Surg Neurol
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Supratentorial gliomas in the pediatric age group at the University of Kentucky Medical Center accounted for 20% of all childhood brain tumors. Seventeen of the 20 children with these tumors, regardless of histologic type, mode of therapy, or other parameters died within five years after tissue diagnosis, and most were dead within two years. Unlike the astrocytic gliomas, the poorly differentiated primitive neuroectodermal tumors tended to spread diffusely throughout the central nervous system and accounted for 35% of the supratentorial gliomas in children at our institution. Results of this study suggest that therapy for the primitive neuroectodermal tumor, unlike other childhood supratentorial gliomas, should be considered for the entire neuraxis.
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The intravenous infusion of iodinated contrast material is an important adjunct to computed tomography with a wide variety of lesions. Some arteriovenous malformations, metastatic lesions and tumors of the sella turcica and cerebellopontine angle which are undetectable by conventional computed tomography may be visualized by this method. Certain other metastatic lesions, primary tumors, abscesses and infarcts which are detectable in the preinfusion tomogram become better defined following infusion. The indications for this examination and the procedures involved are discussed.
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The cause of sciatica is elusive in some cases. In a few instances it is due to the development of adhesions about the nerve root at the point of its entrance into the dural sleeve. ⋯ This condition occurred in partial form in two cases and with total incarceration in five. Relief followed radicolysis and partial or total radicotomy.
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Sixty-nine patients with chronically incapacitating pain were treated with an implantable stimulator over the posterior columns of the spinal cord. Evaluations at 24, 30 and 34 months showed a progressive decrease in the number of patients considered to have an excellent result. Evaluation of 60 patients with pain of benign origin after implantation of the stimulating device showed only ten patients who could be considered to have an excellent result on the basis of their own report of pain relief. The most common failure of the stimulating devices was failure of stimulation into a painful part.