Journal of neurosurgery
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Journal of neurosurgery · Jan 2002
Outcome prediction with serum intercellular adhesion molecule-1 levels after aneurysmal subarachnoid hemorrhage.
Although upregulated adhesion molecule expression has been demonstrated in experimental models of subarachnoid hemorrhage (SAH) and in the cerebrospinal fluid of patients with aneurysmal SAH, the clinical significance of these proinflammatory findings remains unclear. The authors hypothesize that 1) serum levels of soluble intercellular adhesion molecule-l (ICAM-1) are increased in all patients with aneurysmal SAH shortly after the hemorrhagic event, and 2) elevated soluble ICAM-1 values are associated with poor patient outcome, even when controlling for the severity of the initial hemorrhagic insult. ⋯ These data demonstrate a correlation between soluble ICAM-1 levels and functional outcome following aneurysmal SAH that appears to be, at least in part, independent of the initial hemorrhage.
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Journal of neurosurgery · Jan 2002
Prospective multiple outcomes study of outpatient lumbar microdiscectomy: should 75 to 80% success rates be the norm?
The authors assessed the efficacy and outcomes of lumbar microdiscectomy performed on an outpatient basis by administering six questionnaires before and at five time points after surgery. The results were compared with those reported in literature in which the success rates vary between 70% and 80% and in excess of 90%. The authors use the methodology and data derived from their study to evaluate critically the relevance of these two categories of success rates. ⋯ The findings of this study support the evidence that lumbar microdiscectomy performed on an outpatient basis is a very safe and effective means of treating sciatic pain due to disc herniation. The authors believe that their outcome success rates of 75 to 80% are more realistic than those of 90% or more found in some reports.
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Journal of neurosurgery · Jan 2002
Bilateral open-door cervical expansive laminoplasty with hydroxyapatite spacers and titanium screws.
The authors report a simple method for bilateral open-door cervical expansive laminoplasty in which hydroxyapatite (HA) spacers are secured by titanium screws. A biomechanical study was also conducted to confirm the strength of the screw fixation. ⋯ Bilateral open-door cervical expansive laminoplasty in which HA spacers are secured by titanium screws is a simple and quick method that yields sufficient fixation strength.
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Journal of neurosurgery · Jan 2002
Case ReportsAtlantoaxial instability in Dyggve-Melchior-Clausen syndrome. Case report and review of the literature.
Dyggve-Melchior-Clausen (DMC) syndrome is a very rare disease. Only 58 cases have been reported in the literature. The syndrome is probably an autosomal recessive inherited disorder, one that is characterized by mental retardation, the short-spine type of dwarfism, and skeletal abnormalities, especially of the spine, hands, and pelvis. ⋯ In conclusion, treatment of atlantoaxial instability in DMC syndrome must be considered. Specific care must be taken to determine the course of the VA. If posterior and transoral fusion are impossible, anterior transarticular atlantoaxial screw fixation might be the only alternative.
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Journal of neurosurgery · Jan 2002
Case ReportsQuadriplegia in a patient who underwent posterior fossa surgery in the prone position. Case report.
Quadriplegia is a well-known complication of posterior fossa surgery performed while the patient is in the sitting position but is rarely associated with the prone position. A case of an 18-year-old man with a cerebellar medulloblastoma is described. ⋯ Postoperative magnetic resonance imaging demonstrated a long hyperintense C2-T1 lesion on T2-weighted sequences. The authors speculate that, during the prolonged period in which the neck was in hyperflexion, overstretching of the cervical spinal cord and compromise of its blood supply might have caused this devastating complication.