Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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We report a 51-year-old man with an unusual intradural suprasellar chondroid chordoma. He presented with headache and diminution of vision in both eyes. MRI demonstrated the suprasellar tumor as an isointense mass with heterogeneous enhancement after intravenous administration of contrast agent. ⋯ Based on the histological characteristics of the tumor, which was composed of typical chordoma cells and islands of chondroid elements, we diagnosed a chondroid chordoma. We believe this is the first report of an entirely intradural chondroid chordoma on the suprasellar region. Clinical, radiological, and pathological features of the tumor are described.
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We studied 27 patients with cervical ossification of the posterior longitudinal ligament (OPLL) but no clinical symptoms of myelopathy. We investigated the occupation ratio of the spinal canal by OPLL with cervical radiographs, assessed the morphological types of OPLL, and measured the segmental range of motion (ROM) at the level of maximum cord compression on flexion and extension radiographs. Patients were classified as having continuous-type OPLL (17 patients), mixed-type OPLL (seven patients), or segmental-type OPLL (three patients). ⋯ No patient developed myelopathy during the study period. Three patients with massive OPLL did not develop myelopathy and the mobility of their cervical spine was highly restricted, suggesting that dynamic factors such as the segmental ROM preferentially contribute to the development of myelopathy in patients with cervical OPLL. Thus, by controlling the dynamic factors (hypermobility), we might be able to reduce neurological deterioration in patients with cervical OPLL.
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Tadalafil is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). Nitric oxide (NO) functions as a retrograde neurotransmitter in the spinal cord, and postsynaptic structures respond to NO by producing cGMP. The concentrations of cGMP in the spinal cord are controlled by the actions of PDE. ⋯ Tissue MDA levels in the tadalafil and methylprednisolone groups tended to be lower than in the non-treatment group and sham groups (p>0.05). Although there was no difference in neurological outcome scores between the tadalafil, methylprednisolone and non-treatment groups (p>0.05), the animals in the tadalafil and methylprednisolone groups tended to have better scores than the non-treatment group. Thus, tadalafil appears to be beneficial in reducing the effects of injury to the spinal cord by increasing tissue levels of NO and serum activity of SOD.
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Biography Historical Article
Harvey Cushing and some Australian connections: Part 2--post World War 1.
Part 1 of this article (see Vol 17, pp. 168-172) described the early life of Harvey Cushing and his encounters with Australian doctors, mostly in various military hospitals, in France, in World War 1. As none of the doctors he met at that time became neurosurgeons, and hence did not shape their professional development. ⋯ He received the Companion of the Bath from the British Government for his war services and wrote the history of US Base Hospital No. 5, which he directed during the War. Cushing's reputation as a neurosurgeon was now secure and he was ready to play an even greater part as an academic neurosurgeon, teaching students from all parts of the world and continuing his researches into cerebral tumours and the pituitary gland.
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Prognostic factors of hearing preservation after gamma knife radiosurgery for vestibular schwannoma.
We conducted a prospective study to identify prognostic factors of hearing preservation after gamma knife radiosurgery (GKRS) for vestibular schwannoma (VS). Twenty-seven patients with unilateral VS and serviceable hearing underwent GKRS. The mean lesion diameter was 17.3mm (range 6.1-30.0mm), the median marginal dose was 12 Gy (11-15 Gy), and the mean follow-up duration was 35.7 months (9-81 months). ⋯ A normal auditory brainstem response (ABR) (p = 0.008) and Gardner-Robertson class I hearing (p = 0.012) before GKRS were found to be significant prognostic factors of a favorable outcome. Our findings suggest that a normal pre GKRS ABR strongly predicts hearing preservation after GKRS. Accordingly, we advise that ABR should be considered with other prognostic factors when GKRS is considered in patients with VS.