Neurosurgery
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A clinical and light and electron microscopic study of three cases of painful neuroma, surgically resected, was made. It was found (a) that painful neuromas contain large numbers of small diameter, unmyelinated fibers, in an apparently much larger proportion than myelinated fibers and (b) that a consistent, unrestrained growth of perineurial cells parallels the constant regeneration of axis cylinders. ⋯ It is suggested that the increased numbers of unmyelinated axis cylinders in traumatic neuromas could be related to the painful symptoms in some patients. It is further postulated that the unrestricted growth of perineurial cells is an attempt to contain the regeneration of axis cylinders and that the maintenance of perineurial integrity by fascicle ligation is important in the relief of painful human neuromas.
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Eighteen cases of multiple primary brain tumors of different histological types were found in a review of Mayo Clinic records from 1950 to 1978. The predisposing factors, clinical presentation, location, and type of tumor are discussed. The clinical significance and etiology of these multiple tumors are considered.
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Prompt surgical intervention is thought to be necessary in patients with traumatic intracerebellar hematoma. The case reported here ran a benign course without operation. Pertinent serial computed tomographic scans are presented. It is concluded that not all traumatic hematomas of the cerebellum require operations.
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Historical Article
Perspectives in international neurosurgery: neurosurgery in Italy.