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Biomedical subjects

E Nathal

Publications and source records attributed to E Nathal.

9 recordsLinked to original sources

External carotid artery fistula due to microcompression of the gasserian ganglion for relief of trigeminal neuralgia. Case report.

Vascular complications after percutaneous injection procedures for relief of trigeminal neuralgia are varied, ranging from puncture of arterial or venous structures to carotid-cavernous fistulas. The authors present a patient in whom an external carotid artery fistula occurred after a microcompression procedure for the treatment of a left-sided trigeminal neuralgia. This is believed to be the first case of this complication secondary to a percutaneous injection procedure for relief of facial pain.

Carotid Artery Diseases↗

The basal interhemispheric approach for acute anterior communicating aneurysms.

We reviewed the surgical outcome in 85 patients with ruptured anterior communicating artery (ACoA) aneurysms, who were operated on within 72 hours of onset via a basal interhemispheric (BIH) approach (Group 1, N = 48), or an anterior interhemispheric (AIH) approach (Group 2, N = 37). The age, sex ratio and pre-operative grade (Gr) were similar for both groups. The outcome at the time of discharge was as follows for group 1: excellent or good 88%; fair, 6%; vegetative state, 2% and death 4%. For group 2, it was: excellent or good 78%; fair, 16%; vegetative state, 3%; and death, 3%. A significant correlation between admission grade and outcome was found in both groups. The outcome in group 1 was better than in group 2 for patients with a Glasgow Outcome Scale (GOS) better than fair (p < 0.07). No patient in group 1 had postoperative anosmia, but nine patients in group 2 became anosmic. The total number of complications was also significantly less in group 1. Our overall mortality rate was 4%. In conclusion, the BIH approach was more beneficial for treating acute ACoA aneurysm.

Adult↗

Ruptured anterior communicating artery aneurysm causing bilateral abducens nerve paralyses--case report.

A rare case of bilateral abducens nerve paralyses after rupture of an anterior communicating artery (AcoA) aneurysm occurred in a 56-year-old female after sudden onset of severe headache. Bilateral abducens nerve paralyses were present without additional neuro-ophthalmological signs. Computed tomography revealed subarachnoid hemorrhage (SAH). Angiography showed an AcoA aneurysm (15 mm in diameter, directed antero-inferiorly) that was successfully clipped. Postoperatively, the bilateral abducens nerve paralyses gradually recovered and disappeared 3 months after onset. Bilateral abducens nerve paralyses may occur after SAH due to ruptured AcoA aneurysm, and neurosurgeons should be alert to this possibility.

Abducens Nerve↗

Intraoperative anatomical studies in patients with aneurysms of the anterior communicating artery complex.

The intraoperative anatomical findings of the anterior communicating artery (ACoA) complex in 46 patients with anatomical variations were compared to those in an equal number of patients without variations in order to determine the visualization of the elements of the vascular complex. All patients underwent radical surgery for an ACoA aneurysm by one of three different surgical approaches: transsylvian, anterior interhemispheric, or basal interhemispheric. Visualization of the vascular elements was similar in patients with or without anatomical variations. The differences observed were dependent on the surgical approach selected and on the projection of the aneurysm. It was found that, even when the intraoperative anatomical field and the number of vascular elements visualized are different from those obtained in autopsy studies, the vascular microanatomical characteristics can be confirmed with each surgical approach to the extent necessary to ensure safe clipping of aneurysms in patients both with and without anatomical variations.

Cerebral Arteries↗

[Traumatism of the posterior fossa in children].

Reported are 15 cases of children who suffered injuries to their posterior fossa and the subsequent formation of hematomas and their treatment by the physicians in the Neurosurgical Department of the Traumatology Hospital "Magdalena de las Salinas". Of the 15 cases, 11 had epidural hematomas (three of them with supratentorial extensions), one was subdural, two were cerebellar and another of the brainstem. Seven were considered acute, five were subacute and three were chronic. During their admittance to the hospital, five of the patients were in a state of coma, another five were sleepy or confused and the remaining five were conscious. Three of the patients were conservatively treated, two of which had sequelae or were moderately handicapped. Twelve of the patients were surgically intervened suboccipitally, eleven of which successfully recovered and one of which died. A history of brain injury, occipital fracture and signs of posterior fossa lesions lead to suspect the presence of posterior fossa hematoma.

Adolescent↗

[NMDA receptor antagonists in focal cerebral ischemia. An experimental model].

Ischemic cerebrovascular disease is an important cause of morbidity and mortality. One common final pathway in neuronal ischemic damage is the uncontrolled influx of calcium into the cell, mediated by voltage dependent channels or activation of the NMDA (N-methyl D-aspartate) receptor. The therapeutic utility of a non-competitive NMDA blocker (MK-801, 2 mg/kg i.p.), to prevent the neuronal ischemic damage in an experimental middle cerebral artery occlusion model has been tested. The drug was administered 10 minutes before (group 3) and one hour after the arterial occlusion (group 4), and the results were compared with a group in which no medicament was utilized (group 2) and a control group (sham operation, group 1). MK-801 reduced significantly the area of infarction in relation to the control group (p < 0.05), mainly if the MK-801 was administered before the occlusion (group 3). These results suggest that MK-801 may be useful for the prevention of the neuronal ischemic damage caused by focal ischemia. However, before recommending its use in humans, all the possible collateral effects must be defined.

Animals↗