Neurosurgical review
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Neurosurgical review · Jan 2004
Anatomy of the clinoidal region with special emphasis on the caroticoclinoid foramen and interclinoid osseous bridge in a recent Turkish population.
In this study we present the incidence of caroticoclinoid foramen and interclinoid osseous bridge and some topographic aspects regarding the clinoidal internal carotid artery (ICA) in a recent Turkish population to provide a guide for neurosurgeons in any surgical approach, especially to the cavernous sinus. One hundred nineteen adult dry skulls and 52 adult cadaveric heads were used for this purpose. Caroticoclinoid foramen and the interclinoid osseous bridge were divided into three types based on the classification of Keyers [13]. ⋯ The middle clinoid process was prominent in 15.12% of cases and rudimental in 13.23%. The mean distance between the proximal and distal dural rings of the clinoidal ICA was 4.51+/-0.44 mm, and mean diameter of the distal ring was 5.25+/-0.59 mm. Right-left differences were assessed for each parameter, and populational differences are discussed.
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Neurosurgical review · Oct 2003
Intramedullary spinal cord cavernous malformations: clinical features and risk of hemorrhage.
The aim of this study was to review the natural history of symptomatic intramedullary spinal cord (IMSC) cavernous malformations in order to analyze the underlying mechanisms leading to symptoms and determine the potential risk of lesional hemorrhage. Between January 1990 and June 2001, ten consecutive patients with IMSC cavernous malformations were treated surgically in our institution. Age ranged from 17 to 73 years (mean 34.5). ⋯ The postoperative condition was improved in four patients and unchanged in six, and none grew worse. Detailed analysis of history and clinical course in all patients revealed an acute onset of symptoms with subsequent neurological deterioration after each bleeding episode. Based on the significant risk of rehemorrhage and the gratifying functional results, surgery is indicated for symptomatic IMSC cavernous malformations.
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Neurosurgical review · Oct 2003
Magnesium sulfate treatment in experimental spinal cord injury: emphasis on vascular changes and early clinical results.
Injury to the spinal cord results in disruption of neurons, cell membranes, axons, myelin, and endothelial cells. The aim of this study was to demonstrate the protective effect of magnesium sulfate on the blood-spinal cord barrier after acute spinal cord injury (SCI). This experiment was conducted in two parts. ⋯ Remarkable clinical neuroprotection was observed in the treatment groups. Magnesium sulfate showed vaso- and neuroprotective properties after contusion injury to the rat spinal cord. The authors also demonstrated secondary injury of the blood-spinal cord barrier with the Evans blue clearance technique for the first time.
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Neurosurgical review · Jul 2003
The initial treatment of meningocele and myelomeningocele lesions in adulthood: experiences with seven patients.
This is a retrospective study of patients having undergone surgical treatment of spina bifida cystica (SBC) lesions in adulthood. The objectives were to assess the clinical, radiological, and surgical characteristics of SBC lesions in adults. There is almost no study assessing these characteristics. ⋯ Although it is rare, an adult with an untreated SBC is a possible entity. These lesions should be included in the differential diagnosis of dorsal midline lesions in adults. Even though they appear as a simple spinal meningocele clinically, preoperative MR imaging and CT are necessary and helpful in the precise diagnosis and surgical planning.
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Neurosurgical review · Jan 2003
Comment Review Meta AnalysisSpinal hematoma: a literature survey with meta-analysis of 613 patients.
Spinal hematoma has been described in autopsies since 1682 and as a clinical diagnosis since 1867. It is a rare and usually severe neurological disorder that, without adequate treatment, often leads to death or permanent neurological deficit. Epidural as well as subdural and subarachnoid hematomas have been investigated. ⋯ Of the patients investigated in the present work, 39.6% experienced complete recovery. The less severe the preoperative symptoms are and the more quickly surgical decompression can be performed, the better are the chances for complete recovery. It is therefore essential to recognize the relatively typical clinical presentation of spinal hematoma in a timely manner to allow correct diagnostic and therapeutic measures to be taken to maximize the patient's chance of complete recovery.