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  • 1
    Electronic Resource
    Electronic Resource
    The effect of nimodipine on autoregulation of cerebral blood flow after subarachnoid haemorrhage in rat (1995)
    Springer
    Acta neurochirurgica 132 (1995), S. 98-103 
    Details
    ISSN: 0942-0940
    Keywords: Autoregulation ; cerebral blood flow ; nimodipine ; subarachnoid haemorrhage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Disturbance of the autoregulation of the cerebral blood flow (CBF) is frequently seen following subarachnoid haemorrhage (SAH) and is possibly partly caused by cerebral ischaemia. It is well-known, that the calcium channel blocker nimodipine reduces the incidence of cerebral infarction and ischaemic dysfunction after SAH. The aim of the present study was to investigate the effect of nimodipine on autoregulation of CBF in an experimental model of SAH. The autoregulation was investigated in 10 control rats with SAH and in 10 nimodipine treated rats with SAH by serial measurements of CBF using a133Xenon intracarotid injection method during controlled blood pressure manipulations. In the control rats the autoregulation was severely disturbed, no plateau was found where CBF was independent of changes in the arterial blood pressure (MABP). In rats treated with intravenous nimodipine (0.03 mg/kg bodyweight/h), CBF was 33.0% higher and MABP 5.3% higher compared with the controls. CBF was found constant in the MABP interval between 60 and 100 mmHg which indicates, that nimodipine improves the autoregulation of CBF after SAH.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01404855
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  • 2
    Electronic Resource
    Electronic Resource
    Cerebral blood flow autoregulation in experimental subarachnoid haemorrhage in rat (1992)
    Springer
    Acta neurochirurgica 119 (1992), S. 128-133 
    Details
    ISSN: 0942-0940
    Keywords: Experimental subarachnoid haemorrhage ; cerebral autoregulation ; cerebral blood flow ; cerebral vasospasm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Haemodynamic instability is of great importance in clinical management of patients with subarachnoid haemorrhage (SAH). The significance of angiographically demonstrable vasospasm for disturbances of cerebral blood flow (CBF) and cerebral autoregulation has not yet been clarified. The present study was designed to describe disturbances of cerebral autoregulation during the timecourse of experimental SAH (eSAH) in rats. A second aim of the study was to relate the results to a reported timecourse of angiographic vasospasm in the same animal model. Previous studies have shown that the timecourse of angiographically visible vasospasm in eSAH is biphasic with maximal spasm at 10 min and 2 days after induction of eSAH. At 5 days, the vasospasms have resolved. CBF was measured using a133-Xenon intracarotid injection method which allowed serial measurements of mean hemispheric CBF during controlled manipulations of arterial blood pressure. In this way, an autoregulation curve could be constructed. The present study shows that autoregulation is severely disturbed or even totally absent at 2 and 5 days after eSAH. Thus there seems to be no direct correlation between presence of angiographic vasospasm and impairment of autoregulation, or that the impairment of autoregulation is more protracted than the presence of cerebral vasospasm, presuming a correlation exist.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01541796
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    A Comparison Between Ventriculo-Peritoneal and Ventriculo-Atrial Cerebrospinal Fluid Shunts in Relation to Rate of Revision and Durability (1998)
    Springer
    Acta neurochirurgica 140 (1998), S. 459-465 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Cerebrospinal fluid shunts; ventriculo-atrial shunts; ventriculo-peritoneal shunts; hydrocephalus; Kaplan-Meyer method.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Results of 884 first-time shunts inserted in the time period from 1958 to 1989 are retrospectively evaluated, 1) to perform a durability analysis of a shunt based on Kaplan-Meyer method, 2) to compare the rate of revision for ventriculo-atrial (VA) and ventriculo-peritoneal (VP) shunts, 3) to compare the durability of a VA shunt with a VP shunt and 4) to do a stratified durability analysis comparing the VA and VP shunts in relation to the following background variables: shunt type, time period and age of the patient. Furthermore the specific complications related to VA and VP shunts are identified based on findings in the literature. Overall one-year shunt durability is 57% and five-year shunt durability is 37%. The median shunt durability is 1.68 years. Revision rate is 51% for VA shunts and 38.5% for VP (p〈0.05). Shunt durability is longer for VP shunts though the difference is not significant (p〈0.1). By use of stratified analysis of shunt durability no differences however are found between the two shunting methods. Hence the apparent difference in revision rate between VA and VP shunts seems secondary to variations in follow-up time and variations in background variables. To supplement our statistical analysis we have performed a literature study to look at the specific complications associated with VA and VP shunts. It seems as if the specific complications in relation to the VA shunting method are more severe than in relation to the VP shunting method.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050125
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  • 4
    Electronic Resource
    Electronic Resource
    Frequency and causes of shunt revisions in different cerebrospinal fluid shunt types (1995)
    Springer
    Acta neurochirurgica 136 (1995), S. 189-194 
    Details
    ISSN: 0942-0940
    Keywords: Cerebrospinal fluid shunts ; hydrocephalus ; revision rate ; shunt types
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Shunt complications and revisions are common in hydrocephalic patients treated with a ventriculo-atrial or a ventriculo-peritoneal shunt. The reported revision rate differs very much but the rate of revision is close to 50% in many papers. Data from 884 hydrocephalic patients treated with various shunt types in the period 1958–1989 were recorded retrospectively in order to evaluate the frequency of revision for various shunt types and secondly to analyse the specific reasons for the shunt revisions. The rate of shunt revision was 45%. The Pudenz shunt was revised more often (62%) than the remaining shunt types. The Hakim and the Orbis-Sigma shunts had fewer revisions (35% and 27%, respectively) than the other observed shunt types. A defect of or an obstruction in the ventricular catheters was a frequent cause of revision followed by a defect or an obstruction of the distal catheter, a displacement of the distal catheter and an acute infection. Because of the higher rate of revision for the Pudenz shunt the rate of the above mentioned specific complications is also higher in most of the subgroups for that specific shunt type. Driven by these experiences it is reasonable to seek to develop and introduce new shunt types in an attempt to reduce the complication rate.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01410625
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Does nimodipine influence sex difference in outcome after aneurysmal subarachnoid haemorrhage? (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 1168-1171 
    Details
    ISSN: 0942-0940
    Keywords: Delayed cerebral ischaemia ; intracranial aneurysm ; nimodipine ; gender ; subarachnoid haemorrhage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Before nimodipine was introduced as a standard treatment in patients with aneurysmal subarachnoid haemorrhage (SAH) females had a significantly poorer outcome which might be due to a higher frequency of delayed cerebral ischaemia (DCI). We evaluated the overall outcome with regard to gender in 188 consecutive patients with a verified ruptured intracranial aneurysm treated with nimodipine. The only significant differences concerning prognostic factors between the sexes were a higher frequency of SAH at the primary CT in females (p〈0.05) and a higher frequency of middle cerebral artery aneurysms in females (p〈0.01). These factors affect the outcome in females unfavourably. However, contrary to previous studies, we found no difference in overall outcome after three months between the sexes in this clinical material. Our observation can be explained by a positive effect of nimodipine on DCI.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01809746
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    Paper (German National Licenses)
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