Journal of neurosurgery
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Journal of neurosurgery · Sep 1991
Review Case ReportsIntracranial aneurysms in sickle-cell anemia: clinical features and pathogenesis.
Intracranial aneurysms are an unusual complication of sickle-cell anemia; only 15 patients have been described in the world literature. An additional 15 patients with sickle-cell anemia and subarachnoid hemorrhage (SAH) from ruptured intracranial aneurysms are presented. There was a high incidence of multiple aneurysms (60%); some of which were in unusual locations. ⋯ Hemodynamic stress at these loci of arterial wall damage results in aneurysm formation. This hypothesis also explains other cerebrovascular manifestations of sickle-cell anemia, namely vaso-occlusive disease and hemorrhage without aneurysm formation. Pathological material from this series and data from the literature are presented to support this hypothesis.
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Journal of neurosurgery · Sep 1991
Treatment of chronic pain by epidural spinal cord stimulation: a 10-year experience.
Epidural spinal cord stimulation by means of chronically implanted electrodes was carried out on 121 patients with pain of varied benign organic etiology. In 116 patients, the pain was confined to the back and lower extremities and, of these, 56 exhibited the failed-back syndrome. Most patients were referred by a pain management service because of failure of conventional pain treatment modalities. ⋯ Three patients in this series died due to unrelated causes. Epidural spinal cord stimulation has proven to be an effective and safe means of controlling pain on a long-term basis in selected groups of patients. The mechanism of action of stimulation-produced analgesia remains unclear; further studies to elucidate it might allow spinal cord stimulation to be exploited more effectively in disorders that are currently refractory to this treatment modality.
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Journal of neurosurgery · Sep 1991
Case ReportsTransoral transclival clipping of anterior inferior cerebellar artery aneurysm using new rotating applier. Technical note.
A large, partly calcified aneurysm buried in the pons and arising from the junction of the basilar artery and the anterior inferior cerebellar artery was successfully occluded using a variangle aneurysm clip with a new rotating pistol-grip applier which allowed transoral access. The authors believe that the new applier, used in association with the current techniques for dural closure, allows for safe transoral surgery for basilar aneurysms.
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Journal of neurosurgery · Sep 1991
Comment Letter Case ReportsAccessory limbs and spinal dysraphism.