Journal of neurosurgery
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Journal of neurosurgery · Sep 2002
Case ReportsThoracic diastematomyelia with concurrent intradural epidermoid spinal cord tumor and cervical syrinx in an adult. Case report.
Diastematomyelia is a rare entity in which some portion of the spinal cord is split into two by a midline septum. Most cases occur in childhood, but some develop in adulthood. A variety of concurrent spinal anomalies may be found in patients with diastematomyelia. ⋯ Numerous spinal lesions can be found in conjunction with diastematomyelia. To the authors' knowledge, this is the first case in which a thoracic epidermoid cyst and cervical syrinx occurred concurrently with an upper thoracic diastematomyelia. Thorough neuraxis radiographic evaluation and surgical treatment are usually indicated.
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Journal of neurosurgery · Sep 2002
Bilateral decompression of lumbar spinal stenosis involving a unilateral approach with microscope and tubular retractor system.
The authors studied a consecutive series of patients with spinal stenosis in whom surgery was performed by a single surgeon who used a microscopic tubular retractor system (METRx-MD); patients underwent prospective evaluation involving radiography and magnetic resonance (MR) imaging. The objective was to assess the feasibility and surgery-related efficacy of performing unilateral-approach bilateral decompression and utilization of METRx-MD instrumentation in patients with spinal stenosis. ⋯ Minimally invasive bilateral decompression and instrumentation-assisted fusion can be successfully performed via a unilateral approach in patients with acquired spinal stenosis; the procedure can be undertaken on an outpatient basis, with reasonable operative times, minimal blood loss, and acceptable morbidity rates.
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Journal of neurosurgery · Sep 2002
Case ReportsDe novo dissecting aneurysm in a patient with a ruptured saccular lesion. Case report.
Formation of a new saccular aneurysm after successful treatment of ruptured aneurysm has recently raised significant clinical concerns; however, de novo formation and rupture of a dissecting aneurysm has not been discussed. The authors report on a 42-year-old man who initially sought treatment for a ruptured saccular aneurysm of the right middle cerebral artery, which was successfully eliminated by surgical clipping of the aneurysm neck. Two years later, the patient presented with another subarachnoid hemorrhage and was found to have a dissecting aneurysm of the right vertebral artery, which arose from a previously angiographically documented normal artery. This rare association sheds light on the causes and growth of two distinct types of aneurysms, both clinically and pathologically.
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Journal of neurosurgery · Sep 2002
Outcome in neurologically impaired patients with craniovertebral junction tuberculosis: results of combined anteroposterior surgery.
The authors studied the immediate and long-term outcome after transoral decompression, occipitocervical fusion, and antituberculous therapy (ATT) in patients who had neurological deficits due to craniovertebral junction (CVJ) tuberculosis. ⋯ Patients with CVJ tuberculosis with features of cervical myelopathy are ideally managed with transoral decompressive procedures followed by occipitocervical fusion because this therapy provides immediate neurological improvement, stability, and allows early mobilization. The long-term prognosis in patients with this disease is excellent provided it is treated with appropriate surgical intervention(s) and with adequate duration of ATT.
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Journal of neurosurgery · Sep 2002
Biography Historical ArticleCalifornia's Cushing connection: Harvey Cushing trained California's first neurosurgeons.
On September 9, 2000, California celebrated its sesquicentennial anniversary of its admission to the United States. One hundred years ago, in September of 1901, Harvey Cushing began his surgical practice in Baltimore, Maryland. ⋯ Cushing--Howard Naffziger, Carl Rand, and Edward Towne--who played defining roles in establishing modern neurosurgery in the Golden State. In promulgating Cushing's surgical principles and philosophy, these physicians achieved a distinguished place in the history of medicine in California.