Acta neurochirurgica
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Knowledge of segmental innervation of skeletal muscles is essential for diagnosing lumbar radiculopathy. Myotomes and dermatomes are traditionally thought to be innervated by a single spinal segment, but experimental studies have shown that this pattern of segmental innervation allows considerable overlap. ⋯ We describe a patient in whom overlap in segmental innervation complicated adequate diagnosis of a recurrent lumbar hernia. Further, we present an outline of electrophysiological and anatomical studies on segmental innervation.
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Myelocystoceles are rare lesions. Rarer still are thoracic myelocystoceles. Two patients with thoracic myelocystoceles are being reported. ⋯ Surgery in both these patients did not produce any change in the neurological status. The importance of recognizing thoracic myelocystoceles, their clinical presentation, embryology, value of MR myelography in the diagnosis and role of surgery are discussed. The differences between terminal myelocystoceles and thoracic myelocystoceles are also highlighted.
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Acta neurochirurgica · Jul 2006
Comparative Study Clinical TrialThe effects of fenestration of the interpeduncular cistern membrane arousted to the opening of lamina terminalis in patients with ruptured ACoA aneurysms: a prospective, comparative study.
The incidence of chronic hydrocephalus requiring shunt placement is a well-known and common complication of aneurysmal subarachnoid hemorrhage (aSAH). It was suggested that fenestration of the lamina terminalis (LT) during microsurgery for aSAH may be associated with a reduced rate of shunt-dependent chronic hydrocephalus (SDCH). We analyzed that, fenestrations of the LT and Liliequist membrane (LM) would reduce rate of SDCH and improve rate of favorable outcome. ⋯ Our study shows that fenestration of the LM coupled with the opening of the LT reduced-relatively-the incidence of SDCH; this however was not significant. This positive effect was particularly noticeable in patients in whom a cisternal "overflow" was observed at surgery when opening the LM. This corresponded to cases with ventricular dilatation and a IVth ventricle with clots.