Neurosurgical review
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Controversy remains concerning the management of patients with cerebellar hemorrhage. In this study the records of 42 patients were reviewed. In 60% of them the signs of brainstem compression and upward transtentorial herniation were found. ⋯ Immediate surgical decompression of the posterior fossa was life-saving for patients with brainstem compression and upward transtentorial herniation. Mortality was 57% for comatose patients and 9% for drowsy or stuporous patients. Ventriculostomy alone is the treatment of choice in cases with only hydrocephalus without brainstem compression or transtentorial herniation.
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A new technique for interbody lumbar spondylodesis using a new cancellous metal, plug-shaped construct was performed in 35 cases with spondylolisthesis or lumbar instability. All of these patients have had severe low-back pain for years, some with radicular symptoms and had been treated unsuccessfully for years. In a follow-up study, 28 of these patients were examined after a time-period of 4 to 24 months. ⋯ These include tibial or iliac bone grafts, sometimes fixed with screws or plates [6, 9, 12, 17, 20]. This article now describes the new surgical technique for ventral spondylodesis, using a new implant for the interbody fusion of the lumbar and sacral spine. In addition, we describe the indications for ventral spondylodesis and report the results of a rather small follow-up study.
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Neurosurgical review · Jan 1989
Experience with spinal cord stimulation (SCS) in the management of chronic pain in a traumatic transverse lesion syndrome.
Epidural electrical stimulation of the spinal cord by means of percutaneously implanted electrodes was successfully used in cases of traumatic paraplegia with chronic pain, more particularly if vegetative components predominated. Out of seven patients treated in our clinic six reported a good or very good outcome of the stimulation over follow-up periods up to six years. On account of the good effect on chronic pain the use of this stimulation procedure is indicated and justified before considering any destructive operative measures.
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The treatment of the cerebral glioma continues to challenge neurosurgeons and basic scientists. The lack of major success with chemotherapy and radiation therapy has spurred further investigation into the biology of this tumor and host reactions to it. ⋯ In this review we will discuss the immunobiology of the glioma with specific reference to the interactions between the tumor and the host immune system. In addition, ideas for potential therapeutic manipulation of the host-glioma immune interactions will be reviewed stressing potential pitfalls and risks.