Neurochirurgia
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In a retrospective study the CT scans of 138 patients with the clinical diagnosis of SAH were reviewed. CT was highly sensitive in detecting blood in the CSF spaces during the 3 days following SAH, with decreasing accuracy correlated to the time interval between SAH and CT examination. Clinical state on admission and CT findings were closely related, as were the localisation of detectable blood and the site of source of bleeding. Whereas blood clots in the basal cisterns, above the convexities, and intracerebrally, as well as the finding of a brain oedema, were significantly correlated to the time of survival, hydrocephalus and ventricular haemorrhage had no bearing on the survival time.
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A case of postoperative cervical pseudomeningocele in a woman submitted to laminectomy for protruded disc is reported. The patient was investigated by myelography and metrizamide computed tomography and surgically treated with a good neurological result. The other eight reported cases of postoperative cervical pseudomeningocele are reviewed and the role of metrizamide CT scan in diagnosing this unusual complication of cervical laminectomies is emphasized.
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An unusual case of spontaneous spinal subarachnoid haematoma (SAH) is reported. A 42-year-old man developed sudden and excruciating back pain immediately after sitting up from a supine position, and meningeal irritation and spinal cord compression signs of then appeared. ⋯ After prompt surgical evacuation neurological function was totally regained. Physiopathology and diagnosis are discussed with reference to similar cases in literature.
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Case Reports
Acute extradural haematoma following trivial trauma in a case of osteogenesis imperfecta.
A case of an extensive extradural haematoma as a complication in a patient with osteogenesis imperfecta is reported. The significance of careful appraisal and post-traumatic, neurosurgical observation of patients with osteogenesis imperfecta and a history of recent, albeit seemingly trivial, head injury is discussed.
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66 patients with gunshot wounds were treated at the Department of Neurosurgery of Hanover University up to May 1982. These included wounds inflicted by bolt guns of the type used in slaughter houses, and by bolt-setting or nail-setting tools used in building construction work. The total mortality was 50%. ⋯ Postoperatively, there were several complications, mainly pneumonia and cerebrospinal fluid fistulas; in fact, pneumonia was responsible for the death of some patients. The mortality is compared with the findings by other authors. No patients remained in need of care after rehabilitation.