Neurosurgery
-
A case of an abnormal loop of the extracranial vertebral artery enlarging the intervertebral foramen at C5-C6 and the transverse foramen at C5 is reported. This occurrence is rare and was associated with cervicobrachial neuralgia caused by neurovascular compression of the C6 root. The patient was cured by microvascular decompression.
-
From 1974 to 1992, anterior cervical spondylodesis was performed in 163 patients of cervical spondylotic myelopathy, cervical spondylotic radiculopathy, traumatic spinal injury, ossification of the posterior longitudinal ligament, or cervical spondylitis. Forty-five of these patients were followed for more than 4 years. To analyze the long-term results of anterior cervical spondylodesis, a radiological examination was performed in these 45 patients and magnetic resonance imaging was conducted in 41 of them. ⋯ Postoperative canal stenosis caused by the bulging of the discs and the ligamentum flavum was frequently demonstrated with hypo- or isointense signal on T2-weighted images by magnetic resonance imaging in patients followed long term after surgery and in patients with malalignment of the cervical spine due to kyphosis of the fused vertebrae and multisegmental fusion. Neurological improvement was less in patients with bulge of the discs and the ligamentum flavum seen in magnetic resonance imaging than in patients without it. The bulge of the ligamentum flavum was histopathologically defined as hypertrophy of the ligament.
-
Glutamate antagonists are the most powerful neuroprotective drugs in laboratory studies of focal cerebral ischemia. Because the majority of clinical conditions in which focal brain ischemia occurs are associated with high intracranial pressure (ICP), we have used the rat acute subdural hematoma model to evaluate the effects of three glutamate N-methyl-D-aspartate antagonists, MK-801, CGS 19755 (SELFOTEL), D-CPP-ene, and mannitol, upon ICP and also upon the volume of ischemic brain damage. ⋯ N-methyl-D-aspartate antagonists do not increase ICP or jeopardize cerebral perfusion pressure when administered under anesthesia with a controlled PaCO2 level. Further studies in humans are indicated.
-
We report the case of a girl who developed cerebellar medulloblastoma at the age of 12 years and in whom, 4 years after surgical removal and radiotherapy, neoplastic dissemination via the cerebrospinal fluid took place. After only partially effective systemic and intrathecal chemotherapy, an intrathecal administration of lymphokine-activated killer cells and recombinant interleukin-2 allowed complete clinical recovery persisting after a follow-up of 30 months.
-
Case Reports
Congenital intramedullary lipoma of the dorsocervical spinal cord with intracranial extension: case report.
The unusual computed tomographic findings of an extensive intramedullary lipoma of the dorsocervical spinal cord, which extended into the brain stem, in a 9-month-old infant are described and correlated with the surgical findings. The operative therapeutic options are discussed.