A simple and useful coma scale for patients with neurologic emergencies: the Emergency Coma Scale.

Objectives: The Emergency Coma Scale (ECS) was developed in Japan in 2003. We planned a multicenter study to evaluate the utility of the ECS by comparison of the ECS and the Glasgow Coma Scale (GCS).

Methods: Ten medical facilities, including 4 university hospitals in Japan, participated in this study.

Fixative method of carotid shunt using a Sugita's fenestrated aneurysm clip as a device in carotid endarterectomy technical note.

Background: Difficulty for distal exposure of the ICA is sometimes encountered during CEA. A carotid shunt is used to maintain sufficient cerebral blood flow during CEA but requires fixative materials, such as a string or a metallic ring, which often restrict the operative field, especially that of the distal ICA.

Methods: Here, we describe a novel technique for carotid shunt fixation using a unique fixative device in CEA.

Phenomenological aspects of consciousness--its disturbance in acute and chronic stages.

The meaning of a disturbance of consciousness is completely different in an acute as opposed to a chronic stage. In the acute stage, the grade of arousal is the most essential component in order to assess the changes of the level of intracranial pressure in neurosurgical emergency room. A new coma scale called Emergency Coma Scale has been proposed, which represents a combination of the Glasgow Coma Scale and the Japan Coma Scale.

Selective brain hypothermia suppresses noxious-evoked movement in canines.

Systemic hypothermia suppresses noxious-evoked movement, but its main site of action is unknown. We examined the effect of hypothermia in the brain on noxious-evoked movement by selectively cooling the brain. Sixteen beagles were randomly divided into two groups and anesthetized with isoflurane/oxygen.

Managing subdural fluid collection in infants.

Introduction: The authors classify infantile subdural fluid collection (SFC) into four chronological stages: (I) SFC with arachnoid tear, (II) SFC with inner membrane, (III) SFC with inner and outer membrane, and (IV) subdural hematoma, and discuss the appropriate treatment for each stage.

Conclusions: Fontanel tapping can be used for every stage of SFC, but it is best indicated for stage II. Massive bleeding seldom occurs with punctures made with a small needle.