Abstract:
BACKGROUND:The best care and management of patients in persistent vegetative state (PVS) has been the subject of sustained moral and legal debate for a number of years. However, the views of specialist doctors in Belgium involved in the care for patients in PVS are largely unknown. METHODS:A postal questionnaire was sent to 403 members of Belgian Societies of Neurosurgeons, Neurologists and Rehabilitation Doctors. Their views were sought on various aspects of the management and care of PVS, focusing on the issue of the appropriateness of non-treatment and the withdrawal of artificial feeding. FINDINGS:Of the 208 doctors who completed the questionnaires (52%), 172 (83%) indicated that they had been involved in the management of a patient in PVS. 88% of the responding doctors thought it was sometimes appropriate not to treat acute infections or other life-threatening conditions in a PVS patient. Fifty-six percent considered it sometimes appropriate to withdraw artificial feeding. About three-quarter of physicians who considered both treatment-limiting decisions appropriate thought that such decisions could be considered within the first year of the patient being in PVS. Forty percent accorded a decisive influence to an advance directive and only a small number of doctors considered the influence of the patient's family in the decision to withdraw artificial feeding as decisive. Over 80% of the clinicians disagreed with the view that each decision about withdrawing artificial nutrition and hydration (ANH) should come before the courts. INTERPRETATION:Doctors in Belgium seem to be more reluctant to withdraw artificial feeding than not to treat acute infections or other life-threatening conditions in PVS. The reason for this difference appeared to be connected with the moral as well as with the clinical content of the decision. The broad variety of answers on the interval when the vegetative state is to be regarded as permanent and when treatment-limiting decisions are appropriate, could be due to the lack of official guidelines in Belgium. There seems however to be no consensus about a future policy in Belgium for making decisions about the withdrawal of ANH.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Dierickx K,Schotsmans P,Grubb A,Walsh P,Lambe Ndoi
10.1007/s007010050129subject
Has Abstractpub_date
1998-01-01 00:00:00pages
481-9issue
5eissn
0001-6268issn
0942-0940journal_volume
140pub_type
杂志文章abstract:BACKGROUND:Vascular Endothelial Growth/Permeability Factor (VEG/PF) has been correlated with angiogenesis and vascular leakage in diverse pathological conditions of the brain. On the other hand, neoformation of capillaries and vascular hyperpermeability have been related to progressive enlargement of chronic subdural h...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010200047
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Burr hole surgery for moyamoya disease and moyamoya syndrome is known to be an effective, versatile, and relatively simple revascularization technique. We will focus on the technical operative aspects of multiple burr hole surgery as we perform it in our center. METHODS:Periosteal flaps are prepared and pla...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
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更新日期:2019-01-01 00:00:00
abstract::Over the past 5 years 9 patients underwent partial or complete corpus callosotomy for treatment of medically intractable epileptic seizures. A beneficial effect of the procedure was observed in 8 patients. Criteria for performance of the procedure included CT evidence of unilateral cerebral damage and non-localized ep...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
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更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:Endoscopic 3rd ventriculostomy has become the method of choice in the management of occlusive hydrocephalus. The treatment is accompanied by significantly less peri-operative complications than the cerebrospinal fluid shunting procedures previously employed. Close surveillance of patients, however, is necessa...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050294
更新日期:1999-01-01 00:00:00
abstract::For measurement of the cerebral blood flow (CBF) the thermal diffusion method is quite convenient and allows the chronological measurement of CBF and CO2 reactivity of cerebral vessels. We investigated the CO2 reactivity of fifteen head injury patients. The results showed that in head injury cases, the disturbance of ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01842829
更新日期:1990-01-01 00:00:00
abstract::Immunohistochemical staining for proliferating cell nuclear antigen (PCNA) and BrdU using anti-PCNA and anti-BrdU monoclonal antibodies, respectively, was performed in 16 human brain tumours, including 3 glioblastomas multiforme, 2 anaplastic astrocytomas, 1 cerebellar astrocytoma, 2 recurrent meningiomas, 4 non-recur...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400617
更新日期:1992-01-01 00:00:00
abstract::Intra-operative neurophysiological techniques allow reliable identification of the sensorimotor region and make their anatomical and functional preservation feasible. Monopolar cortical stimulation has recently been described as a new mapping technique. In the present study this method was compared to the "traditional...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050433
更新日期:1999-01-01 00:00:00
abstract::Twenty operated cases of angiographically unrecognized microaneurysm (AUM) have been analysed with special reference to intra-operative observations and clipping-technique. Among the patients with intracranial aneurysms that the authors' facility has operated upon, the incidence of asymptomatic incidental AUM that was...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01808877
更新日期:1997-01-01 00:00:00
abstract::Among 64 patients with hemifacial spasm (HFS) and 60 with trigeminal neuralgia (TN) treated by microvascular decompression (MVD), repeated MVD performed on 3 cases with HFS resulted in the absence of spasm in all cases. In 7 cases with TN, this technique resulted in complete remission in 2, recurrence in 3, and no pai...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400583
更新日期:1992-01-01 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:Age is an important factor in determining prognosis following severe head injury (SHI), although mortality in patients > or =65 years is poorly reported. The aim of this study was to document mortality in patients with SHI > or =65 years. METHODS:A retrospective analysis of prospectively collected data from...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0666-x
更新日期:2010-08-01 00:00:00
abstract::The long-term outcome in 26 patients following operation of intracranial saccular aneurysms before the age of twenty is presented. The duration of follow-up ranged from 4 to 33 years (mean 14 years). The oldest patient is now 51 years old. 19 patients (73%) made a complete or good recovery with resumption of normal li...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01476214
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVE:To prospectively compare the demonstration of the intracranial optic pathway in patients with sellar/juxtasellar tumours and with clinical evidence of visual disturbance using either spoiled gradient recalled acquisition in steady state (SPGR) or conventional spin echo (CSE) T1-weighted imaging. MATERIALS AN...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050138
更新日期:1998-01-01 00:00:00
abstract::Sporadic vestibular schwannoma (VS) causes unilateral hearing loss, tinnitus, vertigo and unsteadiness. In many cases, the tumour size may remain unchanged for many years following diagnosis, which is typically made by MRI. In the majority of cases the tumour is small, leaving the clinician and patient with the option...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-007-1179-0
更新日期:2007-01-01 00:00:00
abstract::The authors report a series of 37 cases of unruptured aneurysms, admitted and operated upon over a 5 year period (1985-1990), which represents an incidence of 18% of the total number of aneurysm patients operated upon during this period. These unruptured aneurysms were discovered in 4 types of circumstances: 1) Associ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01541779
更新日期:1992-01-01 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::Clinical presentation, diagnosis, surgical technique and results of 25 cases of intramedullary tumours in patients under 16 years of age are analyzed. Pre-operative spinal deformity was present in 9 patients. Surgery was performed in all. After multilaminectomy with preservation of the intervertebral joints, total rem...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02001471
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To analyse the occurrence of hardware-related complications in patients with deep brain stimulation (DBS), over a long period of time. METHOD:All patients operated on with DBS at our institution between 1993 and 2002 were followed with respect to adverse events related to the implanted hardware. RESULTS:One...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0576-5
更新日期:2005-10-01 00:00:00
abstract::Ventricular shunting has dramatically improved the care of children with hydrocephalus. Yet shunt malfunctions are extremely common and cause significant morbidity. To document shunt problems in children with a neural tube defect and hydrocephalus, 67 children born since 1973 were studied via life-table analysis. 28% ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01418798
更新日期:1985-01-01 00:00:00
abstract::Treatment of vertebral epidural metastases has been in the past and still remains the object of special attention in an attempt to improve the quality of life of these patients. To assess the effects of and indications for surgery, the clinical histories of 53 patients with this malignant disease who had undergone dec...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01407520
更新日期:1990-01-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-003-0076-4
更新日期:2003-09-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01793077
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:The effect of anterior cervical discectomy without fusion (ACD), ACD with fusion by stand-alone cage (ACDF) or with arthroplasty (ACDA) on cervical sagittal alignment is not known and is the subject of this study. METHODS:A total of 142 adult patients with single-level cervical disease were at random alloca...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00701-017-3312-z
更新日期:2017-12-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406620
更新日期:1988-01-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01411190
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Microvascular decompression (MVD) for hemifacial spasm (HFS) has been popular, but it may take enough time to master this special operative technique and procedure. This may induce uneven distribution of the number of MVD operations in each institute, possibly resulting in an overall unsatisfactory quality o...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1724-y
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Increasingly, biomarkers have been identified that correlate with improved overall and progression-free survival (OS and PFS) in glioblastoma, including MGMT methylation status and mutations in the IDH1 gene. In this study, we investigated the clinical and biological factors associated with long-term surviva...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2928-8
更新日期:2016-10-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01402049
更新日期:1991-01-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-1269-x
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Autogenous cranioplasty infection requiring bone flap removal is under-recognised as a major complication causing significant morbidity. Microbial contamination of stored bone flaps may be a significant contributing factor. Current infection control practices and storage procedures vary. It is not known whet...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-012-1517-8
更新日期:2013-02-01 00:00:00