Acta neurochirurgica. Supplement
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Over the past ten years, an average of 135 residents have entered neurosurgical training in the United States each year. These neurosurgeons-to-be come from about 250 applicants who annually enter the national matching program for neurosurgery. After completing training, they join a pool of practicing neurosurgeons that includes about 3,260 board certified neurosurgeons and an additional 390 practicing neurosurgeons who are still in the certification process. ⋯ We do need to restrict the number of trainees to that number we can train properly. The quality of our neurosurgeons needs to be maintained. Beyond that, the market place, however imperfect, is a better long-term regulator of numbers than any governmental or privately-based committee.
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Acta Neurochir. Suppl. · Jan 1997
Comparative StudyIntracranial pressure in a modified experimental model of closed head injury.
Intracranial pressure (ICP) was studied in a modified experimental model of closed head injury, in which the dynamic process of impact versus impulse loading was separately controlled. In this model, mortality of Wistar rats was considerably higher as compared to Sprague-Dawley rats subjected to similar traumatic conditions. Therefore Sprague-Dawley rats were used for all further experiments. ⋯ At the moment of impact there was a momentary blood pressure peak immediately followed by a transient period of hypotension. ICP measurements following directly to an impact-acceleration trauma, revealed an abrupt rise in ICP reaching pathological levels within 5 minutes. In conclusion, this modified model of closed head injury produces a predictable and reproducible pathologic ICP in Sprague-Dawley rats.
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Acta Neurochir. Suppl. · Jan 1997
Characterisation of brain edema following "controlled cortical impact injury" in rats.
Significance, origin and nature of posttraumatic brain edema are still being debated. Recently, a "controlled cortical impact injury" (CCII) was introduced to model traumatic brain injury. Purpose of this study was to investigate the development and nature of brain edema following CCII. ⋯ A significantly decreased ADC (apparent diffusion coefficient) indicates the cytotoxic (ischemic) component of edema in this model. In conclusion, CCII produces significant posttraumatic brain swelling and edema which is both, of vasogenic and cytotoxic nature. Thus, the CCII models the human cortical contusion more appropriately and opens new avenues for therapeutical studies focussing on cortical contusions.