Neurosurgery
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Hemispheric cerebral blood flow was measured in the rhesus monkey before and after infusion of the hypotensive agents sodium nitroprusside and trimethaphan camsylate. The intracarotid injections of 133Xe was utilized, and flow was calculated by the "flow initial" technique. Cerebral blood flow did not change significantly with the administration of trimethaphan camsylate. However, with a small reduction in blood pressure (10.6%) during the administration of sodium nitroprusside, the cerebral blood flow fell significantly (15.4%).
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Four years of clinical experience with a fiberoptic intracranial pressure monitor are presented. One hundred forty patients were monitored, of whom 80 had increased intracranial pressure. Of the patients with nontraumatic intracerebral hematoma and subarachnoid hemorrhage, 100% had increased pressure. ⋯ Despite the evidence, monitoring of intracranial pressure is not routine due to a lack of acceptance and effectiveness. To overcome such problems, a system must meet the criteria of ease of insertion, reliability, and lack of complications. These criteria are fulfilled by the fiberoptic system presented.
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Thirty-one patients suffering from intractable pain associated with chronic low back syndrome, cancer, and other disorders have been studied after an average of 6 months of treatment by electrical stimulation of the spinal cord applied using electrodes inserted through a Touhy needle into the epidural space. As judged by three different subjective rating methods, epidrual stimulation successfully relieved otherwise intractable chronic pain in from 23 to 26 of the 31 patients. Reported improvements in the ability to perform various everyday activities, and elimination of drug usage by many patients, corroborated this finding.