Journal of neurosurgery
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Journal of neurosurgery · Oct 2000
Case ReportsMiddle meningeal artery embolization for refractory chronic subdural hematoma. Case report.
The authors present a case of refractory chronic subdural hematoma (CSH) in a 59-year-old man with coagulopathy due to liver cirrhosis. The patient was successfully treated by embolization of the middle meningeal artery after several drainage procedures. This new therapeutic approach to recurrent CSH is discussed.
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Journal of neurosurgery · Oct 2000
Incidence and outcome of kyphotic deformity following laminectomy for cervical spondylotic myelopathy.
The authors undertook a study to explore the predisposing risk factors, frequency of occurrence, and clinical implications of kyphosis following laminectomy for cervical spondylotic myelopathy (CSM). ⋯ Kyphosis may develop in up to 21% of patients who have undergone laminectomy for CSM. Progression of the deformity appears to be more than twice as likely if preoperative radiological studies demonstrate a straight spine. In this study, clinical outcome did not correlate with either pre- or postoperative sagittal alignment.
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Journal of neurosurgery · Oct 2000
Use of titanium mesh for reconstruction of large anterior cranial base defects.
The authors evaluated the role of titanium mesh used in combination with vascularized pericranium to provide rigid support during reconstruction of anterior skull base defects. Thirteen patients with large anterior skull base defects caused by tumor invasion or traumatic injury involving the cribriform plate, orbital roof, and planum sphenoidale were included in the study. The reconstruction technique involved placement of titanium mesh between two layers of continuous vascularized pericranium. ⋯ Postoperative CSF rhinorrhea occurred in two patients with extensive dural defects, which resolved with temporary lumbar drainage. Use of titanium mesh and a two-layer vascularized pericranial graft is a safe, reproducible, and feasible method for reconstructing the anterior skull base. Patients with large dural defects may need temporary CSF diversion to avoid postoperative fistula formation.
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Journal of neurosurgery · Sep 2000
Biography Historical ArticleBiographical sketch of Kenneth G. McKenzie (1892-1964).
This article is an expanded version of the opening address Dr. Morley delivered at a University of Toronto symposium, "Seventy-Five Years of Neurosurgery in Canada," celebrating the 75th Anniversary of the appointment of Kenneth G. McKenzie, Canada's first career neurosurgeon, to the University of Toronto and the Toronto General Hospital in 1923. ⋯ McKenzie (1892-1964) was the first surgeon in Canada to limit his practice to neurosurgery. This article contains a brief biographical study of the man, his upbringing, and management of his professional life at Toronto General Hospital. Some of his published neurosurgical articles are also reviewed.
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Journal of neurosurgery · Sep 2000
Natural history of unruptured intracranial aneurysms: probability of and risk factors for aneurysm rupture.
The authors conducted a study to investigate the long-term natural history of unruptured intracranial aneurysms and the predictive risk factors determining subsequent rupture in a patient population in which surgical selection of cases was not performed. ⋯ Cigarette smoking, size of the unruptured intracranial aneurysm, and age, inversely, are important factors determining risk for subsequent aneurysm rupture. The authors conclude that such unruptured aneurysms should be surgically treated regardless of their size and of a patient's smoking status, especially in young and middle-aged adults, if this is technically possible and if the patient's concurrent diseases are not contraindications. Cessation of smoking may also be a good alternative to surgery in older patients with small-sized aneurysms.