Abstract:
BACKGROUND:Severe traumatic brain injury (sTBI) is a major cause of morbidity and mortality. Intracranial pressure (ICP) monitoring and management form the cornerstone of treatment paradigms for sTBI in developed countries. We examine the available randomized controlled trial (RCT) data on the impact of ICP management on clinical outcomes after sTBI. METHODS:A systematic review of the literature on ICP management following sTBI was performed to identify pertinent RCT articles. RESULTS:We identified six RCT articles that examined whether ICP monitoring, decompressive craniectomy, or barbiturate coma improved clinical outcomes after sTBI. These studies support (1) the utility of ICP monitoring in the management of sTBI patients and (2) craniectomy and barbiturate coma as effective methods for the management of intracranial hypertension secondary to sTBI. However, despite adequate ICP control in sTBI patients, a significant proportion of surviving patients remain severely disabled. CONCLUSIONS:If one sets the bar at the level of functional independence, then the RCT data raises questions pertaining to the utility of decompressive craniectomy and barbiturate coma in the setting of sTBI.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Abraham P,Rennert RC,Gabel BC,Sack JA,Karanjia N,Warnke P,Chen CCdoi
10.1007/s00701-017-3363-1subject
Has Abstractpub_date
2017-12-01 00:00:00pages
2279-2287issue
12eissn
0001-6268issn
0942-0940pii
10.1007/s00701-017-3363-1journal_volume
159pub_type
杂志文章,评审abstract:BACKGROUND:Cerebral ischemia is considered a key factor in the development of secondary damage after Traumatic Brain Injury (TBI). Studies on Cerebral Blood Flow (CBF) have documented decreased flow in over 50% of patients with TBI, studied in the acute phase. Transcranial Doppler (TCD) sonography is a non-invasive tec...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-002-1012-8
更新日期:2002-11-01 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::A total of 160 patients suspected of having acquired hydrocephalus were studied either by quantitative isotope ventriculography (QIV) or by lumbar isotope cisternography (LIC). Of these patients, 56 had hydrocephalus. Mental deterioration, gait disturbances, ataxia, spasticity, and incontinence were most frequently pr...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01407686
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND:Microvascular decompression (MVD) is a documented effective treatment of trigeminal neuralgia (TN). Lately, reports on endoscopy-assisted microvascular decompression (eaMVD) with better outcome and less risk have emerged. This study was undertaken to verify under which circumstances the endoscope proved esse...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2171-0
更新日期:2014-10-01 00:00:00
abstract::We investigated the role of plasminogen activators (PAs) and their inhibitor (plasminogen activator inhibitor-1, PAI-1) in human brain tumours. The amounts of urokinase-type plasminogen activator (u-PA), tissue-type plasminogen activator (t-PA), and plasminogen activator inhibitor-1 (PAI-1), and the activity of u-PA a...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050112
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:To investigate characteristic clinical and radiological features of extradural arachnoid cysts (EDACs) in the thoracolumbar region, a retrospective review of medical records and imaging studies was performed. EDACs are well known but relatively rare lesions in the thoracolumbar spinal canal. The most common ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-1110-6
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Long-term survival of patients with recurrent gliomas depends on the extent of resection. Thus, the desirability of an intra-operative imaging modality that can augment the resection extension without affecting vital surrounding structures is more than obvious. It was the aim of the present study to evaluate...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-006-0858-6
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Transsphenoidal surgery has been well established as an effective primary treatment for tumours of the sellar region. During the dural opening, the prominent intercavernous sinus poses limitations for this approach and may contribute to incomplete tumour resections. METHOD:Based on our experience from 940 c...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0356-8
更新日期:2009-07-01 00:00:00
abstract::We investigated 76 patients with known subarachnoid haemorrhage (SAH) in order to compare the results of angiography and non-invasive Doppler recordings of cerebral artery blood velocity in the diagnosis of cerebral vasospasm. One radiologist and one neurovascular surgeon assessed angiographic spasm visually on a four...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405268
更新日期:1989-01-01 00:00:00
abstract::One case of a pontine haematoma with clinical symptoms of cerebellopontine angle tumour is described. The haematoma was successfully evacuated, and preoperative neurological deficits disappeared except for minimal right fifth nerve palsy. The pathological specimen was diagnosed as arteriovenous malformation. Lateropon...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02055855
更新日期:1983-01-01 00:00:00
abstract::We report the case of a large osteoblastoma arising in the frontal bone of a 20-year-old female. The lesion was first noted after a fall, and grew steadily in size following further head injury during pregnancy. Initial plain radiography demonstrated an area of radiolucency, with subsequent cross-sectional imaging rev...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-3024-9
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:The authors applied a scaffold-free osteogenic three-dimensional (3D) graft made of adipose-derived mesenchymal stem cells (AMSCs) in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). METHODS:Three patients (two patients and one patient with 1 and 2 levels, respectivel...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-3051-6
更新日期:2017-03-01 00:00:00
abstract::Intra-operative Doppler recordings were carried out on cerebral saccular aneurysms in 12 patients. Distinct fluctuations of flow superimposed on the pulse wave were seen in 6 patients. The fluctuations appeared to be periodic with measured period lengths of 60 to 150 msec. In 3 other patients flow irregularities could...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01402392
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Microscopic transsphenoidal surgery (mTSS) is a well-established method to address adenomas of the pituitary gland. Endoscopic transsphenoidal surgery (eTSS) has become a viable alternative, however. Advocates suggest that the greater illumination, panoramic visualization, and angled endoscopic views afforde...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00701-017-3438-z
更新日期:2018-05-01 00:00:00
abstract:PURPOSE:To analyse the intraoperative complications of a single neurosurgeon, with emphasis on devastating intraoperative incidents, and how they possibly could have been avoided. METHODS:All the patients operated upon by the author between 1986 and 2002, i.e. 252 patients with 270 craniotomies for 294 aneurysms, were...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0452-9
更新日期:2009-09-01 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::The purpose of this study was to evaluate whether wide surgical exposures result in poorer outcome of lumbar disc surgery compared to smaller traditional exposures. The aim was also to assess if a dural tear has any impact on the postoperative clinical outcome. One hundred and twenty-two patients (56 women and 66 men,...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01411260
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:To analyze prospectively the frequency and the risk of symptomatic and asymptomatic haemorrhage after image guided stereotactic biopsy of intra-axial brain tumours. METHODS:The study was conducted within a time frame of 24 months (April 1998-April 2000). 326 patients (150 males, 176 females; mean age 56.8 ye...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010170058
更新日期:2001-01-01 00:00:00
abstract::Three cases of surgically treated non-neoplastic diseases of the sella (two arachnoid cysts and one empty sella) are reported. All three patients had visual deficits but no gross endocrine disturbances. The study of these three clinical cases and an analysis of the relevant literature suggest a possible unitary hypoth...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401097
更新日期:1977-01-01 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:Gamma Knife radiosurgery (GKRS) inverse dose planning is currently far from competing effectively with the quality of dose planning developed by experienced experts. A new inverse planning (IP) method based on « efficient convex optimization algorithms » is proposed, providing high-quality dose plans in real...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04695-x
更新日期:2021-01-05 00:00:00
abstract::In this study, which comprises 144 consecutive head injuries, the initial clinical assessment and the findings of the initial CT scan are related to the outcome. The mortality is related to the patient's level of consciousness and pupillary light reflex on admission. The disability rate (= number of disabled/number of...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405444
更新日期:1982-01-01 00:00:00
abstract::Venous malformations in the posterior fossa are relatively rare. Although the introduction of CT and MRI has made them easier to detect, their treatment is still controversial. Based on our experience with six patients and a review of the literature, we have tried to establish guidelines for their treatment. Since the...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01476418
更新日期:1994-01-01 00:00:00
abstract::The aetiology of incomplete adrenergic denervation and reduction in the number and caliber of the cerebral vessels in hydrocephalus is still obscure. Stretching of the blood vessels alone is far from explaining these major vascular changes. Previous studies have shown that increased lipid peroxidation produces toxic e...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405185
更新日期:1993-01-01 00:00:00
abstract::Our study was carried out in 34 rabbits which were divided into three groups (A, B, C). In group A (10 animals), a mid-laminectomy of the first lumbar (L1) vertebra was performed and the circulation in the exposed spinal cord segment was examined using both procedures, the videomicroscopy as well as the r.S.C.B.F. mea...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01404150
更新日期:1987-01-01 00:00:00
abstract::An infrared based frameless stereotactic navigation device (Easy Guide Neuro) was investigated for its clinical applicability, registration/application accuracy and limitations in a standard operating room set-up. In a five-month period 40 frameless stereotactic procedures (23 female, 17 male, mean age 46.4, yrs range...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02750999
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Patients with intervertebral disc herniation undergo surgical removal of herniated disc material in cases of persisting symptoms and/or neurologic deficits. While motor deficits often prompt surgery, little is known about the optimal timing of surgery in these cases. The aim of this study was to prospectivel...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04614-0
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Evolving of a single centre by means of different transsphenoidal approaches during the survey of methodological advances in pituitary surgery is presented. MATERIALS AND METHODS:Ninety-three consecutive patients with pituitary adenomas underwent transphenoidal pituitary operations at Gulhane Military Medic...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-008-0135-y
更新日期:2008-11-01 00:00:00
abstract::SPECT scanning with Tl-201 and Tc-99m offers a unique, inexpensive functional imaging modality to combine with CT stereotactic craniotomy for guiding resection of necrosis and/or tumour in patients treated with escalated doses of radiation (> 6000 cGy) by either brachytherapy or radiosurgery. Thirty-two cases were ana...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405531
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Modern magnetic resonance imaging (MRI) diagnosis of Tolosa-Hunt syndrome rests upon demonstration of cavernous sinus abnormalities. We present a case of Tolosa-Hunt syndrome who has no abnormal mass lesion in the cavernous sinuses on MRI but with a diagnostic lesion on magnetic resonance angiography (MRA). ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010170112
更新日期:2001-01-01 00:00:00