Neurosurgery
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The realistic chances of hearing preservation and the comparability of international results on hearing preservation in complete microsurgical vestibular schwannoma resections were the focus of this study in a large patient population treated by uniform principles. ⋯ Functional cochlear nerve preservation in complete microsurgical resection should belong to the contemporary standard of treatment goals.
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Although the incidence is low, a very small aneurysm with a thin wall and no neck arises at the superior wall of the supraclinoid portion of the internal carotid artery and is called a "blister-like" aneurysm. However, the pathogenesis of such a vascular lesion remains uncertain. ⋯ The blister-like aneurysm appeared to be a laceration of the carotid wall based on degeneration of the internal elastic lamina.
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Biography Historical Article
Byron Stookey: "the old lion"--an unsung giant of neurosurgery.
BYRON POLK STOOKEY, an outstanding clinician and teacher, served as Director and Chief of Neurosurgery at the Neurological Institute of New York Columbia-Presbyterian Medical Center. Highlights of his clinical contributions include improved peripheral nerve and spine surgery and subtemporal trigeminal nerve section for tic douloureux. Through diverse activities in both the political and academic arenas of patient care, education, and research, stookey helped to build and strengthen neurosurgery between the world wars and helped to prepare the foundation for the accomplishments of recent decades.
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We had previously suggested a protocol for the management of neurosurgical patients with hyponatremia and natriuresis that was based on their volume status as determined by actual blood volume measurements. All patients in that study were found to be hypovolemic or normovolemic and responded, within 72 hours, to salt and fluid replacement. In the present study, the validity of that protocol was tested using central venous pressure as the sole measure of volume status of patients with hyponatremia and natriuresis. ⋯ Hyponatremia with natriuresis in the neurosurgical setting responds to salt and fluid replacement guided by the patients' volume status as determined by the central venous pressure. This study also offers further indirect evidence to suggest that the syndrome of hyponatremia with natriuresis is most often caused by "cerebral salt wasting" rather than by the syndrome of inappropriate secretion of antidiuretic hormone.