Percutaneous retrogasserian glycerol rhizotomy in the treatment of tic douloureux associated with multiple sclerosis.

Objective: Patients with multiple sclerosis (MS) have a relatively high incidence of tic douloureux (TD) and often do not tolerate medical therapy well. The minimally invasive nature of percutaneous retrogasserian glycerol rhizotomy (PRGR) renders it ideal for first-line surgical treatment of TD. We sought to ascertain the benefits of PRGR in patients with MS and to determine whether hypalgesia after PRGR correlates with efficacy.

Evaluation of portable bladder ultrasound: accuracy and effect on nursing practice in an acute care neuroscience unit.

The purpose of this evaluation was to determine the accuracy of a portable ultrasound instrument in assessing bladder volume in an acute care neuroscience population and the effect of ultrasound assessment on nursing practice in an acute care neuroscience unit. In a 6-week prospective evaluation, 105 paired ultrasound measurements were performed by 45 nurses on 30 patients suspected to be retaining urine. Sixty-seven catheterizations were performed, and volumes were compared with corresponding ultrasound readings.

Accuracy of leveling hemodynamic transducer systems.

Critically ill patients frequently have invasive catheters placed to monitor hemodynamic pressures and to calculate hemodynamic indices. Correct leveling to the appropriate anatomical structure is critical as the pressure readings guide management of fluids, drug administration, and other interventions. The authors of this study investigated the accuracy with which registered nurses and respiratory technologists were able to level hemodynamic transducers to the phlebostatic axis using visual checks, a carpenter's level, and a laser leveling device.

Bridging the gap: medical directives for acute care nurse practitioners.

The following article describes the process by which a group of acute care nurse practitioners sought to address the legal challenges of working beyond the traditional scope of nursing practice. It was necessary to establish mechanisms for communicating a diagnosis, as well as for ordering diagnostic tests, treatments and procedures. Medical directives were viewed as an approach to address components of practice involving controlled acts not authorized to nursing.

Nursing research in stroke. A review.

Nurses have demonstrated an interest in research in stroke. Studies encompass a broad variety of subjects; some clearly within the traditional realm of nursing and others that are common to multiple disciplines. Studies are limited in number and most lack the necessary numbers or controls that make data meaningful.

Accuracy of levelling intraventricular collection drainage systems.

In neuroscience critical care units, patients may have ventricular drains placed to aid management of acutely elevated intracranial pressure from a variety of causes. Correct placement of the ventricular drainage collection system, a nursing responsibility, is key to the process, and has the potential to influence patient outcome. A two-part study investigated the accuracy with which registered nurses levelled a ventricular drainage collection system.

Cardiac function in aneurysmal subarachnoid haemorrhage: a study of electrocardiographic and echocardiographic abnormalities.

Electrocardiographic (ECG) changes are reported frequently after subarachnoid haemorrhage (SAH). The aim of this study was to investigate the functional significance of ECG changes by echocardiographic assessment of cardiac function. Forty-five patients with intracranial aneurysms were studied.

Syringomyelia and syringobulbia: pathophysiology, surgical treatment and nursing implications.

Syringomyelia (central cavitation of the spinal cord) and syringobulbia (cavitation of the medulla) are relatively rare disorders. These conditions are often found in association with congenital abnormalities such as Chiari malformations, with neoplasms or as sequelae to spinal cord trauma. The pathology progresses from minor sensory changes to weakness and wasting and, in the case of syringobulbia, to respiratory compromise and even death.

Carotid cavernous fistulas.

Carotid cavernous fistulas treated by endovascular means provide nurses with an excellent opportunity to use their skills in assessment. With knowledge of the local anatomy, that assessment must include evaluation of cranial nerves II through VI, to establish a neurological baseline and monitor changes. The patient problems attributed to pathology are multiple, and require active nursing intervention to optimize recovery and return to independent function.