Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Primary intracerebral haemorrhage (ICH) refers to spontaneous bleeding from intraparenchymal vessels. It accounts for 10-20% of all strokes, with higher incidence rates amongst African and Asian populations. The major risk factors are hypertension and age. ⋯ Elevated intracranial pressure may be treated medically or surgically. Although the latter definitively lowers elevated intracranial pressure, the optimal patient selection criteria are not clear. Aggressive treatment of hypertension is essential in the primary and secondary prevention of ICH.
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Case Reports Comparative Study
Compression of the ulnar nerve at the elbow by an intraneural ganglion.
A rare cause of ulnar nerve compression at the elbow is presented in this report. A 42 year old right-handed mechanic developed subacute, progressive numbness, tingling and weakness in his right hand. Electrophysiologic studies demonstrated a severe conduction block affecting the ulnar nerve in the retrotrochlear groove but without any sign of major axonal loss. ⋯ The patient made a dramatic recovery within 6 weeks post-surgery. The conduction block completely resolved and the hand functions also returned to normal. This and other reported cases point to the importance of early diagnosis and intervention.
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Case Reports
A rare case of dysembryoplastic neuroepithelial tumour in occipital lobe presenting with only headache.
We report an unusual case of dysembryoplastic neuroepithelial tumour (DNT) located in the occipital lobe presenting with only headache. A 31 year old woman presented with headache. She had no history of epilepsy and neurological examination revealed no abnormal findings. ⋯ Magnetic resonance (MR) imaging demonstrated a heterogeneously enhanced mass with hypointense signals on T1- and hyperintense signals on T2-weighted images. The lesion was totally resected and histopathologically diagnosed as DNT. Physicians must bear in mind that DNT may occur in the occipital lobe and present with only mass effect.
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Biography Historical Article
John Carew Eccles, Nobel Laureate (1903-1997).
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Nineteen patients (20 operations) underwent elective carotid endarterectomy without arterial shunt. Carotid cross-clamping caused a significant decrease (from 61.2% to 49.5%, 19.1% decrease from the preclamp baseline) of the ipsilateral cerebral oxygen saturation and it increased to 65.6% after declamping. Cross-clamping also caused a significant decrease (from 2.9 Hz to 1.6 Hz) of the ipsilateral electroencephalogram main frequency and it increased to 3.6 Hz after declamping. ⋯ The reported data indicate that cerebral oxygen saturation less than 54-56.1% and its decrease more than 15.6-18.2% is found to be a predictor of neurologic compromise. In this study, the asymmetry of cerebral oxygen saturation more than 25% was also found to be a risk. Arterial shunt should be used in haemodynamically high risk cases.