Sport-Related Structural Brain Injury and Return to Play: Systematic Review and Expert Insight.

Background: Sport-related structural brain injury (SRSBI) is intracranial pathology incurred during sport. Management mirrors that of non-sport-related brain injury. An empirical vacuum exists regarding return to play (RTP) following SRSBI.

Stereotactic radiosurgery XX: ocular neuromyotonia in association with gamma knife radiosurgery.

Unlabelled: We report three patients who developed symptoms and signs of ocular neuromyotonia (ONM) 3-6 months after receiving gamma knife radiosurgery (GKS) for functioning pituitary tumours. All three patients were complex, requiring multi-modality therapy and all had received prior external irradiation to the sellar region. Although direct causality cannot be attributed, the timing of the development of the symptoms would suggest that the GKS played a contributory role in the development of this rare problem, which we suggest clinicians should be aware of as a potential complication.

The use of ionising radiation for the purpose of arresting external haemorrhage from an intracranial mass lesion.

External bleeding from any form of tumour of the central nervous system is unusual. We present a case where this difficult problem was controlled by the use of Gamma Irradiation from a focused delivery system.

Diagnosis and management of optic nerve sheath meningiomas.

Optic nerve sheath meningiomas account for a third of all intrinsic tumours of the optic nerve. Despite their classification as histologically benign tumours they cause progressive visual loss that often leads to blindness if left untreated. Recent therapeutic advances have increased the treatment options available to clinicians but patient management remains controversial.

Treatment of Nelson's syndrome with temozolomide.

A 64-year-old woman was previously treated for Cushing's disease with trans-sphenoidal surgery, external beam radiotherapy and bilateral adrenalectomy. Progression of an aggressive corticotroph adenoma was evident 3 years post-adrenalectomy; involvement of the clivus was treated with surgery and gamma knife radiosurgery. Tumour spread through the skull base, occiput and left ear with persistent facial pain and left ear discharge; progression continued despite second gamma knife treatment.

Comparison of two protocols for the treatment of retained fetal membranes in dairy cattle.

Two protocols for the treatment of retained fetal membranes in dairy cattle were evaluated in a field trial. Cows that retained the fetal membranes for more than 12h were assigned to two treatment groups in an alternating order. In both groups rectal temperature was measured daily for 10 days after enrollment.

Evaluation of a systemic antibiotic treatment of toxic puerperal metritis in dairy cows.

The objective of this study was to evaluate the efficacy and economic efficiency of a systemic treatment of toxic puerperal metritis in dairy cows with ceftiofur. Cows with abnormal vaginal discharge at a postpartum examination (d 4 to 6 after calving) and a rectal temperature > or = 39.5 degrees C were assigned to three treatment groups.

Facio-hypoglossal anastomosis for the treatment of facial palsy after acoustic neuroma resection.

Despite current micro-neurosurgical techniques the facial nerve may be irrecoverably damaged in up to 40% of operations for large acoustic neuromas. The results of 121 facio-hypoglossal anastomoses performed since 1960 for post-operative facial palsy are reported. Patients began to recover facial function after an average of 2.

Stereotactic craniotomy and intraoperative lesion localisation using the Brown-Robert-Wells frame. Technical note.

A simple technique of stereotactic craniotomy and intraoperative lesion localisation that uses the Brown-Robert-Wells (BRW) stereotactic frame is presented. The method optimises craniotomy placement and facilitates localisation of small intracerebral lesions. Using the system, 16 patients have had resection of intracranial neoplasms from deep and/or eloquent areas of the brain with no neurological morbidity.

Cavernous angioma of the thoracic spinal cord with intra- and extramedullary components.

A 31-year-old male presented with a 1 year history of left leg weakness and right leg sensory changes. Myelography revealed a probable intramedullary lesion at T4 and CT confirmed its intramedullary nature. At operation an almost black, firm mass was found projecting from the dorsal aspect of the cord and was totally excised.

The effect of experimental ischaemia on the direct cortical response of the motor cortex in primates.

We studied the changes in amplitude of the first short latency positive potential (2.3 +/- 0.3 msec, mean +/- S.

Intraoperative monitoring of the electrocochleogram and the preservation of hearing during acoustic neuroma excision.

We have monitored the electrocochleogram (ECochG) of 24 patients, using a transtympanic electrode, during acoustic neuroma excision. All patients had unilateral tumours with good preoperative hearing and complete excision was achieved in each case. Of the 24 patients, seven retained some hearing, however, a further two patients had normal ECochG waveforms at the end of operation but were nevertheless deaf.

Lhermitte-Duclos disease (dysplastic gangliocytoma): a case report with CT and MRI.

A 31 year old female was admitted with a one month history of left foot drop and diplopia. CT of the posterior fossa revealed gross displacement of the 4th ventricle by a large non-enhancing cerebellar mass but gave no indication of its nature. MRI sequences showed two masses within the left cerebellar hemisphere extending into the vermis and demonstrated a very unusual septation within the lesion.

Epidermoid cysts and cholesterol granulomas centered on the posterior fossa: twenty years of diagnosis and management.

The clinical features, diagnosis, and management of 23 posterior fossa epidermoid cysts and 9 petrous apex lesions presenting to one unit over a period of 20 years are summarized. Of the epidermoid cysts, 13 were entirely infratentorial, but the other 10 had an additional supratentorial component. Presenting symptoms and signs were usually long-standing and at onset had often been vague and nonspecific.

Clinical evidence supporting a subthalamic origin of the P15 wave of the somatosensory evoked potentials to median nerve stimulation.

Both somatosensory (SSEPs) and brain-stem auditory evoked potentials (BAEPs) were recorded in 3 patients with localized lesions in the thalamus or brain-stem. In one patient with a right thalamic cystic tumour there was a significant interhemispheric difference in the central conduction time (CCT), but the N14-P15 interval was not affected on either side and BAEPs showed normal wave latencies and interpeak latencies (IPLs). The second patient had a colloid cyst of the third ventricle in which central herniation had occurred resulting in 'locked-in' syndrome.

Preservation of cochlear potentials in a deaf patient fifteen months after excision of an acoustic neuroma.

Intraoperative electrocochleographic monitoring has been used in an attempt to protect cochlear nerve function during acoustic neuroma excision. One patient is presented with an apparently intact cochlear nerve and waves N1 and N2 preserved at the end of surgery, but no hearing on subsequent testing. Fifteen months after operation, cochlear microphonics and the summating potential were still present, but N1 and N2 had disappeared.

Intra-operative electrocochleography to monitor cochlear potentials during acoustic neuroma excision.

Intra-operative electrocochleography (ECochG) was used in an attempt to monitor the action potential of the cochlear nerve during acoustic neuroma surgery in 14 patients with useful pre-operative hearing. Five patients had ECochG potentials preserved and yet only three could hear when tested audiometrically later. Of those losing the potentials intra-operatively all were subsequently deaf and the pattern of waveform loss allowed determination of the probable cause of hearing loss.

Accuracy of intracardiac injections determined by a post-mortem study.

Intracardiac injection sites were traced at necropsy on 18 patients who died after unsuccessful cardiopulmonary resuscitation. In only 13 patients (72%) was the heart punctured. Of the 46 injections carried out, 5 (11%) pierced the left ventricle and 13 (28%) the right ventricle.

Cranial implant problems.

The common problems encountered during cranioplasty procedures have been reviewed and remedial procedures suggested. The problems or situations discussed include: implant selection and impressions, swelling and infection, integument thickness, distortion of plastic implants by autoclaving and seating guides, control of bleeding and swelling during operation, implant immobilization, eyebrow area involvement, dropping the implant, and inadequate skin flaps.