No shinkei geka. Neurological surgery
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Case Reports
[Ketamine infusion therapy for refractory neuralgia in spinal disease: report of two cases].
We report two cases of refractory pain in a spinal disease. One case was a 60-year-old male who presented intractable pain in bilateral upper extremities after anterior fusion (C5/6, 6/7) for cervical spondylosis. The other was a 63-year-old female who also had intractable pain in the left anterio-lateral chest wall with no remarkable past history. ⋯ In case 2, recurrence of the pain was recognized gradually. She underwent continuing infusion therapy of 2mg/kg of ketamine, and it brought about continued pain relief. We conclude that ketamine infusion therapy should also be considered for therapy of refractory neuralgia in spinal disease.
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Case Reports
[Anterior screw fixation combined with posterior interlaminar fusion for fracture of axis: report of two cases].
Two cases of axis fracture are reported. Traffic accidents were the cause of injury in both cases. The odontoid process was dislocated anterolaterally with fracture of the lateral mass of the axis in both cases. ⋯ Various kinds of fixation, such as posterior interlaminar wiring, odontoid screw fixation and Magerl's fixation, have been reported for the treatment of unstable axis fracture. Among them Magerl's method has been regarded as the most stable. When it is not applicable, combination of the first two methods can be an alternative way of treatment for this odontoid process fracture.
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Review Case Reports
[Primary intracerebral malignant fibrous histiocytoma with adhesion to a dura: a case report].
A case of malignant fibrous histiocytoma (MFH) in a 29-year-old man was reported. CT scans revealed an iso density mass which was homogeneously enhanced by contrast medium. MRI demonstrated that the right frontal tumor showed slight low signal intensity in T1-weighted image, and iso signal intensity in T2-weighted image. ⋯ Ki-67 labelling index was 54%. We considered the tumor was a MFH and arose from an intracerebral mesenchymal tissue. We reviewed some literature and briefly discussed clinicopathological features and therapy of intracranial MFH.