Neurosurgery
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Review Case Reports
Spontaneous spinal epidural hematoma during pregnancy: case report and literature review.
Spinal epidural hematoma is a rare cause of spinal cord compression and acute para- or quadriplegia. Traumatic spinal epidural hematomas are usually seen in older men with a history of ankylosing spondylitis and vertebral fracture. Spontaneous spinal epidural hematomas are commonly associated with coagulopathies, tumors, or vascular malformations. There have been only five previously published case reports in the English-language literature of spontaneous spinal epidural hematomas in conjunction with pregnancy. ⋯ The patient made a complete neurological recovery in long-term follow-up. In the meantime, she carried her pregnancy to term and gave birth to a healthy baby. Therefore, we advocate aggressive and early surgical intervention, similar to the five previously reported cases in the English-language literature, in the case of a spinal epidural hematoma causing cord compression and devastating neurological deficit in a pregnant woman.
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Historical Article
A fantastic voyage: a personal perspective on involvement in the development of modern stereotactic and functional neurosurgery (1974-2004).
Stressing environments, individuals, ideas, and global events, this historical stereotactic and functional neurosurgical vignette initially presents a review of factors in the genesis of personal interest and the foundations of involvement in the discipline of neurological surgery. The vignette then traces the development of concepts and instrumentation and their ultimate practical utilization in patient care on the neurosurgical services at the Keck School of Medicine at the University of Southern California over the course of a 3-decade period (1974-2004). The article summarizes and elaborates details of contributions to the literature and complex involvement on the national and international levels as the refinements and capabilities of stereotactic and functional neurosurgery have been reinvented over a generation through the emergence of new technology, ideas, individual ingenuity, and active collegial exchange.
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Hereditary cerebral cavernous malformations (CCMs) are characterized by focal abnormalities of small blood vessels in the brain and consequent hemorrhage and seizures. Previous studies of this type of CCM have mainly reported on this disorder in Hispanic and Caucasian cases. Here, we report on hereditary CCM in a Chinese family further characterized by a novel CCM1 gene mutation. ⋯ Our results indicated a novel hereditary CCM1 gene mutation of 1292delAT, a finding that may contribute to the clarification of the mechanism of the disease.
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We report a series of 37 elderly patients who were surgically treated for intracranial meningioma in the ninth decade of life at our neurosurgical division between 1985 and 2002. ⋯ Surgical removal of a meningioma in the elderly is a safe procedure if the preoperative ASA classification is I or II and if the KPS rating is at least 70. Age seems not to be an insuperable obstacle when adequate management of all risk factors has been obtained.