TY - JOUR. T1 - Outcome following decompressive craniectomy for malignant middle cerebral artery infarction in children. AU - Smith, Sabrina E.. AU - Kirkham, Fenella J.. AU - Deveber, Gabrielle. AU - Millman, Guy. AU - Dirks, Peter B.. AU - Wirrell, Elaine C. AU - Telfeian, Albert E.. AU - Sykes, Kim. AU - Barlow, Karen. AU - Ichord, Rebecca. PY - 2011/1. Y1 - 2011/1. N2 - Aim: Mortality from malignant middle cerebral artery infarction (MMCAI) approaches 80% in adult series. Although decompressive craniectomy decreases mortality and leads to an acceptable outcome in selected adult patients, there are few data on MMCAI in children with stroke. This study evaluated the frequency of MMCAI and the use of decompressive craniectomy in children. Method: We retrospectively reviewed cases of MMCAI from five pediatric tertiary care centers. Results: Ten children (two females, eight males; median age 9y 10mo, range 22mo-14y) had MMCAI, with a median Glasgow Coma Scale score of 6 (range 3-9). MMCAI ...
1. Bang OY, Lee PH, Heo KG, Joo US, Yoon SR, Kim SY. Specific DWI lesion patterns predict prognosis after acute ischaemic stroke within the MCA territory. J Neurol Neurosurg Psychiatry. 2005. 76: 1222-8. 2. Berrouschot J, Sterker M, Bettin S, Köster J, Schneider D. Mortality of space-occupying ("malignant") middle cerebral artery infarction under conservative intensive care. Intensive Care Med. 1998. 24: 620-3. 3. Carter BS, Ogilvy CS, Candia GJ, Rosas HD, Buonanno F. One-year outcome after decompressive surgery for massive nondominant hemispheric infarction. Neurosurgery. 1997. 40: 1168-75. 4. Cho DY, Chen TC, Lee HC. Ultra-early decompressive craniectomy for malignant middle cerebral artery infarction. Surg Neurol. 2003. 60: 227-32. 5. Clarke DJ, Forster A. Improving post-stroke recovery: The role of the multidisciplinary health care team. J Multidiscip Healthc. 2015. 8: 433-42. 6. Demchuk AM, Wein TH, Felberg RA, Christou I, Alexandrov AV. Evolution of rapid middle cerebral artery ...
TY - JOUR. T1 - Decompressive craniectomy for space-occupying supratentorial infarction. T2 - rationale, indications, and outcome.. AU - Lanzino, D. J.. AU - Lanzino, G.. PY - 2000. Y1 - 2000. N2 - A subset of patients with ischemic cerebrovascular stroke suffer a progressive deterioration secondary to massive cerebral ischemia, edema, and increased intracranial pressure (ICP). The evolution is often fatal. In these patients, a decompressive craniectomy converts the closed, rigid cranial vault into an "open box." The result is a dramatic decrease in ICP and a reversal of the clinical and radiological signs of herniation. For these reasons, decompressive craniectomy has been increasingly proposed as a life-saving measure in patients with large, space-occupying hemispheric infarction. The authors review the rationale, indications, and clinical experience with this procedure, which has been performed in patients who have had supratentorial ischemic stroke.. AB - A subset of patients with ischemic ...
Objective: The randomized trials and pooled analysis showed improved outcome and reduced mortality in malignant middle cerebral artery [MMCA] undergoing decompressive hemicraniectomy (DHC) within 48 hours of stroke onset. This could be due to highly selective patient population in trials, not reflecting real world practice. Furthermore, with ischemic stroke being so common in the South Asian and Middle Eastern population, there still exists very little published data on DHC in MMCA stroke patients.. Methods: Retrospective, multicenter cross-sectional study to measure outcome following DHC using the modified Rankin Scale [mRS] and dichotomized as favorable ≤4 or unfavorable ,4, at three months.. Results: In total 137 patients underwent DHC. At 90 days, mortality was 16.8%, 61.3% of patients survived with an mRS ≤4 and 38.7% had an mRS of ,4. Age (55 years), diabetes [p=0.004], hypertension [p=0.021], pupillary abnormality [p=0.048], uncal herniation [p=0.007], temporal lobe involvement ...
Sinking skin flap syndrome (SSFS) is a complication among long-term survivors of stroke or traumatic brain injury treated by decompressive craniectomy. The syndrome encompasses a wide spectrum of neurological symptoms including cognitive decline, seizures, speech and sensorimotor deficits. Early cranioplasty appears to improve cerebral perfusion, but the efficacy of cranioplasty in neurocognitive outcome in long-standing SSFS patient is unclear. We report a 64-year-old patient who suffered from traumatic brain injury and underwent decompressive craniectomy 18 years ago. She had chronic SSFS with pre-cranioplasty assessments demonstrating severe neurocognitive impairments which were static over time. After cranioplasty with custom-made polyetheretherketone flap to restore the 264 cm 2 skull defect, magnetic resonance perfusion scan with pseudo-continuous arterial spin labelling technique showed a two-fold augmentation of cerebral blood flow in both frontal lobes, as well as areas distal to the ...
TY - JOUR. T1 - Decompressive craniectomy for intractable cerebral edema. T2 - Experience of a single center. AU - Ziai, Wendy C.. AU - Port, John D.. AU - Cowan, Jhon A.. AU - Garonzik, Ira M.. AU - Bhardwaj, Anish. AU - Rigamonti, Daniele. PY - 2003/1. Y1 - 2003/1. N2 - Several case reports and small clinical series have reported benefits of decompressive hemicraniectomy in patients with intractable cerebral edema and early clinical herniation. Specific indications and timing for this intervention remain unclear. We present our experience with this procedure in a subset of 18 patients with massive cerebral edema refractory to medical management, treated with decompressive craniectomy over a 3-year period (1997 to 2000). Computerized tomography (CT) scans were independently analyzed by a neuroradiologist blinded to clinical outcome. Eleven male and seven female patients, ages 20 to 69 years (mean ± SEM, 46 ± 14 years), underwent hemicraniectomy for the following diagnoses: 12 hemispheric ...
TY - JOUR. T1 - Decompressive craniectomy as the primary surgical intervention for hemorrhagic contusion. AU - Huang, Abel Po Hao. AU - Tu, Yong Kwang. AU - Tsai, Yi Hsin. AU - Chen, Yuan Shen. AU - Hong, Wei Chen. AU - Yang, Chi Cheng. AU - Kuo, Lu Ting. AU - Su, I. Chang. AU - Huang, She Hao. AU - Huang, Sheng Jean. PY - 2008/11/1. Y1 - 2008/11/1. N2 - The standard surgical treatment of hemorrhagic cerebral contusion is craniotomy with evacuation of the focal lesion. We assessed the safety and feasibility of performing decompressive craniectomy and duraplasty as the primary surgical intervention in this group of patients. Fifty-four consecutive patients with Glasgow Coma Scale (GCS) scores of less than or equal to 8, a frontal or temporal hemorrhagic contusion greater than 20 cm3 in volume, and a midline shift of at least 5 mm or cisternal compression on computer tomography (CT) scan were studied. Sixteen (29.7%) underwent traditional craniotomy with hematoma evacuation, and 38 (70.4%) ...
The prognosis of complete MCAO is very poor.1 2 3 4 5 6 In the clinical management of patients with MCAO, early thrombolysis proved to be beneficial.13 14 However, thrombolysis increases the risk for intracranial hemorrhage.17 18 Decompressive craniectomy has shown to be a lifesaving procedure for malignant MCA infarction.4 7 8 9 10 This experimental study directly compared the benefits of early reperfusion with those of decompressive craniectomy and evaluated the effects of combined treatment on infarction size and cerebral perfusion. To maximize reperfusion effects, we chose 60 minutes of permanent MCAO. We used DWI and PWI to follow the progression of the ischemic lesion and the perfusion deficit in an animal model of hemispheric stroke.. Reperfusion at 1 hour after MCAO significantly reduced the size of the ischemic lesion compared with animals without treatment. After the suture was withdrawn, the area with a bolus delay ,2 seconds decreased from 50% to 65% to approximately 10% to 20% of ...
Ischemic damage produced in the posterior cerebral territory causes significant morbidity and urgently must be considered if the patient need a surgical attitude. Surgical decompression by suboccipital craniectomy seams to be effective to treat secondary edema due to cerebellar damage or in posterior fossa, when medical treatment is not able to control side effects. We report a clinical case of a patient with a subacute ischemic infarction in the vertebro-basilar territory, with perilesional edema, and a posterior fossa decompressive craniectomy (DC) was carried out.
Background: Optimal management of increased intra-cranial pressure following severe traumatic brain injury comprises a combination of sequential medical and surgical interventions. Decompressive craniectomy (DC) is a cautiously recommended surgical option that has been shown to reduce intracranial pressure. Considerable variability in the timing and frequency of using DC across neurosurgical centres reflects, in part, the lack of clarity regarding long-term outcomes. The majority of previous work reporting outcomes among individuals who have received DC following traumatic brain injury (TBI) has focused predominantly on gross physical outcomes, to the relative exclusion of more subtle functional, social and psychological factors. Aim: This paper reviews the methodological aspects of previous studies that have reported outcomes following DC and provides recommendations to guide the future assessment of recovery to enable meaningful conclusions to be drawn from the literature describing outcomes ...
Over the past three decades there has been considerable interest in the use of decompressive craniectomy in the management of neurological emergencies. An increasing number of observational cohort studies have described use of the procedure, most commonly following severe traumatic brain injury and ischemic stroke and more recently in the context of subarachnoid hemorrhage, intracranial infection and in certain inflammatory conditions. Many of these studies have demonstrated that surgical decompression can lower the intracranial pressure in the context of medically intractable intracranial hypertension and many investigators have emphasized the life saving nature of the surgical procedure. However, surgical intervention will not reverse the effects of the pathological condition that precipitated the clinical deterioration and for many years, the concern has been that many survivors will be left with severe disability and dependency. An outcome that patients and their families may find to be
Background: Two randomised controlled trials (RCTs) of decompressive craniectomy (DC) in traumatic brain injury (TBI) have shown poor outcome, but there are considerations of how these protocols relate to real practice. The aims of this study were to evaluate usage and outcome of DC and thiopental in a single centre.. Method: The study included all TBI patients treated at the neurointensive care unit, Akademiska sjukhuset, Uppsala, Sweden, between 2008 and 2014. Of 609 patients aged 16 years or older, 35 treated with DC and 23 treated with thiopental only were studied in particular. Background variables, intracranial pressure (ICP) measures and global outcome were analysed.. Results: Of 35 DC patients, 9 were treated stepwise with thiopental before DC, 9 were treated stepwise with no thiopental before DC and 17 were treated primarily with DC. Six patients received thiopental after DC. For 23 patients, no DC was needed after thiopental. Eighty-eight percent of our DC patients would have qualified ...
BACKGROUND Delayed cranioplasty after decompressive craniectomy was performed using various reconstruction materials and methods. Bone graft infection is a major concern with cranioplasty. This study identified factors that are related to bone graft infection after cranioplasty. METHODS A total of 140 patients underwent reconstructive cranioplasty after decompressive craniectomy between 2000 and 2009. The sample population included 102 male patients and 39 female patients aged 6 years to 76 years, with a mean age of 47.5 years. Autografts were used for cranioplasty when available. Polymethylmethacrylate or customized linear high-density polyethylene was considered when autografts were unavailable. Bone graft infection was defined as the removal of the infected bone graft, and the related factors were evaluated retrospectively. RESULTS Bone graft infection occurred in 11 patients (7.86%). Bone graft infection after cranioplasty was significantly related to the number of operations (p = 0.002),
p=0.02). Bottom line Early cranioplasty didnt raise the an infection price within PIK-293 this scholarly research. The usage of nonmetal allograft components influenced a far more essential role in an infection in cranioplasty. In fact, timing itself had not been a substantial risk element in multivariate evaluation. Therefore the early cranioplasty may provide better outcomes in cognitive wound or functions without increasing chlamydia rate. Keywords: Cranioplasty, An infection, Decompressive craniectomy, Hydroxyapatities Launch Decompressive craniectomy is normally a strategy to alleviate intracranial pressure (ICP) in a variety of emergency circumstances like traumatic human brain injury, ischemic and hemorrhagic human brain and strokes edema in human brain tumor2,3). A big defect of cranial bone tissue after decompressive craniectomy inhibits early treatment process. It really is associated with extended amount of immobility, pulmonary an infection and thromboembolic occasions. A ...
The authors present the case of a 5-year-old child with severe traumatic brain injury in whom decompressive hemicraniectomy was performed for progressive increased intracranial pressure (ICP) unrespon
Paradoxical herniation has been referred to as the herniation of a brain that has been decompressed surgically, without any extra-axial lesion that could account for the herniation 1) 2). It is known as a rare complication of lumbar puncture in patients with decompressive craniectomy. Although rare, paradoxical
Severe Traumatic Brain Injury (sTBI) is a major cause of mortality and morbidity. At the Department of Neurosurgery Umeå University Hospital subjects with sTBI are treated with an intracranial pressure (ICP) guided therapy based on physiological principles, aiming to optimise the microcirculation of the brain so avoiding secondary brain injuries. The investigations in this thesis are unique in the sense that all patients with sTBI were treated according to the guidelines of an ICP targeted therapy based on the "Lund concept".. As the treatment is based on normalisation of the ICP, the accuracy and reliability of the measuring device is of outmost importance. Therefore the accuracy, drift, and complications related to the measuring device was prospectively studied (n=128). The drift was 0,9 ± 0,2 mmHg during a mean of 7,2 ± 0,4 days and the accuracy high. No clinical significant complications were noted.. In 1997 uni- or bilateral decompressive hemi-craniectomy (DC) was introduced into the ...
In 1901 Kocher noted that it may be helpful to "decompress the brain by widely opening the skull to decrease the pressure" (Holder 1901; 262-6). Over a century later, the role of decompressive craniectomy remains one of the most hotly-debated topics in the management of severe TBI. Observation and experience alone tell us that opening up a rigid compartment dramatically improves compliance and reduces the requirement for potentially dangerous interventions such as prolonged therapeutic hypothermia and tightly regulated invasive ventilation. This immediately begs the question why we do not decompress all patients with intracranial hypertension from TBI. Indeed in some situations decompression is the only conceivable option, such as after evacuation of a large extra-axial haematoma where the underlying brain immediately herniates out through the defect. Where equipoise remains, however, the question is whether decompressive craniectomy is a safe and effective option to treat raised ICP due to ...
Intracranial hematomas, whatever its causes, represent an important disabling, and dreaded adults lesion. This brains condition has not well been studied in developing countries. The aim of our study is to overview the management of intracaranial hematomas in Abidjan. It is a retrospective analytical and descriptive study, involving patients who had been admitted and monitored by neurosurgeons for intracranial hematomas, documented in brain CT scan and had been operated on from 1 January 2007 to December 31, 2009 in Abidjan. These 30 patients were 23 men and 7 women. The average age was 58.6 years old. 90% of the patients were admitted with wakefulness issues. Half had a Glasgow score of less than 8. The brain scanner allowed identification of an intraparenchymal hematoma associated or not with a cerebral ventricle contamination in 28 patients. There were 18 external ventricle derivations with or without decompressive craniectomy and 12 independent decompressive craniectomy. The evolution was marked
Large hemispheric infarction (LHI) is a severe form of stroke with high mortality and disability rates. The purpose of this study was to explore predictive indicators of the in-hospital mortality of LHI patients treated conservatively without decompressive hemicraniectomy. We performed a retrospective study of 187 consecutive patients with LHI between January 1, 2016 to May 31, 2019. The receiver operating curves were preformed to evaluate predictive performance of demographics factors, biomarkers and radiologic characteristics. Significant prognostic factors were combined to build a nomogram to predict the risk of in-hospital death of individual patients. One hundred fifty-eight patients with LHI were finally enrolled, 58 of which died. Through multivariate logistic regression analysis, we identified that independent prognostic factors for in-hospital death were age (adjusted odds ratio [aOR] = 1.066; 95% confidence interval [CI], 1.025-1.108; P = 0.001), midline shift (MLS, aOR = 1.330, 95% CI, 1.177
OBJECTIVES: To determine the frequency and duration of cortical spreading depolarization (CSD) and CSD-like episodes in patients with traumatic brain injury (TBI) and malignant middle cerebral artery infarction (MMCAI) requiring craniotomy. DESIGN: A descriptive observational study was carried out during 19 months. SETTING: Neurocritical patients. PATIENTS: Sixteen patients were included: 9 with MMCAI and 7 with moderate or severe TBI, requiring surgical treatment. INTERVENTIONS: A 6-electrode subdural electrocorticographic (ECoG) strip was placed onto the perilesional cortex. MAIN VARIABLES OF INTEREST: An analysis was made of the time profile and the number and duration of CSD and CSD-like episodes recorded from the ECoGs. RESULTS: Of the 16 patients enrolled, 9 presented episodes of CSD or CSD-like phenomena, of highly variable frequency and duration. CONCLUSIONS: Episodes of CSD and CSD-like phenomena are frequently detected in the ischemic penumbra and/or traumatic cortical regions of ...
Article just published in Journal of Neurology and Neuroscience Background: The functional outcome in patients after decompressive craniectomy in malignant mid…
Cranioplasty is routinely performed following decompressive craniectomy in both adult and pediatric populations. In adults, this procedure is associated with higher rates of complications than is elective cranial surgery. This study is a review of the literature describing risk factors for complications after cranioplasty surgery in pediatric patients. A systematic search of PubMed, Cochrane, and SCOPUS databases was undertaken. Articles were selected based on their titles and abstracts. Only studies that focused on a pediatric population were included; case reports were excluded. Studies in which the authors assessed bone flap storage method, timing of cranioplasty, material used (synthetic vs autogenous), skull defect size, and/or complication rates (bone resorption and surgical site infection) were selected for further analysis. Eleven studies that included a total of 441 cranioplasties performed in the pediatric population are included in this review.. The findings are as follows: 1) Based ...
Looking for cranioplasty? Find out information about cranioplasty. Surgical correction of defects in the cranial bones, usually by implants of metal, plastic material, or bone Explanation of cranioplasty
PDF Similar Articles Mail to Author Mail to Editor Effect of Early Bilateral Decompressive Craniectomy on Outcome for Severe Traumatic Brain Injury Mahmut AKYUZ, Tanju UCAR, Cem ACIKBAS, Saim KAZAN, Murat YILMAZ, Recai TUNCER ...
PARVATHY HOSPITAL SUCCESSFULLY CONDUCTS A LANDMARK CRANIOPLASTY SURGERY ~ First time in Tamil Nadu, a patient specific skull implant performed using Titanium plate customized with 3D Image Data ~. Chennai, August 25, 2016 - Parvathy Hospital, leading Ortho & Neuro hospital in the City, successfully conducted a unique Cranioplasty Surgery using a newly designed Titanium plate customized to fit the damaged portion of the skull of a 26 year old patient who sustained severe head injury. The Cranioplasty Surgery using the innovative implant was performed by globally acclaimed Dr. K. Eliyasbasha, Senior Consultant, Neurosurgeon known for his stem cell surgery for cervical cord injured patients.. The patient based in Chennai, who had recently returned from Kenya suffered severe head injury due to a bike accident, was admitted in the hospital with broken skull and brain matter oozing out of the injury. The Glasgow Coma Scale (GCS) of the patient was 4, due to the highest level of severity of the brain ...
This is a randomized, multi-center, prospective, double blind study. The primary objective is to demonstrate the efficacy of RP-1127 compared to placebo in subjects with a severe anterior circulation ischemic stroke who are likely to develop malignant edema. This objective will be addressed by comparing the proportion of RP-1127 treated patients and placebo treated patients with a Day 90 modified Rankin Scale (mRS) ≤ 4 without decompressive craniectomy (DC). ...
Swelling in Courtney Brinckmans brain in the aftermath of her pole-vaulting accident required a decompressive craniectomy. That risky neurosurgical procedure removes part of the skull in order to relieve the pressure that can block blood flow or warp the brain stem, both of which can cause death. Doctors typically wait six to 20 weeks for the swelling to subside before reattaching the skull piece. In the meantime, the skull bit needs to be preserved in a way that will protect its bone marrow. Some doctors prefer to freeze the skull bit. Brinckmans doctors elected to implant it in her abdomen, assuring it will be kept sterile, within a subcutaneous pouch ...
Objective: Current intraoperative monitoring techniques lack adequate surveillance of cerebral blood flow (CBF). Laser Speckle Imaging (LSI) can be used for non-invasive and direct assessment of cortical perfusion. The purpose of this study was to establish precision rates (positive and negative predictive values) for LSI-specific perfusion thresholds of infarcted and non-infarcted tissue in the human brain.. Method: Intraoperative LSI was performed in 22 hemispheres of 22 patients undergoing decompressive craniectomy (DC) for treatment of malignant hemispheric stroke (MHS). Infarct size and configuration was assessed by magnetic resonance imaging (MRI) and a 3-dimensional model reconstruction of the cortical surface (defined by MP RAGE) including the infracted cortical tissue (defined by DWI/ADC) was performed. Next, a color-coded laser speckle blood flow image was superimposed onto the MRI reconstruction and the infracted and non-infarcted areas were traced onto the laser speckle image. ...
Cerebral Ventricular Dimensions After Decompressive Craniectomy: A Comparison Between Bedside Sonographic Duplex Technique and Cranial Computed ...
Polymethyl-methacrylate (PMMA) as part of bone cement is a widely used material in the context of orthopaedic implants and also in cranioplasty. Although PMMA is characterised by excellent biocompatibility with low intrinsic toxicity and inflammatory activation, a minor portion of patients develop allergic reactions. We present the case of a 39-year-old woman with an increasing headache and a corresponding erythema over the parieto-occipital cranioplasty, which was performed 42 days prior using a PMMA compound. A patch test specific for bone cement components confirmed the diagnosis of a PMMA delayed-type hypersensitivity reaction. The prevalence of allergic reactions to bone cement components are known to vary from between 0.6% and 1.6%, however no adequate, pre-interventional diagnostic tool is currently available. Therefore, physicians are required to consider this differential diagnosis even after an extremely delayed onset of symptoms. This case describes the first ever-reported case in the ...
Twelve of the 17 patients enrolled in the study had cranioplasty performed and were included in the present investigation. Their mean ICP in the supine position increased from -0.5 ± 4.8 mm Hg the week before cranioplasty to 6.3 ± 2.5 mm Hg the week after cranioplasty (p , 0.0001), whereas the mean ICP in the sitting position was unchanged (-1.2 ± 4.8 vs -1.1 ± 3.6 mm Hg, p = 0.90). The difference in ICP between the supine and sitting positions was minimal before cranioplasty (1.1 ± 1.8 mm Hg) and increased to 7.4 ± 3.6 mm Hg in the week following cranioplasty (p , 0.0001). During the succeeding 2 weeks of the follow-up period, the mean ICP in the supine and sitting positions decreased in parallel to, respectively, 4.6 ± 3.0 mm Hg (p = 0.0003) and -3.9 ± 2.7 mm Hg (p = 0.040), meaning that the postural ICP difference remained constant at around 8 mm Hg. The mean intracranial PWA increased from 0.7 ± 0.7 mm Hg to 2.9 ± 0.8 mm Hg after cranioplasty (p , 0.0001) and remained around 3 mm ...
Vallabhajosula S, Solnes L, Vallabhajosula B. A broad overview of positron emission tomography radiopharmaceuticals and clinical applications: what is new? Semin Nucl Med. 2011 Jul;41(4):246-64. Voss HU, Heier LA, Schiff ND. Multimodal imaging of recovery of functional networks associated with reversal of paradoxical herniation after cranioplasty. Clin Imaging. 2011 Jul-Aug;35(4):253-8 ...
hello everyone, first off thank you so much for this forum it has helped me and my family enormously My mom suffered TBI and craniectomy was performed (June 2018), and she just got a titanium mesh...
A nonrandomized set of 22 patients participated in the study. The age range of the subject group was 15-65 years of age. The patients were selected from 3 different chiropractic facilities in the United States. Patients were evaluated according to their chief complaint at initial presentation. Patients were excluded from the study if neoplasm, malignancy, fracture, scoliosis secondary to genetic disorders, or previous arthrodesis were identified.. Each patient was examined radiographically for location and severity of scoliosis with sitting anteroposterior full spine imaging. Cobb angles were drawn on each radiograph to identify the degree of curvature present. A specific treatment plan was created based upon the results of each patients radiographic measurements before and after a sample trial of the proposed clinical procedures. Initially, lateral cervical, nasium, lateral lumbar, and anteroposterior lumbopelvic views were taken. These views were taken to quantify forward head posture, ...
This is a Phase 3 study, which means that BIIB093 (study drug) has already been investigated in previous clinical research studies with a small number of people with large hemispheric infarction (LHI). These studies suggested that the study drug was safe, did not cause serious side effects or discomfort, and may reduce brain swelling, disability, and death in subjects with LHI. In this study, we want to investigate the study drug in a larger number of subjects (hundreds) to know more about it. LHI is a type of stroke. An ischemic stroke occurs when blood flow to parts of the brain is blocked, such as by a blood clot. This can cause damage to the brain. In LHI a large portion of the brain is damaged. People who have LHI can develop swelling of the brain called cerebral edema, which can worsen the symptoms and outcomes of LHI. Currently, there are no medications available to specifically reduce brain swelling caused by LHI. In this study, we want to investigate how well the study drug works to ...
THE SINKING by Robert Frenz 10 February 2000 Like sinking ships which suddenly disappear or gradually merge with the sea, suicides can take similar courses. The bullet offers a very brief exercise. Alcohol, tobacco, disease, promiscuity and so on, offer a longer ride downhill. I cannot remember his name so I shall call him John. John had a father who spent most of his waking hours in the pursuit of Mammon. Although the TV program didnt reveal all faces, the look of John indicated that he was race-mixed to a degree with the major element being White. He thought of himself as White although his behavior indicated otherwise. The family moved to Conyer Georgia and established residence in quarters very high on the hawg, so to speak. Daddy Moneybucks soon went his own way leaving John with an emotional cripple for a mother. Being a stranger in town, John was not greeted at first with open arms but he nonetheless was enterprising. His continually stuffed wallet was a means to buy friends. In my ...
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Local Media Ignore Story - Is It Because of Mystery Ship Possibly Involved in Collision? By JEC / Special to the OB Rag A mystery is unfolding offshore from OB. The 65th Newport to Ensenada sailboat race started in Newport
been having this problem for over a month now. seen a few doctors and had blood work and ekgs done with no results. i was told that my problem was stress and anxiety. was put on cymbalta for a few mon...
Oh how sweet the sound of other peoples money! Devoid of the real Truth - Patrick Henry knew that following false hope would lead only to further degradation. The further down the path we are headed the more like beasts we will become.
OS Types and Functions By Black Cluster Yeah, yeah! I felt so bored today and since I have some time to waste, I decided to write this tutorial about the OSs and their functions, absolutely for newbies. Many of my friends have been sinking in the sea of computer in general and been asking, what is the OS? How they operate? etc. Operating System Definition
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The journal focuses on neuroimmunology and neuroinflammation, and the coverage extends to other basic and clinical studies related to neuroscience including molecular biology, psychology, pathology, physiology, endocrinology, pharmacology, oncology, etc.
TY - JOUR. T1 - Neurologic outcome of posttraumatic refractory intracranial hypertension treated with external lumbar drainage. T2 - Commentary. AU - Vender, John R. PY - 2007/2/1. Y1 - 2007/2/1. UR - http://www.scopus.com/inward/record.url?scp=33846975436&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=33846975436&partnerID=8YFLogxK. U2 - 10.1097/01.ta.0000199422.01949.78. DO - 10.1097/01.ta.0000199422.01949.78. M3 - Comment/debate. AN - SCOPUS:33846975436. VL - 62. JO - Journal of Trauma and Acute Care Surgery. JF - Journal of Trauma and Acute Care Surgery. SN - 2163-0755. IS - 2. ER - ...
Looking for online definition of cranioplasty in the Medical Dictionary? cranioplasty explanation free. What is cranioplasty? Meaning of cranioplasty medical term. What does cranioplasty mean?
Cranioplasty is the surgical intervention to repair cranial defects. The aim of cranioplasty is not only a cosmetic issue; also, the repair of cranial defects gives relief to psychological drawbacks and increases the social performances. Many different types of materials were used throughout the history of cranioplasty. With the evolving biomedical technology, new materials are available to be used by the surgeons. Although many different materials and techniques had been described, ongoing researches on both biologic and non biologic substitutions continue aiming to develop the ideal reconstruction material.. Autologous bone grafts remain the best option for adult and pediatric patients with viable donor sites and small-to-medium defects. Large defects in the adult population can be reconstructed with titanium mesh and polymethylmethacrylate overlay with or without the use of computer-assisted design and manufacturing customization. Advances in alloplastic materials and custom manufacturing of ...