Neurosurgery clinics of North America
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Neurosurg. Clin. N. Am. · Apr 1993
Temporal lobectomy that spares the amygdala for temporal lobe epilepsy.
Rationale, surgical techniques, and results in 70 patients with complex partial seizures who underwent temporal lobectomy with sparing of the amygdala are discussed. Removal of entorhinal cortex may be the common denominator that explains the similar results obtained with different types of temporal lobectomies for epilepsy.
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Proper identification of compressive radiculopathy is essential before any treatment can be undertaken. The differential recognition of different pain patterns, sensory symptoms, and neurologic deficits provides the clinical guide to specific nerve root involvement. Appropriate radiology and imaging must correlate with symptoms and signs. Management includes surgical intervention when indicated for relief of radicular pain and restoration of function.
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Intracerebral hemorrhage as a result of a diagnostic or therapeutic procedure is a rare but potentially devastating event. The fear of hemorrhagic complications influences neurosurgical decision making. The incidence of iatrogenic intracerebral hemorrhage and risk factors for this complication are reviewed for neurosurgical procedures as well as for non-neurosurgical procedures with a known risk of intracerebral hemorrhage.
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Neurosurg. Clin. N. Am. · Jul 1992
ReviewIntracerebral hemorrhage due to cerebral arteriovenous malformations.
The most common presentation of a pial arteriovenous malformation (AVM) is spontaneous intracerebral hemorrhage (ICH). The peak incidence of ICH is early in the third decade of life. This article discusses the management of ICH of unknown etiology, ICH from angiographically visible AVM, and ICH from angiographically occult vascular malformations based on the current understanding of the natural history of these disease entities.
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Neurosurg. Clin. N. Am. · Apr 1992
ReviewInfections in neurologic surgery. The intraventricular use of antibiotics.
Intraventricular antibiotic therapy appears to be a useful treatment modality in those CSF infections in which systemic therapy may fail. Consideration should be given to using this form of treatment when infecting organisms are only sensitive to antibiotics with poor penetration of the CSF (e.g., aminoglycosides and vancomycin) and for cases in which intravenous therapy has failed to sterilize the CSF, toxicity from systemic therapy precludes further increases in dosages, and shunts or other CSF hardware might be expected to reduce the efficacy of systemic therapy by providing a foreign body to harbor organisms. Shunts or reservoirs that are infected may be successfully sterilized with IVT therapy alone or in conjunction with systemic therapy, but this has a lower success rate than cases in which the shunt is removed. ⋯ CNS fungal infections can be treated effectively with IVT amphotericin B but with a high risk of significant toxicity. Miconazole appears to be safer than amphotericin B but there is less clinical experience with this drug. Table 1 summarizes the dosages, indications, and toxicity of those antibiotics commonly used for intraventricular administration, which have been reported previously.