Acta neurochirurgica
-
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.
-
Acta neurochirurgica · Jan 1989
Vestibulospinal evoked potential versus motor evoked potential monitoring in experimental spinal cord injuries of cats.
Changes in vestibulospinal evoked potentials (VsEP) and motor evoked potentials (MEP) were examined in 10 cats before and after two different weight-dropping spinal cord injuries. In six animals somatosensory evoked potentials (SEP) were also monitored. The recordings were done from epidural spinal cord electrodes. ⋯ Light spinal cord injury caused somewhat more deterioration in MEPs than VsEP. The higher numbers of severe potential alterations in the lightly injured animals suggest that MEP is a more sensitive method for spinal cord monitoring compared to VsEP and also to SEP. On the other hand, this sensitivity might be a disadvantage during intraoperative monitoring, if MEP alone were used.
-
Acta neurochirurgica · Jan 1989
Subpial spinal evoked potentials in patients undergoing junctional dorsal root entry zone coagulation for pain relief.
Seven patients with complete avulsion of the brachial plexus underwent junctional coagulation lesions of the dorsal root entry zone (DREZ) for relief of intractable pain in the paralyzed arm. Intra-operative monitoring by recording spinal cord somatosensory evoked potentials (SEP) resulting from tibial nerve stimulation was done using subpial recording electrodes situated dorsal to the posterior median sulcus at the C4 and T2 segment. SEP on the normal side showed an initial positive wave and two negative waves followed by a group of high frequency waves of relatively high amplitude which continued into high frequency, low amplitude potentials. ⋯ In one of these patients, the first two negative potentials disappeared. In the fourth patient, who had permanent sensory deficits, the positive steep potential appeared after generation of the lesion. Our results point to the usefulness of the subpial SEPs monitoring during microneuro-surgical procedures on the spinal cord to provide further insight into evoked electrical activity of the normal and injured spinal cord, and to minimize post-operative neurological morbidity.
-
Acta neurochirurgica · Jan 1989
Biography Historical ArticleThe development of neurosurgical techniques: the postoperative notes and sketches of Dr. Harvey Cushing.
In the early development of American neurosurgical techniques, Harvey Cushing is often considered the founding father. As an accomplished artist and prolific writer his original operative sketches and detailed notes at the Peter Bent Brigham Hospital (1912-1932) are now being explored as early documentation of this pioneering surgeon's development of a field. We present four brain tumor cases with his unpublished sketches and direct quotations to illustrate both the trials and tribulations of those times and Cushing's innate surgical genius.
-
Acta neurochirurgica · Jan 1988
Randomized Controlled Trial Clinical TrialAcute surgery for intracerebral haematomas caused by rupture of an intracranial arterial aneurysm. A prospective randomized study.
In a randomized prospective study, 15 patients with an intracerebral haematoma caused by an intracranial aneurysm were treated concervatively and 15 operated on as an emergency. Mortality was 12/15 (80%) in the conservative group and 4/15 (27%) in the surgical group. ⋯ The deaths in the conservative group were caused by both the primary haematoma and rebleeding. The results suggest that intracerebral haematomas caused by rupture of an intracranial aneurysm should be evacuated immediately, and that the aneurysm should be clipped at the same operation.