摘要:

&NA;The authors reviewed 100 consecutive survivors of aneurysm operations and identified 3 patients who developed postoperative epilepsy. The use of prophylactic phenytoin in the first 67 cases did not seem to influence the patient's risk of developing epilepsy. It is concluded that with present microneurosurgical techniques the risk of postoperative epilepsy is small and unselective use of phenytoin prophylaxis should be reconsidered. (Neurosurgery19:784‐788, 1986)

ISSN:0148-396X    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Chronic pain in the perineum is a difficult neurosurgical problem. This article evaluates the effectiveness of sacrococcygeal rhizotomy in 28 patients who had cancer‐related pain or coccydynia, underwent rhizotomy, and were followed for an average of 3 years. Good pain relief was obtained in 53% (10 of 19 patients) with malignant pain, as opposed to 22% (2 of 9 patients) with nonmalignant pain. Sacral rhizotomy is a reasonable treatment for cancer‐related perineal pain, but it is ineffective for coccydynia and other benign perineal pain problems. (Neurosurgery19:789‐793, 1986)

ISSN:0148-396X    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Four patients with chronic subdural hematomas, all of which resolved spontaneously, were followed from the time of injury to resolution of the chronic subdural hematoma. Periodic computed tomographic (CT) scans showed spontaneous resolution 78, 174, 231, and 326 days after the development of the chronic subdural hematoma, respectively. Features of the CT scans and a possible mechanism of spontaneous resolution are discussed. (Neurosurgery19:794‐798, 1986)

ISSN:0148-396X    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;The surgical anatomy of a transtemporal approach to the structures of the clivus was defined with the aid of dissections in 10 cadaver heads. The steps in the dissection consisted of first exposing the cervical internal carotid artery (ICA), the internal jugular vein, and the caudal cranial nerves, each at the skull base; then performing small retromastoid and temporal craniotomies; and, finally, drilling away the petrous and tympanic bone to expose the intratemporal parts of the facial nerve, the petrous ICA, the sigmoid sinus, and the jugular bulb. To expose the structures of the lower clivus, the sigmoid sinus was ligated and divided, the facial nerve was displaced anterosuperiorly, and the inner ear structures were preserved. Dural opening exposed the anterolateral and anterior surfaces of the medulla, the pontomedullary junction, and the spinomedullary junction. The ipsilateral vertebral artery and often the contralateral vertebral artery and the vertebrobasilar junction, the caudal cranial nerves, and the origin of the 6th, 7th, and 8th cranial nerves were well exposed. To expose the structures of the middle clivus, we drilled away the labyrinth, the cochlea, and a portion of the clival bone. The facial nerve was displaced posteroinferiorly. Dural opening exposed the ipsilateral anterior surface of the pons, the midbasilar artery, and the ipsilateral 5th, 6th, 7th, and 8th cranial nerves. A portion of the contralateral anterior surface of the pons was also exposed at times. The superior limit of this exposure was just above the origin of the trigeminal nerve. The exposure of the upper clival structures was limited with this approach, and required medial temporal lobe retraction. Two case reports are included to illustrate the application of the transtemporal approach to the exposure and clipping of aneurysms of the vertebrobasilar system. The advantages and disadvantages of this approach are discussed. (Neurosurgery19:799‐808, 1986)

ISSN:0148-396X    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Thirty‐five patients with complete myelopathies secondary to cervical spine fractures from C‐4 to C‐7 underwent spinal decompressions and fusions between 1975 and 1981. Twenty‐five of these patients underwent simultaneous nerve root decompressions, 23 with an accompanying anterior decompression and fusion and 2 with an accompanying posterior fusion. Substantial recovery of nerve root function occurred in 15 of these patients. A posterior reduction and fusion without nerve root decompression was performed in each of the remaining 10 patients. None of these patients demonstrated a significant improvement neurologically. Operation for nerve root decompression is indicated in selected victims of spinal cord injury. (Neurosurgery19:809‐812, 1986)

ISSN:0148-396X    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;The authors present a case of intranasal schwannoma with extension into the intracranial compartment. Computed tomographic findings are presented, and a combined intranasal and subfrontal operative approach is described. The pathology, origin, and clinical characteristics of intranasal schwannomas are reviewed. (Neurosurgery19:813‐815, 1986)

ISSN:0148-396X    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Reactive gliosis was found in a 40‐year‐old man who presented with intractable seizures thought to be due to a malignant neoplasm. Although two separate lesions located bilaterally in the frontal lobes were evident on the computed tomographic scan, a connection between these lesions along the fibers of the corpus callosum was clearly demonstrated on T2‐weighted magnetic resonance images. The unusual radiological appearance of this gliosis, which simulated a malignant butterfly glioma on magnetic resonance imaging (MRI), is reported. Because MRI is still a new modality, its images should be interpreted with judicious caution. (Neurosurgery19:816‐819, 1986)

ISSN:0148-396X    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Two cases of prostatic carcinoma metastatic to the cranium that presented with clinical and radiographic features simulating meningioma are described. The literature was reviewed, and 13 similar cases were identified. From the data gathered, we conclude that metastatic prostate cancer should be considered in the differential diagnosis of elderly males who present with characteristic clinical and radiological features of meningioma and that the classical description of meningioma is not specific. (Neurosurgery19:820‐823, 1986)

ISSN:0148-396X    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Two cases of ventriculitis withStaphylococcus epidermidisthat failed on therapy with an antistaphylococcal penicillin are presented. Both infections responded to a combination of intravenous and intraventricular vancomycin and rifampin. Vancomycin and rifampin represent an important antibiotic regimen for the management of resistant infections of the central nervous system, especially with those due toS. epidermidisor methicillin‐resistantStaphylococcus aureus.(Neurosurgery19:824‐827, 1986)

ISSN:0148-396X    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;A case of intradural metastasis from endometrial carcinoma to the cauda equina is presented. The clinical presentation and radiographic findings were misleading and suggested a herniated nucleus pulposus. Findings at operation were most suggestive of an ependymoma, but final pathological diagnosis revealed endometrial carcinoma. This has never been reported. Once again it demonstrates that surgeons managing lumbar disc disease must be prepared for possible intradural exploration with an appropriate team. (Neurosurgery19:828‐830, 1986)

ISSN:0148-396X    

出版商:OVID    

年代:1986

数据来源: OVID