ABSTRACT
Intra cranial aneurysms are acquired lesions responsible for about 80% of non-traumatic sub arachnoid hemorrhage. Treatment of the condition in the past has relied on craniotomy and clipping of the aneurysm to prevent a recurrent hemorrhage. Nowadays endovascular coiling is the best primary treatment. The anesthesia in interventional radiology room has special arrangement and precautions. Intra operative management of endovascular cerebral aneurysm from the start including: arrangement of the room, monitoring, induction, maintenance and emergence of the patients. Post-operative care is very important and good management of potential perioperative complications like: aneurysm rupture, cerebral infarction, cerebral vasospasm, contrast reaction and nephropathy is mandatory
Aim of the Study: reviewing the current medical literature as regards the anesthetic considerations and problems of endo-vascular management of intracranial aneurysm
Conclusion: anesthesia in interventional radiology room should have special arrangements and precautions. Intra operative management of endovascular cerebral aneurysm from the start including: arrangement of the room, monitoring, induction, maintenance and emergence of the patients. Post-operative care plays a key role in mitigating potential perioperative complications like: aneurysm rupture, cerebral infarction, cerebral vasospasm, contrast reaction and nephropathy are mandatory
ABSTRACT
Our study was designed to examine the effect of pulsed electromagnetic field [PEMF], capacitative technique, on the healing of fractures at different stages. Forty-four patients were included in the study. They were divided into three groups. The first group comprised twenty-three patients who were subjected to PEMF after application of plaster cast [early treatment group]. The second included six patients who received PEMF after removal of the cast at 8 weeks [late treatment group]. The third group comprised fifteen patients who were only treated with fixation in plaster cast and served as a control group. The three groups were investigated using cross-sectional osteocalcin level at the start and at 8 and 12 weeks. Plain x-rays were done every 2 weeks and bone mineral density [BMD] was assessed with the quantitative CT of periosteal callus and expressed as F [fracture] / N [normal]% at 8 and 12 weeks. Laboratory and radiological data were statistically analyzed. We concluded that PEMF accelerates bone healing as there was a statistically significant difference in osteocalcin level between early treated patients and controls at 8 weeks and a highly significant difference at 12 weeks for patients who continued treatment. Late treatment patients were found to have increased osteocalcin level too. Radiological results confirmed the laboratory results for the positive effect of PEMF on bone healing. We recommend the use of PEMF for enhancement of fracture healing in cases of delayed union and in old age