An Association Between Prophylactic Hypervolemia-Augmented Blood Pressure and Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage Who Underwent Delayed Clipping.

Background: The prior trials investigating triple-H therapy for preventing delayed cerebral ischemia (DCI) enrolled patients with aneurysmal subarachnoid hemorrhage (aSAH) who underwent early aneurysm therapy within 3 days. However, surgical clipping might be performed during 4-7 days that high incidence cerebral vasospasm is likely. We examined effects of hypervolemia-augmented blood pressure (HV-ABP) protocol on DCI prevention when clipping was delayed.

Preoperative predictors of poor outcomes in Thai patients with aneurysmal subarachnoid hemorrhage.

Objective: A scoring system for aneurysmal subarachnoid hemorrhage (aSAH) is useful for guiding treatment decisions, especially in urgent-care limited settings. This study developed a simple algorithm of clinical conditions and grading to predict outcomes in patients treated by clipping or coiling.

Methods: Data on patients with aSAH hospitalized in a university's neurovascular center in Thailand from 2013 to 2018 were obtained for chart review.

Nasal resonance changes after endoscopic endonasal transsphenoidal skull base surgery: Analysis of voice quality.

Objectives: To study the effect of endoscopic endonasal transsphenoidal surgery on voice quality in patients with pituitary lesions.

Methods: An observational study comparing voice quality before and after surgery was conducted between September 2015 and September 2017 at Srinagarind Hospital, Khon Kaen University, Thailand. Pituitary tumor patients who underwent endoscopic endonasal transsphenoidal surgery were recruited.

Cost-effectiveness analysis of endovascular coiling and neurosurgical clipping for aneurysmal subarachnoid hemorrhage in Thailand.

Background: For patients with aneurysmal subarachnoid hemorrhage (aSAH), the Universal Coverage Scheme in Thailand covers the full costs of surgical and endovascular procedures except for those of embolization coils and assisting devices. Costs and effectiveness were compared between endovascular coiling and neurosurgical clipping to inform reimbursement policy decisions.

Methods: Costs and quality-adjusted life years (QALYs) were compared between coiling and clipping using the decision tree and Markov models.

Appropriate Blood Pressure in Cerebral Aneurysm Clipping for Prevention of Delayed Ischemic Neurologic Deficits.

Background: Delayed ischemic neurologic deficit (DNID) is a problem after cerebral aneurysm clipping. Intraoperative hypotension seems to be indicated as a risk factor, but it remains a controversial issue with varying low-blood pressure levels accepted.

Methods: A retrospective, hospital-based, case-control study was performed with patients who received general anesthesia for cerebral aneurysm clipping.

Results of a Preventive Rebleeding Protocol in Patients with Ruptured Cerebral Aneurysm: A Retrospective Cohort Study.

Objective: In 2015, a protocol to prevent rebleeding was implemented to improve the outcome of patients with ruptured intracranial aneurysm. We performed a single-center retrospective analysis to compare the outcomes of pre/post using protocol.

Methodology: Over a 3-year period, 208 patients with ruptured cerebral aneurysm were treated at our institution.

Gender and Population Variation in Craniometry and Freehand Pass Ventriculostomy.

Background: Ventriculostomy using the freehand pass method is subject to complications arising from misplacement of the catheter tip. This method may require multiple passes for successful catheterization. Methods of determining the burr-hole location (known as the Kocher point) were derived historically from European patients and may not be appropriate for other populations with different cranial shapes.

Comparison of dexmedetomidine and fentanyl to prevent haemodynamic response to skull pin application in neurosurgery: double blind randomized controlled trial.

Background: Skull pin application during craniotomy is a highly noxious stimulus. Therefore, the attenuated effect between dexmedetomidine and fentanyl was investigated.

Method: A randomized, double-blind controlled trial included sixty patients, randomly allocated into groups A and B.