Neurosurgery clinics of North America
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Current improvements in radiologic imaging and surgical instrumentation have greatly expanded the role of surgery in management of tumors of the thoracolumbar junction. For primary malignant tumors, the aim of surgery should be curative, with eradiction of all gross disease. For metastatic tumors, indications for surgery include cancer therapy, stabilization, neurologic palliation, tissue diagnosis, and pain relief. Because the thoracolumbar region is a transitional zone, surgical stabilization may require anterior-posterior approaches and instrumentation.
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Neurosurg. Clin. N. Am. · Oct 1997
ReviewClassification and acute management of thoracolumbar fractures.
Successful management of traumatic injuries of the thoracolumbar spine requires understanding of the concepts of spinal stability and instability. There are numerous classifications of injury patterns based on fracture type and the probable forces involved. This article focuses on Denis's three-column theory of spinal stability and its utility in categorizing five injury patterns and the forces involved: specifically, wedge compression fractures, burst fractures, flexion distraction injuries, fracture dislocations, and miscellaneous injuries. The authors also highlight the acute management and evaluation of patients suspected to have these types of injuries.
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Neurosurg. Clin. N. Am. · Apr 1997
ReviewBrain attack. Acute therapeutic interventions. Free radical scavengers and antioxidants.
Evidence suggesting a role of oxygen radical-induced lipid peroxidation in global and focal ischemic brain damage is reviewed, and the potential for treatment of these conditions with antioxidant compounds is highlighted. This article also presents a basis for appreciating the pharmacologic mechanisms by which oxygen radical damage can be inhibited.
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Neurosurg. Clin. N. Am. · Jan 1997
ReviewAtypical facial pain and other pain syndromes. Differential diagnosis and treatment.
Knowledge of each differential diagnosis of prosopalgia is important to any neurosurgeon who treats facial pain. Pain control is possible with treatment specific to the diagnosis, including those forms of facial pain known to be the most difficult to treat. An outline for the management of atypical facial pain, anesthesia dolorosa, and postherpetic neuralgia is presented with a review of the correlative anatomy for each surgical procedure.
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Neurosurg. Clin. N. Am. · Jan 1997
Percutaneous retrogasserian glycerol rhizotomy. Current technique and results.
Despite the establishment of the vasculoneural compression as a frequent cause of trigeminal neuralgia, minimally invasive surgical techniques to treat medically refractory trigeminal neuralgia are needed in order to minimize the risks associated with craniotomy. Percutaneous retro gasserian glycerol rhizotomy (PRGR) is one of the alternative surgical treatments to microvascular decompression. Technical simplicity, less chance of trigeminal sensory loss, no need of intraoperative sensory testing, and no attempted deliberate destruction of the trigeminal nerve are advantages over other percutaneous trigeminal operations.