Pain sensitivity as a correlate of clinical status in individuals with chronic low back pain.

Study Design: A cross-sectional study of baseline correlates of clinical pain and functional status in consecutive patients being treated for chronic low back pain.

Objectives: To determine if an individual's global pain sensitivity, measured by experimental pain threshold to pressure at various regions of the body, is associated with baseline measures of clinical pain and physical functioning.

Summary Of Background Data: Previous studies have demonstrated that in individuals with chronic low back pain, clinical pain and functional status are significantly associated with demographic, structural, and psychosocial factors.

Transmission of Creutzfeldt-Jakob disease to a chimpanzee by electrodes contaminated during neurosurgery.

Stereotactic multicontact electrodes used to probe the cerebral cortex of a middle aged woman with progressive dementia were previously implicated in the accidental transmission of Creutzfeldt-Jakob disease (CJD) to two younger patients. The diagnoses of CJD have been confirmed for all three cases. More than two years after their last use in humans, after three cleanings and repeated sterilisation in ethanol and formaldehyde vapour, the electrodes were implanted in the cortex of a chimpanzee.

Cerebral schistosomiasis caused by Schistosoma haematobium: case report.

The CNS is an unusual site of ectopic infection in schistosomiasis. Cerebral lesions are caused primarily by Schistosoma japonicum, and spinal cord lesions are due primarily to Schistosoma mansoni and Schistosoma haematobium. S.

A clinical and neuropathologic study of silk suture as an embolic agent for brain arteriovenous malformations.

Purpose: To evaluate the safety and efficacy of silk suture as an agent for preoperative embolization of cerebral arteriovenous malformations.

Methods: Clinical and histopathologic results were analyzed in six patients who underwent embolization of cerebral arteriovenous malformations using silk suture in combination with other agents.

Results: Three of the patients treated with silk hemorrhaged after embolization, and two of these patients died.

Effect of lidocaine after experimental cerebral ischemia induced by air embolism.

To investigate possible approaches to the treatment of neural damage induced by air embolism and other forms of acute cerebral ischemia, somatosensory evoked potentials (SEP's) were measured after cerebral air embolism in the anesthetized cat. Air was introduced into the carotid artery in increments of 0.08 ml until the SEP amplitude was reduced to approximately 10% or less of baseline values.

Updated assessment and current classification of spinal meningeal cysts.

The classification of spinal meningeal cysts (MC's) in the literature is indistinct, confusing, and in certain categories histologically misleading. Based on a series of 22 cases, the authors propose a classification comprising three categories: spinal extradural MC's without spinal nerve root fibers (Type I); spinal extradural MC's with spinal nerve root fibers (Type II); and spinal intradural MC's (Type III). Although water-soluble myelography may disclose a filling defect for all three categories, computerized tomographic myelography (CTM) is essential to reveal communication between the cyst and the subarachnoid space.

Delayed postoperative dural arteriovenous malformations. Report of two cases.

The authors present two cases of dural arteriovenous malformations (AVM's) that developed at the site of previous suboccipital craniectomies. No other cases of delayed postoperative dural AVM's have been reported. Congenital and acquired dural AVM's are discussed, with reference to the similarity between postoperative dural AVM's and traumatic dural AVM's.

Reduction of experimental intracranial hypertension by lidocaine.

Previous animal studies in our laboratory revealed that acute cerebral ischemia induced by air embolism is accompanied by a sharp and pronounced rise in both systemic blood pressure and intracranial pressure. To investigate possible approaches to the treatment of severe intracranial hypertension, we produced cerebral air embolism in anesthetized, ventilated cats by the infusion of air into the vertebral artery. Untreated animals consistently experienced severe acute intracranial hypertension.

Skull x-ray examinations after head trauma. Recommendations by a multidisciplinary panel and validation study.

The value of skull radiography in identifying intracranial injury has not yet been satisfactorily defined. A multidisciplinary panel of medical experts was assembled to review the issue of skull radiography for head trauma. The panel identified two main groups of patients--those at high risk of intracranial injury and those at low risk of such injury--and developed a management strategy for imaging in the two groups.

Reactivation of herpesvirus in neurosurgical patients.

The authors are presenting seven patients who had operations between July 1984 and July 1985 and who developed herpes infections postoperatively. Four of the patients developed their infections in a dermatomal distribution that correlated with the nerve roots manipulated at operation. A spectrum of localized herpes reactivation is demonstrated in this series.

Identification of a retained surgical sponge using magnetic resonance imaging.

We report a patient who had a spinal abscess due to a retained surgical sponge. Through the use of magnetic resonance imaging, the sponge was identified. Postoperative foreign body complications are discussed.

Effects of collagenase and chymopapain on spinal nerves and intervertebral discs of cynomolgus monkeys.

In order to test the safety and efficacy of Nucleolysin, a collagenase for intradiscal chemotherapy, laminectomies were performed on the L2-3 intervertebral discs of four groups of three young adult Cynomolgus monkeys. One primate from each group was injected with half the recommended human dose of Nucleolysin, chymopapain, or the same volume of sterile water. The remaining half of the human dose of each drug or equal volume of sterile water was equally divided and placed upon the right L-3 and L-4 nerve roots at their vertebral foramina.

Selective conventional arteriography and computed tomography with and without contrast infusion: minimal requirements for the assessment of transient ischemic attacks.

The authors report two unusual cases referred for extracranial bypass surgery. These patients presented with symptoms of transient ischemic attacks (TIAs) and demonstrated the necessity of conventional selective angiography and computed tomography (CT), with and without contrast infusion, as part of the preoperative assessment. The authors discuss how digital subtraction angiography alone is inadequate and how CT without contrast enhancement may fail to visualize lesions that may exhibit TIA-like symptoms.

Effect of intravenous lidocaine on experimental spinal cord injury.

A series of experiments was conducted to study the effect of systemic intravenous administration of lidocaine on neurological recovery after acute experimental spinal cord injury in cats. The spinal cord was injured by the rapid inflation of an epidural balloon at T-6. The physiological integrity of the spinal cord ceased within 2 seconds in all animals, as demonstrated by acute disappearance of the somatosensory evoked response (SER).

Protective effect of lidocaine in acute cerebral ischemia induced by air embolism.

To investigate possible approaches to the prevention and treatment of neural damage induced by air embolism and other forms of acute cerebral ischemia, a model was used in which cerebral air embolism was produced by infusion of air (0.4 ml) into a vertebral artery of chloralose-anesthetized cats. Neurological function was assessed by measuring cortical somatosensory evoked responses in a group of 10 untreated animals and in a group of eight animals pretreated with intravenous lidocaine (5 mg/kg).

Computed tomography of an optic chiasm glioma in an elderly patient.

A 75-year-old white woman, otherwise healthy, developed progressively reduced visual acuity primarily in her left eye over 2 months. A computed tomography scan of the head demonstrated a moderately large, round, circumscribed, benign-appearing suprasellar mass that was enhanced with infusion of contrast medium. At craniotomy, a glioma of the optic chiasm that extended into the left optic nerve was observed.

The cutting-edge microvascular needle. A scanning electron microscopic study.

The authors have compared the vascular endothelial damage caused by blunt-tipped microvascular needles as reported previously with that of sharp cutting-edged needles of comparable size. The same four distinct vascular lesions were found with cutting-edged needles as with the blunt-tipped needles. Even though one experimenter made all of the lesions, and all of the tissue was handled in the same fashion, there was much variation in the extent of the intimal damage.

Neurogenic pulmonary edema associated with ruptured spinal cord arteriovenous malformation.

A case of neurogenic pulmonary edema (NPE) associated with a ruptured spinal cord arteriovenous malformation (AVM) is presented. The mechanisms involved in the development of NPE are discussed briefly. The possible role of preganglionic sympathetic fibers in the spinal cord in the etiology of NPE is suggested.

Cardiovascular effects of cerebral air embolism.

This study was conducted to determine whether air distributed to the cerebral circulation alone could cause acute cardiovascular dysfunction and thus be a potential mechanism for sudden death following arterial air embolism. Cardiovascular measurements were made in anesthetized, ventilated cats during infusion of air into a vertebral artery. Cerebral air embolism was found to induce an acute hypertensive response accompanied by severe cardiac arrhythmias.

Multiple abscesses of the brain. Case report.

A case of multiple brain abscesses is presented. The patient was treated with systemic antibiotics; one of the lesions acutely increased in size, became life-threatening, and was surgically removed. The patient continued with antibiotic treatment, and the remaining brain abscesses completely disappeared.