Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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We studied 27 patients with cervical ossification of the posterior longitudinal ligament (OPLL) but no clinical symptoms of myelopathy. We investigated the occupation ratio of the spinal canal by OPLL with cervical radiographs, assessed the morphological types of OPLL, and measured the segmental range of motion (ROM) at the level of maximum cord compression on flexion and extension radiographs. Patients were classified as having continuous-type OPLL (17 patients), mixed-type OPLL (seven patients), or segmental-type OPLL (three patients). ⋯ No patient developed myelopathy during the study period. Three patients with massive OPLL did not develop myelopathy and the mobility of their cervical spine was highly restricted, suggesting that dynamic factors such as the segmental ROM preferentially contribute to the development of myelopathy in patients with cervical OPLL. Thus, by controlling the dynamic factors (hypermobility), we might be able to reduce neurological deterioration in patients with cervical OPLL.
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Biography Historical Article
Harvey Cushing and some Australian connections: Part 2--post World War 1.
Part 1 of this article (see Vol 17, pp. 168-172) described the early life of Harvey Cushing and his encounters with Australian doctors, mostly in various military hospitals, in France, in World War 1. As none of the doctors he met at that time became neurosurgeons, and hence did not shape their professional development. ⋯ He received the Companion of the Bath from the British Government for his war services and wrote the history of US Base Hospital No. 5, which he directed during the War. Cushing's reputation as a neurosurgeon was now secure and he was ready to play an even greater part as an academic neurosurgeon, teaching students from all parts of the world and continuing his researches into cerebral tumours and the pituitary gland.
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We report a 51-year-old man with an unusual intradural suprasellar chondroid chordoma. He presented with headache and diminution of vision in both eyes. MRI demonstrated the suprasellar tumor as an isointense mass with heterogeneous enhancement after intravenous administration of contrast agent. ⋯ Based on the histological characteristics of the tumor, which was composed of typical chordoma cells and islands of chondroid elements, we diagnosed a chondroid chordoma. We believe this is the first report of an entirely intradural chondroid chordoma on the suprasellar region. Clinical, radiological, and pathological features of the tumor are described.
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Factors predictive of neurosurgery resident or applicant choice of an academic career compared to private practice are highly desired and difficult to discern. Neither medical school choice, student induction to faculty membership, age nor gender predict academic versus private practice choice among neurosurgery residents. This study was performed to examine the role of pre-residency peer-reviewed publications (PRP) in post-residency career choice. ⋯ Graduates with at least one PRP were 1.34 times more likely to choose an academic career than graduates with no PRP. Therefore, peer-reviewed PRP are strongly associated with resident choice of an academic over private practice neurosurgery career. This information might be useful in predicting the career choices of neurosurgery residents and residency applicants.
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Traumatic brain injury (TBI) is one of the leading causes of death in people under 45 years of age worldwide. Such injury is characterized by a wide spectrum of mechanisms of injury and pathologies. Traumatic axonal injury (TAI), originally described as diffuse axonal injury, is one of the most common pathological features of TBI and is thought to be responsible for the long-lasting neurological impairments following TBI. ⋯ These models are designed to mimic as closely as possible the clinical condition of human TAI and have greatly improved our understanding of different aspects of TAI. The present review summarizes the most widely used experimental models of TAI. Focusing in particular on in vivo models, this survey aims to provide a broad overview of current knowledge and controversies in the development and use of the experimental models of TAI.