Neurosurgery
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Historical Article
Surgical neurology and clinical neurosciences in Edinburgh, Scotland.
Surgical neurology in Edinburgh started > 70 years ago with Norman Dott, after his apprenticeship with Harvey Cushing. It continued under the chairmanship of John Gillingham, until 1980, and then Douglas Miller, who merged the Departments of Surgical Neurology and Medical Neurology to form the Department of Clinical Neurosciences in 1986. Particular strengths of the Edinburgh program have been the management of intracranial aneurysms, stereotactic and functional neurosurgery, the management of head and spinal injury and stroke, and neuro-oncology.
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Despite detailed studies of the perforating arteries, their relationships with the leptomeningeal arteries are almost unknown. These relationships can be of great significance during neurosurgical operations. ⋯ From 4.8 to 100% of certain groups of the perforating vessels originated in the leptomeningeal arteries. Occlusion of a leptomeningeal artery that gives rise to the perforating vessel(s) may lead to superficial and deep infarcts in the same patient.
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Nerve action potential (NAP) recording is a proven and useful tool in the surgical management of nerve injury. Understanding its materials and methods as well as its pitfalls and limitations is necessary for successful and routine use of this tool. ⋯ NAP recording provides useful information regarding the regenerative potential of a damaged nerve long before that potential is clinically evident. This information is critical in the optimal management of nerve injuries. The techniques of NAP recording are straightforward, but attention to detail is important, and full understanding of the method is required.