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R Braakman

Publications and source records attributed to R Braakman.

101 records · Page 6Linked to original sources
PubMedDate not supplied

Aneurysmal subarachnoid hemorrhage. Complications and outcome in a hospital population.

We describe total management results in a prospective series of 264 patients with aneurysmal subarachnoid hemorrhage (SAH) admitted to a neurologic unit. Referrals were actively solicited from general physicians as well as neurologists in the area. The diagnosis was based on computed tomography (CT). Secondary deteriorations were analyzed clinically and with serial CT scanning. Outcome was assessed 3 months after SAH. There were no relevant differences between the analyses of patients with and without an aneurysm confirmed by angiography or autopsy. One third of the patients either died within 1 day (12%) or remained in a poor clinical condition that precluded surgery (22%). One third were in good clinical condition, but contraindications to surgery were judged present or serious complications occurred before surgery could be performed. One third of all patients underwent surgery. Overall mortality in our series was 52%; only 26% made a good recovery. The risk of rebleeding was not related to the patients' initial clinical condition, but all other intracranial complications occurred significantly more often in patients graded poor compared with patients in good clinical condition. The most important causes of death and severe disability were hemorrhage (16%), recurrent hemorrhage (18%), and delayed cerebral ischemia (15%). The most important surgical complication was delayed deterioration caused by ischemia (20% of operated patients). We estimated that recognition of 'warning leaks,' surgery in patients over 65, and improvement of our surgical technique could decrease mortality from 52% to approximately 41%.

Brain Ischemia↗
PubMedDate not supplied

CT, myelography, and phlebography in the detection of lumbar disk herniation: an analysis of the literature.

Despite the large number of reports on the relative usefulness of various radiographic procedures for the diagnosis of lumbar disk herniation, there has been no consensus of opinion on the best imaging procedure. Different study designs, including criteria for patient selection and retrospective consideration of patients who underwent surgery only, hamper direct comparisons between studies. A major drawback is the common use of "accuracy" as a measure of quality. We reviewed the CT, myelographic, and phlebographic findings in lumbar disk herniation published since 1970. After the reports were systematically classified and assessed for quality, the results became more coherent. Many results tend to be sensitive and not very specific. We found there was no clear difference in the overall diagnostic quality of phlebography, myelography, and CT.

Humans↗