Journal of neurosurgery
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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.
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Journal of neurosurgery · Jan 2002
Effect of apolipoprotein E genotype on hematoma volume after trauma.
The apolipoprotein E-epsilon4 (APOE-epsilon4) allele is associated with poor outcome after head injury and spontaneous intracerebral hemorrhage (SICH). The aims of this study were to determine if patients in whom one or more APOE-epsilon4 alleles are present are more likely to sustain intracranial mass lesions after head injury and to determine whether there is an isoform-specific effect on the size of the intracranial hematoma. ⋯ Larger hematomas were found in head-injured patients with one or more APOE-epsilon4 alleles than in patients without the allele. This may contribute to the poorer outcomes observed in these patients.
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Journal of neurosurgery · Jan 2002
ReviewCervical spinal stenosis: outcome after anterior corpectomy, allograft reconstruction, and instrumentation.
The authors undertook a retrospective single-institution review of 261 patients who underwent anterior cervical corpectomy, reconstruction with allograft fibula, and placement of an anterior plating system for the treatment of cervical spinal stenosis to assess fusion rates and procedure-related complications. ⋯ Cervical corpectomy with fibular allograft reconstruction and anterior plating is an effective means of achieving spinal decompression and stabilization in cases of anterior cervical disease. Symptomatic improvement was achieved in 99.2% of patients. In their series the authors found a fusion rate of 86.6% and rates of permanent hoarseness of 3.4%, dysphagia of 0.7%, and an instrumentation failure rate of 5.4%.
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Journal of neurosurgery · Jan 2002
Comparative StudyComparative study of traumatic and spontaneous intracerebral hemorrhage.
Spontaneous intracerebral hemorrhage (SICH) and traumatic intracerebral hemorrhage (TICH) are common disorders. The authors planned to study how these two types of hemorrhage behave pathologically and clinically to gain further insight into their causes, pathogeneses, indications for surgical intervention, and prognoses. ⋯ On the basis of these data the authors suggest that TICH and SICH have different features: TICH affects a slightly younger age group and carries a much better prognosis compared with SICH. In addition, indications for surgical intervention are not well defined for either type of hemorrhage. Practice is subjective and inconsistent. The International Surgical Trial in Intracerebral Haemorrhage may resolve the dilemma for SICH. A similar trial in which surgery is compared with conservative management should be considered for cases of TICH.