RESUMO
Transcranial Doppler (TCD) sonography is emerging as a new ultrasonography technology to look at the interaction between the brain parenchyma and perfusion during cerebrovascular accident. Before TCD sonography the vasospasm following subarachnoid haemorrhage could only be diagnosed either clinically or by invasive method ie, angiography. TCD has been proved as a wonderful non-invasive, repeatable, beat-by-beat, non-expensive technique for detection and follow-up of vasospasm after subarachnoid haemorrhage. In the present series 12 patients suspected to have vasospasm after subarachnoid haemorrhage were confirmed and monitored with the help of TCD. Most of the patients were clinically presented with increasing headache and altered sensorium. It is noticed that vasospasm following subarachnoid haemorrhage has a typical course, which has increasing trend after 4th day of subarachnoid haemorrhage and declining trend after 14th day onwards. Six out of 12 patients were in moderate grade of vasospasm, 2 out of 12 were in severe grade and 4 out of 12 were mild grade of severity.
Assuntos
Hemorragia Subaracnóidea/complicações , Ultrassonografia Doppler Transcraniana , Vasoespasmo Intracraniano/diagnóstico por imagem , Velocidade do Fluxo Sanguíneo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Cerebral Média/fisiologia , Sensibilidade e Especificidade , Vasoespasmo Intracraniano/etiologia , Vasoespasmo Intracraniano/fisiopatologiaRESUMO
A retrospective study of 201 patients who underwent multilevel anterior cervical decompression and fusion by multiple interbody grafting and long segment strut grafting without plate fixation was conducted from January 1991 to December 2001. Previous studies have reported lower fusion rates for anterior cervical decompressions reconstructed with multiple interbody grafts as opposed to a single long strut graft. Our aim was a retrospective study of two fusion techniques with reference to radiological and clinical outcomes in patients operated by the senior author. Of 132 patients who underwent strut grafting, 124 achieved solid fusion (93.9%), whereas 48 of 69 patients who underwent multiple interbody grafting (69.6%) achieved solid fusion. There were five cases of graft displacement or extrusion among strut-grafted patients and one among patients with interbody grafts. More 'good' and 'excellent' clinical outcomes were found among patients who underwent strut grafting (87.1 v. 81.1%). Patients with pseudoarthrosis had significantly poorer clinical outcomes. Therefore, corpectomy or vertebrectomy and strut grafting should be considered after multilevel anterior cervical decompression to increase the likelihood of successful fusion and to improve clinical outcome.
Assuntos
Vértebras Cervicais/cirurgia , Descompressão Cirúrgica/métodos , Compressão da Medula Espinal/cirurgia , Fusão Vertebral/métodos , Adolescente , Adulto , Idoso , Vértebras Cervicais/transplante , Criança , Discotomia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Transplante Autólogo , Resultado do TratamentoRESUMO
A prospective study of 31 percutaneous vertebroplasty procedures (PVP) in 22 patients treated during January 2000 to December 2001 is presented. PVP was performed using polymethylmethacrylate (PMMA) to treat vertebral collapse due to osteoporosis and vertebral metastasis, to obtain analgesia and spinal stabilization. We analyze the efficacy and complications related to the procedure. PVP is a safe, effective and a daycare surgery. It can be performed under local anesthesia and has minimal and manageable complications.
