Abstract:
OBJECTIVE:To establish the risk of recurrence in patients with chronic subdural hematoma (cSDH) on antithrombotic treatment (AT, i.e., antiplatelets and anticoagulants). Secondary end points were perioperative morbidity and mortality between groups (AT vs. no-AT group) and exploration if timing of resumption of AT treatment (i.e., prophylactic early vs. late resumption) influenced the occurrence of thromboembolism and hematoma recurrence. MATERIALS:In a population-based consecutive cohort, we conducted a retrospective review of 763 patients undergoing primary burr hole procedures for cSDH between January 1, 2005, and December 31, 2010, at the Karolinska University Hospital, Stockholm, Sweden. Early AT resumption was ≤30 days and late >30 days after the procedure. RESULTS:A total of 308/763 (40.4%) cSDH patients were on AT treatment at the time of diagnosis. There was no difference in cSDH recurrence within 3 months (11.0% vs. 12.0%, p = 0.69) nor was there any difference in perioperative mortality (4.0% vs. 2.0%, p = 0.16) between those using AT compared to those who were not. However, perioperative morbidity was more common in the AT group compared to no-AT group (10.7% vs. 5.1%, p = 0.003). Comparing early vs. late AT resumption, there was no difference with respect to recurrence (7.0% vs. 13.9%, p = 0.08), but more thromboembolism in the late AT resumption group (2.0% vs. 7.0%, p < 0.01). CONCLUSION:In clinical practice, cSDH patients on AT therapy at the time of diagnosis have similar recurrence rates and mortality compared to those without AT therapy, but with higher morbidity. Early resumption was not associated with more recurrence, but with lower thromboembolic frequency. Early AT resumption seems favorable, and a prospective RCT is needed.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Fornebo I,Sjåvik K,Alibeck M,Kristiansson H,Ståhl F,Förander P,Jakola AS,Bartek J Jrdoi
10.1007/s00701-017-3330-xsubject
Has Abstractpub_date
2017-11-01 00:00:00pages
2045-2052issue
11eissn
0001-6268issn
0942-0940pii
10.1007/s00701-017-3330-xjournal_volume
159pub_type
杂志文章abstract:BACKGROUND:This study was conducted to investigate the usefulness of intracranial cerebrospinal fluid (CSF) volume measurement using MR-based methods in the management of patients with normal pressure hydrocephalus (NPH). METHODS:The study group comprised 19 patients with NPH who showed a favorable outcome after ventr...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010170079
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:In contrast to other regions of the human spine, dorsal fixation with rods and pedicle screws is comparatively rarely performed in the cervical spine. Although this technique provides a higher mechanical strength than the more frequently used lateral mass screws, many surgeons fear the relatively high rate o...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0447-6
更新日期:2010-04-01 00:00:00
abstract::Cavernous malformations (CM) occur very rarely in the ventricular system. We report a patient with a rare location in the third ventricle who had intermittent headaches as the initial symptom. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-004-0393-2
更新日期:2005-01-01 00:00:00
abstract:INTRODUCTION:Intraneural ganglion cysts in the tarsal tunnel are rare but are being increasingly reported. The cysts involve the tibial or plantar nerves and are most commonly derived from a neighboring (degenerative) joint, (i.e., the tibiotalar or subtalar) via an articular branch arising from the medial aspect of th...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-04027-8
更新日期:2019-10-01 00:00:00
abstract:INTRODUCTION:The quality of surgical treatment of intracranial aneurysms is determined by complete aneurysm occlusion and restoration of flow in the parent, branching and perforating vessels. In postoperative digital subtraction angiography (DSA), unexpected aneurysm residuals and vessel occlusions are frequently detec...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0723-5
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:In an increasingly complex and competitive professional environment, improving methods to educate neurosurgical residents is key to ensure high-quality patient care. Electronic (e)Learning resources promise interactive knowledge acquisition. We set out to give a comprehensive overview on available eLearning ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,meta分析
doi:10.1007/s00701-016-3042-7
更新日期:2017-02-01 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:BACKGROUND:As diffusion tensor imaging (DTI) is able to assess tissue integrity, authors used diffusion to detect abnormalities in trigeminal nerves (TGN) in patients with trigeminal neuralgia (TN) caused by neurovascular compression (NVC) who had undergone microvascular decompression (MVD). The authors also studied an...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03913-5
更新日期:2019-07-01 00:00:00
abstract::Cerebral developmental venous anomalies (DVAs) are variations of venous vascular anatomy related to an underdevelopment of either the superficial or deep venous emissary system, resulting in a dilated transmedullary vein fed by multiple smaller venous radicles responsible for drainage of normal brain parenchyma. While...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-020-04213-z
更新日期:2020-05-01 00:00:00
abstract::Symptomatic extracranial vertebral artery (VA) dissection may need surgery. We describe such a case successfully treated with atlantoaxial fusion based on its rare dynamic angiographic findings. A 27-year-old woman suffered from repeated brainstem and cerebellar infarctions from a left extracranial VA dissecting aneur...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-016-2891-4
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Awake craniotomy is a valuable procedure since it allows brain mapping and live monitoring of eloquent brain functions. The advantage of minimizing resource utilization is also emphasized by some physicians in North America. Data on how well an awake craniotomy is tolerated by patients and how much stress it...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-014-2038-4
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:In patients with a vestibular schwannoma, some studies have reported that useful hearing preserved initially after surgery deteriorates gradually in the long term. Studies with more patients are needed to clarify the maintenance rate of postoperative hearing function and to identify prognostic of hearing fun...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04523-2
更新日期:2020-11-01 00:00:00
abstract::A rare case of primary cerebral abscess due to Nocardia asteroides, and its surgical removal, are described. Postoperative meningitis caused by the same fungi was succesfully cured with sulphadiazine and cycloserine. The nocardial disease, its neurological complications, and therapy are reviewed. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401932
更新日期:1977-01-01 00:00:00
abstract::Acute tumor hemorrhage occurring during stereotactic radiosurgery (SRS) for a metastatic lesion, or in the immediate post-treatment period, is believed to be extremely rare. The potential risk of hemorrhage related to SRS procedures in patients with metastatic brain tumors is not yet clearly understood. This case repo...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-012-1447-5
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:The purpose of the study was to measure the effects of increased inspired oxygen on patients suffering severe head injury and consequent influences on the correlations between CPP and brain tissue oxygen (PtiO2) and the effects on brain microdialysate glucose and lactate. METHODS:In a prospective, observatio...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-003-0027-0
更新日期:2003-05-01 00:00:00
abstract::While bone invasion and hyperostosis are frequent phenomena in meningiomas, primary intra-osseous meningiomas are rare. With only 15 reported cases, the osteolytic form of primary intra-osseous meningiomas is most uncommon. Its occurrence in the skull base is an extra-ordinary exception. We have reviewed and categoriz...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-004-0380-7
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Tumours of the brachial plexus region are rare and most publications are case reports or studies with a small series of patients. The aim of this study is to present our experience in managing these lesions. METHODS:We review 18 patients with tumours in the brachial plexus region submitted to surgical treat...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0380-8
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:The microsurgical unilateral laminotomy (MUL) technique for bilateral decompression of lumbar spinal stenosis (LSS) is a less destabilizing alternative to laminectomy and leads to good short-term outcomes. However, little is known about the long-term results including predictive factors. METHODS:Medical rec...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2804-6
更新日期:2016-06-01 00:00:00
abstract::Oculomotor nerve palsy due to a venous varix arising from flow anomalies caused by a dural arteriovenous fistula (AVF) is a rare phenomenon. We report a case of surgical third nerve palsy with a rare underlying AVF as the cause and discuss in detail the patho-anatomy and its significance. A tentorial dural AVF mimicki...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0819-y
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:In surgical treatment of acute subdural hematoma (ASDH), neurosurgeons frequently encounter bleeding from cortical arteries, which is usually controlled with bipolar coagulation. However, bipolar coagulation is associated with a risk of sacrificing the cortical artery, which may affect the prognosis of neuro...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-018-3634-5
更新日期:2018-10-01 00:00:00
abstract:STUDY DESIGN:This report characterises a 25 year old male patient with a complete burst fracture of the fifth lumbar vertebra with dislocation. He was treated by posterior surgery with transpedicular instrumentation and an expandable cage from the posterior approach. OBJECTIVES:Burst fractures of the fifth lumbar vert...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-008-0149-5
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:The external ventricular drain (EVD) placement is one of the most common neurosurgical procedures. This operation is performed by freehand technique in the majority of cases; therefore, the operator's experience plays an important role in success and possible morbidity of this procedure. OBJECTIVE:To evalua...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04671-5
更新日期:2021-01-06 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:Intra-operative monitoring of the position of the central sulcus (CS) is indispensable to properly treat a peri-motor cortex lesion. Noninvasive preoperative studies for identification of CS are also needed for choosing the optimal operative procedure. Magneto-encephalography (MEG) has recently been introduc...
journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章
doi:10.1007/s00701-003-0213-0
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Distal anterior cerebral artery (DACA) aneurysms represent 2-9 % of intracranial aneurysms. They are often more amenable to surgical rather than endovascular treatment due to the size of parent vessels. METHOD:We illustrate surgical approaches for DACA aneurysms arising from different segments of the anteri...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1855-1
更新日期:2013-11-01 00:00:00
abstract::The unusual presentation of Gorham's disease of skull base and cervical spine in a two-year-old female child with radiological signs mimicking those of raised intracranial pressure is discussed. The differential diagnosis consists of skull base tumours, meningitis, osteomyelitis of the base of skull, congenital hydroc...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0806-x
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:The wide variety of intraspinal cystic lesions necessitates different elaborate diagnostic procedures to choose the right therapeutic management in symptomatic patients. Based on the case reports of seven patients with symptomatic spinal arachnoid cysts we discuss the aetiology, diagnostic procedures and the...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010170102
更新日期:2001-01-01 00:00:00
abstract::To clarify the value of clinical long-term follow-up with radiological examination, ranging from 12 to 63 months (average: 35 months), 18 consecutive patients suffering from spontaneous carotid cavernous fistula (CCF), were studied prospectively. Five aged patients without aggressive symptoms were treated conservative...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050059
更新日期:1998-01-01 00:00:00
abstract::A 28-year-old man with genetically confirmed hyperostosis corticalis generalisata (Van Buchem disease) suffered from headache and progressive cognitive and sensibility disorders. Bone formation of the skull was ongoing, leading to narrowing of the intracranial space and foramen magnum. A large bilateral frontoparietal...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-015-2445-1
更新日期:2015-07-01 00:00:00
abstract::A recent modification of the occipital transtentorial approach to the pineal region and medial-posterior hemisphere is described. The patient is operated upon in a lateral reclining (park bench) position with the side to undergo occipitoparietal craniotomy, slightly dependant. Following dural opening to the margins of...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405427
更新日期:1990-01-01 00:00:00