Surg Neurol
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Supratentorial gliomas in the pediatric age group at the University of Kentucky Medical Center accounted for 20% of all childhood brain tumors. Seventeen of the 20 children with these tumors, regardless of histologic type, mode of therapy, or other parameters died within five years after tissue diagnosis, and most were dead within two years. Unlike the astrocytic gliomas, the poorly differentiated primitive neuroectodermal tumors tended to spread diffusely throughout the central nervous system and accounted for 35% of the supratentorial gliomas in children at our institution. Results of this study suggest that therapy for the primitive neuroectodermal tumor, unlike other childhood supratentorial gliomas, should be considered for the entire neuraxis.
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The intravenous infusion of iodinated contrast material is an important adjunct to computed tomography with a wide variety of lesions. Some arteriovenous malformations, metastatic lesions and tumors of the sella turcica and cerebellopontine angle which are undetectable by conventional computed tomography may be visualized by this method. Certain other metastatic lesions, primary tumors, abscesses and infarcts which are detectable in the preinfusion tomogram become better defined following infusion. The indications for this examination and the procedures involved are discussed.
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The cause of sciatica is elusive in some cases. In a few instances it is due to the development of adhesions about the nerve root at the point of its entrance into the dural sleeve. ⋯ This condition occurred in partial form in two cases and with total incarceration in five. Relief followed radicolysis and partial or total radicotomy.
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Twenty-seven patients with chronic pain had dorsal column stimulators implanted for pain control over a period of three years. Technical factors of electrode placement and type of unit were not found to correlate with the degree of pain relief. The preoperative psychological attitude of the patient correlated highly with the degree of pain relief and was the single most important factor in patient selection and evaluation. Theoretical concepts of pain psychophysiology in relation to the gate theory and areas for more extensive investigation of pain are discussed.