Neurosurgery
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To study the association between the clinical examination and the radiological assessment of lumbar disc disease in patients with sciatica. ⋯ The positive correlation between disability status and imaging findings validates both assessment methods. Routine use of disability scores brings a useful contribution to the assessment of sciatica patients.
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Review Case Reports
Cerebellar hemorrhage after spinal surgery: report of two cases and literature review.
Cerebellar hemorrhage remote from the site of surgery may complicate neurosurgical procedures. We describe our experience with two cases of cerebellar hemorrhage after spinal surgery and review the three cases previously reported in the literature to determine whether these cases provide insight regarding the pathogenesis of remote cerebellar hemorrhage. ⋯ Cerebellar hemorrhage must be considered in patients with unexplained neurological deterioration after spinal surgery. Dural opening with loss of cerebrospinal fluid has occurred in every reported case of cerebellar hemorrhage complicating a spinal procedure, supporting the hypothesis that loss of cerebrospinal fluid is central to the pathogenesis of this condition. Because remote cerebellar hemorrhage can occur after procedures with the patient in the supine, sitting, and prone positions, patient positioning seems unlikely to play a causative role in its occurrence.
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Neurosurgery at the Catholic University in Rome was initiated by Gian Franco Rossi in 1969 and has gradually expanded since then. From the beginning, research has been regarded as an essential part of training and daily activities in the university's neurosurgery programs. The professional and research education of all faculty members includes at least 1 year abroad in a reputable neurosurgical center. ⋯ In 1999, Giulio Maira succeeded Dr. Rossi in directing the Institute of Neurosurgery and the Division of General Neurosurgery. In addition to the history of neurosurgery at the Catholic University in Rome, this article describes present challenges and plans for the future in neurosurgery at the university.
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A prospective observational study was conducted to investigate whether episodes of ischemia are detected by continuous cerebral monitoring and whether such episodes are related to clinical outcome. ⋯ Intraparenchymal oximetry and microdialysis can detect but fail to predict the development of delayed cerebral ischemia. There were associations between episodes of low brain oxygen, abnormal microdialysis, and unfavorable outcome, but these associations were weak.
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Case Reports
Dissecting aneurysms of the bilateral vertebral arteries with subarachnoid hemorrhage: report of three cases.
Treatment of one side in cases of dissecting aneurysms of the bilateral vertebral arteries (VAs) with subarachnoid hemorrhage may result in dissection or rupture on the contralateral side. ⋯ Surgical intervention to treat dissecting aneurysms of the bilateral VAs on one side carries the risk of rupture of the contralateral lesion. Increased hemodynamic stress may be important in the development and rupture of dissections in the contralateral VA.