Nō to shinkei = Brain and nerve
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This paper reviews long-term follow-up studies of 78 hydrocephalic patients with myelomeningocele. Seventy-eight (95%) out of 82 patients with myelomeningocele had hydrocephalus. CT, MRI, CT cisternography, and monitoring of intracranial pressure (ICP) with infusion methods were performed to evaluate the indication of shunt insertion or shunt independency. ⋯ The mean value of Evans' index was 48% in this group. Six patients had progressive signs and symptoms of hydrocephalus and were shunted. ICP monitoring and studies of CSF dynamics revealed abnormal findings in ten out of 14 cases in spite of preservation of good intelligence.(ABSTRACT TRUNCATED AT 400 WORDS)
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The clinical picture of spinal epidural hematoma is usually characterized by the sudden onset of pain and acute paraplegia within a few hours. The reports of chronic spinal epidural hematoma above the lumbar level is extremely rare. Here we added one case whose hematoma was at cervical level. ⋯ Left vertebral angiogram showed that a part of posterior cerebral venous blood drained to cervical vertebral plexus. This finding suggested his epidural bleeding was venous in origin. Rupture of internal vertebral venous plexus that has no valves was considered as the source of spinal epidural hematoma.(ABSTRACT TRUNCATED AT 250 WORDS)