Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · May 1976
Brain abscess and subdural empyema. Factors influencing mortality and results of various surgical techniques.
The authors review the results of various surgical techniques in relation to mortality and morbidity in 100 consecutive cases of brain abscess and subdural empyema. The mortality rate is the same with total excision and fractional drainage of brain abscesses, although in acute and subacute cases slight differences between both techniques are seen. ⋯ The authors believe that factors other than surgical procedure influence mortality in cases of brain abscess and subdural empyema. These factors are defined in detail.
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J. Neurol. Neurosurg. Psychiatr. · May 1976
Comparative Study Clinical Trial Controlled Clinical TrialChymopapain in the treatment of ruptured lumbar discs. Preliminary experience in 48 patients.
The results of chemonucleolysis in 48 patients with lumbar disc disease revealed marked improvement in 58%, slight improvement in 23%, and no improvement in 19%. Serious anaphylactic reactions occurred in two patients. ⋯ Only those few investigators participating in the double blind study are now permitted to use intradiscal chymopapain. It is concluded that the ultimate place of chemonucleolysis, if any, in the treatment of ruptured lumbar discs remains to be determined.
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A study of the clinical features of causalgia and the central neuronal effects of injuries to peripheral nerves suggests that causalgia is the functional expression of the intensity of the retrograde neuronal reaction in which pools of dorsal horn neurones become converted into foci of abnormal activity. These foci initiate a chain reaction along transmission pathways as far centrally as the cortex, causalgia being the terminal effect of this disorderly activity on the sensorium. This is the basis of the 'turbulance hypothesis' introduced to account for the pain.