RESUMO
A study of 1,000 STA-MCA by-pass procedures in stroke patients is described as "extremely encouraging", with greater than 90% patency rate and marked improvement in patients who had not responded to medical management or had been turned away from routine vascular surgery.
Assuntos
Artérias Cerebrais/cirurgia , Transtornos Cerebrovasculares/cirurgia , Microcirurgia/métodos , Circulação Cerebrovascular , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
In the belief that secondary cerebral compression, hypoxia, and ischemia materially influence the outcome from severe head injury, a standardized protocol was followed in 160 patients, with emphasis on early diagnosis and evacuation of intracranial mass lesions by craniotomy, artificial ventilation, control of increased intracranial pressure, and aggressive medical therapy. Of these patients, 36% made a good recovery, 24% were moderately disabled, 8% were severely disabled, 2% were vegetative, and 30% died. The mortality rate compares favorably with outcomes in similar patients reported from other centers and there has been no increase in the numbers of severely disabled or vegetative patients. It is proposed that vigorous surgical and medical therapy, by preventing or reversing secondary cerebral insults, enables some patients who would have died to make a good recovery without increasing the proportion of severely disabled patients.
Assuntos
Lesões Encefálicas/terapia , Adolescente , Adulto , Fatores Etários , Idoso , Lesões Encefálicas/diagnóstico , Lesões Encefálicas/fisiopatologia , Criança , Pré-Escolar , Feminino , Humanos , Unidades de Terapia Intensiva/métodos , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores Sexuais , Fatores de TempoRESUMO
A study was made in 10 patients with brain tumors of the effect of methylprednisolone sodium succinate (Solu-Medrol) on clinical neurological status, intracranial pressure, and periventricular elastance. Significant clinical improvement and reduction in periventricular elastance both ocurred within 24 hours of starting treatment, whereas intracranaial pressure was not significantly reduced until the 2nd day of therapy.
Assuntos
Adenoma Cromófobo/tratamento farmacológico , Neoplasias Encefálicas/tratamento farmacológico , Glioblastoma/tratamento farmacológico , Metilprednisolona/uso terapêutico , Adulto , Avaliação de Medicamentos , Humanos , Pressão Intracraniana/efeitos dos fármacos , Pessoa de Meia-Idade , Metástase Neoplásica , Cuidados Pré-OperatóriosRESUMO
The immunocompetence of patients with glioblastomas, but not patients with astrocytomas, is altered. In vitro testing demonstrates an inhibitory factor in the serum of patients with glioblastomas which impairs lymphocytic responsiveness. The degree of this impairment appears important in relation to the clinical course.
