Journal of neurosurgery
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Journal of neurosurgery · Sep 2000
Natural history of unruptured intracranial aneurysms: probability of and risk factors for aneurysm rupture.
The authors conducted a study to investigate the long-term natural history of unruptured intracranial aneurysms and the predictive risk factors determining subsequent rupture in a patient population in which surgical selection of cases was not performed. ⋯ Cigarette smoking, size of the unruptured intracranial aneurysm, and age, inversely, are important factors determining risk for subsequent aneurysm rupture. The authors conclude that such unruptured aneurysms should be surgically treated regardless of their size and of a patient's smoking status, especially in young and middle-aged adults, if this is technically possible and if the patient's concurrent diseases are not contraindications. Cessation of smoking may also be a good alternative to surgery in older patients with small-sized aneurysms.
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Journal of neurosurgery · Sep 2000
Maturation-dependent response of the piglet brain to scaled cortical impact.
The goal of this study was to investigate the relationship between maturational stage and the brain's response to mechanical trauma in a gyrencephalic model of focal brain injury. Age-dependent differences in injury response might explain certain unique clinical syndromes seen in infants and young children and would determine whether specific therapies might be particularly effective or even counterproductive at different ages. ⋯ These results demonstrate that, for this particular focal injury type and severity, vulnerability to mechanical trauma increases progressively during maturation. Because of its developmental and morphological similarity to the human brain, the piglet brain provides distinct advantages in modeling age-specific responses to mechanical trauma. Differences in pathways leading to cell death or repair may be relevant to designing therapies appropriate for patients of different ages.
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Journal of neurosurgery · Sep 2000
Clinical TrialEffect of direct arterial bypass on the prevention of future stroke in patients with the hemorrhagic variety of moyamoya disease.
The authors evaluated the effects of superficial temporal artery-middle cerebral artery (STA-MCA) bypass in the prevention of future stroke, including rebleeding or an ischemic event, in patients suffering from hemorrhagic moyamoya disease by comparing this method with indirect bypass and conservative treatment. ⋯ The effect of STA-MCA bypass on the prevention of recurrent hemorrhage or an ischemic event in patients with hemorrhagic moyamoya disease has been statistically confirmed in this study.
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Journal of neurosurgery · Sep 2000
Biography Historical ArticleBiographical sketch of Kenneth G. McKenzie (1892-1964).
This article is an expanded version of the opening address Dr. Morley delivered at a University of Toronto symposium, "Seventy-Five Years of Neurosurgery in Canada," celebrating the 75th Anniversary of the appointment of Kenneth G. McKenzie, Canada's first career neurosurgeon, to the University of Toronto and the Toronto General Hospital in 1923. ⋯ McKenzie (1892-1964) was the first surgeon in Canada to limit his practice to neurosurgery. This article contains a brief biographical study of the man, his upbringing, and management of his professional life at Toronto General Hospital. Some of his published neurosurgical articles are also reviewed.
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Patients who have undergone frontotemporal craniotomy occasionally complain of scalp deformity in the anterior temporal area. This occurs as a result of inappropriate reconstruction of the temporal muscle and repair of the bone defect at the key hole and surrounding skull. ⋯ This new, biocompatible "key-hole button" is shaped to alleviate the deformity of the temple by filling the bone defect in a more natural way. The specifications of this device and its clinical application are described.