Non-traumatic brain abscess

Between 1953 and 1989 eighty cases of non-traumatic brain abscess were treated in our department. We have re-examined the clinical and neuroradiological features of this pathological process and present our therapeutic approach and results. We believe that the optimal treatment for brain abscess consists of surgical removal.The prognosis for these lesions has undergone a marked improvement over the last two decades in response to neuroradiological, microbiological and surgical advances. The most influential prognostic factor seems to be preoperative clinical status.     

Crossed aphasia. An update

The aim of this article is to present an update of a rare but interesting problem: crossed aphasia. This term indicates the presence of aphasia after unilateral cerebral lesion of the hemisphere ipsilateral to the patient's dominant hand. We report two cases, review the most relevant literature, and analyze clinical, neuroanatomical, and neurophysiological aspects, taking in consideration the various interpretations proposed to explain this unusual language disorder.     

Self-knowledge as a possibility for transforming oneself and the collectivity

In order to encourage a discussion and a team reflection on the meaning of the nursing work in a surgical unit, and considering that nursing workers need to develop self knowledge as participants and constructors of a collective work, a practice, known as technique of the self, was implemented. The objective of this practice was to promote the individual's self knowledge and consequently transform the collectivity. The practice consisted of oral and individual presentations in which each participant talked about his/her perception of him/herself to the group. A written record showing the qualities and advice which could be attributed to each member of the nursing team was made. As these contributions were systematized, each participant received a set of perceptions from the group about him/herself. Such strategies have established opportunities for the dialogue, critical reflection, and closeness among the workers, as well as propitiated personal and team growth.     

Spinal accessory nerve palsy due to neurovascular compression. Report of a case diagnosed by magnetic resonance imaging and magnetic resonance angiography

The case of a young patient with left accessory nerve paralysis is reported. He had slight tilting of the head to the right side, developed over a period of about 6 months. On neurological examination hypotrophy of the left sternocleidomastoid and trapezius muscles was observed. MRI and MR-angiography imaged the presence of a neurovascular compression between the medulla oblungata, at the level of the nerve entry zone, and a vessel loop of an elongated left vertebral artery. In spite of the absence of a surgical demonstration it is our opinion that the neurovascular conflict is the cause of the accessory nerve palsy.     

Intramedullary spinal cord ependymomas — a study of 45 cases with long-term follow-up

Summary Of the 62 patients with intramedullary spinal cord ependymoma treated surgically at our Neurosurgery Division between January 1951 and December 1990 45 had a follow-up of at least 3 years and the longest 30 years. The 28 conus-cauda equina-filum ependymomas operated during the same period are not considered in this study. An analysis of our cases and of the larger published series shows that favourable prognostic factors, apart of course from total tumour removal, which is now usually possible, are a site below the high cervical segments and a mild pre-operative symptom pattern. Patient age at diagnosis, tumour size and low dose (< 40 Gy) radiotherapy seem to have no influence on the prognosis. Aggressive surgical removal is the treatment of choice and also for long-term recurrence.     

Dermoid and epidermoid cysts of the midline in the posterior cranial fossa

Clinical features and surgical outcome of 16 patients with dermoid or epidermoid cysts on the midline of the posterior cranial fossa are compared. Salient points in the comparison are the younger age, presence of associated malformations and better prognosis of dermoid cyst.     

Lumbar disc herniation in teenagers

Summary We report 48 patients operated on for lumbar disc herniation in the second decade of life (aged 13–20 years) in our Neurosurgical Division. To analyze the clinical and diagnostic features and surgical outcome of the disease in teenagers and to point out any differences from adults, we made a detailed study of over 900 juvenile cases and compared them with 11000 adult cases reported in the literature. Low-back pain proved to be less frequent among youngsters both as a first symptom and at diagnosis, while sensorimotor deficits have the same frequency in the two age groups. Herniation occurs more often at L4–L5 and is more frequently median among teenagers. The long-term surgical results in children and adolescents are better than in adults.     

麝香保心丸治疗冠心病心绞痛临床疗效观察

目的 :观测麝香保心丸治疗冠心病心绞痛的疗效。方法 :将 2 0 0例冠心病心绞痛的患者随机分析治疗组 12 0例 ,对照组 80例 ,治疗组口服麝香保心丸 ,每次 2片 ,每日 3次 ,对照组口服单硝酸异酯脂 ,每次 2 0mg ,每日 2次。 结果 :麝香保心丸可显著改善冠心病心绞痛临床症状 ,显著改善心电图 ,缺血总面积。总的症状疗效 :治疗组为 83% ,对照组为6 1% ,(P <0 .0 5 ) ,心电图疗效 :治疗组为 74 % ,对照组为 4 6 % (P <0 .0 5 )。结论 :麝香保心丸治疗冠心病心绞痛优于单硝酸异山梨酯。