Neurosurgery
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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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Comparative Study
Double aneurysms at distal basilar artery: report of nine cases.
Double aneurysms at the basilar bifurcation and the basilar artery-superior cerebellar artery (BA-SCA) junction have not been well investigated previously. We analyzed nine patients with double basilar aneurysms to evaluate their radiological characteristics and suitable treatment. ⋯ Measurement of the posterior cerebral artery-SCA angle is a simple method to estimate the presence of BA-SCA aneurysms and to differentiate double aneurysms from a bilocular aneurysm at the basilar bifurcation. The pterional approach is suitable for clipping double basilar aneurysms because anterior circulation aneurysms often coexist, and the upstanding P1 segment is an obstacle in the subtemporal approach to the basilar bifurcation aneurysm. Nonstraight clips with short blades are convenient to avoid conflicting clips in the narrow surgical space.
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Aneurysms at nonbranching sites in the supraclinoid internal carotid artery (ICA), known as blood blister-like aneurysms or ICA anterior or dorsal wall aneurysms, are not well understood. To clarify this clinical entity, 7408 patients with subarachnoid hemorrhage who were treated during a 5-year period were analyzed. ⋯ Blister-type and saccular-type aneurysms have different shapes and wall characteristics. The saccular type can be treated by clipping, whereas the blister type requires clipping on wrapping material. ICA trunk aneurysms may be a better designation to express the diversity of these aneurysms, rather than ICA blood blister-like or anterior or dorsal wall aneurysms.