No shinkei geka. Neurological surgery
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An extremely rare case of a meningioma in the posterior fossa without dural attachment has been reported. The patient was a 56-year-old male whose chief manifestation was the abnormality of his CT scan. His past history included gastric and colonic polyp when he was 54, 55 years old, and non-Hodgkin's lymphoma before hospitalization in our department. ⋯ Meningiomas without dural attachment are rare in adults, especially extremely rare of the posterior fossa. There are only 23 previous reports of "meningioma of the posterior fossa without dural attachment". Cantore divided these meningiomas into three groups (IV ventricle, inferior tela choroidea and cisterna magna).(ABSTRACT TRUNCATED AT 250 WORDS)
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Case Reports
[Stellate ganglion blocks as the suspected route of infection in a case of cervical epidural abscess].
Spinal epidural abscess is a comparatively rare disease. Its prognosis reportedly depends on degree and duration of the neurological symptoms before the treatment. Thus, the importance of early diagnosis and prompt surgical treatment has been emphasized repeatedly. ⋯ Postoperative MR images confirmed satisfactory decompression of the spinal cord and motor power was gradually recovered after surgery. Approximately 4 months after surgery she could walk independently. Cervical epidural abscess has been rarely reported as a complication of stellate ganglion block.(ABSTRACT TRUNCATED AT 250 WORDS)
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A rare case of penetrating head injury caused by a nail-gun was described. A 24-year-old male was admitted to our hospital due to head injury. He had handled a nail-gun at a construction site. ⋯ The characteristics of craniocerebral nail-gun injuries were less damage and better prognosis compared with gunshot injuries. However intracranial infection and vascular injury were possible lethal complications. In this case, preoperative examination, such as CT scan and CAG was valuable and the early operation for the sake of safety was very effective.
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It is well known that the worsening of neurological findings after spinal cord injury is due to the secondary progression of pathological changes which may be caused by spinal cord blood flow disturbance. We measured spinal blood flow of 5mm rostrally and caudally distant portions from the injured point, using the laser Doppler flowmeter experimentally. Forty rats were used. ⋯ Lastly, in the animals, carbon perfusion was performed through the left ventricle. The normal figured vasculature in the preparation of the injured and measured portion was calculated with a microcomputer imaging analyzer and compared with control groups. The number of the normal vessels was significantly more abundant on the caudal side than on the rostral side (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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A series of 610 patients who had aneurysm surgery within 7 days of the hemorrhage were analyzed as to the relationship between the preoperative Glasgow Coma Scale (GCS) score and the outcome assessed by using the Glasgow Outcome Scale (GOS) at 6 months after surgery. The patient distribution in accordance with the GCS scores in descending order from 15 to 3 was as follows: 265, 109, 44, 24, 17, 20, 25, 15, 18, 12, 16, 23, and 22 cases, respectively. In general, the larger the GCS score, the better the outcome. ⋯ As for demarcation levels along the GCS axis in terms of the GOS, a significant difference in the outcome was observed at the level of GCS scores between 15 and 14 (P < 0.0001, Wilcoxon test). However, no borderlines were evident at any GCS levels other than 15/14. The problems of applying the GCS to the grading system of aneurysmal subarachnoid hemorrhage are discussed.