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At least 37 records · Page 2Linked to original sources
PubMed2006

Outcome after surgical decompression of severe traumatic brain injury.

One of the factors that affects outcome following severe traumatic brain injury is development and progression of cerebral oedema with associated increase in intracranial pressure (ICP). Uncontrolled elevations of ICP may compromise energy metabolism of the injured brain and lead to secondary injury, affecting neurological outcome of the patient. Decompressive craniectomy has been used for over a century as a treatment of refractory brain swelling in a variety of neurological conditions. However, conclusive evidence of whether it has a beneficial or adverse affect on outcome is lacking. This article reviews the existing evidence on the role of decompressive craniectomy in management of patients with traumatic brain injury and stresses the need for randomised controlled trials.

Brain Injuries↗
PubMed2003

Recovery of spinal cord conduction after surgical decompression for cervical spondylotic myelopathy: serial somatosensory evoked potential studies.

OBJECTIVE: We tested the utility of scalp-recorded median and tibial somatosensory evoked potentials (SEPs) as a measure of delineating the time course of postoperative recovery from cervical spondylotic myelopathy. DESIGN: We evaluated serial median and tibial SEP studies for 20 hands and 22 feet in 13 cervical spondylotic myelopathy patients during the first 6 mo postoperatively or longer. Serial sensory assessment of the hands and feet served to evaluate clinical correlation with the SEPs. RESULTS: The studies distinguished three recovery patterns of the SEPs based on the time course of the latencies of the N20 component for the median SEP and the P40 component for the tibial SEP. The latency started to decrease by 0.5 msec or more within 2 wk (seven hands and eight feet) or later than 2 wk (six hands and eight feet) postoperatively, or the change did not reach 0.5 msec (seven hands and six feet). In the late recovery group, the SEP improvement began as late as 10 wk postoperatively. Sensory recovery correlated with the SEP change in every group. CONCLUSIONS: An early onset of the SEP recovery predicts a favorable clinical course. The SEP may begin to improve later, and once it occurs, progressive return of function will follow.

Adult↗
PubMedDate not supplied

Surgical decompression of chronic central core lesions of the Achilles tendon.

We report the outcome of 14 athletes with chronic recalcitrant achillodynia and central core degeneration of the Achilles tendon. The patients underwent surgery after an average time from onset of symptoms to surgery of 87 months. All patients had undergone conservative management, including physical therapy treatment, orthoses, nonsteroidal antiinflammatory drugs, and steroid injections. At an average follow-up of 35 months (range, 27 to 52), only 5 patients had an excellent or good result, despite reexploration in 6 of the 14 patients. In athletes with long-standing pain and central core degeneration of the Achilles tendon, prognosis is poor, and even reexploration is not successful. If the referral pattern allows, surgery should probably be undertaken earlier.

Achilles Tendon↗