Asymptomatic aneurysm of the cavernous and supraclinoid internal carotid artery in a patient with Balamuthia mandrillaris encephalitis.

This is the first report to our knowledge of the successful treatment of an asymptomatic mycotic aneurysm associated with Balamuthia mandrillaris encephalitis. A 27-year-old male with end-stage renal disease presented with generalized seizures following renal transplantation. MRI demonstrated multiple brain masses and an aneurysm of the cavernous and supraclinoid carotid artery.

Neurosurgical intervention in the diagnosis and treatment of Balamuthia mandrillaris encephalitis.

The authors describe the unique presentation of Balamuthia mandrillaris encephalitis in a kidney donor and two recipients. All three patients suffered acute clinical deterioration, with radiological or clinical evidence of intracranial hypertension. Brain autopsy in the donor and an urgent brain biopsy in a recipient established the diagnosis.

Treatment and outcomes for pediatric head injuries in Mississippi.

Object: This report summarizes the treatments and outcomes of a large series of patients with pediatric head injuries (PHIs), who were admitted to a tertiary pediatric trauma center at the University of Mississippi Medical Center from January 1, 2003 through December 31, 2006.

Methods: Data were retrieved from the Department of Neurosurgery's Brain Trauma Registry (BTR) on patients who are ≤16 years old. Data include Glasgow Coma Scale (GCS) and injury severity scores (ISS) on admission and Glasgow Outcome Scale (GOS) scores at 6 months follow-up.

The development of military medical care for peripheral nerve injuries during World War I.

Although the clinical and electrical diagnoses and treatments of peripheral nerve injuries (PNIs) had been described prior to World War I, many reports were fragmented and incomplete. Individual physicians' experiences were not extensive, and in 1914 the patient with a PNI remained a subject of medical curiosity, and was hardly a focus of comprehensive care. World War I altered these conditions; casualties with septic wounds and PNIs swamped the general hospitals.

Cerebrovascular physiology in perinates with congenital hydrocephalus.

Purpose: This study investigated changes in regional cerebral blood flow (rCBF), autoregulation (AR), and mean CO(2) reactivity (CO(2)r) in nine neonates, who underwent cerebrospinal fluid (CSF) diversion for congenital hydrocephalus.

Methods: During shunt insertion, a thermal diffusion probe inserted adjacent to the ventricular catheter in the right parietal region recorded rCBF. Changes in rCBF, mean arterial pressure, intracranial pressure (ICP), and expired CO(2) tension were recorded before and after removing CSF.

An uncommon illness with a rare presentation: neurosurgical management of ADEM with tumefactive demyelination in children.

Purpose: This study determined the statewide incidence and prevalence of acute disseminated encephalomyelitis (ADEM) and examined the course of three pediatric patients treated for tumefactive demyelination (TD) at the Blair E. Batson Children's Hospital.

Methods: Analyses of ICD-9-CM code hospital records and clinical database were conducted.

Cauda equina syndrome (CES) from lumbar disc herniations.

Study Design: A retrospective review was performed to determine the outcomes of patients with cauda equina syndrome (CES) from a herniated lumbar disc at our institutions.

Objective: CES from lumbar herniated discs is considered the only absolute indication for surgery. It is considered a neurosurgical emergency with the outcome related to how quickly it is diagnosed and treated.

Tumefaction of the dural sinuses associated with a coagulopathy following treatment of hydrocephalus in a perinate: case report.

The authors describe an infant with abnormal development of the cerebral venous system associated with in utero ventriculomegaly and perinatal hemorrhage. When the patient was 6 weeks of age progressive ventriculomegaly followed by cerebrospinal fluid diversion resulted in tumefaction of the dural sinuses, intravascular thrombosis, and a coagulopathy. Oral anticoagulation therapy safely reversed the coagulopathy.

Nelson's wound: treatment of spinal cord injury in 19th and early 20th century military conflicts.

During the first half of the 19th century, warfare did not provide a background for a systematic analysis of spinal cord injury (SCI). Medical officers participating in the Peninsular and Crimean Wars emphasized the dismal prognosis of this injury, although authors of sketchy civil reports persuaded a few surgeons to operate on closed fractures. The American Medical and Surgical History of the War of the Rebellion was the first text to provide summary of results in 642 cases of gunshot wounds of the spine.

Headaches, shunts, and obstructive sleep apnea: report of two cases.

Objective: This report describes two shunted patients evaluated with continuous intracranial pressure (ICP) monitors for worsening headaches and subsequently diagnosed with obstructive sleep apnea.

Clinical Presentation And Intervention: ICPs were monitored with strain-gauge sensors inserted into the frontal cortex. After the initial diagnosis of sleep apnea, 8-hour attended polysomnography was performed in each patient.

Intracranial hemorrhage following blunt injury to a shunt valve.

Case Report: The authors report a case of a child who sustained blunt injury to a shunt valve during a basketball game, which resulted in an intracranial hemorrhage.

Conclusion: This occurrence, although rare, reinforces the recommendation for protective headgear when patients with shunts engage in activities that may result in direct impact to the head.

Surgery of the head and 70-day brain surgeons.

In 1917, the Sugeon General of the United States Army, William Gorgas, learned that almost 15% of the casualties on the Western Front sustained intracranial injuries. Soon after the United States declared war in April 1917, the Council of National Defense established a General Medical Board and attached a brain surgery subsection to its Committee of Ophthalmology. Postcards were sent to experts around the country, asking for the names of individuals who had specialty training or practice in brain surgery.

Changes in visual acuity associated with shunt failure.

Object: The object of this article was to report on a retrospective analysis of the clinical findings in a series of patients with changes in visual acuity associated with shunt failure.

Methods And Results: Over a 10-year period, 350 patients underwent revisions for shunt failure. The clinical course of patients who demonstrated changes in visual acuity (VA) before or during hospitalization were reviewed; follow-up was achieved using outpatient records and telephone calls with physicians, family, or caregivers.

The use of recombinant activated factor VII to reverse warfarin-induced anticoagulation in patients with hemorrhages in the central nervous system: preliminary findings.

Object: In this report the authors describe the use of the hemostatic agent recombinant activated factor VII (rFVIIa) in the perioperative treatment of hemorrhages in the central nervous system that are associated with warfarin therapy.

Methods: Two patients sustained hemorrhages within the spinal canal, and the other two had acute intracranial subdural hematomas. All patients had normal platelet counts, activated partial thromboplastin times, and fibrinogen levels, and all received fresh frozen plasma in conjunction with rFVIIa.