Neurosurgery
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Malignant hyperthermia is a seemingly rare genetic myopathy. Hypermetabolic crisis accompanied by a rise in body temperature to as high as 44 degrees C is its hallmark. Malignant hyperthermia is usually triggered by potent inhaled anesthetics or depolarizing muscle relaxants. ⋯ The contracture study was positive in all patients. No anesthetic or surgical complication was encountered. This study demonstrates that neurosurgical procedures can be performed safely in patients at risk of developing malignant hyperthermia while they undergo appropriately selected general anesthesia.
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Biography Historical Article
The American centennial of brain tumor surgery.
Early in 1887 the first well-documented total removal of an unequivocal brain tumor in America was carried out in New York City by Robert F. Weir. The patient died during the immediate postoperative period. ⋯ In 1886, a Dr. Morse in California had probably performed a partial removal of a glioma from a patient who died shortly after the operation. To celebrate the centennial of Keen's triumph, it is worthwhile as well to contemplate the efforts of his contemporaries.
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Multiple thoracic disc herniation is rare, and one of the main problems in its treatment has been the lack of accuracy in diagnostic tests. Now, with the advent of computed tomographic scanning with metrizamide in the subarachnoid space, the accuracy has been greatly improved. ⋯ Computed tomographic metrizamide myelography clearly showed anterior compression of the spinal cord due to disc herniation at T5-T6, T6-T7, T7-T8, T8-T9, and T9-T10. Removal of the herniated discs was followed by interbody fusion using autogenous bone grafts, and excellent results were obtained.
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Distal anterior choroidal artery aneurysms with intraventricular hemorrhage are rare and difficult to treat. We report the case of a 46-year-old woman with a left distal anterior choroidal artery aneurysm presenting as a typical subarachnoid hemorrhage from which she had no focal neurological signs. ⋯ This is the first report of a successfully treated distal anterior choroidal artery aneurysm. Reports of this unusual aneurysm and methods of approaching deep temporal lesions are reviewed.