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  • 2005-2009
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  • 1995-1999  (2)
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  • 1998  (2)
  • 1
    Electronic Resource
    Electronic Resource
    Thrombin Activity in CSF after SAH is Correlated with the Degree of SAH, the Persistence of Subarachnoid Clot and the Development of Vasospasm (1998)
    Springer
    Acta neurochirurgica 140 (1998), S. 579-584 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Fibrinopeptide; subarachnoid haemorrhage; thrombin; vasospasm.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  We previously reported that the coagulation system in cerebrospinal fluid (CSF) is strongly activated in the early stage of a subarachnoid haemorrhage (SAH). We evaluated the relationship among thrombin activity, degree of SAH, amount of clearance of SAH, and vasospasm. The CSF levels of fibrinopeptide A (FPA) were measured by radio-immunoassay in 36 SAH patients, who were diagnosed by computerized tomography (CT) within 12 hours and on whom surgery was performed within 48 hours. Clearance of SAH (%) was evaluated as the size of the clot in the basal cistern visualized between the initial and postoperative CT. The mean level of FPA in the patients of Group 3 (Fisher's CT classification) (182.2 ng/ml) was significantly higher than those in the patients of Group 2 (36.2 ng/ml). There was a significant difference in the mean level of FPA between patients with (47.6 ng/ml) and without infarction (408.3 ng/ml). In 18 of the 27 patients of Group 3 for whom the clearance of the SAH was determined, the patients showing a lower clearance rate (〈50%) of SAH demonstrated a significantly higher rate of infarction and a significantly higher level of FPA (466.6 ng/ml) than did the patients with a higher clearance rate (〉50%) of SAH (79.2 ng/ml). These results suggest that, the thrombin activity in CSF is correlated with the degree of SAH, the persistence of subarachnoid clot and the development of vasospasm.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050143
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Current Treatment Strategies and Factors influencing Outcome in Patients with Bacterial Brain Abscess (1998)
    Springer
    Acta neurochirurgica 140 (1998), S. 1263-1270 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Brain abscess; infection; mortality; outcome; intraventricular rupture of brain abscess.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  We clearly determined the key to managing patients with brain abscess by retrospectively evaluating the factors affecting poor outcome in these patients. This study included 113 patients with brain abscess diagnosed in the CT era. Basic characteristics and therapeutic parameters were estimated as independent predictors of poor outcome by using univariate and multivariate logistic regression analysis. Patients with poor outcomes more frequently had deeply-located abscesses (p〈0.02), IVROBA (intraventricular rupture of brain abscess) (p〈0.001) and were in a severely deteriorated neurological state (p〈0.001) than those with good outcomes. Multiple logistic regression analysis predicted that IVROBA (ORs, 24.5; 95% CI, 3.04 to 197.9) and severely deteriorated cases (ORs, 13.7; 95% CI, 2.34 to 80.8) resulting from IVROBA increased the relative risk of poor outcome. Patients with IVROBA more frequently had also deeply-located abscesses (p〈0.005), positively immunocompromised states (p〈0.05) an (p〈0.003) than those without IVROBA. Patients with metastatic abscess had also IVROBA (p〈0.006). Multiple logistic regression analysis anticipated that deeply-located abscess (ORs, 3.90; 95% CI, 1.38 to 11.04), and metastatic abscess (ORs, 12.26; 95% CI, 1.35 to 111.2) increased the relative risk of IVROBA. Patients in an obtunded state and with marked neurological deficit had IVROBA more often than patients in an alert state and/or mild neurological deficit (ORs, 3.23; 95% CI, 1.17 to 8.86, (p〈0.03) before treatment. Our findings suggest that IVROBA strongly influences poor outcome in patients with brain abscess. The key to decreasing poor outcomes may be the prevention and management of IVROBA, by evaluating intracranial pressure pathophysiology. IVROBA should be aggressively treated by aspiration methods for the abscess coupled with appropriate intravenous and intrathecial administration of antibiotics.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050248
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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