Indications and limitations for CT-guided stereotaxic surgery of hypertensive intracerebral haemorrhage, based on the analysis of postoperative complications and poor ability of daily living in 158 cases

1993 ◽  
Vol 125 (1-4) ◽  
pp. 27-33 ◽  
Author(s):  
M. Hokama ◽  
Y. Tanizaki ◽  
K. Mastuo ◽  
K. Hongo ◽  
Sh. Kobayashi
Keyword(s):  
Postoperative Complications ◽  
Intracerebral Haemorrhage ◽  
Daily Living ◽  
Ct Guided ◽  
Stereotaxic Surgery

Changing concepts in the treatment of colloid cysts

1987 ◽  
Vol 66 (2) ◽  
pp. 186-191 ◽  
Author(s):  
Walter A. Hall ◽  
L. Dade Lunsford
Keyword(s):  
Third Ventricle ◽  
Ct Scanning ◽  
Morbidity Rate ◽  
Ct Guided ◽  
Content Type ◽  
Persistent Symptoms ◽  
The Third ◽  
Stereotaxic Surgery ◽  
Colloid Cysts ◽  
The University

✓ Since computerized tomography (CT) scanning became available at the University Health Center of Pittsburgh in July, 1975, 17 patients have undergone removal of colloid cysts of the third ventricle by transfrontal, transcallosal, or stereotaxic surgery. All patients presented with symptoms and signs of increased intracranial pressure; CT scanning proved to be the best neurodiagnostic test to define the colloid cysts. Since the development of CT-guided stereotaxic surgery, the authors have preferentially performed stereotaxic aspiration in seven patients; three of these subsequently required craniotomies to remove residual cysts producing persistent symptoms. The viscosity of the intracystic colloid material and/or displacement of the cyst away from the aspiration needle were reasons for unsuccessful aspiration; the CT appearance did not correlate with the ability to aspirate the lesion by the stereotaxic technique. Postoperative patency of the ventricular system was documented by intraoperative CT ventriculography performed during stereotaxic surgery. Removal of the cyst wall was not necessary. Because of the low associated morbidity rate, percutaneous stereotaxic aspiration is recommended as the initial treatment of choice for colloid cysts of the third ventricle. If stereotaxic aspiration fails and symptoms persist, craniotomy should be performed.

Retrospective study of CT-guided radiofrequency ablation and laparoscopic radiofrequency ablation in the treatment of recurrent small hepatocellular carcinoma against the diaphragmatic dome.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 272-272
Author(s):  
Qin Zheng ◽  
Huaiyin Ding ◽  
Chuandong Zhu ◽  
Lixue Wang ◽  
Yuan Wan
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Intraoperative Complications ◽  
Safety Margin ◽  
Small Hepatocellular Carcinoma ◽  
Ct Guided ◽  
Significant Difference ◽  
Small Hcc

272 Background: Radiofrequency ablation (RFA) have been used to treat hepatocellular carcinoma (HCC) in the subphrenic area. Very few studies focus on ablation of recurrent small HCC against the diaphragmatic dome. The therapeutic safety, efficacy, and hospital fee have never been compared between CT guided RFA and laparoscopic RFA (L-RFA) either. Methods: CT guided RFA and L-RFA were performed in totally 116 patients with 151 local recurrent HCC lesions abutting the diaphragm. We compared major and minor postoperative complications, hospital stay and fee, overall survival (OS), and local tumor progression (LTP) between two groups for evaluating respective therapeutic efficacy and safety. Moreover, in CT-guided percutaneous RFA group, depending on the locations of recurrent HCC nodules differentiated puncture paths and ablation methods were used, and intraoperative complications were recorded. Results: There is no significant difference in OS and LTP between CT- guided RFA and LRFA.In recorded postoperative complications, the morbidity in CT-guided RFA group is lower than that of L-RFA group. The average safety margin is 8 and 11 mm in CT-guided RFA and LRFA group, respectively. The shoulder and back pain is significantly high in L-RFA group probably due to pneumoperitoneum. Moreover, overall hospital stay and cost is also lower in CT-guided RFA group. Conclusions: Both CT-guided RFA and L-RFA are considered to be an effective approach for recurrent small HCC abutting diaphragm. Particularly, CT-guided RFA is an easy and economic with less complications if suitable puncture paths and ablation methods can be applied.

scholarly journals Stapled haemorrhoidopexy vs. open haemorrhoidectomy: a comparative study

2019 ◽  
Vol 6 (4) ◽  
pp. 1259
Author(s):  
Naman Aggarwal ◽  
Saurabh Agrawal ◽  
Jitendra P. Ray
Keyword(s):  
Postoperative Complications ◽  
Daily Living ◽  
Open Group ◽  
Common Symptom ◽  
Stapled Haemorrhoidopexy ◽  
Haemorrhoidal Disease ◽  
Early Return ◽  
Group Data ◽  
Number Of Patients ◽  
Grade 3

Background: Haemorrhoidal disease is one of the most common anorectal disorders. The grading of haemorrhoids depend on their severity and tendency to prolapse. Surgery is essential for grade 3 and 4 haemorrhoids. This study aims to compare the outcomes of the stapled haemorrhoidopexy and open haemorrhoidectomy in terms of intra and postoperative complications in terms of pain, return to activity of daily living (ADL) i.e. return to functional activity.Methods: A single-centred observational follow-up study on patients undergoing surgery for haemorrhoids between 2016-2017. Total number of patients operated were 106. Total cases included in the study are 95, out of which 59 were in open haemorrhoidectomy group and 36 in stapled haemorrhoidopexy group. Data was collected and the various parameters compared between the two groups.Results: The most common symptom found in the study was bleeding per rectum (91%). Intraoperative bleeding was more in open group compared to the stapled group (p<0.005). The pain experienced in the immediate postoperative period was higher for the open group (p<0.005). Noticeable difference in the hospital stay between the two groups was observed, with stapled group being discharged earlier (p<0.005). The immediate postoperative complications were not significantly different in the two groups. The need for postoperative analgesia was seen to be lesser in the stapled group compared to the open group (p<0.005).Conclusions: Our study confirms that stapled haemorrhoidopexy is better than open haemorrhoidectomy in terms of intra operative duration and pain experienced by the patient with an early return to activities of daily living.

CT guided functional stereotaxic surgery

1987 ◽  
Vol 87 (1-2) ◽  
pp. 8-13 ◽  
Author(s):  
J. D. S. McKean ◽  
P. B. R. Allen ◽  
L. J. Filipow ◽  
J. D. R. Miller
Keyword(s):  
Ct Guided ◽  
Stereotaxic Surgery

Stereotaxic surgery in the treatment of multiple brain abscesses

1988 ◽  
Vol 69 (2) ◽  
pp. 188-194 ◽  
Author(s):  
Gregg N. Dyste ◽  
Patrick W. Hitchon ◽  
Arnold H. Menezes ◽  
John C. VanGilder ◽  
George M. Greene
Keyword(s):  
Ct Guided ◽  
Content Type ◽  
Deep White Matter ◽  
Prior Therapy ◽  
Stereotaxic Surgery ◽  
Brain Abscesses ◽  
Neurologically Normal ◽  
The Brain ◽  
Fine Print

✓ Controversy exists regarding the optimal treatment for patients with multiple brain abscesses. These lesions are often small and located deep in the brain and close to vital structures, making surgery difficult. With this in mind the authors review their experience in treating multiple abscesses using computerized tomography (CT)-guided stereotaxic aspiration. From 1983 to 1985, 15 patients were treated for multiple brain abscesses, of whom eight underwent stereotaxic aspiration. There were a total of 28 abscesses in these eight patients: 11 abscesses were aspirated and two excised using CT-guided techniques. Most were cortical in location, although there were 12 in the deep white matter, one in the thalamus, and two in the caudate nucleus. All patients received a total of 6 weeks of antibiotic therapy. Follow-up CT showed resolution of the abscesses in all patients. Currently, four are neurologically normal, one has a mild hemiparesis, one has a well-controlled seizure disorder, and one requires supportive care. A single death occurred 5 weeks postoperatively of unrelated causes. Location, size, and age of an abscess all have bearing upon the response to management and outcome of the patient. Stereotaxic surgery is a procedure with minimal morbidity and mortality. Stereotaxic aspiration should be considered in patients with small, multiple, or deep-seated abscesses, in those who are poor operative candidates, and in those who have failed prior therapy.

scholarly journals CT-Guided Percutaneous Femoroplasty for the Treatment of Proximal Femoral Metastases

2016 ◽  
Vol 5;19 (5;19) ◽  
pp. E767-E773
Author(s):  
Yingze Zhang
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Pain Intensity ◽  
Daily Living ◽  
Academic Medical Center ◽  
Ct Guidance ◽  
Ct Guided ◽  
Before And After ◽  
Femoral Metastasis

Background: The spine, pelvis, skull, and femur are the most common sites of bone metastases, and pain is the main symptom of metastatic tumors. Percutaneous femoroplasty (PFP) is becoming increasingly popular for treating proximal femoral metastases. Objectives: To assess the clinical value and feasibility of PFP performed under the guidance of computed tomography (CT). Study Design: A retrospective clinical review comparing pain intensity and the ability to perform activities of daily living before and after treatment with PFP. Setting: Single academic medical center. Methods: Sixteen patients with proximal femoral metastasis were treated with PFP under CT guidance and followed up for 6 – 12 months. Pain intensity was evaluated using the visual analog scale (VAS) and patients’ quality of life was evaluated using the Barthel Index of Activities of Daily Living (BIADL) preoperatively and at both 7 days and 6 months after PFP. Results: The mean VAS score decreased from 7.44 ± 0.81 preoperatively to 2.69 ± 0.79 at 7 days postoperatively and 1.25 ± 0.93 at 6 months postoperatively. The BIADL score increased from 44.06 ± 9.53 preoperatively to 69.06 ± 8.61 at 7 days postoperatively and 83.13 ± 6.55 at 6 months postoperatively. No patients suffered from pulmonary embolism or complications such as pathologic fracture of the proximal femur. The median overall survival was 12 months. One patient experienced cement leakage into the hip, and the injection was immediately stopped. Then dexamethasone was injected intravenously to prevent potential pulmonary fat embolism caused by localized high pressure. Limitations: The study evaluated a single group of patients before and after CT-guided PFP and did not include a comparison with conventional fluoroscopic approaches in a large patient sample. Conclusion: Use of CT-guided PFP was associated with a low risk of complications and improvement in patients’ quality of life. CT guidance made the operation easy and safe, and thus, this approach represents a potential treatment option for proximal femoral metastases if indications are observed closely. Key words: CT guidance, percutaneous femoroplasty, proximal femoral metastasis, pain relief, cementoplasty

scholarly journals Preoperative anaemia and red blood cell transfusion in patients with aneurysmal subarachnoid and intracerebral haemorrhage – A multicentre subanalysis of the German PBM Network Registry

2022 ◽  
Author(s):  
Elke Schmitt ◽  
Patrick Meybohm ◽  
Vanessa Neef ◽  
Peter Baumgarten ◽  
Alexandra Bayer ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Cell ◽  
Hospital Mortality ◽  
Intracerebral Haemorrhage ◽  
Red Blood Cell ◽  
Surgical Patients ◽  
Observation Study ◽  
Increased Risk ◽  
Rbc Transfusion ◽  
Preoperative Anaemia

Abstract Purpose Anaemia is common in patients presenting with aneurysmal subarachnoid (aSAH) and intracerebral haemorrhage (ICH). In surgical patients, anaemia was identified as an idenpendent risk factor for postoperative mortality, prolonged hospital length of stay (LOS) and increased risk of red blood cell (RBC) transfusion. This multicentre cohort observation study describes the incidence and effects of preoperative anaemia in this critical patient collective for a 10-year period. Methods This multicentre observational study included adult in-hospital surgical patients diagnosed with aSAH or ICH of 21 German hospitals (discharged from 1 January 2010 until 30 September 2020). Descriptive, univariate and multivariate analyses were performed to investigate the incidence and association of preoperative anaemia with RBC transfusion, in-hospital mortality and postoperative complications in patients with aSAH and ICH. Results A total of n = 9,081 patients were analysed (aSAH n = 5,008; ICH n = 4,073). Preoperative anaemia was present at 28.3% in aSAH and 40.9% in ICH. RBC transfusion rates were 29.9% in aSAH and 29.3% in ICH. Multivariate analysis revealed that preoperative anaemia is associated with a higher risk for RBC transfusion (OR= 3.25 in aSAH, OR = 4.16 in ICH, p < 0.001), for in-hospital mortality (OR= 1.48 in aSAH, OR= 1.53 in ICH, p < 0.001) and for several postoperative complications. Conclusions Preoperative anaemia is associated with increased RBC transfusion rates, in-hospital mortality and postoperative complications in patients with aSAH and ICH. Trial registration: ClinicalTrials.gov, NCT02147795, https://clinicaltrials.gov/ct2/show/NCT02147795

scholarly journals Clinical results of CT-guided stereotaxic surgery for patients with high-grade hypertensive putaminal hemorrhage.

Nosotchu ◽  
2000 ◽  
Vol 22 (4) ◽  
pp. 595-599
Author(s):  
Shodo Fujioka ◽  
Masaji Murakami ◽  
Ukitaka Ushio
Keyword(s):  
Clinical Results ◽  
High Grade ◽  
Ct Guided ◽  
Stereotaxic Surgery ◽  
Putaminal Hemorrhage

The Production of Gesture and Speech by People With Aphasia: Influence of Communicative Constraints

2019 ◽  
Vol 62 (12) ◽  
pp. 4417-4432 ◽  
Author(s):  
Carola de Beer ◽  
Jan P. de Ruiter ◽  
Martina Hielscher-Fastabend ◽  
Katharina Hogrefe
Keyword(s):  
Language Impairment ◽  
Daily Living ◽  
Linguistic Performance ◽  
Task Effects ◽  
Communicative Abilities ◽  
Gesture Production ◽  
And Task ◽  
Group Effects

Purpose People with aphasia (PWA) use different kinds of gesture spontaneously when they communicate. Although there is evidence that the nature of the communicative task influences the linguistic performance of PWA, so far little is known about the influence of the communicative task on the production of gestures by PWA. We aimed to investigate the influence of varying communicative constraints on the production of gesture and spoken expression by PWA in comparison to persons without language impairment. Method Twenty-six PWA with varying aphasia severities and 26 control participants (CP) without language impairment participated in the study. Spoken expression and gesture production were investigated in 2 different tasks: (a) spontaneous conversation about topics of daily living and (b) a cartoon narration task, that is, retellings of short cartoon clips. The frequencies of words and gestures as well as of different gesture types produced by the participants were analyzed and tested for potential effects of group and task. Results Main results for task effects revealed that PWA and CP used more iconic gestures and pantomimes in the cartoon narration task than in spontaneous conversation. Metaphoric gestures, deictic gestures, number gestures, and emblems were more frequently used in spontaneous conversation than in cartoon narrations by both participant groups. Group effects show that, in both tasks, PWA's gesture-to-word ratios were higher than those for the CP. Furthermore, PWA produced more interactive gestures than the CP in both tasks, as well as more number gestures and pantomimes in spontaneous conversation. Conclusions The current results suggest that PWA use gestures to compensate for their verbal limitations under varying communicative constraints. The properties of the communicative task influence the use of different gesture types in people with and without aphasia. Thus, the influence of communicative constraints needs to be considered when assessing PWA's multimodal communicative abilities.

Assistive Technology for Cognition: Perspectives on Funding

2013 ◽  
Vol 23 (2) ◽  
pp. 84-89
Author(s):  
Kathy de Domingo
Keyword(s):  
Assistive Technology ◽  
Daily Living ◽  
Occupational Therapists ◽  
Personal Digital Assistants ◽  
Speech Language Pathology ◽  
Prosthetic Devices ◽  
Funding Sources ◽  
Ankle Foot Orthoses ◽  
Language Pathology ◽  
Communication Challenges

Physical and occupational therapists commonly provide services that incorporate prosthetic and orthotic devices such as crutches, canes, reachers, and ankle–foot orthoses to support mobility and activities of daily living (ADLs). Likewise, speech-language pathologists provide services incorporating prosthetic devices to support communication such as an electrolarynx, microcomputers, and mobile devices and apps with voice output capability. Assistive technology for cognition (ATC) includes the use of personal digital assistants (PDAs), tablets, and smart phones — cognitive prostheses — to compensate for cognitive challenges following acquired brain injury (ABI). Whereas funding sources for devices and services that support/compensate for mobility, ADLs, and communication challenges are generally well established, funding for ATC devices and services is relatively new to the field of speech-language pathology. This article explores the funding aspect of ATC devices and services.

Sign in / Sign up

Export Citation Format

Share Document