1,720,990 research outputs found
The central cord syndrome in patients with cervical spinal cord tumorsA XIX century vignette from (Karl) Julius Vogel (1814-1880)
No full textBetween 1830 and 1850, (Karl) Julius Vogel was one of the most important German pathologists. He received his doctorate in medicine in 1838 from the University of Munich and habilitation in pathology in 1840. In 1846, he moved to the University of Giessen as a full professor of pathology. From 1855, he taught special pathology and therapy at the University of Halle and became director of the internal clinic. Vogel and Heinrich Adolph Karl Dittmar were the first clinicians to describe the symptoms and pathological findings of central cord syndrome in a cervical spine tumor
Intracerebral hemorrhage after cranioplasty: an unpredictable treacherous complication due to reperfusion or possible systemic inflammatory response syndrome
No full textIntroduction: In case of malignant cerebral infarction and progressive neurological
worsening, decompressive craniectomy is the surgical option that is recommended
when medical therapies fail. The occurrence of an intracerebral hemorrhage after
reconstruction of the bone defect is extremely rare. This is an extremely rare
complication, with only four cases reported thus far in the literature.
Case Report: A 54-year-old male suffered a malignant cerebral infarction and
progressive neurological worsening requiring decompressive hemicraniectomy. Three
months later, an autologous cranioplasty was performed. Postoperatively, the patient
experienced a generalized epileptic seizure and a hemorrhage in the left cerebellar
hemisphere on control CT scan. After surgical removal the patient did not improve, and
CT revealed the occurrence of further cerebellar, mesencephalic, and intraventricular
hemorrhages. Systemic inflammatory response syndrome was suspected, but death
occurred 72 hours after cranioplasty.
Conclusions: The reperfusion-hyperperfusion mechanism after cranioplasty might favor
intracerebral hemorrhages limited to the ischemic tissue, which is unable to support the
cerebral blood perfusion pressure. When diffuse atypical hemorrhages far from the
surgical site occur after cranioplasty, a systemic inflammatory response syndrome is
supposed
In Reply to the Letter to the Editor Regarding “A Limited Study on Brain Disease in Kit?b al-Tays?r (Liber Teisir) of Ibn Zuhr (Avenzoar)”
No full textA comparison of acute vascular damage caused by ADAPT versus a stent retriever device after thrombectomy in acute ischemic stroke: a histological and ultrastructural study in an animal model
No full textBACKGROUND:
It has been amply demonstrated that endovascular procedures can be successful treatment for stroke, both in terms of revascularization and clinical outcome. There is not, however, a published comparison of any histological or ultrastructural damage to the vessels that may be caused by a direct aspiration first pass technique (ADAPT) or stent retrievers (SR) used in these procedures. This study analyses and compares acute damage to the arterial wall caused by ADAPT or SR.
MATERIAL AND METHODS:
Damage to the walls of swine extracranial arteries was evaluated after ADAPT with the Penumbra system or thrombectomy with an SR (Solitaire 6×30). The procedures were performed after injecting thrombi into the selected arteries (arteries with diameters similar to those of the human internal carotid artery and first segment of the middle cerebral artery). After the procedures, the animal was euthanized and 12 arterial samples were obtained for analysis by optical and electronic microscopy.
RESULTS:
Tissue samples from the vessels treated with SR showed almost complete loss of endothelium, thickening of the internal elastic lamina, and degeneration of the elastic fibers of the bordering lamina media and adventitia. In contrast, tissue samples of the vessels treated with ADAPT had a clear integral internal elastic lamina and uninterrupted endothelial lining, although cell alignment was altered and there were surface lacerations due to manipulation of the samples.
CONCLUSIONS:
Both techniques caused acute damage to the vessel walls, however, thrombectomy with SR appeared to be more harmful to all layers of the arterial wall, particularly the endothelium
In reply to "Ways to improve outcome of decompressive craniectomy: judicious utilization of microneurosurgical technique adjuncts"
No full textWe read with interest the article “Measurement of bone flap surface area and midline shift to
predict overall survival after decompressive craniectomy ”. 1 Decompressive craniectomy is
associated with multitude of therapeutic effects including enlargement of the intracranial
volume , re-opening up of perimesencephalic cisterns, improvement of cerebral compliance,
increase in cerebral blood flow and cerebral perfusion, improvement of cerebrovascular regulation
and reduction in midline shift, and intracranial pressure . However, outcome of decompressive
craniectomy depends on various factors i.e. age of patient, primary intracranial pathology, size of
decompressive craniectomy, preoperative midline shift, preoperative rise in intracranial pressure
level, co-morbid illness, neurological status, mass effect and still controversy exists regarding size of
decompressive craniectomy, optimal patient group, timings and surgical technique
Letter to the Editor Regarding “Did Ibn Zuhr (Avenzoar)Postulate Before Vesalius That Liquid Collects in Ventricles in the Hydrocephalus?”
No full text
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Cone-beam CT angiography to assess the microvascular anatomy of intracranial arterial dissections
No full textBackground: Intracranial artery dissection is a rare and generally under-recognized cause of ischaemic stroke or subarachnoid haemorrhage. Objectives: The aim of this study was to analyse the efficacy of cone-beam computed tomography angiography (CBCT-A) to detect arterial ultrastructural alterations in intracranial artery dissection. Method: This is an observational and retrospective case series. Results: Between January 2018 and November 2020, four patients were admitted with an acute ischaemic stroke due to intracranial dissection studied with CBCT-A. In all cases, the CBCT-A documented vascular ultrastructural alterations related with the intracranial dissection. Conclusions: CBCT-A is an intraprocedural diagnostic technique that is useful for the diagnosis of intracranial dissections
Reconstruction of Skull Defects in the Middle Ages and Renaissance.
No full textIn Egyptian, Greco-Roman, and Arabic medicine, the closure of a skull defect was not provided at the end of a therapeutic trepanation or in cases of bone removal. The literature from the Middle Ages and Renaissance disclosed some striking and forgotten practices. Gilbertus Anglicus (c. 1180 to c. 1250) cites the use of a piece of a cup made from wooden bowl (ciphum or mazer) or a gold sheet to cover the gap and protect the brain in these patients; this citation probably reflected a widely known folk practice. Pietro d'Argellata introduced the use of a fixed piece of dried gourd for brain protection to reconstruct a skull defect. In the late Renaissance, the negative folklore describing this outlandish practice likely led to the use of silver and lead sheets. Nevertheless, for centuries, large numbers of surgeons preferred to leave the dura mater uncovered after bone removal, and failed to apply any brain protection.In Egyptian, Greco-Roman, and Arabic medicine, the closure of a skull defect was not provided at the end of a
therapeutic trepanation or in cases of bone removal. The literature from the Middle Ages and Renaissance disclosed
some striking and forgotten practices. Gilbertus Anglicus (c. 1180 to c. 1250) cites the use of a piece of a cup made
from wooden bowl (ciphum or mazer) or a gold sheet to cover the gap and protect the brain in these patients; this
citation probably reflected a widely known folk practice. Pietro d’Argellata introduced the use of a fixed piece of
dried gourd for brain protection to reconstruct a skull defect. In the late Renaissance, the negative folklore describing
this outlandish practice likely led to the use of silver and lead sheets. Nevertheless, for centuries, large numbers of
surgeons preferred to leave the dura mater uncovered after bone removal, and failed to apply any brain protection
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