Journal of neurosurgery
-
The purpose of this study was to report the author's experience with 14 cases of terminal and nine cases of nonterminal myelocystoceles and to highlight the differences between these two groups in regard to the embryological origins, clinical presentation, operative findings, results on neuroimaging studies, and prognosis for these lesions. ⋯ Myelocystoceles, both terminal and nonterminal, are different from other skin-covered masses in the back. A proper imaging evaluation is required to differentiate myelocystoceles from other skin-covered masses in this area, because the surgical treatment and prognosis are different for this subset of patients with occult spinal dysraphism. Terminal myelocystoceles are different from nonterminal ones embryologically, clinically, radiologically, surgically, and prognostically. These differences are discussed.
-
Journal of neurosurgery · Aug 2007
Editorial CommentAntiepileptic drugs and subarachnoid hemorrhage.
-
Journal of neurosurgery · Aug 2007
Randomized Controlled Trial Multicenter StudyOutcome in patients with subarachnoid hemorrhage treated with antiepileptic drugs.
Prophylactic use of antiepileptic drugs (AEDs) in patients admitted with aneurysmal subarachnoid hemorrhage (SAH) is common practice; however, the impact of this treatment strategy on in-hospital complications and outcome has not been systematically studied. The goal in this study was twofold: first, to describe the prescribing pattern for AEDs in an international study population; and second, to delineate the impact of AEDs on in-hospital complications and outcome in patients with SAH. ⋯ Prophylactic AED treatment in patients with aneurysmal SAH is common, follows an arbitrary prescribing pattern, and is associated with increased in-hospital complications and worse outcome.
-
Journal of neurosurgery · Aug 2007
Randomized Controlled Trial Multicenter StudyIntraventricular hemorrhage from ruptured aneurysm: clinical characteristics, complications, and outcomes in a large, prospective, multicenter study population.
In this study the authors analyzed the relationship of intraventricular hemorrhage (IVH) to in-hospital complications and clinical outcome in a large population of patients with aneurysmal subarachnoid hemorrhage (SAH). ⋯ The presence of IVH in patients with SAH has an important predictive value with regard to these aspects.
-
Journal of neurosurgery · Aug 2007
Case ReportsDynamic phases of peroneal and tibial intraneural ganglia formation: a new dimension added to the unifying articular theory.
The pathogenesis of intraneural ganglia has been a controversial issue for longer than a century. Recently the authors identified a stereotypical pattern of occurrence of peroneal and tibial intraneural ganglia, and based on an understanding of their pathogenesis provided a unifying articular explanation. Atypical features, which occasionally are observed, have offered an opportunity to verify further and expand on the authors' proposed theory. ⋯ These three cases together with data obtained from a retrospective review of the authors' clinical material and findings reported in the literature provide firm evidence for mechanisms underlying intraneural ganglia formation. Thus, expansion of the authors' unified articular theory permits understanding and elucidation of unusual presentations of intraneural cysts. Whereas an articular connection and fluid following the path of least resistance was pivotal, the authors now incorporate dynamic aspects of cyst formation due to pressure fluxes. These basic principles explain patterns of ascent, cross-over, and descent down terminal nerve branches based on articular connections, paths of diminished resistance to fluid flow within recognized anatomical compartments, and the effects of fluctuating pressure gradients.