British journal of neurosurgery
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We have reviewed 35 years experience of extradural haemorrhage (EDH) in a large neurosurgical unit, based in two university hospitals, one dealing exclusively with children and the other a general hospital. A steady reduction in the mortality rate from 29 to 8.5% occurred during that period. ⋯ However, no single feature could be identified as the major contributor to falling mortality results. Clinical awareness and early diagnosis are the keys to successful management of EDH.
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Case Reports
Pyomyelia: an intramedullary spinal abscess complicating lumbar lipoma with spina bifida.
We report a case of spinal dysraphism, complicated by an intramedullary spinal abscess (IMSA). The magnetic resonance images of this case are shown and the pathophysiology of this condition is discussed.
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Paraffin sections of 305 meningeal tumours were analysed for the presence of nucleolar organizer region (Ag-NOR) in the neoplastic cells, using a one step silver-colloidal staining method. The mean (+/- SEM) Ag-NOR counts were 2.73 +/- 0.21 for atypical and 2.91 +/- 0.18 for papillary variants of meningioma. ⋯ Differences in the mean Ag-NOR numbers between meningothelial and transitional variants in their primary and recurrent tumours were not significantly different (p > 0.05). The results of this study indicates that estimation of Ag-NORs can be applied in predicting the aggressive clinical behaviour of primary meningeal tumours.
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Twenty unselected pituitary adenomas have been examined for proliferative indices (PIs), and anterior pituitary hormone expression. All but two of the tumours were non-functional with proliferative indices from less than 0.1 to 0.5%. Two tumours were null cell adenomas with PIs less than 0.1 and 0.2%. ⋯ Gonadotrophin and TSH immunoreactivity was heterogenous and was found in 12/20 (60%) of the tumours. There was no significant relationship between PI, hormone expression or any other measured parameter. The biological behaviour of pituitary adenomas with a PI of less than 0.1% is uncertain, but those with a PI of greater than 0.1% are more likely to recur although longer follow-up is needed to confirm this.
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Case Reports
Giant cell reparative granuloma of the craniofacial complex: case report and review of the literature.
Giant cell reparative granuloma (GCRG) is an infrequent non-tumoural lesion affecting particularly the maxillary and mandibular bones and only rarely the cranial bones. The pathogenesis is still controversial and the differential diagnosis, especially from giant cell tumours of bone, is difficult. A case of GCRG of the sphenoid masquerading as an intracranial tumour is reported here. The relevant literature is reviewed.