Surg Neurol
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Case Reports
Omental transplantation using a superficial temporal artery previously used for encephaloduroarteriosynangiosis.
Childhood moyamoya disease is a chronically progressive cerebrovascular occlusive disease affecting the territories of the anterior, middle, and posterior cerebral arteries. Surgery used in treatment of moyamoya disease to vascularize the brain include direct and indirect anastomoses. ⋯ In summary, OMT using a branch of the STA used in previously performed EDAS is required for patients with moyamoya disease who continue to manifest paraparesis, urinary incontinence, and/or progressive mental retardation even after multiple EDAS.
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Twenty patients with thoracic disc herniations underwent removal of the transverse process, articular facet, pedicle, and rib--a procedure described by Larson as the lateral extracavitary approach. Eleven patients presented with myelopathy: five mild, nine moderate, and four severe. ⋯ Postoperative follow-up ranged from 1 to 8 years. The pros and cons of each of the surgical approaches to this type of lesion are considered with reference to the published data.
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As the spinal canal expands at T10 level naturally, it has been thought that the migration of a bullet within the spinal canal above this level is prevented and the migration of a bullet may only occur between T10 and S1 level. Here, a very rare case of a bullet traversing the length of the spinal canal is reported.
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Intracranial hemorrhage may be a particularly devastating complication of anticoagulant therapy. Very few accounts have reported data on the duration of anticoagulant discontinuation following intracranial hemorrhage or the intensity of anticoagulation during treatment for it, although we must adequately manage such a complication. ⋯ The patients with anticoagulant-related intracranial hemorrhage may undergo surgery with thrombotest values approximately between 20% and 60%, and anticoagulants can be resumed after an interval of 3 days. Aggressive surgery should particularly be performed in patients with anticoagulation-related chronic SDH or subcortical hemorrhage, as in the cases of anticoagulant-unrelated intracranial hemorrhage.
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Patients in the acute stage after a severe head injury often exhibit systemic stress responses. The aim of the present study is to assess in such patients the clinical significance of the change of catecholamines (CA) and of blood glucose. ⋯ These findings suggest that in the acute stage of severe head injury hyperglycemia and elevation of serum levels of CA are common components of the stress response, significant indicators of severity, and significant predictors of outcome.