scholarly journals Delayed neurological deterioration with an unknown cause subsequent to surgery for intraspinal meningiomas

2015 ◽  
Vol 9 (5) ◽  
pp. 2325-2330 ◽  
Author(s):  
TAO YANG ◽  
LIANG WU ◽  
XIAOFENG DENG ◽  
CHENLONG YANG ◽  
YAN ZHANG ◽  
...  
Keyword(s):  
Neurological Deterioration ◽  
Delayed Neurological Deterioration

Prevention of postoperative posterior tethering of spinal cord after resection of ependymoma

2003 ◽  
Vol 99 (2) ◽  
pp. 181-187 ◽  
Author(s):  
Takeo Goto ◽  
Kenji Ohata ◽  
Toshihiro Takami ◽  
Misao Nishikawa ◽  
Akimasa Nishio ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Neurological Deterioration ◽  
Fisher Exact Test ◽  
Content Type ◽  
Exact Test ◽  
Spinal Ependymoma ◽  
Group A ◽  
Delayed Neurological Deterioration ◽  
Group B ◽  
Fine Print

Object. The authors evaluated an alternative method to avoid postoperative posterior tethering of the spinal cord following resection of spinal ependymomas. Methods. Twenty-five patients with spinal ependymoma underwent surgery between 1978 and 2002. There were 16 male and nine female patients whose ages at the time of surgery ranged from 14 to 64 years (mean 41.8 years). The follow-up period ranged from 6 to 279 months (mean 112.4 months). In the initial 17 patients (Group A), the procedure to prevent arachnoidal adhesion consisted of the layer-to-layer closure of three meninges and laminoplasty. In the subsequently treated eight patients (Group B), the authors performed an alternative technique that included pial suturing, dural closure with Gore-Tex membrane—assisted patch grafting, and expansive laminoplasty. In Group A, postoperative adhesion was radiologically detected in eight cases (47%), and delayed neurological deterioration secondary to posterior tethering of the cord was found in five cases. In Group B, there was no evidence of adhesive posterior tethering or delayed neurological deterioration. A significant intergroup statistical difference was demonstrated for radiologically documented posterior tethering (p < 0.05, Fisher exact test). Moreover, patients with radiologically demonstrated posterior tethering suffered a significant delayed neurological functional deterioration (p < 0.01, Fisher exact test). Conclusions. This new technique for closure of the surgical wound is effective in preventing of postoperative posterior spinal cord tethering after excision of spinal ependymoma.

scholarly journals Determinants of Early Versus Delayed Neurological Deterioration in Intracerebral Hemorrhage

Stroke ◽  
2019 ◽  
Vol 50 (6) ◽  
pp. 1409-1414 ◽  
Author(s):  
Shoujiang You ◽  
Danni Zheng ◽  
Candice Delcourt ◽  
Shoichiro Sato ◽  
Yongjun Cao ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Neurological Deterioration ◽  
Delayed Neurological Deterioration

scholarly journals Platelet-to-neutrophil Ratio after Intravenous Thrombolysis Predicts Unfavorable Outcomes in Acute Ischemic Stroke

2020 ◽  
Vol 17 (4) ◽  
pp. 411-419
Author(s):  
Mei-Qi Wang ◽  
Ying-Ying Sun ◽  
Yan Wang ◽  
Xiu-Li Yan ◽  
Hang Jin ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Intravenous Thrombolysis ◽  
Final Analysis ◽  
Hemorrhagic Transformation ◽  
Neurological Deterioration ◽  
Receiver Operating Curve ◽  
Outcome Indicators ◽  
Early Neurological Deterioration ◽  
Delayed Neurological Deterioration

Background and Purpose: Platelet-to-neutrophil ratio (PNR) was suggested to be an independent protective predictor for 90-days outcomes in acute ischemic stroke (AIS) patients in previous studies. This study aims to investigate the association between PNR and outcomes of AIS in intravenous thrombolysis (IVT) group. Methods: Data on acute ischemic stroke patients who received intravenous thrombolysis from April 2015 to March 2019 were collected. We defined the PNR value at admission as pre-IVT PNR and after IVT within 24 h was defined as post-IVT PNR. Clinical outcome indicators included early neurological deterioration (END), hemorrhagic transformation (HT), delayed neurological deterioration (DND), and poor 3-month outcome (3m-mRS >2). Results: A total of 581 patients were enrolled in the final analysis. The age was 61(53-69) years, and 423(72.8%) were males. Post-IVT PNR was independently associated with hemorrhagic transformation (OR = 0.974; 95%CI = 0.956-0.992; P=0.006), early neurological deterioration (OR = 0.939; 95%CI = 0.913-0.966; P = 0.01), delayed neurological deterioration (OR = 0.949; 95%CI = 0.912- 0.988; P = 0.011), and poor outcome (OR = 0.962; 95%CI = 0.948-0.976; P<0.001). PNR level was identified as high (at the cut-off value or above) or low (below the cut-off value) according to receiver operating curve (ROC) analyses on each endpoint. Comparison of early neurological deterioration, hemorrhagic transformation, delayed neurological deterioration, and poor 3-month outcome (3m-mRS >2) between patients at high and low levels for platelet-to-neutrophil ratio (PNR) showed statistical differences (p<0.001). Conclusions: Post-IVT PNR was independently associated with early neurological deterioration, hemorrhagic transformation, delayed neurological deterioration, and poor 3-month outcome. Lower PNR can predict a worse outcome.

Cerebral Vasospasm after Head Injury

Neurosurgery ◽  
1984 ◽  
Vol 15 (6) ◽  
pp. 855-858 ◽  
Author(s):  
Alberto Pasqualin ◽  
Carlo Vivenza ◽  
Luisa Rosta ◽  
Claudio Licata ◽  
Paolo Cavazzani ◽  
...  
Keyword(s):  
Head Injury ◽  
Cerebral Vasospasm ◽  
Degradation Products ◽  
Ct Scanning ◽  
Neurological Deterioration ◽  
Acute Subdural Hematoma ◽  
Digital Subtraction ◽  
Computed Tomographic ◽  
Motorcycle Accident ◽  
Delayed Neurological Deterioration

Abstract Cerebral vasospasm occurs frequently after head injury. Correlation between neurological deterioration and vasospasm has been reported previously, but delayed neurological deterioration secondary to vasospasm in head injury is a rare occurrence. We report the case of a 57-year-old man who, after a motorcycle accident, developed an acute subdural hematoma and a thick subarachnoid deposition of blood in the left sylvian-insular cistern. After surgical evacuation of the hematoma, the patient improved until the 10th postoperative day, when he developed aphasia and a right hempiparesis. Angiography demonstrated multitapering spasm, and a computed tomographic (CT) scan showed persistence of the cisternal deposition of blood. Despite therapy with hypervolemia, the patient improved only slightly. The association of head injury with substantial subarachnoid hemorrhage producing vasospasm has been considered rarely. Delayed posttraumatic vasospasm secondary to blood degradation products seems to play some role in the vasospasm after head injury. CT scanning may be useful in predicting vasospasm in such patients, and digital subtraction angiography might be useful in demonstrating it.

Delayed Neurological Deterioration After Mild Head Injury

Neurosurgery ◽  
2013 ◽  
Vol 73 (5) ◽  
pp. 753-760 ◽  
Author(s):  
Osamah J. Choudhry ◽  
Charles J. Prestigiacomo ◽  
Nihar Gala ◽  
Shira Slasky ◽  
Ziad C. Sifri
Keyword(s):  
Head Injury ◽  
Neurological Deterioration ◽  
Mild Head Injury ◽  
Delayed Neurological Deterioration

scholarly journals Hypertrophic Olivary Degeneration after Pontine Hemorrhage: A Cause of Delayed Neurological Deterioration

2013 ◽  
Vol 36 (2) ◽  
pp. 153-154 ◽  
Author(s):  
Inês Menezes Cordeiro ◽  
Joana B. Tavares ◽  
Sofia Reimão ◽  
Ruth Geraldes ◽  
José M. Ferro
Keyword(s):  
Neurological Deterioration ◽  
Hypertrophic Olivary Degeneration ◽  
Pontine Hemorrhage ◽  
Delayed Neurological Deterioration
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