Characteristics and incidence of fibromyalgia in patients who receive worker's compensation.

The aim of our study was to investigate the incidence of fibromyalgia syndrome (FMS) in patients with work-related injuries, the potential risk factors for and causes of FMS, and the disabilities associated with FMS.

Solitary primary CNS lymphoma: long term survival following total resection.

Primary non-Hodgkin's CNS lymphoma is rare, constituting 0.3-1.5% of all intracranial neoplasms in patients without AIDS.

Ganglion cyst of the odontoid process. Case report and review of the literature.

Study Design: This case report illustrates that although it is rare, a ganglion cyst can occur intraosseously in the odontoid process.

Objectives: The tissue diagnosis was established by surgical resection of the cyst membrane and evacuation of the cyst content. The patient tolerated the procedure well, and the hospital course was uneventful.

Determinants of head injury mortality: importance of the low risk patient.

Data were obtained prospectively for 7,912 head-injured patients admitted from 1980 to 1981 to 41 hospitals in 3 U.S. metropolitan areas.

Neurobehavioral outcome following minor head injury: a three-center study.

The majority of hospital admissions for head trauma are due to minor injuries; that is, no or only transient loss of consciousness without major complications and not requiring intracranial surgery. Despite the low mortality rate following minor head injury, there is controversy surrounding the extent of morbidity and the long-term sequelae. The authors postulated that consecutively admitted patients who fulfilled research diagnostic criteria for minor head injury and who were carefully screened for antecedent neuropsychiatric disorder and prior head injury would exhibit subacute cognitive and memory deficits that would resolve over a period of 1 to 3 months postinjury.

Emergency skull radiography: the effect of restrictive criteria on skull radiography and CT use.

A prospective study was performed to determine the effect of restrictive criteria on the use of emergency skull radiography and computed tomography (CT) of the head. Emergency skull radiography required the completion of a special requisition form. Emergency CT of the head was done at the request of senior consultants and was available on a full-time basis.

Seizures and head injury in an urban community.

Among 811 patients hospitalized for head injury (HI) in the Bronx, 14 (1.7%) had HI caused by a seizure, 47 (5.8%) had a history of seizures of some type unrelated to the index HI episode, and 40 (4.

Cognitive sequelae and recovery course after moderate and severe head injury.

The quality of survival after severe and moderate head injury is highly dependent on the adequacy of cognitive recovery. The intellectual sequelae of head injury impede social and occupational reintegration more than physical disabilities do. The present study examines the course of cognitive recovery from the time of admission to 1 year after trauma.

Vasoactive intestinal peptide in cerebrospinal fluid.

Immunoreactive vasoactive intestinal peptide (VIP) was measured in lumbar and ventricular cerebrospinal fluid (CSF) from patients with various neurological disorders and in 2 hour aliquots of cisternal fluid removed continuously from rhesus monkeys. Although most of the VIP in concentrated pools of human ventricular fluid and of monkey cisternal fluid co-eluted with synthetic porcine VIP28 on a column of Sephadex G-25 superfine, there was evidence that smaller immunoreactive fragments were also present. A circadian pattern of CSF VIP concentration was observed in 2 of the 3 monkeys studied, with highest levels occurring at night and lowest during the day.

Extrapharyngeal (anterolateral) approach to the cervical spine.

The extrapharyngeal approach to the anterior cervical spine is a safe, rapid surgical exposure. Other surgical exposures such as the posterior, lateral, and intraoral (transpharyngeal) have inherent limitations that this approach avoids. By going anterior to the sternocleidomastoid muscle and great vessels, the surgical exposure of the anterior cervical spine is wide and the vital structures of the neck are visualized and not injured.

The National Traumatic Coma Data Bank. Part 1: Design, purpose, goals, and results.

This paper describes the pilot phase of the National Traumatic Coma Data Bank, a cooperative effort of six clinical head-injury centers in the United States. Data were collected on 581 hospitalized patients with severe non-penetrating traumatic head injury. Severe head injury was defined on the basis of a Glasgow Coma Scale (GCS) score of 8 or less following nonsurgical resuscitation or deterioration to a GCS score of 8 or less within 48 hours after head injury.

Estimation of intracranial pressure by CT scan in closed head trauma.

The predictive values of certain features of computerized tomographic (CT) scans in estimating intracranial pressure (ICP) were investigated in 40 patients following closed head injuries. The various features of CT scans selected for study included ventricular compression, the size of the parenchymal mass lesion, midline shift, and an intraventricular clot. All patients with intraventricular clot exhibited severe elevation of pressure.

Free and conjugated dopamine in human ventricular fluid.

Free dopamine and an acid hydrolyzable conjugate of dopamine were measured in human ventricular fluid specimens with a radioenzymatic assay and by high performance liquid chromatography (HPLC) with electrochemical detection. Only trace amounts of free norepinephrine and dopamine were detected in ventricular fluid from patients with movement disorders. When the ventricular fluid was hydrolyzed by heating in HClO4 by lyophilization in dilute HClO4, however, a substantial amount of free dopamine was released.

Acute epidural hematoma following epileptic seizures.

In cases of acute cranial epidural hematoma following trauma incurred during a major motor seizure, the symptoms and signs of the hematoma can be erroneously attributed to the postictal state. Since delay in diagnosis commonly leads to a poor or fatal outcome, an expanding mass should be suspected when status epilepticus, focal seizures, or postictal neurological deficits appear in an epileptic who has not previously had these symptoms.

Diminished ventricular fluid dopamine metabolites in adult-onset dystonia.

Homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA), the respective metabolites of dopamine and serotonin, were measured in ventricular fluid obtained from 20 patients with torsion dystonia at the time of ventriculography prior to thalamic surgery. The patients could be divided into two distinct types of dystonia--childhood-onset and adult-onset--which were identifiable on clinical and biochemical grounds. In the 14 patients with childhood-onset dystonia, the first symptom appeared in one limb in early childhood and the disease usually progressed rapidly.

Ventricular fluid homovanillic acid and 5-hydroxyindoleacetic acid concentrations in patients with movement disorders.

Ventricular fluid concentrations of homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA), the respective metabolites of dopamine and serotonin, were measured in 57 patients undergoing thalamotomy for relief of movement disorders. The diseases included were Parkinson disease, dystonia, cerebral palsy, multiple sclerosis, and posttraumatic or posthypoxic encephalopathy. Untreated parkinsonian patients had the lowest mean HVA level (119 ng per milliliter).

Definitive treatment of chronic subdural hematoma by twist-drill craniostomy and closed-system drainage.

A simple method of bedside twist-drill craniostomy and closed-system drainage for evacuation of chronic and subactue subdural hematoma is introduced. The principles and theoretical considerations that form the basis for this technique are discussed. The technique was used in 21 patients with chronic or subacute subdural hematoma; it has produced results superior to those of the conventional methods used in our patient population.

Intracranial surgery for cerebral artery aneurysms. Five years' experience.

During the previous five years, there were 133 cases of intracranial surgery for cerebral artery aneurysms. For patients with aneurysms in the anterior circulation and in good preoperative condition, the surgical morbidity was 28% and the mortality was 19%. A depressed sensorium preoperatively, an age of 50 years or above, and an interval of less than 15 days from rupture to surgery were associated with markedly increased mortality.

Complication of a large cranial defect. Case report.

A patient with acute subdural hematoma was successfully treated with hemicraniectomy. He developed contralateral weakness 4 months after surgery which was reversed by cranioplasty. The presumptive mechanism is a gradient between atmospheric and intracranial pressure.