Neurochirurgia
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66 patients with gunshot wounds were treated at the Department of Neurosurgery of Hanover University up to May 1982. These included wounds inflicted by bolt guns of the type used in slaughter houses, and by bolt-setting or nail-setting tools used in building construction work. The total mortality was 50%. ⋯ Postoperatively, there were several complications, mainly pneumonia and cerebrospinal fluid fistulas; in fact, pneumonia was responsible for the death of some patients. The mortality is compared with the findings by other authors. No patients remained in need of care after rehabilitation.
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We report about hypertensive crises, cardial arrhythmia and respiratory complications in 47 patients undergoing thermocoagulation of the gasserian ganglion. Therapeutic proposals are discussed.
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Case Reports
[Spontaneous healing of a cavernous carotid sinus fistula caused by a gun shot injury].
We report about a 22-year-old male with a carotid cavernous fistula after gunshot injury. A few weeks later the fistula turned into an intracavernous aneurysm of the internal carotid artery. ⋯ According to the literature a carotid cavernous fistula is found in 0.4% to 1.7% of all cases with head trauma. Its spontaneous cure is a rare occurrence.
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Case Reports
Congenital dermoid cysts at the anterior fontanelle. Report of three cases in Italian children.
The authors report three cases in Italian children of congenital dermoid cyst at the anterior fontanelle. These are the first case reports in Europeans. Their rarity, however, is probably only apparent, since the latest reports in the literature show their wide-spread incidence. The anatomo-clinical and radiological findings and the surgical features of the three cases are described and the main pathological aspects of these cases are briefly discussed.
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The authors implanted a diaphragm pacer in a 71-year-old man who had suffered for two years from continuous hiccup of unknown cause with resulting insomnia. Preoperative transcutaneous stimulation of the phrenic nerves in the neck resulted in diaphragm contractions but did not affect his hiccup. Postoperatively, the patient was free of symptoms for two weeks. ⋯ For ten months the patient has suffered from hiccup only in the day time during which time he has also used the pacer. With a few exceptions he has been free of symptoms and without pacing during the night, which enables him to sleep normally. The effect of phrenic nerve stimulation on hiccup could be due to interference with the abnormal activation of the phrenic nerve, whatever its cause.