Three procedure-related complications occurred during TBA (dissection, n = 1; temporary vessel occlusions, n = 2). One of these remained asymptomatic, whereas this may have contributed Bromosporine cell line to the development of infarction on follow-up computed tomographic scans in two cases.
CONCLUSION: In a population of patients with a high risk of infarction resulting from vasospasm after subarachnoid hemorrhage, the frequency of infarction in the distribution of vessels undergoing TBA amounts to 7% and
is significantly lower than in vessels not undergoing TBA despite some risk inherent to the procedure.”
“OBJECTIVE: The goals of this study were to investigate the risk factors, indications, complications, and outcome for patients with ventriculoperitoneal shunts (VPSs) after subarachnoid hemorrhage and to define a subgroup eligible for future prospective studies designed to clarify indications for placement of a VPS.
METHODS: Clinical characteristics of 236 prospectively evaluated patients with subarachnoid hemorrhage and 6 months of follow-up were analyzed. Hydrocephalus was estimated by the relative bicaudate index (RBCI) measured on computed tomographic scans at the time of shunting. Patients were divided into three groups by ventricle size: Group 1 included 121 patients with small ventricles (RBCI < 1.0), Group 2 included 88 patients with borderline ventricle size (RBCI 1.0-1.4), and Group 3 included 27 patients with
markedly enlarged ventricles (RBCI > 1.4).
RESULTS: Initially, 86 patients (36%) underwent ventriculoperitoneal shunting: 19 in Group 1 (16%), 43 in Group 2 (49%), and 24 in Group 3
(90%). Indications find more for placement of a VPS, risk factors, and outcome differed markedly by group. Four patients (3% of those not initially shunted) developed delayed hydrocephalus requiring a VPS, including one in Group 2 (2%). The 6-month shunt complication rate was 13%. Evaluation of patients in PF-6463922 in vitro Group 2 indicated that functional status was an important factor in selecting candidates for shunting, and that patients receiving shunts and shunt-free patients demonstrated improvement in functional status during follow-up.
CONCLUSION: Although we currently use a proactive shunting paradigm for posthemorrhagic hydrocephalus, this report demonstrates that a conservative approach to patients with borderline ventricle size (i.e., RBCI of 1.0-1.4) and normal intracranial pressure should be evaluated in a prospective randomized trial.”
“OBJECTIVE: Intracranial dural arteriovenous fistulae (DAVFs) can present as disabling intracranial hemorrhage. The aim of this study was to investigate the independent effects of specific demographic and clinical variables on hemorrhagic presentation in patients with DAVFs.
METHODS: All patients with DAVFs evaluated at the University of California at San Francisco from July 1988 through June 2004 were identified. Clinical and radiographic characteristics were recorded using a detailed abstraction form.
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