Journal of neurosurgery
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Journal of neurosurgery · Jun 1988
Case ReportsExtravasation injury to the hand by intravenous phenytoin. Report of three cases.
Extravasation of intravenous phenytoin can result in serious soft-tissue complications. Three patients are presented, one of whom lost a hand. ⋯ Caution is recommended in the intravenous administration of phenytoin. Infusions at rates of less than 50 mg/min and education of nursing staff about this potential complication will decrease its incidence.
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Journal of neurosurgery · May 1988
Case ReportsPenetrating intracranial wood wounds: clinical limitations of computerized tomography.
The case history of a patient with a periorbital penetrating wooden foreign body is presented. The computerized tomography (CT) densities of several different sources of wood were compared using an experimental model. The clinical usefulness and practical limitations of CT in the evaluation of intracranial foreign bodies is discussed, and the management of this type of injury is reviewed.
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Journal of neurosurgery · May 1988
Prognostic value of auditory brain-stem responses for late postconcussion symptoms following minor head injury.
Minor head injury is frequently followed by a subjective postconcussion syndrome. Brain-stem auditory evoked responses (BAER's) were found to be pathological in different small series of patients with a postconcussion syndrome who were examined months after sustaining a slight cranial or cervical trauma; abnormal BAER's have also been reported in larger groups of patients examined early after minor head injury. A relationship between these findings and late subjective symptoms has never been demonstrated. ⋯ This study confirms the disturbance of brain-stem function in some head-injured patients. However, the lack of correlation with a postconcussion syndrome limits the prognostic value of BAER recordings for postconcussion syndrome. The data suggest that BAER's not be used for medicolegal evaluation of patients with a postconcussion syndrome.
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Journal of neurosurgery · Mar 1988
Case ReportsIntraventricular varix causing hemorrhage. Case report.
A case of a cerebrovascular varix located in the right lateral ventricle is reported. The patient suffered intraventricular and subarachnoid hemorrhages. The intraventricular varix was coagulated and excised.
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Journal of neurosurgery · Mar 1988
Case ReportsTreatment of resistant intracranial hypertension with hypertonic saline. Report of two cases.
The authors describe two patients with traumatic cerebral edema and intracranial hypertension in whom the continued use of mannitol and furosemide resulted in a progressive lessening of the effect of these agents on the intracranial pressure (ICP) and caused prerenal failure. Intravenous administration of hypertonic saline (50 ml and 20 ml of a 5-mmol/ml saline solution over 10 minutes in Cases 1 and 2, respectively) produced a prolonged reduction in the ICP and improved renal function in both cases. It is suggested that if a reduction in ICP without diuresis is required in patients with traumatic cerebral edema, treatment with intravenous hypertonic saline should be considered.