Neurosurgery
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The significant factors in the development of the neurosurgery program at the University of Florida have been the funding for 10 endowed chairs and a Brain Institute, the achievement of departmental status in the College of Medicine, the collaborative research with a strong Department of Neuroscience, and the strong commitment by the faculty to subspecialty neurosurgery and to service in the national neurosurgical organizations.
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Case Reports
Resolution of traumatic hypertrophic periodontoid cicatrix after posterior cervical fusion: case report.
The case of a 38-year-old man with delayed myelopathy 19 years after a nontreated odontoid type II fracture is reported. Magnetic resonance imaging of the craniocervical region revealed a periodontoid cicatrix. The clinical syndrome improved, and complete resolution of the retro-odontoid mass was achieved 9 months after posterior cervical fixation. The implications of this unique case for the management of myelopathy associated with nonunion of odontoid fractures are discussed.
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Historical Article
Intentional cranial deformation: a disappearing form of self-mutilation.
Of the forms of human self-mutilation that have been recorded, few have been so widespread and long lasting as intentional cranial deformation. The earliest known record of the practice is from Iraq and dates back to 45,000 BC. ⋯ Although tatooing, ear piercing, and circumcision are commonly practiced in our society, cranial deformation has almost completely disappeared from contemporary cultures, with the exception of isolated groups in Africa and South America. Intentional cranial deformation is intriguing for those who study the human cranium.
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Although the majority of head injuries in children and adults involve dynamic loading conditions, some patients suffer static loading. Static loading occurs when forces are applied slowly to the head, and it produces a much different pattern of injuries. Crush injuries are usually described in the context of industrial accidents, but in our experience, these injuries are not rare in children. ⋯ There was one cervical spine injury but no major vascular injuries. One child had pituitary transection, four had cranial nerve palsies, and another developed a delayed cerebrospinal fluid rhinorrhea 18 months after injury. All children made good cognitive recoveries, with some having relatively mild fixed focal deficits.(ABSTRACT TRUNCATED AT 250 WORDS)
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Medical treatments and strategies are increasingly being subjected to evaluations of economic efficiency. Although the reasons for this are many, it is becoming ever more important for physicians to have an understanding of the uses and limitations of such evaluations. Cost effectiveness analysis (CEA) is a technique that measures the cost of medical technology per unit of a defined health output, usually life years saved with an adjustment for quality of survival. ⋯ Marginal and incremental CEAs are techniques that help to address the cost effectiveness of different amounts of a particular treatment and the differential costs and benefits of competing strategies, respectively. A review is presented of the theoretical basis of CEA and its component parts. Emphasis is placed on generating an understanding of the method rather than providing a step-by-step protocol for the undertaking of such studies.