Abstract:
:Cerebral edema is frequently encountered in clinical practice in critically ill patients with acute brain injury from diverse origins and is a major cause of increased morbidity and death in this subset of patients. The consequences of cerebral edema can be lethal and include cerebral ischemia from compromised regional or global cerebral blood flow (CBF) and intracranial compartmental shifts due to intracranial pressure gradients that result in compression of vital brain structures. The overall goal of medical management of cerebral edema is to maintain regional and global CBF to meet the metabolic requirements of the brain and prevent secondary neuronal injury from cerebral ischemia. Medical management of cerebral edema involves using a systematic and algorithmic approach, from general measures (optimal head and neck positioning for facilitating intracranial venous outflow, avoidance of dehydration and systemic hypotension, and maintenance of normothermia) to specific therapeutic interventions (controlled hyperventilation, administration of corticosteroids and diuretics, osmotherapy, and pharmacological cerebral metabolic suppression). This article reviews and highlights the medical management of cerebral edema based on pathophysiological principles in acute brain injury.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Raslan A,Bhardwaj Adoi
10.3171/foc.2007.22.5.13subject
Has Abstractpub_date
2007-05-15 00:00:00pages
E12issue
5issn
1092-0684pii
220512journal_volume
22pub_type
杂志文章,评审abstract::OBJECTIVEEnhanced recovery after surgery (ERAS) is a multidimensional approach to improving the care of surgical patients using subspecialty- and procedure-specific evidence-based protocols. The literature provides evidence of the benefits of ERAS implementation, which include expedited functional recovery, decreased ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.1.FOCUS18700
更新日期:2019-04-01 00:00:00
abstract::The authors report the case of a 30-year-old woman who was a long-term intranasal cocaine abuser and who presented with transient ischemic attacks and multiple cerebral infarctions that were associated with moyamoya syndrome. The authors suggest that, because of its sympathomimetic effects, chronic cocaine use may pro...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:1998-11-15 00:00:00
abstract:OBJECT:The goal in this study was to determine if there was a change in intracranial venous diameters after endovascular treatment of carotid distribution vasospasm caused by subarachnoid hemorrhage. METHODS:The venous diameters were measured in all patients who received intraarterial papaverine and/or balloon angiopl...
journal_title:Neurosurgical focus
pub_type: 临床试验,杂志文章
doi:10.3171/foc.2006.21.3.16
更新日期:2006-09-15 00:00:00
abstract::Moyamoya disease is an uncommon cerebrovascular condition characterized by progressive stenosis of the bilateral internal carotid arteries with compensatory formation of an abnormal network of perforating blood vessels providing collateral circulation. The etiology and pathogenesis of moyamoya disease remain unclear. ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2009.1.FOCUS08302
更新日期:2009-04-01 00:00:00
abstract::Deep brain stimulation (DBS) has been used to treat various neurological and psychiatric disorders. Over the years, the most suitable surgical candidates and targets for some of these conditions have been characterized and the benefits of DBS well demonstrated in double-blinded randomized trials. This review will disc...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2009.4.FOCUS0982
更新日期:2009-07-01 00:00:00
abstract:OBJECT:The aim of this study was to test the validity of the hypothesis that patients in whom brain metastasis is the first indication of an undiagnosed primary tumor have a better chance of survival than similar patients with a known primary lesion. METHODS:Between January 1983 and December 1998, 342 patients with co...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2007.22.3.8
更新日期:2007-03-15 00:00:00
abstract::OBJECTIVE The accuracy of robot-guided pedicle screw placement has been proven to be high, but little is known about the impact of such guidance on clinical outcomes such as the rate of revision surgeries for screw malposition. In addition, there are very few data about the impact of robot-guided fusion on patient-rep...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.3.FOCUS16534
更新日期:2017-05-01 00:00:00
abstract::The authors describe a surgical technique for the correction of symptomatic degenerative lumbar scoliosis. Using a single, unilateral, interbody cage placed on the concave side of the coronal deformity, combined with a dorsal decompression and instrumented posterolateral fusion, this technique has resulted in excellen...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.12.FOCUS09281
更新日期:2010-03-01 00:00:00
abstract:OBJECT:Lamotrigine is an antiepileptic drug that inhibits presynaptic voltage-gated sodium channels and reduces the presynaptic release of glutamate in pathological states. Neuroprotective effects of this drug have already been demonstrated in cerebral ischemia models. The aim of the present study was to determine the ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC.2008.25.11.E6
更新日期:2008-01-01 00:00:00
abstract::Incidental findings pose considerable management dilemmas for the treating physician and psychological burden for the respective patient. With an aging population, more patients will be diagnosed with asymptomatic internal carotid artery stenosis. Patients will have to be counseled with regard to treatment options acc...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.9.FOCUS11222
更新日期:2011-12-01 00:00:00
abstract::Arteriovenous fistulae of the internal maxillary artery are exceedingly rare, with less than 30 cases reported in the literature. Most of these lesions are congenital, iatrogenic, or posttraumatic. The most common presentation of internal maxillary artery fistulae is pulsatile tinnitus and headache. Because these lesi...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.1.FocusVid.18479
更新日期:2019-01-01 00:00:00
abstract::This video demonstrates a surgical technique of resecting dorsum sellae meningioma using a combined interhemispheric translamina terminalis approach and pterional approach with clinoidectomy. The tumor, 5 cm in maximum diameter, originated from the dorsum sellae, compressed the third ventricle and the midbrain, and di...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.10.FocusVid.17302
更新日期:2017-10-01 00:00:00
abstract::Stereotactic radiosurgery (SRS) with the Gamma Knife and linear accelerator has revolutionized neurosurgery over the past 20 years. The most common indications for radiosurgery today are tumors and arteriovenous malformations of the brain. Functional indications such as treatment of movement disorders or intractable p...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC-07/12/E3
更新日期:2007-01-01 00:00:00
abstract::Hemivertebrae are a common cause of congenital scoliosis. Depending on their location and the magnitude of the resultant deformity, they may be asymptomatic or require treatment. In the past, treatment has focused on prevention of deformity progression in growing children. Little has been written about congenital scol...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2003.14.2.10
更新日期:2003-02-15 00:00:00
abstract::OBJECTIVE The microscopic transoral, endoscopic transnasal, and endoscopic transoral approaches are used alone and in combination for a variety of craniovertebral junction (CVJ) pathologies. The endoscopic transoral approach provides a more direct exposure that is not restricted by the nasal cavity, pterygoid plates, ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.11.FOCUS15498
更新日期:2016-02-01 00:00:00
abstract::Electrodiagnostic testing in patients who have upper-extremity symptoms, which may include carpal tunnel syndrome (CTS), has been the gold standard for diagnosis for many years. Despite their value, these tests are underutilized. The authors examined the use patterns of electrodiagnostic testing at the University of V...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1997.3.1.5
更新日期:1997-07-15 00:00:00
abstract::OBJECTIVE Traumatic brain injury (TBI) in children is a significant public health concern estimated to result in over 500,000 emergency department (ED) visits and more than 60,000 hospitalizations in the United States annually. Sports activities are one important mechanism leading to pediatric TBI. In this study, the ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.1.FOCUS15612
更新日期:2016-04-01 00:00:00
abstract:OBJECT:Postoperative infection after cranial surgery is a serious complication that requires immediate recognition and treatment. In certain cases such as postoperative meningitis, the patient can be treated with antibiotics only. In cases that involve a bone flap infection, subdural empyema, or cerebral abscess, howev...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC/2008/24/6/E10
更新日期:2008-01-01 00:00:00
abstract::The best management strategy for symptomatic vertebrobasilar ischemia is currently not well-defined. Noninvasive Optimal Vessel Analysis (NOVA, VasSol, Inc.) is computer software that, using quantitative magnetic resonance (MR) angiography technology, represents the only commercially available means of noninvasively m...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC/2008/24/2/E14
更新日期:2008-01-01 00:00:00
abstract::Germ line and somatic mutations in the neurofibromatosis Type 2 (NF2) tumor suppressor gene predispose individuals to tumors of the nervous system, including schwannomas and meningiomas. Since identification of the NF2 gene more than a decade ago, a large body of information has been collected on the nature and conseq...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2005.19.5.7
更新日期:2005-11-15 00:00:00
abstract::Focal cortical dysplasias (FCDs) are congenital malformations of cortical development that are a frequent cause of refractory epilepsy in both children and adults. With advances in structural and functional neuroimaging, these lesions are increasingly being identified as a cause of intractable epilepsy in patients und...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC/2008/25/9/E6
更新日期:2008-09-01 00:00:00
abstract::The surgical management of compressive cervical ossification of the posterior longitudinal ligament (OPLL) can be challenging. Traditionally, approach indications for decompression of cervical spondylotic myelopathy have been used. However, the postoperative complication profile after cervical OPLL decompression is un...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.1.FOCUS10278
更新日期:2011-03-01 00:00:00
abstract::OBJECTIVE The aim of this study was to identify and discuss operative nuances utilizing image guidance in the surgical management of aggressive sacral tumors. METHODS The authors report on their single-institution, multi-surgeon, retrospective case series involving patients with pathology-proven aggressive sacral tumo...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2016.6.FOCUS16125
更新日期:2017-01-01 00:00:00
abstract::Seizures and epilepsy are frequent clinical manifestations of cerebral cavernous malformations (CCMs) and represent the most common symptomatic presentation of supratentorial lesions. Clinicians often diagnose CCMs in patients after a first seizure, or in some cases after obtaining neuroimaging studies in patients suf...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2006.21.1.8
更新日期:2006-07-15 00:00:00
abstract::There has been increasing awareness that glioblastoma, which may seem histopathologically similar across many tumors, actually represents a group of molecularly distinct tumors. Emerging evidence suggests that cells even within the same tumor exhibit wide-ranging molecular diversity. Parallel to the discoveries of mol...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2014.9.FOCUS14521
更新日期:2014-12-01 00:00:00
abstract:OBJECT:A variety of anterior, posterior, and combined approaches exist to decompress the spinal cord, restore sagittal alignment, and avoid kyphosis, but the optimal surgical strategy remains controversial. The authors compared the anterior and posterior approach used to treat multilevel cervical spondylotic myelopathy...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2010.1.FOCUS09253
更新日期:2010-03-01 00:00:00
abstract::In Cushing disease, a pituitary corticotroph neoplasm causes secondary adrenal hypercortisolism. This condition has known morbidity and mortality, underscoring the need for an efficient and accurate diagnostic approach. An 11 p.m. salivary cortisol level is a modern, simple initial screening tool for the diagnosis of ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2007.23.3.2
更新日期:2007-01-01 00:00:00
abstract::Since the publication of preliminary results from the International Study of Unruptured Intracranial Aneurysms in 1998 there has been a great deal of debate concerning the natural history of these lesions and their attendant risk of aneurysmal subarachnoid hemorrhage. Therefore, the authors reviewed a selected number ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2004.17.5.3
更新日期:2004-11-15 00:00:00
abstract::For a physician has the worth of many other warriors, both for the excision of arrows and for the administration of soothing drugs. Homer, Iliad XI.514-515 Ever since armed conflict has been used as a means to settle disputes among men, there have been those who have been tasked to mend the wounds that ravage a soldie...
journal_title:Neurosurgical focus
pub_type: 历史文章
doi:10.3171/2010.3.FOCUSMar2010Intro
更新日期:2010-05-01 00:00:00
abstract::The widespread use of fusion procedures in the management of spinal disorders has led investigators to explore the use of growth and differentiation factors in such procedures. As an adjuvant to allograft bone or as a replacement for harvested autograft, bone morphogenetic proteins (BMPs) appear to improve fusion rate...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2001.10.4.4
更新日期:2001-04-15 00:00:00