Journal of neurosurgery
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Journal of neurosurgery · Aug 1984
Cancer pain relief using chronic morphine infusion. Early experience with a programmable implanted drug pump.
Fourteen patients were implanted with drug pumps to provide chronic epidural or intrathecal morphine to relieve pain due to cancer. A new programmable pump was used in seven of the patients and a constant infusion device was used in the other seven patients. ⋯ The programmable device has the obvious advantage of being able to vary dose according to patient need and requires less frequent refilling. Four programmable pump failures occurred, two requiring replacement.
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Journal of neurosurgery · Aug 1984
Evaluation of cervical spinal cord injuries with metrizamide myelography-CT scanning.
In the past, patients with injuries of the cervical spine and spinal cord have been diagnosed by means of myelography and polytomography. In an attempt to improve the radiographic evaluation of patients with cervical spinal cord injuries the authors performed computerized tomography (CT) scanning of the cervical spine following injection of metrizamide into the spinal subarachnoid space. In 23 patients with cervical spinal cord injuries, metrizamide myelography was performed via a C1-2 puncture. ⋯ In patients with fractures, CT scanning identified the site and nature of the injury without the need for turning the patient to the lateral position. In several patients with an apparently stable cervical spine, the CT scan showed apophyseal joint widening indicative of instability. The authors conclude that CT scanning of the cervical spine after the introduction of metrizamide into the subarachnoid space provides a definitive evaluation of the cervical spinal cord, the bone structures of the cervical spine, and their relationship to each other.
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Journal of neurosurgery · Aug 1984
Case ReportsSurgical treatment for spontaneous carotid dissection with impending stroke. Case report.
A case of spontaneous carotid artery dissection is presented. In the case described, superficial temporal artery-middle cerebral artery anastomosis was performed because of impending stroke. Surgical revascularization is indicated in a case that shows such a rapid evolution of stroke that spontaneous resolution of the dissection cannot be awaited.