Periosteal chondroma of the cervical spine: one more cause of neural foramen enlargement.

A case of cervical periosteal chondroma presenting with an enlarged neural foramen is described. Review of the literature showed that cervical chondromas are rare but that their characteristic clinical and computed tomographic findings aid in their diagnosis. The computed tomographic findings of two previously reported cases of cervical periosteal chondroma resembled those of the present case. On computed tomographic scanning, an iso-or high-density mass containing stippled calcifications and originating in a posterior cervical neural arch was observed in all three cases. Extensive spinal canal and extradural involvement was observed in five of the seven reported cases, including the one reported here.

Upright patient positioning in the management of intracranial hypertension.

Utilizing either a subarachnoid screw or an intraventricular cannula, intracranial pressure was continuously monitored in 24 patients with established or potential neurological impairment of various etiologies. Marked diminution in intracranial pressure was observed in the sitting or semisitting position in the 13 patients with documented intracranial hypertension as well as in the 11 in whom intracranial pressure was not elevated. This sustained effect was noted even when superimposed on intensive medical management of intracranial hypertension.

An experimental study of the influence of antifibrinolytic therapy on post-subarachnoid-hemorrhagic cerebral vasospasm and hydrocephalus.

The incidence and severity of cerebral vasospasm and hydrocephalus following induced subarachnoid hemorrhage in an experimental group of animals that subsequently received epsilon-aminocaproic acid was compared to that seen in a control group that received no antifibrinolytic therapy. No augmentation of either vasospasm or hydrocephalus could be attributed to the epsilon-aminocaproic acid in the treated as compared to the control group.

Experimental peripheral nerve repair: environmental control directed at the cellular level.

This study recognizes recent advances in the understanding of the anatomy and physiology of peripheral nerves at the cellular level. It has reproduced study conditions originally advocated by de Medinaceli and coworkers, with modifications. Eighty-four rats were divided into three groups. Group A underwent sciatic nerve transection and standard perineurial repair. Group B nerves were frozen, severed with a vibrating blade, and reconnected by tubulization with a rubber cuff while bathed in solutions designed to inhibit Ca++-calmodulin activation, maintain colloid osmotic pressure, and mimic ambient electrolytic conditions. Group C underwent a similar procedure as group B, with the rubber cuff replaced by a polyglycolic acid mesh. All animals were randomized and evaluated functionally in terms of a sciatic index. By post-operative day 225, animals of group A recovered 37% of function, group B recovered 74%, and group C recovered 67%. Compound action potential recordings revealed a velocity recovery of 41% in group A, 70% in group B, and 81% in group C. Microscopic evaluation provided evidence for corresponding structural improvement. This new method of nerve repair is uncomplicated, relatively inexpensive, and easily adaptable to other animal models.