British journal of neurosurgery
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Biography Historical Article
Wylie McKissock--reminiscences of a commanding figure in British neurosurgery.
Wylie McKissock founded the neurosurgical unit at Atkinson Morley's Hospital which has grown to become the largest neurosurgical unit serving London. He trained a large number of British and overseas neurosurgeons, six of whom achieved presidency of the Society of British Neurological Surgeons. McKissock made a great contribution to the development of British neurosurgery, and reminiscences from some of his trainees and colleagues are collected together in this article.
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A prospective study was undertaken to establish the normal spectrum of early gadolinium-enhanced magnetic resonance (MR) imaging findings in patients who had resolution of symptoms after lumbar discectomy. Thirty-four patients underwent MR examinations 6 weeks and 6 months after lumbar discectomy on a 1.5 T superconducting unit, including sagittal and axial spin-echo (SE) T1-weighted images before and after intravenous administration of gadolinium-DTPA, as well as sagittal turbo (or fast-) SE T2-weighted images. All patients showed soft tissue enhancement along the surgical track in the subcutaneous soft tissue lateral to the spinous process and in the epidural space. ⋯ Enhancement of the intervertebral space was seen in 67% of patients 6 weeks after surgery and in 86% of patients after 6 months. It may be concluded that, despite the use of gadolinium-DTPA, MR studies obtained in the initial postoperative period are difficult to interpret, because of the normal sequence of changes. Consequently, the clinical picture still remains the major indicator for recurrent surgery.