Neurochirurgia
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Case Reports
Results of spinal cord stimulation in patients suffering from chronic pain after a two year observation period.
Attempts were made to treat 50 patients suffering from various types of chronic pain with SCS (PISCES). In 33 patients the test stimulation was successful so that an implantation of the system was carried out. After a minimum observation period of two years, only six patients still reported satisfactory alleviation of pain. A more careful selection of patients suffering from different types of pain would appear to be the pre-requisite for better results.
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The article describes the pathophysiological mechanisms of injuries caused by shots in the head. In particular, the effect exercised on the cerebral tissue by the impact of rapid projectiles is explained. ⋯ These cases are discussed and critically assessed, using the results communicated in other papers as basis. The requisite surgical measures are considered; the need for effecting complete cleansing of the path of the bullet is viewed with some reserve.
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31 patients with craniocerebral gunshot wounds were examined in the acute phase and 14 out of 22 survivors followed up for a period of up to 3 years. The clinical and CT findings as well as treatment measures are explained. The value of CT is convincingly demonstrated with this type of injury, as with others, but its prognostic value including prediction of follow-up results remains limited.
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Comparative Study Clinical Trial Controlled Clinical Trial
[Influence of sorbitol and mannitol on intracranial pressure (author's transl)].
The intracranial pressure was measured by an intraventricular catheter in 53 patients, in the course of 156 infusions of 40% Sorbitol and 72 infusions of 20% Mannitol. The amounts given and the rate of infusion were varied. ⋯ After Sorbitol the influence on lowering the pressure was more marked and longer lasting than after injections of Mannitol. As a possible treatment for raised intracranial pressure one may conclude that small amounts given over a shorter time (50-80 ml/5 min) produce the most favourable effect.