Neurosurgery
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Historically, neurosurgery has improved the environment of the nervous system to promote maximal spontaneous recovery of function. The population of patients whom we treat at present is a small portion of those who suffer from disabling neurological illnesses. ⋯ In order to meet the present challenge, neurosurgeons must broaden our vision, our role, and our future educational goals. In this review, we summarize the landmark advances in the basic and clinical neurosciences and the results of clinical trials that are driving our evolution from passive reaction to disease to active attempts to restore lost central nervous system function.
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The University of Lausanne was founded in 1537. The faculty of medicine was created in 1890, and the service of surgery was directed by César Roux. Roux, a well-known surgeon, was visited by Harvey Cushing during 1900-1901. ⋯ Eric Zander created the division of neurosurgery in 1959; it became an independent service in 1967. Nicolas de Tribolet served as chairman from 1984 until 1994, when he was asked to take charge of the merger of the university services of Geneva and Lausanne. In October 1997, Jean-Guy Villemure joined him in the newly merged department, becoming chairman in Lausanne, while de Tribolet is chairman in Geneva and head of the department comprising both services.
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To study the distribution of intracranial arachnoid cysts in a large and nonbiased patient population. ⋯ Arachnoid cysts have a strong predilection for the middle cranial fossa that may be explained by a meningeal maldevelopment theory: the arachnoid coverings of the temporal and frontal lobes fail to merge when the sylvian fissure is formed in early fetal life, thereby creating a noncommunicating fluid compartment entirely surrounded by arachnoid membranes. Why males develop more middle fossa cysts on the left side remains a mystery.
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Accepted management strategies for odontoid fractures include external immobilization and surgical stabilization using anterior or posterior approaches. Displaced Type II fractures and rostral Type III fractures are at high risk for nonunion. Anterior fixation of odontoid fractures with a single cortical lag screw is a relatively new technique that combines rigid internal stabilization with preservation of intrinsic C1-C2 motion. We retrospectively reviewed our series of 26 consecutive patients who underwent odontoid screw fixation, to further define the safety and efficacy of the technique. ⋯ Single-screw anterior odontoid fixation was associated with a relatively low complication rate and a high fusion rate in this study. We think that this should be the preferred treatment method for acute Type II odontoid fractures.
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To assess the potential for long-term serviceable hearing preservation in intracanalicular acoustic tumor patients who underwent stereotactic radiosurgery. ⋯ Gamma knife radiosurgery (using conformal dose planning, small-beam geometry, and < or = 14 Gy to the margin) prevents tumor growth and achieves excellent hearing preservation rates.