Neurosurgery
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Tuberculous meningitis (TBM) and its complications continue to have devastating neurological consequences for patients. Budgetary constraints, especially in developing countries, have made it necessary to select patients for shunting who are likely to experience good recoveries. To date, the value of cerebrospinal fluid shunting for human immunodeficiency virus (HIV)-positive patients with TBM has not been clearly established. ⋯ In the absence of obvious clinical benefit, HIV-positive patients with TBM should undergo a trial of ventricular or lumbar cerebrospinal fluid drainage, and only those who exhibit significant neurological improvement should proceed to shunt surgery.
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Comparative Study
Magnesium sulfate in the management of patients with Fisher Grade 3 subarachnoid hemorrhage: a pilot study.
To evaluate the effect of magnesium sulfate (MgSO4) on the clinical course of patients with severe aneurysmal subarachnoid hemorrhage (SAH). ⋯ Administration guidelines for the use of MgSO4 in aneurysmal SAH were established. A prospective double-blind placebo-controlled trial is required to establish the effectiveness of MgSO4 for treating vasospasm in aneurysmal SAH.
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Biography Historical Article
The early history of neurosurgery in the American South.
As a specialty, neurosurgery was not on firm footing at the turn of the century (1900); however, it was brought into being in the American South early in the 20th century by seven young surgeons, all of whom performed neurosurgical procedures as part of their general surgery practice. A close look at the seven reveals that they were trained and/or influenced in varying degrees by either Dr. ⋯ Victor Horsley, two outstanding surgeons and teachers of this period. After overcoming many obstacles, these seven men firmly established the surgical specialty of neurosurgery in the South.
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To evaluate an integrated battery of preoperative functional magnetic resonance imaging (fMRI) tasks developed to identify cortical areas associated with tactile, motor, language, and visual functions. ⋯ This integrated fMRI task battery offers standardized and noninvasive preoperative maps of multiple critical functions to facilitate assessment of surgical risk, planning of surgical routes, and direction of conventional, intraoperative electrophysiological procedures. Thus, a greater range of structural and functional relationships is brought to bear in the service of optimal outcomes for neurosurgery.
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Biography Historical Article
Pollice Verso, by Jean-Léon Gérôme (1824-1904).