Abstract:
BACKGROUND:Mortality and morbidity of aneurysmal subarachnoid haemorrhage (aSAH) remain high, and prognosis is influenced by multiple non-modifiable factors such as aSAH severity. By analysing the chronology of aSAH management, we aim at identifying modifiable factors with emphasis on the occurrence of rebleeds in a setting with 24/7 surgical and endovascular availability of aneurysm repair and routine administration of tranexamic acid. METHODS:Retrospective analysis of institutional quality registry data of aSAH cases admitted into neurosurgical care during the time period 01 January 2013-31 December 2017. We registered time and mode of aneurysm repair, haemorrhage patterns, course of treatment, mortality and functional outcome. Rebleeding was scored along the entire timeline from ictus to discharge from the primary stay. RESULTS:We included 544 patients (368, 67.6% female), aged 58 ± 14 years (range 1-95 years). Aneurysm repair was performed in 486/544 (89.3%) patients at median 7.4 h after arrival and within 3, 6, 12 and 24 h in 26.8%, 44.7%, 73.0% and 96.1%, respectively. There were circadian variations in time to repair and in rebleeds. Rebleeding prior to aneurysm repair occurred in 9.7% and increased with aSAH severity and often in conjunction with patient relocations or interventions. Rebleeds occurred more often during surgical repair outside regular working hours, whereas rebleeds after repair (1.8%) were linked to endovascular repair. CONCLUSIONS:The risk of rebleed is imminent throughout the entire timeline of aSAH management even with ultra-early aneurysm repair. Several modifiable factors can be linked to the occurrence of rebleeds and they should be identified and optimised within neurosurgical departments.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Sorteberg A,Romundstad L,Sorteberg Wdoi
10.1007/s00701-020-04673-3subject
Has Abstractpub_date
2021-01-06 00:00:00eissn
0001-6268issn
0942-0940pii
10.1007/s00701-020-04673-3pub_type
杂志文章abstract::The common method of presentation of intracranial aneurysms is at the time of their rupture (with subarachnoid haemorrhage) or on the occasion of their compression of neighbouring structures. While giant aneurysms may occasionally present with subarachnoid haemorrhage, their more common methods of presentation are due...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400726
更新日期:1992-01-01 00:00:00
abstract::A case of a ruptured aneurysm is presented in which the angiograms did not disclose the sac. Rupture of an aneurysm of the anterior communicating artery was suspected from the distribution of subarachnoid blood on computerized tomography (CT), and the presence of a sac was highly suggestive on magnetic resonance imagi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405281
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:Cavernous angiomas are vascular malformations which rarely involve the cavities of the lateral ventricles. Knowledge of the specific clinical and neuroradiological features displayed by these lesions is limited by the scarcity of patients included in the reported series. OBJECTIVE AND METHODS:The aim of thi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-009-0186-8
更新日期:2009-02-01 00:00:00
abstract:AIM:To study the value of early (24 h) post-operative ACTH and serum cortisol as predictors of remission after transsphenoidal surgery in Cushing's disease. METHODS:We prospectively studied 44 patients who underwent transsphenoidal surgery for Cushing's disease between 1997 and 2005. The mean follow-up period of patie...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1133-1
更新日期:2007-01-01 00:00:00
abstract:OBJECT:The object of surgical treatment for hemifacial spasm (HFS) is the exclusion of pulsatile neurovascular compression of the root exit zone (REZ). However, spasm persists transiently or permanently in some cases even after complete decompression. In particular, we mainly experience these results when the vertebral...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-1247-3
更新日期:2012-03-01 00:00:00
abstract::The intracranial fracture of aneurysm clips due to stress corrosion failure is an increasingly common long term postoperative complication. To study the susceptibility of different clips to this process, we evaluated seven aneurysm clips (Mayfield, Yasargil, Vari-Angle McFadden, Scoville, Heifetz, and Pivot) in vitro....
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406875
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:The Woven EndoBridge (WEB) device has been increasingly used for the treatment of intracranial aneurysms after aneurysmal subarachnoid hemorrhage (SAH). Still, recent major clinical trials on patient management after SAH have defined WEB embolization as an exclusion criterion. In an analysis of an unselected...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03992-4
更新日期:2019-09-01 00:00:00
abstract:PURPOSE:Patients with oligodendrogliomas with allelic loss of chromosomal arm 1p and 19q have been shown, especially with anaplastic oligodendrogliomas, to have both a better initial and long-term response to chemotherapy as well as an improved overall survival. Effective treatment of patients with brain tumors require...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0743-1
更新日期:2010-11-01 00:00:00
abstract::In 40 postmortem specimens the cervical posterior roots were examined under the surgical microscope, and intradural communicating fibres between neighbouring segments were demonstrated. The implications of these frequent variants for the diagnosis of prolapsed cervical discs are discussed. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400951
更新日期:1980-01-01 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:The arcade of Struthers has been described as possible cause of compression of the ulnar nerve but several authors and our own experience have doubt cast on its existence. We, therefore, performed an anatomical study to determine whether or not the arcade of Struthers exists. METHODS:Ten arms from fresh fro...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-003-0006-5
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Hair-sparing techniques in cranial neurosurgery have gained traction in recent years and previous studies have shown no difference in infection rates, yet limited data exists evaluating the specific closure techniques utilized during hair-sparing craniotomies. Therefore, it was the intention of this study to...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04239-3
更新日期:2020-04-01 00:00:00
abstract::General aspects of glioblastomas are considered such as preoperative diagnosis, stereotactic punctures for tissue samples, location and tumour size, interference with CSF circulation. The operative risk and different approaches to treatment are discussed, and the results are compared. The described combined treatment ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406638
更新日期:1978-01-01 00:00:00
abstract:BACKGROUND:Operative skills are key to neurosurgical resident training. They should be acquired in a structured manner and preferably starting early in residency. The aim of this study was to test the hypothesis that the outcome and complication rate of anterior cervical discectomy and fusion with or without instrument...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-015-2396-6
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Giant and large pituitary adenomas (PA) constitute a specific subset of PAs, with gross total resection (GTR) rates frequently not exceeding 50%. Both an anatomical inaccessibility and an inadequate tumor visualization are thought to play a role. This study analyzes risk factors for postoperative residuals a...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04497-1
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Despite advances in laboratory diagnostics, antibiotic regimens, and neurosurgical techniques, brain abscess (BA) remains a potentially fatal infectious disease. This study analyzed clinical and epidemiological aspects of BA in Chinese patients treated at a single center during a 62-year period. METHOD:We r...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2741-4
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Paragangliomas are tumors that arise from the paraganglion system, which is a component of the neuroendocrine system. Approximately 10% are located in the extra-adrenal paraganglion system. Paragangliomas of the spine, however, are rare. They usually present as an intradural tumor in the cauda equina. There ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0362-x
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Torcular meningioma is a rare type of brain tumor with few reports regarding the appropriate resection approach for this disease. In cases without sinus occlusion, surgeons are advised to spare the sinus; however, the sinus may interfere with the visual field. METHOD:Endoscopic supracerebellar infratentoria...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03950-0
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:Induced endothelin-1 (ET-1) production and decreased nitric oxide synthase (NOS) bioavailability have been found in aneurysmal subarachnoid hemorrhage (SAH). Atorvastatin is recognized to have pleiotropic effects including increasing NOS bioavailability as well as reducing inflammation and oxidative damage ot...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0652-3
更新日期:2010-08-01 00:00:00
abstract::The effects of the new spasmolytic agent HA1077, which belongs to the calciumantagonists but acts by mechanisms different from those of conventional calcium channel blockers, on the cerebral microcirculation were studied in rats using isolated and cannulated intracerebral (parenchymal) arterioles of 50 microns average...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01420194
更新日期:1990-01-01 00:00:00
abstract::As an alternative to the gauze often used on scalp incisions, we prepared a pad made of non-woven sheets, coated with adhesive on one side. Unlike conventional gauze, the pad did not slip away from the incision line or become entangled with the scalp clips, thus demonstrating its high usefulness for this purpose. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01411309
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:The BrainIT group works collaboratively on developing standards for collection and analyses of data from brain-injured patients and to facilitate a more efficient infrastructure for assessing new health care technology with the primary objective of improving patient care. European Community (EC) funding supp...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,多中心研究
doi:10.1007/s00701-010-0719-1
更新日期:2010-11-01 00:00:00
abstract::The monoclonal antibody Ki-67 has been tested as a marker of proliferating cells in 52 stereotactic brain tumour biopsies. The antibody reacts with a nuclear protein expressed in G1,S, G2n and M-phases of the cell cycle. Using the immunoperoxidase technique on squash preparations the percentage of Ki-67 positive cells...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01560376
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:In patients with mass lesions near "eloquent" cortical areas different preoperative mapping techniques can be used. Two of the most widely used approaches include positron emission tomography (PET) and functional MRI (fMRI). We employed both methods in the same patients undergoing presurgical evaluation and ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-002-0992-8
更新日期:2002-09-01 00:00:00
abstract::Nine cases of posttraumatic primary brain stem haematoma are described. All cases presented ocular and vegetative symptoms. Hyperextension was regarded as the most likely mechanism of injury. All patients were treated conservatively; half of them with a good outcome. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01428496
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Tarlov cysts (TCs) are expanded nerve root sheaths that occur near the dorsal root ganglion and result from increased intraspinal hydrostatic pressure. TCs most frequently affect the lumbosacral plexus and therefore may cause specific symptoms such as perineal pain and neurogenic bladder, bowel, and sphincte...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-018-3494-z
更新日期:2018-04-01 00:00:00
abstract::A 34-year-old female patient suffering from right-sided facial palsy presented to our hospital. Her hearing range was within normal limits. She had undergone GKS after receiving a diagnosis of facial nerve schwannoma (FNS). On the fourth day after GKS, the patient experienced sudden onset hearing loss on the right sid...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1983-7
更新日期:2014-02-01 00:00:00
abstract::To evaluate the interrelationships between anterior pituitary function and the antidiuretic system in patients harbouring hypothalamo-hypophyseal tumorous lesions, combined anterior pituitary stimulation tests were performed in the pre (n = 192 patients) and postoperative (n = 151 patients) state. Basal and stimulated...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01842828
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Common primary bone tumors include osteosarcomas (OSC) and Ewing sarcomas (EWS). The skull is a rare site, and literature about their treatment and survival is scarce. Using the Surveillance, Epidemiology, and End Results (SEER) database, this study aims to assess the treatment and survival of skull OSC and ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-018-3754-y
更新日期:2019-02-01 00:00:00
abstract::We studied the influence of the type of surgery (microsurgery or macrosurgery) and extent (complete resection with lobectomy, complete resection alone, partial resection with lobectomy or partial resection alone) on early postoperative results and survival time in 118 consecutive patients who underwent surgery for gli...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01402111
更新日期:1991-01-01 00:00:00