Journal of neurosurgery
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Journal of neurosurgery · Feb 1982
Intrathecal and intraventricular morphine for pain in cancer patients: initial study.
Intractable pain in six cancer patients was treated with lumbar intrathecal morphine (two patients) and intraventricular morphine (four patients). Daily percutaneous injections of morphine through Ommaya reservoirs were made. ⋯ Morphine requirements gradually increased. Side effects were minimal, and there were no complications.
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Journal of neurosurgery · Jan 1982
Case ReportsSpontaneous migration of an intracranial bullet to the cervical spinal canal causing Lhermitte's sign. Case report.
A case is presented of a woman who was shot in the left occipital area with a .32 caliber automatic pistol. She was neurologically intact on admission, and skull x-ray films revealed the bullet in the right suboccipital area. ⋯ Repeat films showed that the bullet had migrated to the C-4 vertebral level. The bullet was subsequently removed via a total laminectomy at C3-4.
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Journal of neurosurgery · Jan 1982
Case ReportsNontraumatic dissecting aneurysm of the vertebral artery. Case report.
A case is described of a nontraumatic dissecting aneurysm of the vertebral artery, which presented as a subarachnoid hemorrhage (SAH). Differentiation from vasospasm and from atherosclerosis is critical. Dissection between the adventitia and media should be noted in the differential diagnosis of SAH when an aneurysm or vascular malformation is not demonstrated angiographically.
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Journal of neurosurgery · Nov 1981
Osmotic blood-brain barrier disruption in the posterior fossa of the dog.
Transient reversible osmotic blood-brain barrier disruption was produced in the posterior fossa of 33 dogs. A percutaneous catheter technique was used for the infusion of hypertonic mannitol into the vertebral artery. Neither the catheter technique nor the osmotic barrier modification resulted in interference with brain-stem function in most animals. ⋯ Methotrexate delivered to the brain via the vertebral artery resulted in a drug concentration of 100 to 300 ng/gm brain tissue. When the same amount of drug was given following osmotic blood-brain barrier disruption, brain tissue contained 1100 to 5000 ng of methotrexate/gm of brain tissue. Finally, the adequacy of the blood-brain barrier modification in the posterior fossa was shown to be quantifiable by the amount of enhancement on computerized tomographic scans.
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Journal of neurosurgery · Nov 1981
Anastomosis between internal carotid artery and anterior cerebral artery with other anomalies of the circle of Willis in a fetal brain.
A rare vascular anomaly was found in a 21-week-old fetal brain. It consisted of an anastomotic loop between the internal carotid artery and the anterior cerebral artery. ⋯ Anomalies and variations of the circle of Willis are probably genetically determined and develop at an early embryonic stage. They are frequently found in association with other cerebrovascular diseases, such as aneurysms.