Neurosurgery
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To quantitate the relief of intractable cancer pain by the use of intraventricular morphine administration. ⋯ Intraventricular morphine administration is a useful method for palliation of intractable cancer pain.
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To determine the frequency of unexpected major arterial occlusion and incomplete aneurysm clipping on intraoperative angiography after cerebral aneurysm clipping and to determine factors that predict these unexpected findings. ⋯ Intraoperative angiography detects unexpected arterial occlusions and residual aneurysms in 12% of cases and can decrease complications of aneurysm surgery, although the yield in unselected patients is low. The subgroup of patients with giant, basilar apex, and posterior communicating artery aneurysms has a significantly higher incidence of untoward findings and may benefit from increased usage of intraoperative angiography.
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Despite detailed studies of the perforating arteries, their relationships with the leptomeningeal arteries are almost unknown. These relationships can be of great significance during neurosurgical operations. ⋯ From 4.8 to 100% of certain groups of the perforating vessels originated in the leptomeningeal arteries. Occlusion of a leptomeningeal artery that gives rise to the perforating vessel(s) may lead to superficial and deep infarcts in the same patient.
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Nerve action potential (NAP) recording is a proven and useful tool in the surgical management of nerve injury. Understanding its materials and methods as well as its pitfalls and limitations is necessary for successful and routine use of this tool. ⋯ NAP recording provides useful information regarding the regenerative potential of a damaged nerve long before that potential is clinically evident. This information is critical in the optimal management of nerve injuries. The techniques of NAP recording are straightforward, but attention to detail is important, and full understanding of the method is required.