Journal of neurology, neurosurgery, and psychiatry
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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.
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J. Neurol. Neurosurg. Psychiatr. · Sep 1975
Cutaneous afferent activity in median and radial nerve fascicles: a microelectrode study.
Cutaneous afferent activity was recorded in fascicles of the median and radial nerves of normal subjects using percutaneous microelectrodes. Multi-unit fascicular responses were dominated by activity in large myelinated fibres. ⋯ Pricking pain appeared with the activation of slow myelinated fibres. The only sensations induced by electrical stimuli were tactile or painful.
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J. Neurol. Neurosurg. Psychiatr. · Sep 1975
Ventricular size after shunting for idiopathic normal pressure hydrocephalus.
It has been presumed that idiopathic normal pressure hydrocephalus is due to obstruction. We visualized the ventricles in 19 patients subsequent to shunting. We found no consistent relationship between clinical improvement after shunting and reduction in ventricular size. This suggests that the positive effect of shunting in at least some instances is due to some other factor than reduced ventricular size.
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Blood coagulation tests were performed on admission to the hospital and on consecutive days after severe and moderate head injury in 34 patients. Platelet counts and fibrinogen were normal at admission and raised thereafter. The partial thromboplastin time was shortened at admission and lengthened in the following days. ⋯ The ethanol gelation test was negative in all patients during the post-traumatic time course. It was concluded that, in the first 24 hours after injury, activated coagulation was present after head injury. In contrast with data of other authors, disseminated intravascular coagulation did not occur in these series.