Neurosurgery
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Multi-level cervical spondylosis and ossification of the posterior longitudinal ligament (OPLL) are well-documented causes of myelopathy. The choice of surgical procedures remain controversial. Between January 1983 and December 1987, we have performed anterior cervical vertebrectomy in 45 patients with cervical myelopathy caused by multi-level spondylosis and OPLL. ⋯ Neurological signs did not improve in 5 patients (11%). One patient died because of agranulocytosis secondary to treatment with antibiotics. In conclusion, cervical cord compression caused by lesions located principally in the anterior aspect of the spinal canal may be completely relieved via anterior vertebrectomy, discectomy, removal of the calcified ligament, and fusion.
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Case Reports
Diagnosis and treatment of an odontoid fracture in a patient with polyostotic fibrous dysplasia: case report.
Fibrous dysplasia of the cervical spine is rare. No prior reports have discussed odontoid fractures in the setting of fibrous dysplasia. ⋯ A review of fibrous dysplasia is presented. Alternative methods of diagnosis and treatment options in our patient are discussed.
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A rare neurovascular complication of a antebrachial arteriovenous fistula in a chronic hemodialysis patient is reported. A large brachial venous pseudoaneurysm caused median neuralgia by direct compression of the nerve. Surgical resection of the pseudoaneurysm resulted in complete relief of neuralgia.
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Case Reports
Evaluation and follow-up of carotid-cavernous fistulas by transcranial Doppler sonography: illustrative case.
The availability of transcranial Doppler sonography has resulted in an easy, noninvasive, reproducible, and highly reliable method for evaluating the flow characteristics of carotid-cavernous sinus fistulas. It also allows the follow-up of the effect of different interventional measures, specifically, embolization with detachable balloons. An illustrative case is reported, in which the findings of serial transcranial Doppler sonograms are correlated with findings on computed tomographic scans and angiograms. The impact of our findings on future approaches to the hemodynamic classification of these acquired vascular shunts is discussed.
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The cerebral effects of alterations in plasma osmolality (Osm) and colloid oncotic pressure (COP) were examined in normocarbic, normothermic, pentobarbital-anesthetized rabbits that had been subjected to cryogenic brain injury. Monitored variables in all animals included mean arterial, right atrial, and intracranial pressures (MAP, CVP, and ICP), electroencephalographic (EEG) recordings, and cerebral blood flow (CBF). When surgical preparation was complete, a left parietal lesion was produced with liquid nitrogen. ⋯ The animals were killed by exsanguination 25 minutes after completion of plasmapheresis. The brain was removed, the hemispheres separated, weighed, and sliced, and the specific gravities (SpGr) of the regional tissue determined. There were no differences in MAP, CVP, regional CBF, or EEG activity among the groups.(ABSTRACT TRUNCATED AT 250 WORDS)