British journal of neurosurgery
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Endosaccular packing of inoperable aneurysms with electrolytic platinum coils was performed in 50 patients. Complete embolization of the aneurysms was achieved in 100% of small, 95% of large and 85% of giant aneurysms, with combined procedural and periprocedural morbidity and mortality rates of 6 and 4%, respectively. ⋯ This treatment should therefore be considered for all inoperable aneurysms and particularly for aneurysms involving the posterior circulation. Its long-term efficacy remains uncertain.
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Sixty-seven consecutive patients with burst or dislocation fractures of the thoracic or lumbar spine were submitted to early surgical reduction, via the transpedicular route, over a 5-year period. The first 22 patients received Harrington instrumentation, while transpedicular devices were applied in the last 44 cases, at either the thoracic or the lumbar level. One patient did not receive any spinal instrumentation. ⋯ The rate of post-operative complications was low. Placement of transpedicular devices proved to be a safe and effective procedure. The overall results were consistent with the thesis that the transpedicular approach compares favourably with alternative surgical methods.
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Despite the high incidence of chronic subdural haematoma (SDH), to date relatively few authors have undertaken a systematic analysis of the results attained following burr-hole craniostomy and closed-system drainage on the basis of a study involving a large patient population defined according to clear-cut criteria. Between 1980 and 1993, surgery was performed on 212 patients with a chronic SDH. In a retrospective study, the condition of each patient was assessed at the time of admission on the basis of the Bender Scale and the results 4 weeks after discharge were classified according to the Glasgow Outcome Scale (GOS). ⋯ The results were related to the condition at admission (p < 0.001) and the patient's age (p < 0.05). Factors that did not have a significant effect on the outcome included whether the SDH formation was bilateral or unilateral, the extent of neomembranous organization of the haematoma, and the amount of primary cerebral expansion following decompression. We were able to confirm the results of previous studies that the method used is a highly effective treatment, with a low incidence of complications.
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Review Case Reports
Lateral parascapular extrapleural approach for single-stage excision of dumb-bell neurofibroma.
An excision of a T1 dumb-bell neurofibroma via a single-stage lateral parascapular extrapleural approach is described. The different surgical approaches that can be used to approach dumb-bell tumours are reviewed, together with the relevant literature.