematic review and implications for triage.

Guidelines for cauda equina syndrome. Red flags and white flags. Systematic review and implications for triage.

Abstract：

INTRODUCTION:Patients with cauda equina syndrome (CES) are frequently referred late when neurological damage cannot be reversed. National Guidelines for emergency referral, imaging and treatment of CES contain symptoms and/or signs that are those of late often, irreversible CES. Referral at this stage may be too late for that patient. METHODS:Seven sources were reviewed. Advice re emergency referral/imaging/treatment were reviewed. Symptoms/signs were compared with a standard classification of CES. RESULTS:37 recommendations: 12 (32%) were symptoms/signs of bilateral radiculopathy (treatment usually leads to favourable outcomes). Thirteen recommendations (35%) were described in an imprecise way (could be interpreted as early or late CES). Twelve sets of symptoms/signs (32%) were those of late, often irreversible CES where an unfavourable outcome would be expected. CONCLUSIONS:Thirty-two percent of the so-called "red flag" symptoms and signs of CES in seven sources were definitely those of late, irreversible CES. These could be seen as "white flags" [flags of defeat and surrender]. Thirty-five percent of the recommendations if interpreted pessimistically (e.g. absent perineal sensation or urinary incontinence) would also be white flags; potentially therefore two-thirds of the so-called "red flag" symptoms/signs of CES could be those of late irreversible CES. Only 32% of the symptoms/signs were true "red flags" i.e. they warn of further, avoidable damage ahead. Guidelines should be redrawn to emphasise referral of patients who are at risk of developing CES or who have early CES. It is illogical for these guidelines to emphasise the clinical features of severe, often untreatable, CES. Demand for emergency MRI will increase; MRI is part of triage and should be performed at the DGH.

journal_name

Br J Neurosurg

journal_title

British journal of neurosurgery

authors

Todd NV

doi

10.1080/02688697.2017.1297364

subject

Has Abstract

pub_date

2017-06-01 00:00:00

pages

336-339

issue

3

eissn

0268-8697

issn

1360-046X

journal_volume

31

pub_type

杂志文章,评审

相关文献

BRITISH JOURNAL OF NEUROSURGERY文献大全
  • The emerging role of leptin, Adiponectin and Visfatin in Ischemic/Hemorrhagic stroke.

    abstract：:Introduction: Adipose tissue acts as an active endocrine organ and may be involved in the biological mechanism of stroke. Adipokines can serve as key messenger of central energy and metabolic homeostasis and can contribute to the crosstalk between adipose tissue and brain. Recent research has offered vague data on the...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.1080/02688697.2019.1578862

    authors： Ilhan N,Susam S,Canpolat O,Belhan O

    更新日期：2019-10-01 00:00:00

  • Chordoid glioma: an uncommon tumour of the third ventricle.

    abstract：:Chordoid glioma, a rare tumour of the third ventricle, has distinctive histological appearances. Fewer than 20 cases have been reported in the literature, all but three in females. This paper describes a 54-year-old man with a chordoid glioma and reviews the clinicopathological features of this lesion. ...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章,评审

    doi：10.1080/02688690120036865

    authors： Galloway M,Afshar F,Geddes JF

    更新日期：2001-04-01 00:00:00

  • Unruptured intracranial aneurysms: an assessment of the annual risk of rupture based on epidemiological and clinical data.

    abstract：:From autopsy and neuroradiological studies a maximum prevalence of unruptured intracranial aneurysms (UA) of 0.5% in the general population is revealed. Studies concerning the incidence of aneurysmal subarachnoid haemorrhage (SAH) revealed 10 cases per 100,000 inhabitants per year. From these epidemiological parameter...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章,评审

    doi：10.3109/02688698809001008

    authors： Rosenørn J,Eskesen V,Schmidt K

    更新日期：1988-01-01 00:00:00

  • Post-operative spinal subdural extra-arachnoid hygroma causing cauda equina compression: a report of two cases.

    abstract：:We present two cases of symptomatic, post-lumbar surgery cauda equina compression due to formation of a dissecting subdural extra-arachnoid cerebrospinal fluid (CSF) collection (hygroma) under tension. In both cases, a small inadvertent durotomy was sustained during the initial surgery. Surgical re-exploration confirm...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688697.2011.625063

    authors： Singleton WG,Ramnarine D,Patel N,Wigfield C

    更新日期：2012-06-01 00:00:00

  • Metastatic brain carotid body paraganglioma with endocrine activity: a case report and literature review.

    abstract：:A woman with hypertension and hyperglycemia was diagnosed a metastatic brain carotid body paraganglioma. Her blood pressure, glucose, and norepinephrine were normal after craniotomy. Although most carotid body tumors are benign, a few show distant metastasis. This is the first reported case of intracerebral metastases...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.1080/02688697.2017.1328042

    authors： Wang X,Zhu X,Chen J,Liu Y,Mao Q

    更新日期：2019-06-01 00:00:00

  • The reproducibility of transcranial Doppler middle cerebral artery velocity measurements: implications for clinical practice.

    abstract：:Use of transcranial Doppler (TCD) to diagnose vasospasm has been criticised. We examined reproducibility of TCD middle cerebral artery (MCA) velocity measurements. Thirty-six healthy adult volunteers were recruited. Four operators, two experienced and two inexperienced, participated. MCA velocity was measured twice by...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.1080/02688690701210539

    authors： McMahon CJ,McDermott P,Horsfall D,Selvarajah JR,King AT,Vail A

    更新日期：2007-02-01 00:00:00

  • Does nimodipine eliminate arterial hypertension as a prognostic risk factor in subarachnoid haemorrhage?

    abstract：:Several studies have demonstrated an association between arterial hypertension (AH) and an increased morbidity and mortality from both cardiovascular diseases and stroke (including subarachnoid haemorrhage, SAH). Among the functional disturbances implicated in hypertension much interest has been focused on the calcium...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688699108998477

    authors： Brandt L,Säveland H,Romner B,Ryman T

    更新日期：1991-01-01 00:00:00

  • Angiographic characteristics of unruptured middle cerebral artery aneurysms predicting perforator injuries.

    abstract：PURPOSE:The aim of the present study was to delineate preoperative factors that may predict perforator injuries following open surgery for an unruptured middle cerebral artery (MCA) aneurysm. METHODS:The authors conducted a retrospective review of 85 consecutive patients who underwent surgical clipping of 91 unrupture...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688697.2010.535924

    authors： Yeon JY,Kim JS,Hong SC

    更新日期：2011-08-01 00:00:00

  • Recurrent aneurysmal subarachnoid haemorrhage: incidence, timing and effects. A re-appraisal in a surgical series.

    abstract：:A series of 510 patients with proven aneurysmal subarachnoid haemorrhage (SAH) is reported. The incidence of recurrent haemorrhage during the period awaiting surgery was 13.7%. There was no significant difference in incidence between good and poor grade patients. Following rebleeding there was an immediate mortality o...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688698808999657

    authors： O'Neill P,West CR,Chadwick DW,Conway M,Foy PM,Maloney P,Pickard JD,Spillane JA,Shaw MD

    更新日期：1988-01-01 00:00:00

  • Vertigo caused by scalenus anterior compression of the subclavian artery: a report of two cases.

    abstract：:Two cases of vertigo with subclavian artery stenosis are presented. In both cases, the angiograms revealed left subclavian artery stenosis at the middle portion of the clavicle as well as kinked origin of the vertebral artery. After resection of the anterior scalene muscle, the stenosis and the vertigo resolved. ...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章,评审

    doi：10.3109/02688699008992713

    authors： Nishijima M,Akai T,Kuwayama N,Nakada J,Furuichi S,Takaku A

    更新日期：1990-01-01 00:00:00

  • Acute onset of trigeminal neuralgia, facial paresis and dysphagia after mild head injury.

    abstract：:The authors report the rare and first documented case of concomitant microvascular decompression of trigeminal, facial and glossopharyngeal nerves for the management of intractable to medical therapy acute onset of trigeminal neuralgia, facial paresis and dysphagia after mild head injury. ...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688697.2013.815327

    authors： Gkekas N,Primikiris P,Georgakoulias N

    更新日期：2014-01-01 00:00:00

  • Osteomyelitis of the skull vault from a human bite.

    abstract：:We report a case of extensive osteomyelitis of the skull vault from a human bite. The presentation and surgical management of this unusual condition is described. The microbiological findings are comparable to known patterns of infection after human bites. Surgical management and prophylaxis after this injury are disc...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.1080/02688699746582

    authors： Phillips NI,Robertson IJ

    更新日期：1997-04-01 00:00:00

  • Huge calcified chronic subdural haematoma.

    abstract：:Huge calcified chronic subdural hematoma is quite rare. We reported a such case in a old man. The intraoperative photographs of the case fully demonstrated the morphology of the calcified chronic subdural hematoma. ...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688697.2010.520763

    authors： Rao Z,Li J,Yin H,You C

    更新日期：2010-12-01 00:00:00

  • De novo intracranial collision tumour in previously evacuated intracerebral haematoma site.

    abstract：:The authors report the rare and first documented case of intracranial collision tumour occurrence in a previously evacuated intracerebral haematoma site. Surgery trauma could predispose to collision tumour occurrence. Research efforts should try to reveal the possible pathogenesis of this condition. ...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688697.2012.697220

    authors： Gkekas N,Georgakoulias N,Kakiopoulos G,Seretis A

    更新日期：2012-12-01 00:00:00

  • The autoimmune basis of hypopituitarism in traumatic brain injury: fiction or reality?

    abstract：:Post-traumatic hypopituitarism has remained as an obscured cause of worsening morbidity and mortality in head injury patients. Researchers have for decades been puzzled by the mechanism of pituitary dysfunction in these cases. Amongst other causes like direct injury, vascular injury etc, an immunological basis of hypo...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.1080/02688697.2018.1485875

    authors： Harsh V,Jha S,Kumar H,Kumar A

    更新日期：2019-02-01 00:00:00

  • Subtotal petrosectomy in the treatment of cerebrospinal fluid fistulae of the lateral skull base.

    abstract：:Cerebrospinal fluid (CSF) fistulae almost invariably lead to meningitis, even in the absence of other clinically obvious sequelae of the fistula such as a CSF fluid leak. The only effective means of reducing the risk of meningitis is surgical closure of the fistula. If surgery is to be recommended to patients with CSF...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.1080/02688699745646

    authors： Hamilton JW,Foy PM,Lesser TH

    更新日期：1997-12-01 00:00:00

  • Vascular neurofibromatosis affecting the internal carotid artery: a case report.

    abstract：:A patient with von Recklinghausen's disease presented with a right sixth nerve palsy. Investigations demonstrated unilateral dolichoectasia of the intracranial carotid artery and sphenoid wing dysplasia. This case demonstrates an association not previously documented, that of unilateral fusiform dilatation of the caro...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688699409027975

    authors： Steel TR,Bentivoglio PB,Garrick R

    更新日期：1994-01-01 00:00:00

  • Publication fate of abstracts presented at Society of British Neurological Surgeons meetings.

    abstract：INTRODUCTION:Society of British Neurological Surgeons (SBNS) meetings are important national events which allow for the presentation of current academic work. The publication rate of presented abstracts is considered a proxy marker of the scientific strength of a conference. We aimed to determine the publication fate o...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688697.2014.915008

    authors： Jamjoom AA,Hughes MA,Chuen CK,Hammersley RL,Fouyas IP

    更新日期：2015-04-01 00:00:00

  • Toxic effects of bleomycin on the hypothalamus following its administration into a cystic craniopharyngioma.

    abstract：:A 48-year-old man with a cystic craniopharyngioma developed hypersomnia, personality changes, memory impairment and thermal dysfunction following intracystic administration of bleomycin through an Ommaya reservoir after partial removal of the tumour. The patient's neurological deterioration was thought to be related t...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688699409101192

    authors： Haisa T,Ueki K,Yoshida S

    更新日期：1994-01-01 00:00:00

  • Normobaric hyperoxia therapy for traumatic brain injury and stroke: a review.

    abstract：:Traumatic brain injury (TBI) and acute ischaemic stroke are major causes of mortality and morbidity and there is an urgent demand for new neuroprotective strategies following the translational failure of neuroprotective drug trials. Oxygen therapy--especially normobaric, may offer a simple and effective therapeutic st...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章,评审

    doi：10.3109/02688690903050352

    authors： Kumaria A,Tolias CM

    更新日期：2009-12-01 00:00:00

  • Intrasellar pituitary mucocele: diagnostic dilemma.

    abstract：:Isolated intrasellar pituitary mucocele following transsphenoidal sinus surgery is extremely rare. The clinical features resemble a pituitary tumor, therefore careful radiological interpretation is crucial to reach the correct diagnosis. We report a case of intrasellar mucocele who had transsphenoidal sinus surgery pe...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688697.2013.817535

    authors： Tang IP,Chai CK,Kumar G,Prepageran N,Waran V

    更新日期：2014-06-01 00:00:00

  • Nebivolol attenuates cerebral vasospasm both by increasing endothelial nitric oxide and by decreasing oxidative stress in an experimental subarachnoid haemorrhage.

    abstract：OBJECTIVE:Evidence suggests that reduction of nitric oxide (NO) bioavailability due to oxidative stress plays a central role in the pathophysiology of cerebral vasospasm after subarachnoid haemorrhage (SAH). To prevent SAH-induced cerebral vasospasm, therefore we used nebivolol hydrochloride as a NO-mediated vasodilato...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.1080/02688697.2017.1297367

    authors： Aladag MA,Turkoz Y,Parlakpinar H,Gul M

    更新日期：2017-08-01 00:00:00

  • Rathke's cleft cysts within a growth hormone producing pituitary adenoma.

    abstract：:Two cases with a unique association of Rathke's cleft cysts and a growth hormone-secreting pituitary adenoma in the same tumour tissue are reported. The embryological pathogenesis, diagnostic evaluation and treatment of these lesions are discussed. ...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.1080/02688699550041755

    authors： Nishio S Fujiwara T Morioka M Fukui S

    更新日期：1995-01-01 00:00:00

  • Public disclosure of surgeon's results--pituitary surgery.

    abstract：OBJECTIVE:There are few agreed quantifiable outcome measures in pituitary surgery. The goal of this study is to present the measurement of resection volume after surgery for pituitary tumours as a surgeon-specific outcome measure that may have use in illustrating the performance of individual surgeons internally and ex...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688697.2013.847172

    authors： Phillips N,Tyagi A,Marks P,Nix P

    更新日期：2014-06-01 00:00:00

  • Intraparenchymal meningioma within the basal ganglia of a child: A case report.

    abstract：:Intraparenchymal meningiomas are rare. To date, no such lesion has been reported within the basal ganglia of a paediatric patient. Here, we describe the case of a 15-year-old-boy who presented with symptoms referable to a cystic, calcified, left basal ganglia intraparenchymal meningioma and discuss the surgical manage...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688697.2015.1096910

    authors： Reynolds MR,Boland MR,Arias EJ,Farrell M,Javadpour M,Caird J

    更新日期：2016-06-01 00:00:00

  • Muscle and nerve biopsy for the neurosurgical trainee.

    abstract：BACKGROUND:Nerve and muscle biopsy are common procedures often performed by junior surgical trainees. This educational review article describes the operative details of performing biopsies of muscle and nerve. Indications, pre-operative investigations and complication rates are described to aid in proper patient select...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章,评审

    doi：10.3109/02688697.2013.793288

    authors： Hart MG,Santarius T,Trivedi RA

    更新日期：2013-12-01 00:00:00

  • Pneumorrhachis with pneumocranium: an unusual complication of intra-abdominal sepsis.

    abstract：:We present this unusual case of a 60-year-old gentleman who presented with meningism and reduced conscious level. Imaging demonstrated a perforated sigmoid colon with retroperitoneal air associated with pneumorrhachis and pneumocranium. He required a Hartmann's procedure and broad spectrum intra-thecal antibiotics whi...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688697.2010.500420

    authors： Amit A,Toll EC,Siddique S,Nelson RJ

    更新日期：2011-02-01 00:00:00

  • Metastasis of pulmonary adenocarcinoma in right sylvian secretory meningioma.

    abstract：:We report a secretory meningioma with metastasis from a pulmonary adenocarcinoma in a 48-year-old woman. Secretory meningioma can simulate metastatic disease both clinically and pathologically. Secretory meningioma and tumour-to-tumour metastasis are each rare, and we believe this to be the first report of their coinc...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.1080/026886902753512646

    authors： Cserni G,Bori R,Huszka E,Kiss AC

    更新日期：2002-02-01 00:00:00

  • Effect of pre- and postganglionic lesioning of the trigeminal nerve on cerebral blood flow and glucose metabolism following a subarachnoid haemorrhage in the squirrel monkey.

    abstract：:Simultaneous cerebral blood flow (CBF) and glucose metabolism (CMRglu) studies with a double isotope autoradiographic technique were applied to squirrel monkeys submitted to a unilateral pre- or postganglionic trigeminal lesion. The CBF values were not affected following a pre- or postganglionic lesion per se. In cont...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688699209002929

    authors： Shiokawa Y,Delgado-Zygmunt TJ,Arbab MA,Svendgaard NA

    更新日期：1992-01-01 00:00:00

  • Anterior cerebral artery dissecting aneurysm associated with untreated craniopharyngioma.

    abstract：:Coexistence of cerebral aneurysm and untreated craniopharyngioma is extremely rare. We present an extremely rare case of anterior cerebral artery dissecting aneurysm associated with untreated craniopharyngioma, and discuss the relationship between these two lesions. ...

    journal_title：British journal of neurosurgery

    pub_type： 杂志文章

    doi：10.3109/02688697.2012.701677

    authors： Takeuchi S,Wada K,Sakakibara F,Nawashiro H,Mori K

    更新日期：2013-02-01 00:00:00