Basal ganglia haematomas in non-comatose patients: subacute stereotactic aspiration improves long-term outcome in comparison to purely medical treatment

2004 ◽  
Author(s):  
Gerhard Marquardt ◽  
Robert Wolff ◽  
Rudolf W. C. Janzen ◽  
Volker Seifert
Keyword(s):  
Basal Ganglia ◽  
Medical Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Stereotactic Aspiration

Predictors of long term outcome in survivors of prosthetic valve thrombosis: role of medical treatment at discharge

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P2129-P2129
Author(s):  
M. Mutuberria Urdaniz ◽  
J. F. Rodriguez ◽  
J. Baneras ◽  
J. G. Acosta ◽  
I. Buera ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Prosthetic Valve ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Prosthetic Valve Thrombosis ◽  
Valve Thrombosis

scholarly journals Cavernous Malformation of Brainstem, Thalamus, and Basal Ganglia

Neurosurgery ◽  
2012 ◽  
Vol 72 (4) ◽  
pp. 573-589 ◽  
Author(s):  
Paritosh Pandey ◽  
Erick M. Westbroek ◽  
Peter A. Gooderham ◽  
Gary K. Steinberg
Keyword(s):  
Basal Ganglia ◽  
Neurological Deficits ◽  
Term Outcome ◽  
Cavernous Malformations ◽  
Long Term Outcome ◽  
Brain Malformations ◽  
Hemorrhage Risk ◽  
Clinical Records

Abstract BACKGROUND: Cavernous malformations (CMs) in deep locations account for 9% to 35% of brain malformations and are surgically challenging. OBJECTIVE: To study the clinical features and outcomes following surgery for deep CMs and the complication of hypertrophic olivary degeneration (HOD). METHODS: Clinical records, radiological findings, operative details, and complications of 176 patients with deep CMs were reviewed retrospectively. RESULTS: Of 176 patients with 179 CMs, 136 CMs were in the brainstem, 27 in the basal ganglia, and 16 in the thalamus. Cranial nerve deficits (51.1%), hemiparesis (40.9%), numbness (34.7%), and cerebellar symptoms (38.6%) presented most commonly. Hemorrhage presented in 172 patients (70 single, 102 multiple). The annual retrospective hemorrhage rate was 5.1% (assuming CMs are congenital with uniform hemorrhage risk throughout life); the rebleed rate was 31.5%/patient per year. Surgical approach depended on the proximity of the CM to the pial or ependymal surface. Postoperatively, 121 patients (68.8%) had no new neurological deficits. Follow-up occurred in 170 patients. Delayed postoperative HOD developed in 9/134 (6.7%) patients with brainstem CMs. HOD occurred predominantly following surgery for pontine CMs (9/10 patients). Three patients with HOD had palatal myoclonus, nystagmus, and oscillopsia, whereas 1 patient each had limb tremor and hemiballismus. At follow-up, 105 patients (61.8%) improved, 44 (25.9%) were unchanged, and 19 (11.2%) worsened neurologically. Good preoperative modified Rankin Score (98.2% vs 54.5%, P = .001) and single hemorrhage (89% vs 77.3%, P < .05) were predictive of good long-term outcome. CONCLUSION: Symptomatic deep CMs can be resected with acceptable morbidity and outcomes. Good preoperative modified Rankin Score and single hemorrhage are predictors of good long-term outcome.

Long-term outcome of the medical treatment of gastro-esophageal reflux disease

2001 ◽  
Vol 58 (3) ◽  
pp. 146-150
Author(s):  
F. Viani ◽  
G. Dorta
Keyword(s):  
Medical Treatment ◽  
Reflux Disease ◽  
Esophageal Reflux ◽  
Term Outcome ◽  
Long Term Outcome

Die Refluxösophagitis ist eine häufige und chronische verlaufende Erkrankung. Die Beeinträchtigung der Lebensqualität durch die Symptome sowie das Risiko von Komplikationen erfordern oft eine Langzeitbehandlung. Grundstein der Behandlung der Refluxösophagitis ist die Hemmung der Magensäure mit einem Protonenpumpenhemmer (PPH) oder einem H2-Rezeptorantagonisten. Dabei haben sich die PPH im Vergleich zu den mit H2-Rezeptorantagonisten sowohl in der Behandlung der Symptome als auch in der Heilung der erosiven Ösophagusläsionen als wirksamer erwiesen. Antazida oder Prokinetika sind in der Langzeitbehandlung nur sehr beschränkt wirksam und deshalb nicht indiziert. Die Behandlungsstrategie richtet sich nach dem Schweregrad der Symptome und der Ösophagitis. Patienten mit leichter Ösophagitis können langfristig mit H2-Rezeptorantagonisten oder PPH nach Bedarf oder kontinuierlich behandelt werden. Bei schwerer Ösophagitis ist eine konsequente Langzeittherapie mit einem PPH indiziert, um Komplikationen zu vermeiden. Rezidive der Ösophagitis unter Langzeittherapie sollten durch ein PPH behandelt werden, danach ist die Langzeittherapie anzupassen, sei es durch Dosiserhöhung oder durch einen Wechsel auf stärker säurehemmende Medikamente.

scholarly journals Long-Term Outcome After Percutaneous Peripheral Intervention vs Medical Treatment for Patients With Superficial Femoral Artery Occlusive Disease

2008 ◽  
Vol 72 (5) ◽  
pp. 734-739 ◽  
Author(s):  
Chizuko Kamiya ◽  
Shingo Sakamoto ◽  
Yuiichi Tamori ◽  
Tsuyoshi Yoshimuta ◽  
Masahiro Higashi ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Occlusive Disease ◽  
Term Outcome ◽  
Long Term Outcome

CAVERNOUS MALFORMATIONS OF THE BASAL GANGLIA AND THALAMUS

Neurosurgery ◽  
2009 ◽  
Vol 65 (1) ◽  
pp. 7-19 ◽  
Author(s):  
Bradley A. Gross ◽  
H. Hunt Batjer ◽  
Issam A. Awad ◽  
Bernard R. Bendok
Keyword(s):  
Basal Ganglia ◽  
Natural History ◽  
French Literature ◽  
Outcome Data ◽  
Therapeutic Modality ◽  
Surgical Morbidity ◽  
Term Outcome ◽  
Cavernous Malformations ◽  
Long Term Outcome

ABSTRACT CAVERNOUS MALFORMATIONS OF the basal ganglia and thalamus present a unique therapeutic challenge to the neurosurgeon given their unclear natural history, the risk of surgical treatment, and the unproven efficacy of radiosurgical therapy. Via a PubMed search of the English and French literature, we have systematically reviewed the natural history and surgical and radiosurgical management of these lesions reported through April 2008. Including rates cited for “deep” cavernous malformations, annual bleeding rates for these lesions varied from 2.8% to 4.1% in the natural history studies. Across surgical series providing postoperative or long-term outcome data on 103 patients, we found an 89% resection rate, a 10% risk of long-term surgical morbidity, and a 1.9% risk of surgical mortality. The decrease in hemorrhage risk reported 2 years after radiosurgery might be a result of natural hemorrhage clustering, underscoring the unproven efficacy of this therapeutic modality. Given the compounded risks of radiation-induced injury and post-radiosurgical rebleeding, radiosurgery at modest dosimetry (12–14 Gy marginal doses) is only an option for patients with surgically inaccessible, aggressive lesions.

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