Spontaneous Intracerebral Hematomas: A New Proposal about the Usefulness and Limits of Surgical Treatment

Neurosurgery ◽  
1984 ◽  
Vol 15 (5) ◽  
pp. 663-666 ◽  
Author(s):  
Lorenzo Volpin ◽  
Patrizio Cervellini ◽  
Federico Colombo ◽  
Mariano Zanusso ◽  
Antonio Benedetti
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Clinical Condition ◽  
Ct Scans ◽  
Hematoma Volume ◽  
Computed Tomographic ◽  
The Many

Abstract We analyzed the volume of 132 spontaneous supratentorial intracerebral hematomas calculated with computed tomographic (CT) scans and related it to the clinical condition of the patients on admission and to the outcome at their discharge from the hospital (1 to 3 months after the ictus). Fifty patients were operated on, and 82 received only medical treatment. In evaluating outcome, we were more interested in survival than its quality. The main problem is the evaluation and treatment of the many patients who are comatose upon admission (about half of the patients). We concluded that surgical treatment by evacuation of the hematoma increases the percentage of survival of comatose patients with a hematoma volume between 26 and 85 ml.

scholarly journals Coccygodynia: surgical treatment

2002 ◽  
Vol 10 (4) ◽  
pp. 26-30 ◽  
Author(s):  
Alceu Gomes Chueire ◽  
Guaracy Carvalho Filho ◽  
Luciano Barboza de Souza
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Clinical Condition

The coccygodinya is a clinical condition that is caracterized by tumescence and by ache in the coccyx area. It can be related with trauma or with anatomic conformation of this area. The coccygodynia occurs more frequently in women. We report that in the medical treatment it must use conservative strategies and only when those strategies fail it is indicated the surgical treatment which gives good results. The aim of this study is to evoluate the sirurgical treatment by coccygectomy with 12 pacients being evuluated showing good results in 10 cases, regular in 2 cases and no bad result.

Paranasal Sinus Pathologies in Patients Presenting with Headache as the Primary Symptom

Cephalalgia ◽  
2006 ◽  
Vol 26 (4) ◽  
pp. 423-427 ◽  
Author(s):  
S-H Lin ◽  
C-Y Ho
Keyword(s):  
Differential Diagnosis ◽  
Medical Treatment ◽  
Paranasal Sinus ◽  
Paranasal Sinuses ◽  
Chronic Headache ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Nasal Endoscopy ◽  
Diagnostic Tools ◽  
Computed Tomographic

Headache is a frequent symptom of lesions in the paranasal sinuses. Although some inflammatory symptoms are suggestive of pathologies of the paranasal sinuses, occasional headache is sometimes the major presenting symptom. In a retrospective study, we examined the chart histories of 36 patients presenting for treatment at our hospital from 1 January 1992 to 30 June 2001 who were diagnosed as having pathologies of the paranasal sinuses with the primary symptom being headache. All patients had been evaluated with complete otolaryngological and neurological examinations, diagnostic nasal endoscopy, and sinus computed tomographic (CT) scans. Sinus surgery was arranged after failure in performing appropriate medical treatment. Among the 36 patients, 33 showed significant improvement after sinus operation (92%). A paranasal sinus aetiology of headache is an important factor in the differential diagnosis of chronic headache. Those patients who are clinically suspected of having headaches arising from paranasal sinus pathology should receive comprehensive otorhinolaryngological examination and evaluation. Nasal endoscopy and sinus CT scans are good diagnostic tools. Surgical management may be beneficial in those for whom medical treatment fails to resolve the problem.

scholarly journals Is it possible to estimate the need for surgical management in patients with a tubo-ovarian abscess at admission? A retrospective long-term analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Murat Gözüküçük ◽  
Esra Gülen Yıldız
Keyword(s):  
Surgical Treatment ◽  
Antibiotic Therapy ◽  
Treatment Failure ◽  
Medical Treatment ◽  
Length Of Hospital Stay ◽  
Treatment Modalities ◽  
Laboratory Findings ◽  
Factors Affecting ◽  
Laboratory Infection ◽  
Major Factors

Abstract Background This study aimed to determine the possible prognostic factors correlated with the treatment modalities of tubo-ovarian abscesses (TOAs) and thus to assess whether the need for surgery was predictable at the time of initial admission. Materials and methods Between January 2012 and December 2019, patients who were hospitalized with a TOA in our clinic were retrospectively recruited. The age of the patients, clinical and sonographic presentation, pelvic inflammatory risk factors, antibiotic therapy, applied surgical treatment, laboratory infection parameters, and length of hospital stay were recorded. Results The records of 115 patients hospitalized with a prediagnosis of TOA were reviewed for the current study. After hospitalization, TOA was ruled out in 19 patients, and data regarding 96 patients was included for analysis. Twenty-eight (29.2%) patients underwent surgical treatment due to failed antibiotic therapy. Sixty-eight (70.8%) were successfully treated with parenteral antibiotics. Medical treatment failure and need for surgery were more common in patients with a large abscess (volume, > 40 cm3, or diameter, > 5 cm). The group treated by surgical intervention was statistically older than the patients receiving medical treatment (p < 0.05). Conclusions Although the treatment in TOA may vary according to clinical, sonographic, and laboratory findings; age of patients, the abscess size, and volume were seen as the major factors affecting medical treatment failure. Moreover, TOA treatment should be planned on a more individual basis.

Corynebacterium Diphtheriae Endocarditis - Surgery for Some but Not All!

2005 ◽  
Vol 13 (2) ◽  
pp. 119-126 ◽  
Author(s):  
Bashisth Mishra ◽  
Rebecca J Dignan ◽  
Clifford F Hughes ◽  
Nick Hendel
Keyword(s):  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Medical Treatment ◽  
Rare Disease ◽  
Corynebacterium Diphtheriae ◽  
Aggressive Disease ◽  
Prosthetic Valves ◽  
Immediate Surgery

Corynebacterium diphtheriae endocarditis was thought to be a rare disease. We reviewed our experience in four cases of this disease treated over a period of 10 years. Seventy cases reported in literature were reviewed. The outcome is good if cases are carefully selected for medical or surgical treatment. We conclude that infective endocarditis due to C. diphtheriae, is perhaps more common than expected. It may be recognized more frequently and on occasion may be an aggressive disease. Those patients with an abnormal valve (including prosthetic valves) should be subjected to surgery at the earliest available opportunity, whereas patients with normal valves may be carefully watched during the course of medical treatment as long as immediate surgery can occur if needed.

Computed Tomographic Discography in the Evaluation of Extreme Lateral Disc Herniation

Neurosurgery ◽  
1984 ◽  
Vol 14 (3) ◽  
pp. 350-352 ◽  
Author(s):  
J. C. Angtuaco Edgardo ◽  
C. Holder John ◽  
C. Boop Warren ◽  
F. Binet Eugene
Keyword(s):  
Lumbar Spine ◽  
High Resolution ◽  
Contrast Enhancement ◽  
Thin Section ◽  
Preoperative Evaluation ◽  
Intervertebral Discs ◽  
Ct Scans ◽  
Computed Tomographic ◽  
Disc Herniations ◽  
Lateral Disc Herniation

Abstract Thin section, high resolution computed tomographic (CT) scans of the lumbar spine produce images that can show herniated intervertebral discs without intravenous or intrathecal contrast enhancement. With this technique, the diagnosis of posterolateral and midline herniation has been greatly facilitated. This communication reports the use of CT discography in the preoperative evaluation of two patients who were shown at discography and proven at operation to have extreme lateral disc herniations.

scholarly journals Low Stroke Rate of Carotid Stenosis Under the Guideline-Oriented Medical Treatment Compared With Surgical Treatment

2016 ◽  
Vol 57 (1) ◽  
pp. 80-86 ◽  
Author(s):  
Kimitoshi Sato ◽  
Kazuhiro Fujiyoshi ◽  
Keika Hoshi ◽  
Chiharu Noda ◽  
Minako Yamaoka-Tojo ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Carotid Stenosis ◽  
Stroke Rate

scholarly journals Early Pregnancy Failure: Medical versus Surgical Management

2021 ◽  
Vol 16 (2) ◽  
pp. 63-67
Author(s):  
Nasima Begum ◽  
Shahnaz Akhter ◽  
Luna Laila
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Early Pregnancy ◽  
Randomized Study ◽  
First Trimester ◽  
Patient’S Satisfaction ◽  
Medical Evacuation ◽  
Early Pregnancy Failure ◽  
Surgical Evacuation ◽  
Treatment Use

Introduction: Misoprostol is increasingly used to treat women who have a failed pregnancy may be due to blighted ovum (anembryonic gestation), incomplete abortion, missed abortion, inevitable abortion in the first trimester. Medical treatment with Misoprostol is an alternative to conventional surgical treatment. Use of Misoprostol is simple, highly acceptable, noninvasive and preferred by women. In addition to surgical risk and patient's preference, medical evacuation reduces the need for hospital stay and the overall management cost. Objective: To determine the efficacy and safety of Misoprostol for evacuation of uterus in early pregnancy loss and to compare the result with surgical evacuation. Materials and Methods: It was a prospective randomized study conducted on 50 patients at the department of Obstetrics and Gynaecology, Border Guard Hospital, Dhaka during the period from February 2018 to July 2019. Here 25 patients received Misoprostol as medical treatment and 25 patients received surgical treatment. Results: Of the 25 women assigned to receive Misoprostol, 19(76%) had complete expulsion by 24 hours and 22(88%) by 7 days. Complete evacuation after 1st dose was 68% and after 2nd dose 88%. Misoprostol treatment failed in 3(12%) cases and required surgical evacuation. Among the respondents 80% women stated that they would use Misoprostol again if the need arises. Conclusion: Medical treatment with Misoprostol is a cheaper alternative to surgery. Given its success rate near about 88% with mild side effects controllable with additional medication and above all patient’s satisfaction, it should be prioritized over the evacuation curettage in patients who meet the treatment criteria. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 63-67

scholarly journals The association of frontal recess anatomy and mucosal disease on the presence of chronic frontal sinusitis: a computed tomographic analysis

2014 ◽  
Vol 52 (3) ◽  
pp. 208-214
Author(s):  
W.-S. Lai ◽  
P.-L. Yang ◽  
C.-H. Lee ◽  
Y.-Y. Lin ◽  
Y.-H. Chu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Strong Association ◽  
Ct Scans ◽  
Mucosal Inflammation ◽  
Frontal Sinusitis ◽  
Logistic Regression Models ◽  
Computed Tomographic ◽  
Frontal Recess ◽  
Inflammatory Conditions ◽  
Increased Risk

Objectives: The frontal sinus has the most complex and variable drainage routes of all paranasal sinus regions. The goal of this study was to identify these anatomical factors and inflammation areas relating to chronic frontal sinusitis by comparing radiological presentations in patients with and without frontal sinusitis. Methods: All adult patients with chronic rhinosinusitis who had received computed tomography (CT) scans of the nasal cavities and paranasal sinuses between October 2010 and September 2011. Logistic regression analysis was used to compare the distribution of various frontal recess cells and surrounding inflammatory conditions in patients with and without frontal sinusitis. Results: Analysis of 240 sides of CT scans was performed with 66 sides excluded. The opacification of the frontal recess and sinus lateralis demonstrated a strong association with an increased presence of frontal sinusitis by multiple logistic regression models. Conclusion: Opacification of the frontal recess and sinus lateralis was found to be associated with a significantly increased risk of frontal sinusitis and developing severe blockage of drainage pathways. It provides evidence that mucosal inflammation disease in these two areas is a very important factor leading to chronic frontal sinusitis.

scholarly journals The hyperdense sylvian fissure MCA ”dot“ sign: a marker of acute CT ischemia

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 346-346
Author(s):  
Philip A Barber ◽  
Andrew M Demchuk ◽  
Mark E Hudon ◽  
Warwick Pexman ◽  
Michael D Hill ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Symptom Onset ◽  
Clinical Information ◽  
Diagnostic Value ◽  
Sylvian Fissure ◽  
Ct Scans ◽  
Kappa Statistics ◽  
Computed Tomographic ◽  
Good Range

P40 Background: The hyperdense appearance of the middle cerebral artery is now a familiar early warning of large cerebral infarction, brain oedema and poor prognosis. Less well described, however, is the hyperdensity associated with embolic occlusion of branches of the middle cerebral artery seen in the sylvian fissure (MCA ”dot“ sign). The aim of this study was to define this sign, and to determine the incidence, its diagnostic value, and reliability. Methods: Computed tomographic (CT) scans performed on patients with acute ischemic stroke within 3 hours of symptom onset were analysed for signs of thromboembolic stroke and evidence of early CT ischemia. Two neuroradiologists and two stroke neurologists initially blinded to all clinical information, and then with knowledge of the affected hemisphere evaluated scans for the presence of a hyperdense MCA sign (HMCA), a hyperdense sylvian fissure MCA ”dot“ sign, and for early MCA territory ischemic changes. Results: Of 100 consecutive patients presenting within 3 hours of symptom onset early CT ischemia was seen in 74 % of the baseline CT scans. The HMCA sign was seen in 5% of CT scans whereas the MCA ”dot“ sign was seen in 16% of which 2 were associated with a HMCA sign. The presence of a HMCA sign was associated with a greater probability of dependence or death than when a MCA ”dot“ sign was observed or no hyperdensity was seen (P<0.05). All 5 patients with a HMCA sign, including 2 with an associated MCA ”dot“ sign were either dead or dependent at 3 months. Patients with a dot sign alone had independent outcomes in 64% of cases (P<0.8). Balanced kappa statistics for both signs were in the moderate to good range when the side of stroke was known. Conclusions: The hyperdense sylvian fissure MCA ”dot“ sign is an early marker of thromboembolic occlusion of the distal MCA and of its branches.

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