Journal of neurosurgery
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Journal of neurosurgery · Jun 2002
Biography Historical ArticleGeorge J. Heuer: forgotten pioneer neurosurgeon at the Johns Hopkins Hospital.
George J. Heuer was a pioneer in neurosurgery at The Johns Hopkins Hospital in the early 20th century; he trained under Harvey Cushing and acted as a mentor to Walter Dandy. In his early career, Heuer focused on research and clinical work in the field of neurosurgery and temporarily led the neurosurgery section at Johns Hopkins. ⋯ Throughout his academic years, Heuer continued to operate on the nervous system and to perform spinal cord and peripheral nerve surgery. He played an important role along with Cushing and Dandy in the creation of neurosurgery as a specialty, but he is rarely given credit for this accomplishment. The authors describe Heuer's contributions to neurosurgery as well as his distinguished surgical career.
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Journal of neurosurgery · Jun 2002
ReviewTissue resonance analysis; a novel method for noninvasive monitoring of intracranial pressure. Technical note.
A number of noninvasive methods used to measure intracranial pressure (ICP) have been proposed in the literature. For a variety of reasons, however, none of these have displayed significant practical applicability. The authors describe their development of a new, computerized, portable device based on tissue resonance analysis (TRA) technology for the noninvasive monitoring and measurement of ICP. ⋯ The ICP values obtained using the two methods were highly correlated (r = 0.99), without a statistically significant difference between simultaneously obtained readings (p = 1). By using an integrative approach that reflects all components of the intracranial compartment, TRA allows for accurate noninvasive recordings of ICP. This method has significant advantages over other noninvasive technologies reported to date.
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Journal of neurosurgery · Jun 2002
Clinical TrialCerebral oxygen and microdialysis monitoring during aneurysm surgery: effects of blood pressure, cerebrospinal fluid drainage, and temporary clipping on infarction.
The aim of this study was to investigate potential episodes of cerebral ischemia during surgery for large and complicated aneurysms, by examining the effects of arterial temporary clipping and the impact of confounding variables such as blood pressure and cerebrospinal fluid (CSF) drainage. ⋯ The brain tissue PO2 decreases with hypotension, and, when it is below 8 mm Hg for longer than 30 minutes during temporary clipping, it is associated with increasing extracellular glutamate levels and cerebral infarction.
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Journal of neurosurgery · Jun 2002
Functional benefits and cost/benefit analysis of continuous intrathecal baclofen infusion for the management of severe spasticity.
Intrathecally delivered baclofen has been used as a treatment for severe spasticity since 1984. Despite this, there are uncertainties surrounding the benefits of treatment and the costs involved. The authors assessed the evidence of benefits and identified costs and the cost/benefit ratio for continuous intrathecal baclofen infusion in the treatment of severe spasticity. ⋯ In carefully selected patients who have not responded to less invasive treatments, continuous intrathecal baclofen infusion is likely to lead to worthwhile functional benefits. Continuous intrathecal baclofen infusion has an acceptable cost/benefit ratio compared with other interventions that are funded by the health service.
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Journal of neurosurgery · Jun 2002
High risk of acute deterioration in patients harboring symptomatic colloid cysts of the third ventricle.
Patients harboring colloid cysts of the third ventricle can present with acute neurological deterioration, or the first indication of the lesion may appear when the patient suddenly dies. The risk of such an occurrence in a patient already identified as harboring a colloid cyst is unknown. The goal of this study was to estimate the risk of acute deterioration in patients with colloid cysts. ⋯ Acute deterioration was a frequent presentation among a national cohort of Dutch patients harboring symptomatic colloid cysts. The risk of acute deterioration in a symptomatic patient with a colloid cyst in The Netherlands is estimated to be 34%. The estimated risk for an asymptomatic patient with an incidental colloid cyst is significantly lower. These results strongly advocate the selection of surgical treatment for patients with symptomatic colloid cysts.