Journal of neurosurgery
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Journal of neurosurgery · Nov 1985
Case ReportsCT demonstration of spontaneous internal carotid artery dissection. Case report.
A case of internal carotid artery dissection is presented. It was diagnosed by computerized tomography (CT) and confirmed by angiography. The typical clinical presentation and radiographic evaluation are briefly reviewed. High-resolution CT scanning with intravenous contrast enhancement is a valuable diagnostic aid in the diagnosis of this entity.
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Journal of neurosurgery · Oct 1985
Peripheral nerve stimulation suppression of C-fiber-evoked flexion reflex in rats. Part 1: Parameters of continuous stimulation.
Transcutaneous electrical nerve stimulation (TENS) is now a well established clinical technique to alleviate chronic pain. Its mechanism of action remains unknown and the stimulation parameters used are based on subjective reports from patients. ⋯ A stimulation frequency of 80 Hz gave the most profound inhibition. The implications for clinical treatment are discussed.
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Journal of neurosurgery · Oct 1985
Clinical evaluation of two methods of subdural pressure monitoring.
Recordings from two different types of subdural pressure monitor with simultaneous intraventricular pressure (IVP) tracings are compared in 20 head-injured patients. In the first 10 patients a fluid-filled catheter was placed subdurally and connected to an external transducer, and in the second 10 the Gaeltec model ICT/b solid state miniature transducer was used. The latter system has the advantage that both zero and calibration checks can be carried out after insertion. ⋯ With the Gaeltec transducer, 72% of subdural pressure readings corresponded with IVP, while only 9% were lower and 19% were higher than IVP. The differences may have been due to technical causes or to true pressure differentials. The subdural catheter appears too unreliable for routine clinical use, but the Gaeltec transducer may be a satisfactory alternative to ventricular pressure monitoring.
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Journal of neurosurgery · Sep 1985
Randomized Controlled Trial Clinical TrialUse of intrathecal morphine for postoperative pain relief following lumbar spine surgery.
A randomized prospective double-blind trial of intrathecal morphine for postoperative pain relief following lumbar spine surgery is described. Intrathecal morphine significantly reduced the mean pain score in the postoperative period (p less than 0.01) and there was a corresponding significant reduction in the need for additional postoperative analgesia (p less than 0.05). The possible mechanism of action of intrathecal morphine and the potential advantages of this technique are discussed. Possible side effects are also considered, and caution is urged until wider experience has been obtained.
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Journal of neurosurgery · Aug 1985
Perforating branches of the middle cerebral artery. Microsurgical anatomy of their extracerebral segments.
Perforating branches of the middle cerebral artery (MCA) were examined under magnification in 50 formalin-fixed brain hemispheres. Perforating vessels varied in number from three to 18, with an average of nine. The greater the number of vessels, the smaller was their diameter. ⋯ Anastomoses were not found among the perforating arteries. In two specimens, a fusion between a perforating artery and the MCA trunk was noted. Since the perforating vessels are obviously end arteries, injury to them must be avoided during operations for MCA aneurysms.