Acta neurochirurgica
-
Acta neurochirurgica · Jan 1990
Spinal cord stimulation in 112 patients with epi-/intradural fibrosis following operation for lumbar disc herniation.
A total of 112 patients with epi-/intradural fibrosis following operation for lumbar disc herniation were treated by spinal cord stimulation. Lumbosacral spinal fibrosis is seen particularly often after extensive and repeated operations. Radicular pain responds better to stimulation than back pain. ⋯ Among about 5,000 patients who underwent surgical treatment for lumbar disc herniation, an indication for spinal cord stimulation was found in 1.5%. By comparison, the frequency of the "last resort" procedure of microsurgical cordotomy was 0.3%. We no longer use other ablative methods like extirpation of spinal ganglia.
-
Acta neurochirurgica · Jan 1990
Influence of surgery and antiepileptic drugs on seizures symptomatic of cerebral tumours.
One hundred and twenty-eight adult patients presenting with and operated on for supratentorial neoplasms were studied. Sixty-five had preoperative seizures and were treated with antiepileptic drugs (AEDs). Among the 63 patients without preoperative epileptic fits, 41 were given AEDs (either phenobarbital or phenytoin) as prophylactic treatment and 22 were not treated. ⋯ In patients with preoperative epilepsy, AEDs should be continued after surgery. However long-term AEDs treatment should not be recommended in patients without preoperative epilepsy. In fact, no significant difference in late seizure occurrence was found between preventively treated and untreated patients.
-
We present a programme of Neurosurgery concerning pre- and post-graduate education. Objectives are divided into general objectives, intermediate and specific. We suggest also a syllabus for students and another for residents, containing a list of theoretical lectures, seminars and guidelines for practical tuition. ⋯ S. We emphasize the need for personal teaching as the only element of general guidance for the programme. We also emphasize the necessity of criticism, change and evolution, in order to perfect the programme we are offering.