Neurosurgery
-
Abnormal coagulation and fibrinolysis is a frequent complication in patients with head injury. This complication can be severe enough to lead to hemorrhage or thrombosis. A study was undertaken to determine if the hemostatic abnormalities are reliable indicators of outcome. ⋯ Other tests did not provide additional predictive value. Abnormal hemostasis frequently complicates the course of patients with head injuries. This study demonstrates that hemostasis tests are predictors of outcome in these patients.
-
Case Reports
Paraparesis during myelography associated with a ruptured thoracic intervertebral disc.
Serious or permanent neurological complications following routine lumbar myelography are uncommon in clinical practice. We describe the sudden and dramatic onset of a symmetrical dense paraparesis in a patient after an uneventful lumbar puncture performed during myelography. A herniated thoracic intervertebral disc was subsequently diagnosed and successfully treated.
-
Multi-level cervical spondylosis and ossification of the posterior longitudinal ligament (OPLL) are well-documented causes of myelopathy. The choice of surgical procedures remain controversial. Between January 1983 and December 1987, we have performed anterior cervical vertebrectomy in 45 patients with cervical myelopathy caused by multi-level spondylosis and OPLL. ⋯ Neurological signs did not improve in 5 patients (11%). One patient died because of agranulocytosis secondary to treatment with antibiotics. In conclusion, cervical cord compression caused by lesions located principally in the anterior aspect of the spinal canal may be completely relieved via anterior vertebrectomy, discectomy, removal of the calcified ligament, and fusion.
-
Biography Historical Article
The Johns Hopkins medical centennial. 1889-1989: a century of neurosurgery.
-
Case Reports
Diagnosis and treatment of an odontoid fracture in a patient with polyostotic fibrous dysplasia: case report.
Fibrous dysplasia of the cervical spine is rare. No prior reports have discussed odontoid fractures in the setting of fibrous dysplasia. ⋯ A review of fibrous dysplasia is presented. Alternative methods of diagnosis and treatment options in our patient are discussed.