Treatment and Prognosis of Postoperative Acute Cerebral Venous Infarctions

IntroductionThe incidence of cerebral venous infarctions is not high, but this condition can cause serious complications. This paper summarizes the cases of serious complications after cerebral venous infarctions and proposes corresponding treatment strategies.MethodsA retrospective analysis was performed on 5 patients that had severe complications secondary to injury or sacrifice of related veins during the resection of different intracranial lesions (cerebellopontine angle, lateral ventricle, frontal lobe, falx parietal lobe, frontal parietal lobe). There were 2 males and 3 females, aged 34-58 years. Routine CT and MRI/MRV examinations were performed before the operation, and the diagnoses were a hemifacial spasm, a meningioma of the lateral ventricle, a hemangioma, a falx meningioma and a glioma. Postoperative CT examinations were performed to understand the intracranial conditions of the patients.ResultsFive cases had injuries to associated veins, which included the cerebellar cortical vein, internal cerebral vein, middle frontal vein, straight sinus, and postfrontal vein, during the operations. There were 2 cases of venous infarctions, 3 cases of hemorrhagic infarctions, 2 cases who had conservative treatment, 3 cases who had surgical treatment, 1 case who died (the hemifacial spasm), 1 case who had a vegetative survival (the lateral ventricular meningioma), and 3 cases with good recoveries (the hemangioma, falx meningioma, and glioma).ConclusionsSurgeons should pay more attention to intracranial vein injuries during procedures. Acute neurological dysfunction or even death may occur after these injuries. Surgeons should closely monitor the condition of the patient and proceed with surgical intervention if necessary. The prognosis is usually good for these surgery cases, but the prognosis can be poor if important veins are injured. The key to avoiding cerebral venous infarctions is to preserve the integrity of the veins to the greatest extent during the operation.

Brain Death

This chapter considers the issue of brain death. The cornerstone of the diagnosis of brain death is a careful and sure clinical neurologic examination. In addition, a thorough evaluation of clinical history, neuroradiologic studies, and laboratory tests needs to be carried out to rule out potential confounding variables. The diagnosis of brain death rests on two major and indispensable tenets. The first is that the cause of brain nonfunction must be inherently irreversible. The second is that the vital structures of the brain necessary to maintain consciousness and independent vegetative survival are damaged beyond all possible recovery. It looks at how to determine that brain death has occurred. It goes on to outline the clinical signs for brain death. The chapter also looks at the differences between brain death and prolonged coma. Finally, it explains the management of the brain dead patient.

Reproductive Behaviour of Natural Populations of Meadow Salsify (Tragopogon pratensis)

The reproductive characteristics of natural populations of meadow salsify were monitored between May 1990 and October 1991. Plants in even-aged populations did not produce seeds prior to the second winter and plants in uneven-aged populations died after seed production suggesting that meadow salsify at this site is a monocarpic perennial and not a true biennial. Delayed seed production may enhance abundance of this species by increasing the size of its bud bank. Plants of uneven-aged populations flowered over a range of root crown diameters; the percentage of plants bearing flowers increased with increasing root crown diameters. The minimum root crown diameter at which plants flowered in 1990 and 1991 was 0.2 and 0.6 cm respectively demonstrating that factor(s) other than plant size regulate flowering in this species. Seed production ranged between 100 to 850 seeds per plant. Total number of flower heads per plant and florets per plant were positively correlated with each other and with the root crown diameter. Root crown diameter is, therefore, a good indicator of potential fecundity in meadow salsify. Greater seed production by larger plants may compensate, at least in part, for the high juvenile mortality and longer generation time in this species. The results suggest that prolific seed production and long vegetative survival are important strategies in the maintenance of meadow salsify populations.