METHODS: Patients who were comatose at hospital arrival and thereafter were investigated for 1 year using a comprehensive neuropsychological test battery and 2 HRQOL questionnaires.
RESULTS: Thirty-five of 70 patients survived the bleed, and 26 underwent neuropsychological testing. Two distinct patient groups emerged, one (n = 14) with good cognitive click here function, having mild deficits only, and the other (n = 12) with poor cognitive and poor motor
function. Patients performing poorly were older (P = .04), had fewer years of education (P = .005) and larger preoperative ventricular scores, and were more often shunted (P = .02). There were also differences between the 2 groups in the Glasgow Outcome Scale (P = .001), the modified Rankin Scale
(P = .001), and employment status. HRQOL was more reduced in patients with poor cognitive function.
CONCLUSION: A high fraction of survivors among preoperative comatose aneurysmal SAH patients (Hunt and Hess grade V) recover to good physical and cognitive function, enabling them to live a normal life.”
“Objective: Color duplex ultrasound (CDU) imaging is a noninvasive alternative to computed tomography (CT) for the detection of endoleak. This study compared CT and CDU imaging in the detection of endoleaks requiring intervention after endovascular aneurysm repair (EVAR).
Methods: All EVARs performed at our institution from 1996 to 2007 were retrospectively reviewed. CDU and DAPT concentration CT scans <= 3 months were paired and the presence of an endoleak and its type were recorded. Clinical follow-up was reviewed and interventions for endoleak were recorded. Interventions were performed for type I, for type II with sac enlargement, and for type III Selleckchem IWP-2 endoleaks. The first analysis of clinical test outcomes used the findings of CT scan as a gold standard and the second used the findings at time of intervention as a gold standard.
Results: During the time period reviewed, 496 patients underwent EVAR, and 236 of these had CDU and CT follow-up
studies paired <= 3 months of each other. Mean follow-up was 17 months (range, <1-111 months). We reviewed 944 studies or 472 pairs. Eighteen patients (7.6%) required intervention for 19 endoleaks: six type I, II type II, and two type III. Early endoleak (<= 1 month) requiring reintervention was detected in I vs late endoleak (mean, 28 months; range, 0.6-88 months) in 18. All type I and III endoleaks were treated with endovascular cuff or limb extension placement. Three type II endoleaks were treated with open ligation, and coil or glue embolization was used in eight. CDU imaging detected endoleaks requiring intervention in 89% of cases, whereas CT detected endoleak in 58% (P < .05). The ability to correctly identify the type of endoleak as confirmed at time of intervention was 74% with CDU imaging vs 42% by CT (P < .05).