British journal of neurosurgery
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Review Case Reports
The autonomic dysfunction syndrome: aetiology and treatment.
Nine patients with autonomic dysfunction syndrome (ADS) characterised by sympathetic discharge and extensor posturing are presented. Morphine was given to three patients and in all cases consistently stopped the episodes. Dantrolene was given to one patient and reduced the severity of the extensor posturing without affecting the other components of the ADS. ⋯ The autonomic dysfunction syndrome appears to be related to both severe closed head injury and acute hydrocephalus. The clinical similarity of the two diverse etiologic groups and the absence of precipitating increased ICP in the former suggests the common theme is a release of the brain stem from higher control. The responses to morphine and bromocriptine suggest that the opiate and dopaminergic pathways play roles in the entity.
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Case Reports Comparative Study
Comparative study of brain abscess by computed tomography and magnetic resonance imaging: report of two cases.
Two cases of cerebral abscess with different presentations are reported. The source of the abscess remained obscure in one case while in the other arose from infection of the right frontal sinus. While in one case a magnetic resonance image was obtained preoperatively, both cases underwent parallel monitoring in the postsurgery period by computed tomography and magnetic resonance imaging. The relative merits of these two imaging techniques in the diagnosis and monitoring of such lesions are discussed, and the literature is reviewed.
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In order to evaluate the efficacy and safety of ventriculo-pleural shunting as an alternative to conventional atrial and peritoneal procedures, we have carried out a retrospective study of 88 pleural shunting procedures. There was a 7% complication rate related to the use of the pleural space as the shunt terminus. Complications at the pleural end included shunt obstruction (functional or structural), pleural effusion, pneumothorax, and other technical problems. ⋯ The complications that are unique to this procedure are pneumothorax and pleural effusion. They were encountered infrequently in this series. Ventriculo-pleural shunting may be indicated when other routes are not available.