Neurosurgery
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Hemorrhage from brain tumor was confirmed clinically, surgically, or on autopsy in 94 of 1861 cases (5.1%) treated during the past 18 years: 49 of 311 pituitary adenomas (15.8%) and 45 of 1550 other brain tumors (2.9%). The higher incidence of hemorrhage from pituitary adenoma was statistically significant (p less than 0.001). In brain tumors other than pituitary adenoma, the incidence of hemorrhage was significantly higher in the patients under 14 years old (17 of the 322 cases, 5.3%) than in the patients over 15 years old (28 of the 1228 cases; 2.3%) (p less than 0.001). ⋯ The following precipitating factors were found in 7 of the 17 patients aged under 14: ventricular drainage in 2, ventriculoperitoneal shunt in 2, carotid angiography in 1, head injury in 1, and leukemia in 1. Seven of the 17 patients under 14 years old died of massive bleeding from the tumor. Unless there is evidence of vascular disease such as cerebral aneurysm, vascular malformation, or hypertensive cerebrovascular disease, intracranial hemorrhage should be suspected of being due to a brain tumor.
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This is the report of the Committee on Neurosurgical Education of the World Federation of Neurosurgical Societies, which report was presented at the Seventh International Congress of Neurological Surgery in Munich in July 1981. The Committee was charged to conduct a survey of neurosurgical training requirements and certifying mechanisms throughout the world. These data are summarized in the tables in this report.
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Comparative Study
Vascular change in the spinal cord after impact injury in the rat.
The vascular changes during the transient paraparesis after experimental spinal cord injury in rats have been studied. The artificial movement of the exogenous protein tracer horseradish peroxidase caused by traumatic mechanical pressure was determined 5 minutes after impact injury. A disturbance of terminal microcirculation and extensive dilatation of the vasculature in the traumatized area were observed 5 days after impact injury. Some reasons for the latter effects are discussed.
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We studied the effect of the opiate antagonist naloxone on the recovery of cats injured with a 400-g-cm impact injury to T-9. The animals were evaluated by recording somatosensory evoked potentials and performing weekly neurological examinations. ⋯ Recovery occurred in only one of five animals that were treated with an infusion of naloxone, 10 mg/kg/hour, and in none of five animals given 1 mg/kg as a bolus. Because these results are not related to any observed change in blood pressure, we believe that naloxone may be achieving its effect through the preservation of spinal cord blood flow, as well as other mechanisms that have yet to be defined.