Journal of neurosurgery
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The authors compare clinical outcomes demonstrated in patients with traumatic central cord syndrome (CCS) who underwent early (< or = 24 hours after injury) or late (> 24 hours after injury) surgery. ⋯ Early surgery is safe and more cost effective than late surgery for the treatment of traumatic CCS, based on ICU stay and LOS and improved overall motor recovery, in patients whose CCS was related to acute disc herniation or fracture. In the setting of spinal stenosis or spondylosis, early surgery was safe but did not improve motor outcome compared with late surgery.
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Journal of neurosurgery · Jul 2002
Comparative StudyCation dysfunction associated with cerebral ischemia followed by reperfusion: a comparison of microdialysis and ion-selective electrode methods.
Disruption of ionic homeostasis during ischemia is a well-characterized event and is identified by a rise in the concentration of extracellular potassium [K+]e, with a concomitant reduction in the concentration of extracellular sodium [Na+]e. Results of clinical studies in which microdialysis has been used, however, have shown only modest changes in the levels of extracellular ions. The object of this study was to measure [K+]e and [Na+]e by using ion-selective electrodes (ISEs) and to compare these measurements with those obtained using the well-established method of microdialysis. ⋯ Our results indicate that the flexible ISE is a reliable and accurate tool for monitoring ionic dysfunction that accompanies brain injury.
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Journal of neurosurgery · Jul 2002
Magnetic resonance imaging correlation in pediatric spinal cord injury without radiographic abnormality.
The authors conducted a study to determine correlations between clinical syndromes and early magnetic resonance (MR) imaging-documented findings in children with spinal cord injury without radiographic abnormality (SCIWORA). ⋯ In this series, the predominant neurological presentation of SCIWORA was a mild, partial syndrome that resolved within 72 hours. Magnetic resonance imaging revealed abnormal features only in those patients with complete neurological deficits. These findings suggest that in the acute setting conventional MR imaging sequences may lack the sensitivity to demonstrate neural and extraneural abnormalities associated with partial or temporary neurological deficits of SCIWORA, even when those deficits persist beyond 72 hours.
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Journal of neurosurgery · Jul 2002
Case ReportsEagle syndrome: entrapment of the glossopharyngeal nerve? Case report and review of the literature.
Eagle syndrome is characterized by unilateral pain in the oropharynx, the side of the face, and the earlobe. It is caused by an elongated styloid process; resection of the elongated process eliminates the pain. Although quite rare, this syndrome is well represented in the oral, ear, nose, and throat surgery literature. ⋯ After the diagnosis of Eagle syndrome was made based on radiographic findings and was confirmed using a local anesthetic block, resection of the elongated styloid process was performed, resulting in complete and lasting pain relief. Eagle syndrome, which is caused by compression of the glossopharyngeal nerve as it passes the elongated styloid process, may be classified as an entrapment syndrome deserving of neurosurgical attention. The goal of this report is to familiarize neurosurgeons with Eagle syndrome and its diagnostic work up and treatment.
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Journal of neurosurgery · Jul 2002
Ischemic depolarization monitoring: evaluation of protein synthesis in the hippocampal CA1 after brief unilateral ischemia in a gerbil model.
The authors investigate whether depolarization monitoring is an accurate index of ischemic damage in a gerbil model of unilateral ischemia and assess the effects of brief cerebral ischemia on protein synthesis in this model. ⋯ In this study the authors demonstrate that monitoring of ischemic depolarization is a useful method to predict neuronal damage in the hippocampal CA1 in this model, and they identify subtle changes in protein synthesis after brief ischemia. Sublethal ischemia was divided into three categories by its depolarization period (< 90 seconds, 90-180 seconds, and > 180-210 seconds) with regard to changes in protein synthesis.