Kissing spines: fact or fancy?

In the Neurosurgical Clinic in Groningen 64 patients underwent surgery between 1975 and 1985 for a clinical and radiological syndrome described by Baastrup in 1933 and called in the Anglo-saxon literature: "kissing spines". Because the results of the surgical treatment were disappointing we submitted these results to further analysis.

The recurrence of supratentorial meningiomas after surgery.

A series of 113 consecutive patients underwent surgical treatment for a supratentorial meningioma between January 1955 and January 1975. There were 73 women and 40 men. There were 10 postoperative deaths (8.

Anatomical relations in the carpal tunnel: a computed tomographic study.

Computed tomography of the carpal tunnel was performed in the hands of both patients and controls in a neutral position, in flexion and in extension. The median nerve was not compressed between the long flexors and the flexor retinaculum in either flexion or extension of the wrist. In flexion, the nerve usually moved dorsally, away from the flexor retinaculum.

Cerebrospinal fluid shunting for hydrocephalus: a retrospective analysis.

A series of 383 extracranial CSF shunts performed between Jan. 1980 and Jan. 1985 for hydrocephalus in children and adults is reviewed.

Tumours of the thalamic region. A retrospective study of 27 cases.

Twenty seven patients with thalamic tumours were evaluated retrospectively in the Neurosurgical Clinic of the University Hospital in Groningen between 1969 and 1983. The diagnosis was based on neuroradiological studies. The authors recommend stereotactic biopsy of thalamic tumours followed by irradiation in selected cases.

Sympathetic dysfunction in patients with persistent pain after prolapsed disc surgery. A thermographic study.

Vasomotor function in the lower limbs was tested by means of thermography in 48 patients with and without residual complaints after surgery for a prolapsed intervertebral disc. There is a definite correlation between the severity of the complaints and the thermographic responses which corresponds well with the evidence for a sympathetic reflex dystrophy of the legs (causalgia).

Barbiturates for cerebral aneurysm surgery. A review of preliminary results.

Ninety-two cerebral aneurysm cases treated by clipping under moderate hypothermia are reviewed. Twenty-three of these cases received pentobarbitone during surgery in doses sufficient to render the EEG flat. The overall combined mortality and morbidity (complication rate) among 69 non-barbiturate cases was 21.

The cause of failure in high cervical percutaneous cordotomy: an analysis.

Factors that might have contributed to failure of high cervical percutaneous cordotomy in 23 patients with intractable pain were investigated. Cordotomy failed in 3 patients, 20 had initially good pain relief (87%). True recurrence occurred in 5 patients, 3 of them developed pain elsewhere.

Transfrontal pituitary surgery: clinical results, intraoperative management, and postoperative monitoring.

Sixty-nine cases of pituitary tumours with suprasellar extensions are reviewed. Twenty cases were recurrent. All were removed via a frontal craniotomy and surgery was performed under moderate hypothermia in all except seven cases.

Some considerations on the central regulation of respiration and its disturbances.

The effect of increased intracranial pressure on the respiration pattern was studied in cats. It appeared that the different patterns described by Plum and Brown blend into each other under certain conditions.

Relation of false localizing signs and remote hyperaemia in patients with intracranial mass lesions.

Seventeen patients with intracranial mass lesions underwent rCBF measurements with the xenon-133 carotid injection technique. In 11 patients remote areas of hyperaemia were found. There was a relation between location of the remote hyperaemia and the site of the mass lesion.

Some principles of postoperative epidural pressure monitoring.

A retrospective analysis is presented of 115 cerebral tumour cases where continuous epidural pressure (EDP) monitoring was carried out postoperatively using an implantable transducer constructed on a coplanar principle. Correct implantation of the transducer is crucial to reliable measurement. The influence of transducer location on EDP is highly significant and can be accounted for at least partly by hydrostatic forces.

Regional cerebral blood flow in patients with subarachnoid haemorrhage.

With a multidetector scintillation camera regional cerebral blood flow, rCBF, was evaluated in 13 patients with subarachnoid haemorrhage. Mean CBF was subnormal, and there seems to be a relationship between CBF and severity of the neurological deficit. The regional pattern showed ischaemic as well as hyperaemic areas.

Techniques in transfemoral lumbar epidural phlebography.

For lumbar epidural phlebography an even distribution of the injected contrast medium over the epidural and intervertebral venous system is of the greatest importance in order to prevent the false positive diagnosis of a lumbar disk lesion due to an artificial filling defect. Various catheter placement techniques and other procedures designed to enhance epidural opacification are compared in this respect. In the author's opinion, selective injection of the contrast medium into an intervertebral vein, when possible, leads to the most reliable epidural filling.