Neurosurgery
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We report the case of a young girl who suffered bilateral upper extremity paralysis after minor head trauma. Her clinical picture, as well as radiographic evidence of a fracture at C1, led to the diagnosis of Bell's cruciate paralysis, caused by a small lesion in the rostral part of the pyramidal decussation. Magnetic resonance images showed, in addition to a Chiari Type I malformation, an abnormality in the medulla. All previous cases of cruciate paralysis lack both pathological and radiographic supporting evidence.
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Abnormal coagulation and fibrinolysis is a frequent complication in patients with head injury. This complication can be severe enough to lead to hemorrhage or thrombosis. A study was undertaken to determine if the hemostatic abnormalities are reliable indicators of outcome. ⋯ Other tests did not provide additional predictive value. Abnormal hemostasis frequently complicates the course of patients with head injuries. This study demonstrates that hemostasis tests are predictors of outcome in these patients.
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Biography Historical Article
The Johns Hopkins medical centennial. 1889-1989: a century of neurosurgery.
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Case Reports
Paraparesis during myelography associated with a ruptured thoracic intervertebral disc.
Serious or permanent neurological complications following routine lumbar myelography are uncommon in clinical practice. We describe the sudden and dramatic onset of a symmetrical dense paraparesis in a patient after an uneventful lumbar puncture performed during myelography. A herniated thoracic intervertebral disc was subsequently diagnosed and successfully treated.