1,721,436 research outputs found
A review of stereotaxy and lysis for intracranial hemorrhage
No full textIntracranial hemorrhage represents a significant cause of human morbidity and mortality, leaving as many as 80% of patients either dead or disabled. Techniques for management of hemorrhage include optimal medical care, craniotomy, endoscopy, and stereotaxy. This work reviews the history of cranial stereotaxy for evacuation of nontraumatic hemorrhage beginning with techniques for mechanical disruption of the coagulated hemorrhage modeled after Archimedes screw. We discuss the properties of urokinase and tissue plasminogen activator, which have been utilized for lysis, and the outcomes after stereotactic fibrinolytic evacuation of intracerebral hemorrhage. The ongoing clinical trials evaluating the efficacy of stereotactic fibrinolysis are also discussed
Intracerebral hernatoma lysis
No full textObject. Currently no adequate surgical treatment exists for spontaneous intracerebral hemorrhage (ICH). Implantable polymers can be used effectively to deliver therapeutic agents to the local site of the pathological process, thus reducing adverse systemic effects. The authors report the use of stereotactically implanted polymers loaded with tissue plasminogen activator (tPA) to induce lysis of ICH in a rabbit model. Methods. Ethylene vinyl acetate (EVAc) polymers were loaded with bovine serum albumin (BSA) only or with BSA plus tPA. In vitro pharmacokinetic (three polymers) and thrombolysis (12 polymers) studies were performed. For the in vivo study, 12 rabbits were fixed in a stereotactic frame, and 0.2 ml of clotted autologous blood was injected into the right frontal lobe parenchyma. After 20 minutes, control BSA polymers were stereotactically implanted at the hemorrhage site in six rabbits, and experimental BSA plus tPA polymers were implanted in six rabbits. Animals were killed at 3 days, and blood clot volume was assessed. The pharmacokinetic study showed release of 146 ng of tPA over 3 days. The tPA activity correlated with vitro thrombolysis. In the in vivo study. the six animals treated with tPA polymers had a mean ((+/- standard error of the mean [SEM]) thrombus volume of 1.43 +/- 0.29 mm(3), at 3 days, whereas the six animals treated with blank (BSA-only) polymers had a mean (+/- SEM) thrombus volume of 19.9c) +/- 3.74 mm(3) (p < 0.001). Conclusions. Ethylene vinyl acetate polyrners release tPA over the course of 3 days. Stereotactic implantation of tPA-loaded EVAc polymers significantly reduced ICH volume. polymers loaded with tPA may be useful clinically for lysis of ICH with out the side effects of systemic administration of IPA
Varicosis of the Venous Epidural Plexus Caused by Portocaval Hypertension Mimicking Symptomatic Lumbar Disc Herniation - Case Report and Review of the Literature
No full text- …
