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L Nelson Hopkins

Publications and source records attributed to L Nelson Hopkins.

92 records · Page 6Linked to original sources

Endovascular surgery: the future without limits.

The new millennium brings with it tremendous advances in technology and information sharing. Various medical, surgical, and engineering specialities are becoming more focused, thus enabling experts in these fields to gain insight and understanding previously unappreciated by those who came before us. Economic and technologic evolution will eliminate some of the drawbacks of endovascular therapy, such as persistent neck remnants. It is likely that drug delivery systems exist that would allow maximal benefit with little or no systemic adverse effects. It is likely that devices are available that could minimize various procedural complications. We as future neurosurgeons must persist in the quest to find collaborations that will promote cross-fertilization and cross-pollination among cardiologists, neurosurgeons, physicists, radiologists, neurologists, engineers, and other scientists so that the technology can be translated to reality. It is clear that, in time, transcatheter techniques will replace many operations for the treatment of cerebrovascular pathologies. Let us not allow ourselves the luxury of time.

Angioplasty↗

Effect of endovascular treatment on headaches in patients with unruptured intracranial aneurysms.

BACKGROUND: Patients with unruptured intracranial aneurysms often present with headaches. OBJECTIVE: To determine the effect of endovascular treatment on the character and frequency of headaches in patients with unruptured intracranial aneurysms. METHODS: We reviewed the medical records of all patients who underwent endovascular treatment for unruptured intracranial aneurysms within a 9.5-year period. These patients were mailed a standard questionnaire in which they were asked about the frequency and character of any headache experienced before or after (or both) endovascular treatment. They were also asked to grade improvement or worsening of headaches after the procedure as mild (activities of daily living were not affected), moderate (activities of daily living were affected), or significant (the change resulted in an ability to perform new activities of daily living or an inability to perform previous activities of daily living). RESULTS: Forty-seven patients with unruptured aneurysms who underwent Guglielmi detachable coil embolization responded to the questionnaire. Of these, 32 patients (mean age, 52.7 years [SD, 13.4]; 22 were women) had experienced headaches before the procedure. Nineteen patients (59%) reported improvement in severity of headaches after embolization. Improvement was graded as significant by 7 patients, moderate by 8, and mild by 4. Two patients (6%) reported worsening severity of headaches graded as moderate. Five of 15 patients without headaches before embolization reported onset of mild (n = 4) or severe (n = 1) headaches after treatment. CONCLUSION: Guglielmi detachable coil embolization of unruptured intracranial aneurysms was associated with reduction in severity of headaches in the majority of patients who had experienced preprocedural headaches.

Activities of Daily Living↗