Biomedical subjects

A Egge

Publications and source records attributed to A Egge.

9 recordsLinked to original sources

PubMed2005

Outcome 1 year after aneurysmal subarachnoid hemorrhage: relation between cognitive performance and neuroimaging.

OBJECTIVE: To assess the cognitive impairment and the association between neuropsychological measures and neuroimaging 1 year after aneurysmal subarachnoid hemorrhage (SAH). METHOD: Forty-two patients were examined clinically according to Glasgow Outcome Scale (GOS). Computed tomography (CT), single photon emission computed tomography (SPECT) and neuropsychological examination were performed. RESULTS: There were no association between GOS and cognitive impairment index based on the neuropsychological examination. CT showed no sign of cerebral ischemia in 17 (40%) and low attenuating areas indicating cerebral infarction(s) in 25 (60%) patients. A significant correlation (P = 0.01) was observed between the cognitive impairment index and the SPECT index (r = 0.6). SPECT measurement was the only independent predictor for cognitive impairment. CONCLUSION: GOS is a crude outcome measure and patients classified with good recoveries may have significant cognitive deficits. Neuropsychological examination is the preferred method for outcome evaluation as this method specifically addresses the disabilities affecting patients' everyday life.

Adult↗

PubMed2002

Results of surgery for aneurysmal subarachnoid haemorrhage in northern Norway: a retrospective study with special focus on timing of surgery in a rural area.

OBJECTIVES: This study reports data on time consumption before aneurysm surgery and the results of treatment in northern Norway. MATERIAL AND METHODS: A total of 279 cases were identified and included in our analysis of time span from bleeding to arrival at our department. Fifty-one patients were treated conservatively, either because of bad clinical condition or because angiography revealed no aneurysm. The remaining 228 patients were operated and included in our analysis of outcome after early aneurysm surgery. RESULTS: Among all 279 patients with aneurysmal subarachnoid haemorrhage (SAH), median time from ictus to arrival at the university hospital was 1 (0-30) day. Forty-one per cent arrived at the day of bleeding and 86% within the first 3 days after bleeding. Among the 228 patients who underwent surgical aneurysm repair, median time from bleeding to operation was 2 (0-33) days. Early aneurysm surgery (< 72 h) was performed in 146 patients (64%). Fifty patients (22%) underwent intermediate surgery (days 4-10) and 32 patients (14%) were operated later (day 11 or later). A significant association was found between Hunt and Hess (HH) grade and Glasgow Outcome Scale (GOS) score (P < 0.001). CONCLUSIONS: Most patients suffering aneurysmal SAH in northern Norway undergo early aneurysm surgery and the outcome is comparable with that obtained in other Scandinavian centres. Initial Hunt and Hess grade is a major determinant for outcome in aneurysmal subarachnoid haemorrhage.

Adult↗

PubMed2002

Risk factors for aneurysmal subarachnoid haemorrhage: the Tromsø study.

OBJECTIVES: To conduct a population based case-control study with premorbid registration of potential risk factors to address the difficulty in identifying risk factors for aneurysmal subarachnoid haemorrhage (SAH). SAH is rare in prospective studies, and retrospective studies may have a selection bias. METHODS: The Tromsø health study is a population based survey of risk factors for cardiovascular disease in 27 161 subjects. 26 cases of aneurysmal SAH were identified in which risk factors were registered before the bleeding. Four age and sex matched controls were selected for each case. A backward logistic regression analysis was conducted and odds ratios (ORs) for significant risk factors were calculated. Systolic and diastolic blood pressure, cigarette smoking habits, serum concentrations of lipoproteins, body mass index, and coffee consumption were analysed. RESULTS: The crude annual incidence rate of aneurysmal SAH was 8.84/100 000 population. The proportion of current smokers was significantly (p = 0.003) higher in patients with SAH (73.1%) than in controls (41.3%). Drinking more than five cups of coffee per day was more common among patients (85%) than controls (59%) (p = 0.004). Mean (SD) systolic blood pressure was higher (p = 0.017) in patients (154.0 (32.5)) than in controls (136.3 (23.3)). Regression analysis showed that cigarette smoking (p = 0.04), systolic blood pressure (p < 0.0001), and coffee consumption (p = 0.004) were independent risk factors for SAH. The OR of current smokers versus never smokers was 4.55 (95% confidence interval (CI) 1.08 to 19.30) and the OR of drinking more than five cups of coffee a day was 3.86 (95% CI 1.01 to 14.73). The OR of an increase in systolic blood pressure of 20 mm Hg was 2.46 (95% CI 1.52 to 3.97). CONCLUSIONS: Cigarette smoking and hypertension are significant independent risk factors for aneurysmal SAH. A high coffee consumption may also predispose patients to aneurysmal SAH.

Adult↗

PubMed2001

Prophylactic hyperdynamic postoperative fluid therapy after aneurysmal subarachnoid hemorrhage: a clinical, prospective, randomized, controlled study.

OBJECTIVE: To investigate the role of prophylactic hyperdynamic postoperative fluid therapy in preventing delayed ischemic neurological deficits attributable to cerebral vasospasm. METHODS: We designed a prospected, randomized, controlled study and included 32 patients with subarachnoid hemorrhage. Sixteen patients received hypervolemic hypertensive hemodilution fluid therapy; the other 16 patients received normovolemic fluid therapy. All patients were monitored for at least 12 days, with clinical assessments, transcranial Doppler recordings, single-photon emission computed tomographic (SPECT) scanning, and routine computed tomographic scanning. For fluid balance monitoring, a number of blood samples were obtained on a daily basis and continuous central venous pressure and mean arterial blood pressure measurements were performed for both groups. All patients received intravenous nimodipine infusions between Day 1 and Day 12. End points of this study were clinical outcomes, clinically evident and transcranial Doppler sonography-evident vasospasm, SPECT findings, complications, and costs. Clinical examinations (using the Glasgow Outcome Scale) performed 1 year after discharge, together with neuropsychological assessments and SPECT scanning, were the basis for the evaluation of clinical outcomes. RESULTS: No differences were observed between the two groups with respect to cerebral vasospasm (as observed clinically or on transcranial Doppler recordings). When regional cerebral blood flow was evaluated by means of SPECT analysis performed on Day 12 after subarachnoid hemorrhage, no differences were revealed. One-year clinical follow-up assessments (with the Glasgow Outcome Scale), including SPECT findings and neuropsychological function results, did not demonstrate any significant group differences. Costs were higher and complications were more frequent for the hyperdynamic therapy group. CONCLUSION: Neither early nor late outcome measures revealed any significant differences between the two subarachnoid hemorrhage treatment models.

Aged↗

PubMed1997

[Early surgery of subarachnoid hemorrhage from cerebral aneurysms. A material from health care region 5].

During the period 1986 to 1993, 94 patients were admitted consecutively to the neurosurgical department of Tromsø university hospital following subarachnoid haemorrhage. Nine-three patients were operated on. Five patients were in extremely poor condition and three were operated on as emergency cases after computerized tomography without previous angiography. They are included in the total management outcome and also in the outcomes after early surgery. Of all the patients, 63.8% returned to their previous activities, 12.8% experienced moderate invalidity, and 9.6% had serious invalidities. The total management mortality was 13.8%. Fifty-four patients were operated on within three days, and 64.8% of these returned to their previous activities. Of these 14.8% ended up with moderate invalidity; mortality was 11.1%. Of eight patients above 70 years of age, five underwent early surgery. In six of these older patients the final outcome was good, one became disabled and one died. We consider early surgery to be by far the most important factor for achieving optimal results from surgery.

Adult↗

PubMed1994

Symptomatic, expansive middle cranial fossa arachnoid cyst treated by a cysto-peritoneal shunt. Case report and evaluation of treatment options.

We report a symptomatic space-occupying arachnoid cyst in a 16-year-old boy. During the last two years, he was frequently absent from school because of headaches. Due to symptoms of nausea, fever and headache the patient was primarily referred to a surgical unit, where appendectomy was performed, revealing a normal appendix. Postoperatively, the patient complained of severe headache. Computed tomography (CT) of the head demonstrated a large left-sided middle cranial fossa arachnoid cyst. The patient was operated with insertion of a cysto-peritoneal shunt. A total regress of the clinical symptoms was seen at follow-up examination 3 months after shunting.

Adolescent↗

PubMed1994

Modified Robinson-Smith procedure for the treatment of cervical radiculopathy.

In the present study, a modified Robinson-Smith procedure was used surgery for cervical radiculopathy in 52 patients. Thirty-one one-level and 21 two-level operations were performed. All patients were followed up between 1 and 3 years (mean 23 months) after surgery with a clinical evaluation by an independent investigator including a radiological examination. In 26 patients the postoperative result was classified as excellent, in 23 the result was good, in 2 satisfactory, while one patient was unchanged compared to the preoperative examination. No patient developed worsening of symptoms after surgery. Of 18 patients with duration of symptoms of more than 4 years, 16 demonstrated markedly improvement. No permanent postoperative complications were seen. A modified Robinson-Smith procedure appears to be safe and reliable and can be recommended in surgery for cervical radiculopathy.

Adult↗

PubMed1983

Aspiration and lung abscess in cystic fibrosis.

Large abscess cavities are not commonly encountered in patients with cystic fibrosis (CF). One such patient is reported in whom an abscess developed secondary to aspiration of sand and salt water. Material obtained at bronchoscopy revealed anaerobes as well as the aerobic organisms previously cultured from her sputum. Rapid improvement occurred after institution of antibiotic therapy specifically directed against the anaerobic organisms.

Adult↗

PubMedDate not supplied

Reliability and variability in the measurement of interlimbal distance with a semiautomated video replay analysis system (SAVRAS).

This paper reports on the reliability and variability of a semi-automated, video replay and analysis system (SAVRAS) in determining interlimbal distance in patients with strabismus. Factors under investigation were: choice of observer, choice of video frame, patient age and patient state (awake or anesthetized). It was demonstrated that SAVRAS was a highly reliable and reproducible system. This system is currently in use to evaluate the relationship between the succinylcholine induced ocular position, under anesthesia, and the postoperative awake alignment.

Child, Preschool↗