Microsurgical clipping of cerebral aneurysms after the ISAT Study.
Explore the source record for details and available documents.
SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
In lesions located in the lateral ventricle of the dominant hemisphere the contralateral transcallosal approach provides maximum protection of the dominant side as well as excellent visualization of the cella media of the contralateral lateral ventricle. We demonstrated this safe approach in a rare case with intraventricular aneurysm of the left medial choroid artery. The literature on aneurysms in the lateral ventricle is discussed.
A case of repeated subarachnoid haemorrhage (SAH) caused by rupture of a dissecting intracranial vertebral aneurysm is reported. The clinical manifestations, angiographic findings, pre-operative assessment with neurophysiological monitoring, and surgery are presented. A review of the literature suggests that this type of intracranial aneurysm is being recognized with increasing frequency in SAH and fatality, and therefore exploration and treatment of vertebrobasilar (V-B) dissecting aneurysms is necessary. We emphasize that a balloon Matas test with monitoring of somatosensory evoked potentials (SEP), auditory brain stem responses (ABR), and its wedge pressure in occluding the vertebral artery before operation are objective assessments of treatment for dissecting intracranial vertebral aneurysm.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Previous studies have reported haemodynamic interactions between dihydropyridine calcium antagonists and general anaesthesia. During anaesthesia for intracranial aneurysm surgery, we prospectively compared haemodynamic values obtained from 13 patients being treated with nicardipine HCl (0.15 mg.kg-1.hr-1 IV) for cerebral vasospasm against values obtained from 11 untreated controls. Prior to induction of anaesthesia, nicardipine-treated patients had significantly elevated mean +/- SD cardiac index (5.67 +/- 1.30 vs 3.99 +/- 0.73 L.min-1.m-2) while MAP (86 +/- 10 vs 99 +/- 14 mmHg) and systemic vascular resistance (647 +/- 227 vs 1141 +/- 404 dynes.sec-1.cm-5) were reduced. Heart rate, CVP, and PACWP were similar between groups. Anaesthesia induction and tracheal intubation resulted in similar haemodynamic values between groups with the exception of CVP (10 +/- 5 vs 5 +/- 2 mmHg) and PACWP (15 +/- 5 vs 8 +/- 3 mmHg) which were elevated in the nicardipine group (P less than 0.01). Mannitol infusion and deliberate hypotension resulted in nearly identical haemodynamic responses in both groups. Nicardipine-treated patients required more intravenous fluids during the operative procedure (2.4 +/- 0.3 L vs 1.5 +/- 0.4 L, P less than 0.05) and were less likely to require isoflurane supplementation to morphine sulphate/nitrous oxide anaesthesia (P less than 0.01). In summary, our experience with nicardipine HCl revealed no major untoward effects with respect to maintenance of intraoperative haemodynamic stability despite continuous antivasospasm therapy with this vasodilator.
In the last 10 years the use of mechanical stapling devices in endoscopic surgery have found wide-spread application and acceptance. Even one of the most common surgical operations, the appendectomy, is done regularly laparoscopically. Therefore, utilization of endostaples is commonplace and often results in the spillage of fired staples beyond the margin tissue. We report the case of a 23-year-old patient who developed the clinical signs of bowel obstruction 2 weeks after laparoscopical appendectomy. An exploratory laparotomy was subsequently performed. At the time of exploration, a single band was identified that draped over the ilium central affixed to a staple. The staple was removed and the obstruction relieved without bowel resection. The patient had an uncomplicated recovery. We believe that the cause of this mechanical bowel obstruction was a loose staple.