Neurosurgery
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Before 1937, members of the Department of Surgery and Gynecology practiced emergency neurosurgery at the University of Virginia in the same fashion as in other hospitals in the United States. In 1937, Claude C. Coleman, Chairman of the Department of Neurosurgery at the Medical College of Virginia in Richmond, organized a Division of Neurosurgery as part of the Department of Surgery and Gynecology at the University of Virginia. ⋯ Laws, Jr., in 1992, Dheerendra Prasad in 1995, Gregory Helm in 1996, and Mark Shaffrey in 1997. Resident training has been a priority of the Department of Neurosurgery; many academic neurosurgeons were trained and practiced their specialty in the Department early in their careers. Sixty years after its foundation, the Department of Neurosurgery continues its commitment to patient care, research, and the "... instruction of those who come after us."
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To demonstrate that microvascular decompression of the left medulla oblongata is a safe and effective modality for treating elevated blood pressure in patients with severe medically refractory "essential" hypertension (HTN). ⋯ Microvascular decompression of the left rostral ventrolateral medulla oblongata may be an effective treatment modality for patients suffering from severe HTN and/or autonomic dysreflexia refractory to medical management.
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Review Case Reports
Nontraumatic atlanto-occipital and atlantoaxial rotatory subluxation: case report.
Concomitant atlantoaxial and atlanto-occipital subluxation resulting from any cause is extremely rare. We have found only five previously reported cases and describe another, suggesting a treatment plan. ⋯ Disruption of the occipito-atlanto-axial complex can result from relatively minor head and neck infections and should be suspected in children with persisting neck pain and decreased neck movements. It may not be necessary to perform an occipitoaxial fusion to treat these patients, and a more limited fusion may be successful.
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One of the largest contemporary neurosurgical experiences with hypothermic circulatory arrest was analyzed for trends in patient selection and clinical variables affecting outcome. ⋯ Current indications for hypothermic circulatory arrest include only giant and complex posterior circulation aneurysms that cannot be treated using conventional techniques or that recur after endovascular coiling. Surgical morbidity and mortality rates reflect the increasing complexity of the aneurysms treated but are still more favorable than the natural history of these lesions. This experience demonstrates that management in specialized neurovascular centers can minimize the morbidity associated with circulatory arrest so that it remains a viable treatment option for complex posterior circulation aneurysms.
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Biography Historical Article
Library: historical perspective. John Farquhar Fulton.