Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Symptomatic spontaneous pneumocephalus after a spinal fusion for spondylolisthesis without injury to the dura mater is rare. There are only a few reports of tension pneumocephalus after spinal operations published in English. ⋯ CT cisternography and MRI showed no anatomical defects that could have caused the pneumocephalus. We suggest that spontaneous pneumocephalus without dural injury may occur after a spondylolisthesis operation because of increased intra-abdominal pressure, and thus may be avoided by the careful management of abdominal pressure.
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The main goals of this study were to investigate the effect of age on thermal and thermal pain thresholds and reaction time, and to analyze the influence of age-related changes in reaction time on thermal and thermal pain thresholds. Thermal thresholds (warm/cold) and thermal pain thresholds (hot/cold) were evaluated by the method of limits. Visual reaction time was evaluated in a similar way by a customized computer program. ⋯ While warm and cold thresholds and cold pain thresholds increased with age, hot pain thresholds decreased with age. The age-related change in reaction time was insufficient to explain the age-related changes in thermal and thermal pain thresholds. In conclusion, age affects thermal and thermal pain thresholds independently of reaction time.
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The external structure of each cavernous sinus (CS) is made of four dural walls. The aim of this study was to describe the anatomy of the dural walls of the CS. We studied 42 adult cadaveric heads, fixed with formalin and injected with coloured silicon. The main findings were: (i) the lateral wall of the CS has two layers - the external, which is thick and pearly grey, and the internal, which is semi-transparent and containing the cranial nerves (CNs); (ii) the medial wall of the CS has two areas - sellar and sphenoidal, both made up of one dural layer only; and (iii) the superior wall of the CS is formed by three triangles - oculomotor, clinoid and carotid - CN III may be found in a cisternal space of the oculomotor triangle; and (iv) the posterior wall of the CS is made up of two dural layers - meningeal dura and periostic dura - and this wall is close to the vertical segment of CN VI.
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Case Reports
A ventriculoperitoneal shunt catheter wrapped around a right mammary prosthesis forming a pseudocyst.
Breast cerebrospinal fluid pseudocysts are a rare complication of ventriculoperitoneal (VP) shunting. It is very unusual for the peritoneal catheter of a shunt to become wrapped around a prosthesis a previously augmented breast. ⋯ We observed on frequent follow-up chest X-rays performed for pneumonia and mechanical ventilation that the peritoneal catheter had gradually wrapped around her prosthesis. She developed a progressively enlarging breast lump which resolved with drainage of the cerebrospinal fluid collection and revision of the VP shunt.
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Hematoma growth is common in intracerebral hemorrhage (ICH) and is associated with a poor outcome for patients. To evaluate the efficacy and safety of recombinant activated factor VII (rFVIIa) used as a hemostatic agent in patients with ICH without hemophilia, we searched Medline, Scopus, the Cochrane Library, Clinicaltrials.gov and the Stroke Trials Directory. Five randomized controlled trials were selected for analysis. ⋯ There was a significant increase in arterial thromboembolic adverse events (TAE) in patients treated with rFVIIa. There was an increase in deep vein thrombosis in patients with spontaneous ICH and traumatic ICH. In conclusion, the use of rFVIIa reduces the growth of the hematoma but does not improve patient survival or functional outcome after ICH; in addition, rFVIIa increases the incidence of arterial TAE.