Neurosurgery
-
Biography Historical Article
The early history of neurosurgery in the American South.
As a specialty, neurosurgery was not on firm footing at the turn of the century (1900); however, it was brought into being in the American South early in the 20th century by seven young surgeons, all of whom performed neurosurgical procedures as part of their general surgery practice. A close look at the seven reveals that they were trained and/or influenced in varying degrees by either Dr. ⋯ Victor Horsley, two outstanding surgeons and teachers of this period. After overcoming many obstacles, these seven men firmly established the surgical specialty of neurosurgery in the South.
-
To conduct a topic review of studies related to cerebral concussion in athletes, as an aid to improving decision-making and outcomes. ⋯ Neuropsychological testing seems to be an effective way to obtain useful data on the short-term and long-term effects of mild traumatic brain injury. Moreover, knowledge of the various definitions and management strategies, as well as the utility of neuropsychological testing, is essential for those involved in decision-making with athletes with mild traumatic brain injuries.
-
There is no question that substantial progress has been made over the last 30 years, since the pioneering multinational studies of Jennett and colleagues, in our understanding of the mechanisms involved in the production, progression, and amelioration of brain damage. The introduction of computed tomography and simple but elegant classifications of the severity of injury (e.g., the Glasgow Coma Scale and the Glasgow Outcome Scale) were seminal milestones in neurotraumatology. ⋯ Better attention to easily delineated abnormalities, such as shock, hypoxia, and hypercarbia, and the early evacuation of mass lesions coupled with the concurrent development of modern principles of critical care account for substantial reductions in mortality and a reduction in the number of vegetative, contracted, spastic survivors. Future improvement in the care of patients with head injuries will increasingly be dependent on advances in molecular neurobiology and psychology, our ability to successfully modulate genetic expression, and progress in the treatment of related illnesses, such as stroke, subarachnoid hemorrhage, depression, and Alzheimer's disease.
-
The goal of this study was to investigate the clinical and paraclinical features, treatment, and outcomes of patients with multiple sclerosis (MS) and coexisting spinal cord compression secondary to either cervical spondylosis or cervical disc disease. Patients with MS commonly experience neurological disabilities that present as myelopathy associated with bladder dysfunction. For some patients with MS, however, this neurological deterioration may result from coexisting spinal cord compression attributable to either spondylosis or a herniated disc. Overlapping symptoms of the two conditions do not allow clear clinical determination of the underlying cause of worsening. ⋯ Carefully selected patients with MS and cervical spinal cord compression secondary to either spondylosis or disc disease may benefit from surgical decompression, with minimal associated morbidity. Clinical features (especially neck pain and cervical radiculopathy) and magnetic resonance imaging may assist clinicians in differentiating between the two conditions and may guide appropriate treatment without undue delay.