Anatomoclinical correlations in cranio-cerebral thanatogenerating traumatisms.
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Biomedical subjects
Publications and source records attributed to N Ianovici.
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This paper presents 17 cases of tumours of the third ventricle which have been hospitalized, explored and treated in the Neurosurgical Clinic of the St. Trinity Hospital during the last ten years (1986-1996). There are emphasized the histopathological features of these tumours, according to pathological anatomy exams and to the dates in the literature, the main elements of the clinical picture typical for these tumours, the main paraclinical investigating methods, possibilities of healing and postoperative results. Finally, there are presented the results on these 17 clinical observation as well as a presentation of the further possibilities in diagnosis and treatment which will improve substantially the number of healed cases, diminishing the incidence of postoperative morbidity and mortality.
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The authors present five cases of posttraumatic petronosal fistulas. The stress the rarity of these cases, their anatomo-pathological aspects, the pathophysiological consequences of the osteo-meningeal fissure and the necessity of the neurosurgical treatment.
The goal of investigation was to determine the role of calcium and magnesium ions in the cerebrospinal fluid in ethylic-traumatic coma. We measured the level of calcium in the cerebrospinal fluid within simple photometric test and the magnesium level within xylidyl blue photometric test. We found a high mortality in patients with high level of calcium in cerebrospinal fluid and low level of magnesium in cerebrospinal fluid. At patients with ethylic-traumatic coma high levels of calcium in cerebrospinal fluid are caused by the excitatory amino acids cascade and increased of hematoencephalic barrier permeability. Decreased levels of magnesium in cerebrospinal fluid are associated with convulsions and a poor prognosis of the patients. These analyses are very important for establishment of prognosis in patients with ethylic-traumatic coma.
In our article we analysed the current conservative therapeutic options in spontaneous intracerebral haemorrhage as well as a few controversies regarding the efficiency of some types of treatment. Spontaneous intracerebral haemorrhage represents a major neurosurgical emergency. In spite of the severe prognosis of the disease, there is reason for optimism. There are important improvements in treatment of arterial hypertension, and cerebral lesions. The aim of the conservative medical treatment is to maintain good oxygenation, decreased arterial pressure, control of the intracranial hypertension, cerebral oedema, prevention of seizures. All these contribute to improving the vital and functional prognosis.
Intracerebral hematoma represent a frequent complication of hypertension. It is accompanied by significant mortality and complications. It is mainly a surgical condition but we prefer conservative therapeutic options in cases where feasible. The conservative treatment gives better results but surgery becomes obsolete in cases when medical treatment fails.
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Minimal invasive neurosurgery refers to the technological advances accomplished in refining surgical access thus enabling neurosurgeons to reduce the morbidity and improve the accuracy and quality of neurosurgical procedures. Neuro-endoscopy comprises a promising minimal invasive technique being applied in an increasing amount of cases as diseases of cerebrospinal fluid dynamics, brain and spinal tumours, cysts, infections, evacuation of haematomas et al. Representing an important scientific modality neuro-endoscopy favours the rapid recovery of the patient and improves its postoperative quality of life. Personnel training is compulsory so that a safe operative performance is performed. Greater experience in the field would be necessary for broadened applications. Neuro-endoscopy presents exciting scientific possibilities in the future.
Vascular coma is one of the leading complications in patients suffering cerebrovascular accidents and it is therefore entirely appropriate that we should consider what critical care has to offer in this devastating disease process. Vascular coma patients need ventilatory assistance; Intubation and mechanical ventilation represent a life saving intervention. As critical care is subjected to progressive changes, careful definition of the role of mechanical ventilation, its types, and the ability of such a form of life sustaining support to affect patient outcome in multi-sided directions is mandatory.
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