British journal of neurosurgery
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On 8 January 1989 at 20:25 h, a British Midland Boeing 737/400 on approach to East Midlands Airport crashed across the M1 motorway with the immediate loss of 39 lives from the 126 people on board. In the aftermath of the accident a clinical review was commenced to determine the mechanisms of injury in the 87 initial survivors and hopefully provide data to improve commercial aircraft safety in the future. Seventy-seven survivors sustained head and facial trauma in the crash, 45 of whom had periods of amnesia surrounding the event. ⋯ Loss of consciousness and duration of amnesia were directly related to the degree of superficial head trauma. Adoption of the fully flexed brace position for crash-landing offered significant protection from head injury and concussion, and possibly reduced injuries from behind. Suggestions are made for potentially improving the survivability of aircraft accidents.
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The descriptions of two techniques allowing for CT target determination in functional neurosurgery are presented, the first for thalamic and peri-thalamic explorations in the treatment of dyskinesiae and chronic pain, the second for the implantation of multiple hemispheric depth electrodes in the assessment of chronic drug-resistant epilepsy.
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Percutaneous retrogasserian glycerol rhizotomy has shown encouraging results in the treatment of trigeminal neuralgia. An experimental study was undertaken using a rat sciatic nerve model to elucidate the mechanism of action of anhydrous glycerol and to study the acute changes which develop within one week. Extraneural glycerol was applied in 20 adult Wistar rats. ⋯ The sciatic nerve of the opposite limb in the same animals was used as a control. The nerve were examined with light and electron microscopy including a morphometric study to assess the type of fibres affected. The specific pattern of involvement of larger and medium sized myelinated fibres with relative preservation of unmyelinated fibres was noted.