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N G Dan

Publications and source records attributed to N G Dan.

At least 19 recordsLinked to original sources
PubMed2002

Mistaken identity: a case of false positive on CT angiography.

We describe the case of a 42-year-old female presenting with subarachnoid haemorrhage from a posterior inferior cerebellar artery (PICA) aneurysm rupture on intracranial digital subtraction angiography (DSA). One year postoperatively, the patient was followed with CT angiography and was reported to show a de novo aneurysm at the bifurcation of the left inferior cerebellar artery (ICA). Subsequent DSA revealed an aberrant vein crossing over the ICA bifurcation on mask phase images. This is the first reported case of a such a reason for a 'false positive' on CT angiography (CTA). The case demonstrates that although CTA has a reported high specificity, careful interpretation of multiple views is required to diagnose intracranial aneurysms when compared to the 'gold' standard of CTA.

Adult↗
PubMed2001

A 20-year review of percutaneous balloon compression of the trigeminal ganglion.

OBJECT: The aim of this study was to investigate outcomes and complication rates associated with percutaneous balloon compression (PBC) of the trigeminal ganglion over a long follow-up period. METHODS: This retrospective review was conducted in 496 patients with typical symptoms of unilateral trigeminal neuralgia who underwent 531 PBCs of the trigeminal ganglion between 1980 and 1999. The mean length of follow up was 10.7 years. The treatment used was a modification of that first described by Mullan and Lichtor in 1983. There were nine technical failures. Of the 522 successful procedures, prompt pain relief ensued in all patients except one. Recurrence of pain was found in 95 patients (19.2%) within 5 years and in 158 patients (31.9%) over the entire study period. Symptomatic dysesthesias occurred in 19 patients (3.8%), but corneal anesthesia and anesthesia dolorosa did not. CONCLUSIONS: In this review the authors present data on the largest cohort of patients with the longest follow up for this procedure in the current literature. The balance between the recurrence rate and troublesome sensory complications achieved in this series is favorable when compared with previously published studies on outcomes of PBC and the two alternative percutaneous methods, radiofrequency thermocoagulation and glycerol rhizolysis. The PBC procedure has additional advantages in that it is relatively straightforward and quick, and can be performed during a brief period of general anesthesia with no discomfort to the patient. This makes it an attractive first choice in the treatment of trigeminal neuralgia.

Adult↗
PubMed2000

Spinal angulation after anterior discectomy and graftless fusion.

A study was made to assess the degree of kyphotic angulation after anterior cervical discectomy and graftless fusion. The possibility of a progressive increase in kyphotic angle was also examined. Fifty-two consecutive patients presenting for review after anterior cervical discectomy and graftless fusion were examined through the use of lateral cervical radiographs and the presence and degree of kyphotic angulation was examined. The majority of operated levels (66%) demonstrated 0-5 degrees of kyphotic angulation and a further 14 (24%) demonstrated between 6 degrees and 10 degrees of kyphotic angulation.

Cervical Vertebrae↗
PubMed1986

Preventable causes of death and disability from neurotrauma.

Preventable causes of death and disability have been studied retrospectively in a series of 1161 cases of neurotrauma occurring in New South Wales in 1977-78, and prospectively in 153 cases of neurotrauma occurring in country districts in South Australia in 1981-82. In the first study, it was found that at least 80 deaths could be attributed to preventable causes; chiefly, transfer to an inappropriate hospital and/or delay in instituting treatment. Apparent failures in initial management of shock and airway obstruction were evident in this study and also in the South Australian study, which identified major deficiencies in cardiorespiratory management in 7% of cases transferred from country areas. These studies confirm that there is a need for better training, at all levels, in the management of neurotrauma. They also provide powerful arguments for the concept of an integrated regional trauma service.

Australia↗
PubMed1986

Experience with extradural haematomas in New South Wales.

A retrospective study of 126 patients with extradural haematomas was made to determine whether their outcome could be modified by alteration of their management. Poor outcome occurred in those over 65 years of age, in motor smash victims, in those with fixed pupils, in those with major associated injuries or those comatose on hospital admission. The detection of skull fracture or of a lucid interval was not prognostically useful. A graduation in mortality according to the type of hospital was present but did not reach statistical significance. Failure to correct shock and delay in instituting definitive treatment were the major preventable factors which could be modified to improve outcome.

Adolescent↗
PubMed1986

Experience with multiple intracranial haematomas in New South Wales.

A retrospective survey of head injuries in NSW in 1977 and 1978 was conducted by the Trauma Subcommittee of the Neurosurgical Society of Australasia. This paper describes the findings for 129 patients who had more than one significant intracranial haematoma. Overall, the case fatality rate for these patients was 85%. The presence of low or fluctuating blood pressure was associated with a significantly higher mortality than in the rest of the group. Bilateral reacting pupils or an improvement in level of consciousness following decompressive surgery carried a more favourable prognosis. There was 100% fatality if surgery was not carried out or if the bleeding was not found at operation. A subset of patients who died was selected on the basis of a calculated prognostic variable, and compared with a similar subset of survivors. A higher proportion of patients who died had a delay in the provision of definitive treatment and failure to correct shock. This comparison was made on two criteria. Using the first accepted optimal treatment in 1984, nearly all cases were treated suboptimally, as might be expected. Using the second, acceptable treatment in 1977-78, it was calculated that between nine and 12 patients died with MIH in NSW in the 2 years of the survey, whose deaths might have been prevented.

Accidents, Traffic↗
PubMed1986

Experience with acute subdural haematomas in New South Wales.

A retrospective survey of head injuries in NSW in 1977 and 1978 was conducted by the Trauma Subcommittee of the Neurosurgical Society of Australasia. Two hundred and ninety patients, who were found to have acute or subacute subdural haematomas, were considered. The mortality rate was 76%, with 19% making a satisfactory recovery. Several factors were found to produce significant improvement in outcome. The availability of neurosurgical facilities at the time of admission made a significant difference. Those patients who had decompressive operations also fared better. No patient survived without operation. Shock, defined as a systolic blood pressure lower than 90 mmHg for more than 60 min was associated with significantly increased mortality. The chance of developing a significant hypotensive episode was greater if two or more other parts of the body were injured. If three other areas were injured, the mortality was 100%. A case control study suggested that some 35 (16%) of all deaths could have resulted from preventable causes, notably delay in instituting definitive treatment and/or inadequate treatment of shock.

Acute Disease↗
PubMed1986

Epidemiology and clinical outcomes of neurotrauma in New South Wales.

This study of 1161 neurotrauma patients in New South Wales hospitals was designed to examine the role of preventable causes of death and disability in cases of spinal injury, extradural, subdural and multiple intracranial haematomas in order to make recommendations for improvements in accident, emergency, ambulance and hospital services. Methods have been developed for standardizing diagnosis in different classes of hospital for the assessment of severity in terms of the patient's age, sex, physical signs, head and spine injuries and other injuries. Estimates have been made of the number of preventable deaths by a case control study of each category of neurotrauma under study.

Adolescent↗
PubMed1986

Experience with chronic subdural haematomas in New South Wales.

This study considered 135 cases of chronic subdural haematoma following head injury in 1977 and 1978. The majority were in the older age group and more often males. Falls were the commonest cause. Among intracranial haematomas they carry a much better prognosis. However, there was a mortality rate of 9% and delay in diagnosis was the most likely preventable factor contributing to this. Accordingly the possibility of this complication after head injury should be known to those concerned in the later hospital treatment and follow-up management especially of older patients and alcoholics. When the diagnosis has been made, the preferred surgical method of treatment is drainage through burrholes. Follow-up CT scanning should be arranged usually about 8 weeks afterwards unless there are clinical indications for an earlier examination.

Adolescent↗
PubMed1986

The incidence of epilepsy after ventricular shunting procedures.

One hundred eighty of 207 consecutive patients with ventricular shunts were studied to determine the incidence of post-shunt epilepsy. Of these 17 (9.4%) developed seizures. The incidence fell from 15.2% in children younger than 1 year to 6.9% in patients over 50 years of age, but age was not statistically significant. Of patients with a parietal ventricular catheterization site only 6.6% had convulsions, in contrast to 54.5% of those with a frontal locus. The incidence of seizures rose with multiple ventricular catheter revisions, but was unrelated to bilaterality of shunting. The risk of seizures fell from 5% in the 1st year after shunting to 1.1% after the 3rd year.

Adolescent↗
PubMed1984

Intracranial subdural haematoma after metrizamide myelography.

Headaches for a short period after metrizamide myelography are common. It is unusual for these headaches to persist beyond four days. The case of a patient whose headache dated from the time of myelography and in whom an intracranial subdural haematoma developed after myelography is presented, to draw attention to this rare complication.

Adult↗
PubMed1984

Nerve entrapment syndromes of the lower limb.

The general features of entrapment are discussed. Common and less common lower limb entrapments are surveyed with consideration of differential diagnoses. Treatment modalities are summarised.

Femoral Nerve↗