Tentorial block of cerebrospinal fluid associated with a lumbar neurofibroma. Case report.
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Aged↗
Biomedical subjects
G Neil-Dwyer
Publications and source records attributed to G Neil-Dwyer.
Studies on cerebral blood flow and oxygen metabolism in patients with established cerebral infarcts undergoing omental transposition.
Regional cerebral blood flow, blood volume, fractional oxygen extraction, and oxygen consumption were measured by positron emission tomography in 4 stroke patients prior to and 6 months following omental transposition surgery. Preoperatively, 3 patients showed the typical picture of established infarction with a matched reduction in flow and oxygen metabolism and a normal oxygen extraction fraction in the symptomatic hemisphere. One patient showed a chronically impaired perfusion reserve with a proportionally greater reduction in flow than oxygen metabolism and a compensatory rise in oxygen extraction ratio. No change in the physiological parameters was demonstrated in the postoperative studies.
Cerebral Infarction↗
'Brain attack'--aneurysmal subarachnoid haemorrhage: death due to delayed diagnosis.
The objectives of this study were to determine how quickly patients who have an aneurysmal subarachnoid haemorrhage are diagnosed and referred to a regional neurosurgical unit for assessment and management. We examined whether delayed diagnosis resulted in poorer management outcome and how such delays could and should be avoided. An in-depth analysis of pre-hospital and hospital management of 180 consecutive patients with an aneurysmal subarachnoid haemorrhage was carried out at the Wessex Neurological Centre, a regional neuro-surgical unit with a catchment population of 2.8 million people. One hundred and eighty patients with a proven (computed tomography and/or lumbar puncture) aneurysmal subarachnoid haemorrhage were studied. The main outcome measures were management of mortality and morbidity using the Glasgow Outcome Scale (three months to one year follow-up period). Of the 180 patients, 136 were suitable for the study. Diagnosis was delayed in 69 (51%). In this group, failure to recognise this condition resulted in 45 patients (65%) suffering a second or third haemorrhage before being diagnosed. As a direct consequence of this delay significantly more patients died or were severely disabled than those whose haemorrhage was diagnosed without delay (chi 2 = 8.27, p < 0.005). Delays in diagnosis and transfer to a neurosurgical unit are largely avoidable.
Adolescent↗