Neurosurgery
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We propose a modification to the currently prevailing grading systems in patients with subarachnoid hemorrhage. The changes will make them correlate more strongly with the surgical results. ⋯ To grade patients with subarachnoid hemorrhage objectively, three responses should be recorded separately in the Glasgow Coma Scale score. Patients with confused verbal responses should be graded lower than those who are oriented, even when they have the same total score.
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To determine the indications for, efficacy of, and safety of depth electrode placement using magnetic resonance imaging (MRI)-guided stereotactic surgery in patients with intractable epilepsy. ⋯ We have found intracerebral electrode placement to be as safe as subdural strip electrode placement and have found combined depth and strip electrode monitoring to be highly effective in localizing the onset zones of complex partial seizures. Intracranial monitoring was particularly useful in the detection of a single ictal onset zone in the absence of neuroimaging abnormality and in the definitive diagnosis of bilateral independent ictal onset zones in the temporal lobe epilepsy syndrome. The specific technical aspects of the procedure that contribute to a successful outcome are reviewed. A comparison with earlier reported series suggests that MRI-guided stereotaxy and pial inspection may reduce complications of depth electrode placement.
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The current members of the faculty at the University of Chicago are acutely aware of the great historic tradition they have inherited. Like all academic medical centers, they are challenged by the current socioeconomic climate, but with the vast intellectual resources of the University of Chicago and its secure place in the community, both locally and nationally, we are confident of our ability to make a continuing contribution to the development of neurosurgery.