COVID-19 and Spontaneous Resolution of Lumbar Disk Prolapse: A Retrospective Cohort Study of Patients Awaiting Microdiscectomy.

Background:  Between individual patients with lumbar disk prolapse (LDP), the natural course of disease is significantly variable. Spontaneous resolution is reported to occur in up to 70% of cases. However, we currently cannot predict for whom and when this will occur.

Intracranial Hypertension Secondary to Cervical Dural Arteriovenous Fistula.

Idiopathic intracranial hypertension (IIH) is a disease of mainly unknown etiology. Latest theories as to the pathogenesis have postulated a final common pathway of cerebral venous hypertension secondary to venous outflow impairment leading to decreased cerebrospinal fluid absorption. We present the case of a 42-year-old female who was treated for several years for headache and for approximately 12 months for IIH until appropriate imaging showed a right-sided cervical dural arteriovenous fistula (AVF) at the level of C4.

Symptomatology following traumatic brain injury in a multidisciplinary clinic: experiences from a tertiary centre.

Background: Physical, cognitive and emotional sequelae in patients with traumatic brain injury (TBI) have been identified; some as late as two years post-injury. To aid in the specialist management of such patients, a multidisciplinary neurotrauma clinic was initiated at a tertiary centre.  Aim: This study sought to describe the clinical features of patients who attended the clinic.

Idiopathic intracranial hypertension VISION (venous intervention versus shunting in IIH for optic nerve disc swelling) trial: patient perspective questionnaire.

Introduction: Headaches, visual problems and tinnitus are symptoms of Idiopathic Intracranial Hypertension (IIH) which resolve with reduction of CSF pressure. Impaired cranial venous outflow has been implicated in the pathogenesis and there is evidence of good treatment results in IIH using venous sinus stenting. We are currently initiating a multi-centre randomised controlled trial, the VISION study (Venous Intervention versus Shunting in IIH for Optic Disc Swelling) comparing radiological (venous sinus stenting) to surgical intervention (CSF shunting).

Case report: Angiosarcoma of the cervical spine.

Angiosarcomas (ASs) are rare malignant vascular tumours, which only occasionally occur in the spine. The prognosis is generally poor due to rarity of the condition as well as lack of data of treatment options. We present the case of a 75-year old man with a primary angiosarcoma of C2 and C3 who underwent occipito-cervical (to C6) fixation.

The management of minor head trauma (GCS 15-13) across a Trauma Network.

Objectives: To determine the variations in the management of patients with minor head injuries across a Trauma Network.

Methods: An 18-point questionnaire covering aspects of hospital care and follow-up of patients with minor head injuries was sent out to 19 wards in 10 different trauma units within our network.

Results: Fifty-eight percent of wards routinely admitting patients with minor head injuries have no management protocol in place.

Case Report: Traumatic Carotid-Cavernous Fistula.

Carotid-cavernous fistulae (CCFs) are a rare complication of head trauma, with potentially serious consequences. We report the case of a 45-year-old male patient who presented with posttraumatic CCF 2 months after sustaining a head injury. Appropriate imaging in the form of computed tomography of the head, magnetic resonance imaging of the head, and digital subtraction angiography of the intracranial vessels was performed, and the CCF was successfully coil embolized.

Intradural migration of cervical posterior fixation rods.

Background: Instrumented spinal fixations are an important tool in the management of traumatic conditions and delayed complications are rare.

Case Report: We present a case of open reduction and fixation of traumatic C5/6 facet fracture dislocation with late complication in the form of intradural hardware migration.

Conclusion: To our knowledge, this is the first report of an intradural rod migration distant to the initial surgery in a patient without posterior decompression.

Cerebral aneurysms and accelerated atherosclerosis in Russell-Silver syndrome: a new subtype? Case report.

The authors describe the case of a 32-year-old woman known to have Russell-Silver syndrome who presented with repeated aneurysmal subarachnoid hemorrhage. Multiple intracranial aneurysms and advanced peripheral vascular disease were demonstrated. The authors postulate a link between these vascular features and the patient's genetic condition.

History of neurosurgery at the Royal Free Hospital in London.

The recent move of the neurosurgical services from The Royal Free London NHS Foundation Trust in Hampstead to The National Hospital for Neurology and Neurosurgery at Queen Square signified the end of an era of neurosurgery in North London. It also represents also another chapter in the history of the remarkable North London hospital that is The Royal Free Hospital. This short article looks at the history of the Department of Neurosurgery at The Royal Free Hospital and the factors contributing to the reorganisation of neurosurgical services in North London.

Apoptotic cells and clonally expanded cytotoxic T cells in bone marrow trephines of patients with myelodysplastic syndrome.

Aims: There is increasing evidence that autoimmunity is involved in the pathogenesis of myelodysplastic syndromes (MDS). We examined the number of apoptotic cells, and analysed the T cells and the T cell receptor gene rearrangements in bone marrow trephines of patients with low-grade MDS [refractory anaemia (RA), refractory anaemia with ringed sideroblasts (RAS) and refractory cytopenia with multilineage dysplasia (RCMD)] to investigate the correlation between T cells and apoptosis.

Methods And Results: Bone marrow trephines from 30 patients with RA, seven patients with RCMD, four patients with RAS and 11 normal bone marrow donors were stained for CD3 and for apoptotic cells using immunohistochemistry and terminal deoxynucleotidyl transferase 2'-deoxyuridine, 5'-triphosphate (dUTP) nick end labelling (TUNEL) technique, respectively.

Spontaneous resolution of a symptomatic synovial cyst of the lumbar spine.

We present a case of spontaneous resolution of a lumbar intraspinal synovial cyst. We discuss the management options, including conservative management.

Impact of brain biopsy on the management of patients with nonneoplastic undiagnosed neurological disorders.

Objective: We sought to assess the diagnostic yield, complication rates, and therapeutic impact of open brain biopsy and serial stereotactic brain biopsy in the management of patients with nonneoplastic neurological conditions in which conventional investigations did not yield a definitive diagnosis.

Methods: A retrospective case note analysis was undertaken in consecutive patients undergoing brain biopsy at The Walton Centre for Neurology and Neurosurgery during a 15-year period. The diagnostic yield, prebiopsy diagnostic category, biopsy technique (open versus stereotactic), complication rates, and impact on clinical management were assessed.

CSF diversion in benign intracranial hypertension using a lumbo-atrial shunt.

An obese woman with benign intracranial hypertension had been managed for several years with lumbo-peritoneal shunting. Following a bilopancreatic procedure performed for management of her obesity dense peritoneal adhesions caused repeated shunt failure. The shunt system was successfully converted to a lumbo-atrial system.

Predisposing conditions and risk factors for development of symptomatic meningioma in adults.

Background: Risk factors and predisposing factors for the development of symptomatic meningioma during adult life are not well known.

Methods: Data from 306 consecutive patients with primary meningioma were collected retrospectively in a hypothesis-generating study. Factors studied included localisation of tumours, blood group typing, and risk factors, such as diabetes mellitus, coronary arterial disease, hypertension, rheumatoid arthritis, bronchial asthma, smoking, obesity, and second primary tumour.