Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
-
The far lateral approaches to the lumbar spine require accurate knowledge of regional anatomy. The aim of this study is to evaluate the course of the lumbar nerve roots and their relation to important bony landmarks. Seven adult male cadavers fixed with formaldehyde were used. ⋯ The nerve roots of L1 and L2 crossed the transverse processes in their first two quarters, the L3 nerve root crossed the transverse process in its second, third or fourth quarters, and the L4 nerve roots crossed the L5 transverse process in its third and fourth quarter or even external to it. Descending toward the lower lumbar vertebrae, the diameter of the lumbar nerve root increases and the nerve roots exit the intervertebral foramen with a larger angle. The special relation between the nerve roots and the caudal vertebra transverse process should be remembered during far lateral lumbar spine approaches.
-
Clinical Trial Controlled Clinical Trial
Barbiturate therapy for patients with refractory intracranial hypertension following severe traumatic brain injury: its effects on tissue oxygenation, brain temperature and autoregulation.
The aim of this study was to explore the effects of barbiturate coma on cerebral tissue oxygen tension and cerebrovascular pressure reactivity (PRx), as an index of cerebral autoregulation in severe head injury patients. This was a prospective observational clinical study of 12 patients with severe traumatic brain injury, carried out at a tertiary-level neurosurgical intensive care unit between April 2002 and May 2005. All patients received standard neurosurgical intensive care and monitoring. ⋯ Of eight patients with prebarbiturate PTiO2 levels above 10 mmHg, six had a further improvement in oxygenation. Thus, concordant favourable changes in ICP, PRx and PTiO2 with barbiturate coma were seen in those who survived. Effective response to barbiturates can be detected by improved PTiO2 and autoregulation (PRx) in severe head injury patients.
-
Several neurosurgical events occurred during the voyage of the First Fleet from England to Australia in 1787-1788. The early records also describe a number of head injuries during the first years of European settlement in Australia.
-
Penetrating head injury from nailguns has become increasingly recognised due to their frequent use in the construction industry and home. We report a New Zealand case series of 12 penetrating nailgun head injuries, the largest of its type, detailing presentation, management, risk factors and outcomes. ⋯ Prognostic factors on initial imaging are discussed. The majority of injuries, despite being visually impressive, are associated with minimal neurological impairment.
-
To evaluate the correlation between admission Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) in chronic subdural hematoma (CSDH). ⋯ GCS and GOS are well-correlated in CSDH.