The "no-drill" technique of anterior clinoidectomy: a cranial base approach to the paraclinoid and parasellar region.

Introduction: A high-speed power-drilling technique of anterior clinoidectomy has been advocated in all publications on paraclinoid region surgery. The entire shaft of the power drill is exposed in the operative field; thus, all neurovascular structures in proximity to any portion of the full length of the rotating drill bit are at risk for direct mechanical and/or thermal injury. Ultrasonic bone removal has recently been developed to mitigate the potential complications of the traditional power-drilling technique of anterior clinoidectomy.

Chronic hypopituitarism after traumatic brain injury: risk assessment and relationship to outcome.

Objective: Chronic pituitary dysfunction is increasingly recognized as a sequela of traumatic brain injury. We sought to define the incidence, risk factors, and neurobehavioral consequences of chronic hormonal deficiencies after complicated mild, moderate, or severe traumatic brain injury.

Methods: Patients aged 14 to 80 years were prospectively enrolled at the time of injury and assessed at 3 and 6 to 9 months after injury for hormonal function and neurobehavioral consequences.

Nonmissile penetrating spinal injury. Case report and review of the literature.

Nonmissile penetrating spinal injuries (NMPSIs) are rare, even among the population of patients treated in large trauma centers. Patients who present with retained foreign body fragments due to stabbings represent an even smaller subset of NMPSI, and their optimal management is unclear. The authors report the case of a 42-year-old man who presented to the University of California at Davis Medical Center with a retained knife blade after suffering a stab wound to the lower thoracic spine.

Gene expression in blood changes rapidly in neutrophils and monocytes after ischemic stroke in humans: a microarray study.

Ischemic brain and peripheral white blood cells release cytokines, chemokines and other molecules that activate the peripheral white blood cells after stroke. To assess gene expression in these peripheral white blood cells, whole blood was examined using oligonucleotide microarrays in 15 patients at 2.4+/-0.

Distal posterior inferior cerebellar artery aneurysms: clinical features and management.

Object: Aneurysms located on the distal portion of the posterior inferior cerebellar artery (PICA) are uncommon, and their underlying pathology, natural history, and clinical management are poorly understood. To clarify these lesions more fully, the authors undertook a retrospective analysis of the clinical features and management results of 22 distal PICA aneurysms in 20 consecutive patients treated at one institution by the same surgeon during the past decade.

Methods: The series included 10 men and 10 women (mean age at presentation 51 years).