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Hubert Lee, Jeffrey J. Perry, Shane W. English, Fahad Alkherayf, Joanne Joseph, Steven Nobile, Linghong Linda Zhou, Howard Lesiuk, Richard Moulton, Charles Agbi, John Sinclair and Dar Dowlatshahi

important variables; however, a practical clinical tool remains to be developed. These models are limited by outdated practices, study-specific aneurysmal subarachnoid hemorrhage (aSAH) scales, cumbersome measures of intraventricular hemorrhage (IVH), institution-specific technology to measure CBF, and small sample size. Timely diagnosis of DCI can be difficult, as the degree of arterial vessel-caliber reduction does not necessarily correlate with development of neurological symptoms. A clinical prediction rule, a mathematical tool using patient characteristics and

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Rosa Q. So, Vibhor Krishna, Nicolas Kon Kam King, Huijuan Yang, Zhuo Zhang, Francesco Sammartino, Andres M. Lozano, Richard A. Wennberg and Cuntai Guan

seizure prediction from thalamic recordings and potentially devising a closed-loop stimulation system. 24 Initial evidence suggests that seizures can be detected earlier from thalamic local field potentials (LFPs) than from scalp electroencephalography (EEG). 25 We have extended these preliminary findings in a series of patients with nonresective yet primarily partial epilepsy who underwent anterior nucleus DBS. We used a nonlinear method of predicting seizures by comparing similarity index (SI) between a reference window and the periictal recordings. 17 We

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Paul M. Foreman, Michelle H. Chua, Mark R. Harrigan, Winfield S. Fisher III, R. Shane Tubbs, Mohammadali M. Shoja and Christoph J. Griessenauer

of aSAH patients treated in the United States, we seek to externally validate the Practical Risk Chart for the prediction of DCI in patients with aSAH. Methods A prospective cohort of aSAH patients was used to externally validate the previously published Practical Risk Chart for the prediction of DCI. 5 All patients were obtained from the CARAS (Cerebral Aneurysm Renin Angiotensin System) study, a prospective, blinded study designed to evaluate associations between common genetic polymorphisms in the renin angiotensin system and occurrence and rupture of cerebral

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Sung C. Choi, Jan P. Muizelaar, Thomas Y. Barnes, Anthony Marmarou, Danny M. Brooks and Harold F. Young

P rediction of outcome for the severely head-injured patient has received much attention in recent years 1–3, 5–17 but remains difficult to achieve. An accurate prediction rule enhances the formulation of appropriate therapeutic and management plans, and can also provide a basis for family counseling. Such rules have been constructed using mathematic/statistical models that describe and quantify the relationships between possible prognostic factors (for example, age, motor score, and oculocephalic response) and outcome. 5–7, 15, 17 Previous attempts at

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The prediction of recurrence in meningiomas

A flow cytometric study of paraffin-embedded archival material

Paul L. May, John C. Broome, John Lawry, Robert A. Buxton and Robert D. E. Battersby

found for the proliferation index value between the two groups (p < 0.002, Mann-Whitney U-test). No value above 19.2% was found in the nonrecurrent group, whereas 10 of the 15 tumors in the recurrent group had values above 19.2%. Fig. 1. Scattergram showing the proliferative indices of the recurrent and nonrecurrent groups of meningiomas. There is a significant difference (p < 0.002) between the two groups. No tumor in the nonrecurrent group had a proliferative index of greater than 19.2%. Discussion The prediction of the biological behavior of

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Parisa Azimi and Hasan Reza Mohammadi

C hildhood hydrocephalus is prevalent and is difficult to treat. Endoscopic third ventriculostomy (ETV) is a novel treatment that can be successful in some children and can avoid dependence on a lifelong ventricular shunt system. Indications for ETV and prediction of the chances of ETV success are, however, controversial, and deciding whether to perform ETV in these patients is very difficult. Thus, if a marker of success for ETV outcome could be established, it would be possible to create a better decision-making process based on each patient's status. 5

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Improved confidence of outcome prediction in severe head injury

A comparative analysis of the clinical examination, multimodality evoked potentials, CT scanning, and intracranial pressure

Raj K. Narayan, Richard P. Greenberg, J. Douglas Miller, Gregory G. Enas, Sung C. Choi, Pulla R. S. Kishore, John B. Selhorst, Harry A. Lutz III and Donald P. Becker

of these influences renders even the best prognostic system imperfect. Outcome predictions altered by such complications always err toward over-optimism. Although undesirable, such over-optimistic predictions can be accounted for and do not have adverse implications with regard to patient management. Far more serious, however, are errors of undue pessimism. These are not related to unexpected complications, and represent an inherent weakness of the prognostic system. The optimal prognostic indicant, or combination of indicants would, therefore, predict outcome with

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Byron Young, Robert P. Rapp, J. A. Norton, Dennis Haack, Phillip A. Tibbs and James R. Bean

T he Glasgow Coma Scale (GCS) 11 is used in numerous neurosurgical units to evaluate head-injured patients. This report is a detailed statistical analysis of the relationship between GCS scores obtained during the 1st week following head injury and outcome at 1 year. The value of additional data obtained from computerized tomography (CT) scanning for improving accuracy of outcome predictions based on GCS scores is also assessed. The paper describes how, when, and with what accuracy outcome predictions can be made for the individual head-injured patient

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Sung C. Choi, John D. Ward and Donald P. Becker

objective basis for family counseling. Several techniques proposed for prognosis in head injury involve relatively complex statistical formulas. 3, 7, 12, 15 Although such formulas can be applied using calculators or computers, it would be convenient to have a simple chart from which outcome prediction is easily determined from a simple clinical examination performed on postinjury Days 1 and 4. Clinical Material and Methods Patients The analysis is based on 264 patients with head injury who were admitted to the Neurosurgical Service of the Medical College of

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Douglas Kondziolka, Phillip V. Parry, L. Dade Lunsford, Hideyuki Kano, John C. Flickinger, Susan Rakfal, Yoshio Arai, Jay S. Loeffler, Stephen Rush, Jonathan P. S. Knisely, Jason Sheehan, William Friedman, Ahmad A. Tarhini, Lanie Francis, Frank Lieberman, Manmeet S. Ahluwalia, Mark E. Linskey, Michael McDermott, Paul Sperduto and Roger Stupp

P atients and their doctors both seek a reliable prediction of survival when a diagnosis of cancer is made. The most universal question is, “How long do you think the patient will live?” 22 Survival expectations are a frequent topic in doctor-patient discussions and doctor-doctor interactions. Thus, the reliability and accuracy of clinical and imaging data on individual patients outcomes is an important topic for study. 6–9 , 11 , 12 , 14 , 15 , 21 , 23 , 28 , 29 The majority of reports that detail clinical outcomes in patients with primary or metastatic