Luminescent light diffuser for diffuse lighting applications.

The lighting industry currently accounts for a significant proportion of all energy demand. Luminescent white lighting is often impure, inefficient, expensive, and detrimentally emits as a point source, meaning the light is emitted from a focused point. A luminescent light diffuser offers the potential to create a spatially broad lighting fixture.

Spinal intramedullary teratoma with exophytic components: report of two cases and review of the literature.

True intramedullary teratoma is an extremely rare tumor, with only seven cases reported in the literature. The authors present two personal cases of spinal intramedullary cystic teratoma of the conus medullaris with exophytic growth and some unusual aspects. Their cases are unusual not only because they were diagnosed by MRI but also because the monitored microsurgical removal of the tumor was apparently total, with excellent results, in clinical and neuroradiologic terms.

Intraoperative cervical epidurography: a simple modality for assessing the adequacy of decompression during anterior cervical procedures. Technical note.

Object: Intraoperative cervical epidurography (ICE) was used during anterior cervical procedures to assess the success of bone resection and indicate the need for immediate correction in the event of inadequate decompression.

Methods: The adequacy of decompression was assessed by the operating neurosurgeon who performed ICE after anterior microdiscectomy with exposure of the dura mater. If the decompression was deemed inadequate, additional bone was removed using a high-speed drill.

Bilateral subdural effusion and cerebral displacement associated with spontaneous intracranial hypotension: diagnostic and management strategies. Report of two cases.

The authors describe two patients with bilateral subdural effusion and cerebral displacement associated with spontaneous intracranial hypotension (SIH) and discuss the possible pathophysiological origins of these abnormalities. The signs seen on magnetic resonance imaging in both cases, such as tonsillar descent, subdural effusion, meningeal enhancement, downward displacement of the optic chiasm, and crowding of this structure and the hypothalamus between the pituitary gland and brain, can help to establish the diagnosis of SIH. Therapy with a lumbar epidural blood patch resulted in the rapid resolution of all symptoms and most morphological abnormalities.

Unilateral decompressive craniectomy for children with severe brain injury. Report of seven cases and review of the relevant literature.

Unlabelled: Severe head injuries in children (under 15 years of age) have many features that differentiate them from head injuries in adults. In such cases, non-surgical treatment cannot always prevent fatal herniation. We report on seven cases of children with severe head injury, presenting with decorticate posturing and treated by unilateral decompressive craniectomy.

Combined transarticular lateral and medial approach with partial facetectomy for lumbar foraminal stenosis. Technical note.

The authors performed a microsurgical combined transarticular lateral and medial procedure with partial facetectomy in 24 patients (16 men and nine women) with lumbar intervertebral foraminal stenosis to decompress the affected nerve root. The goal of this surgery was to maintain the integrity of the facet joint, to guarantee satisfactory exploration, and to obtain a sufficient decompression of the intervertebral foramen. Because only minimal bone resection is required, the risk of secondary instability induced by complete facetectomy is avoided.

Ocular manifestations of sphenoid mucoceles: clinical features and neurosurgical management of three cases and review of the literature.

Background: Sphenoid mucoceles (SMCs) are unusual lesions, with about 130 cases reported in the literature. Although benign, they may involve the orbit and cause acute restrictive ophthalmoplegia, proptosis, and reduced visual acuity.

Methods And Results: We present three cases (1 male, 2 females, aged 35, 36, and 46 years) of orbital involvement with acute decreased visual acuity by SMC.

Gliomatosis cerebri: intra vitam stereotactic determination in two cases and review of the literature.

Gliomatosis cerebri (GC) is an infiltrative neoplastic process that is diffusely distributed through neural structures, whose anatomical configuration remains intact. Most of the cases with GC reported in the literature were diagnosed at autopsy (101/110, 92%). We report two cases of GC in a 42-year-old woman and a 65-year-old man.

The value of intraoperative angiography in surgery of intracranial aneurysms: a prospective study in 126 patients.

The value of intraoperative digital subtraction angiography in surgery for intracranial aneurysms, the benefits and cost-effectiveness are a matter of discussion. We prospectively studied 126 patients with 144 aneurysms, most on the anterior intracranial circulation, who underwent clipping and intraoperative angiography. Follow-up was 28.

Posterior cervical foraminotomy. A follow-up study of 67 surgically treated patients with compressive radiculopathy.

A retrospective study was conducted on 67 patients undergoing posterior cervical foraminotomy (PCF) for unilateral intraforaminal soft and hard disc disease. Neurologic impairment, employment, and severity of associated signs were assessed preoperatively and at a 3.1-year average follow-up (range, 1.

[Acupuncture and other forms of treatment for patients with chronic back pain].

As in all pain sites, one has to distinguish between acute and chronic pain in spinal pain syndromes. The treatment of chronic spinal pain is dominated by non-operative procedures. There are three main procedures in this field of treatment: the manual medicine, the therapeutic application of local anesthetics and acupuncture.

Malignant prolactinoma: case report and review of the literature.

Background: Malignant prolactinomas are rare events. To date, only 14 patients with metastases in- or outside the central nervous system have been reported.

Case Description: We present a patient who developed a metastasis to the cauda equina, which is the first case documented with MRI.

[Why still use myelography in neurosurgery?].

Recently CT scan and NMR imaging have become diagnostic routine methods for spine lesions, while myelography is no longer the method of choice in most cases. From the experience of our clinic, however, there remain some neurosurgical indications, which will be the contents of this publication. We would like to give a review of the present literature.

[Supratentorial glioma: analysis of clinical and temporal parameters in 163 cases].

163 cases of supratentorial astrocytomas and glioblastomas were evaluated retrospectively after close-meshed observation and treatment. We attached the greatest importance to the reevaluation of already known prognostic parameters and to the temporal analysis of the course of gliomas. We could confirm the influence of the histologic grade on the survival time.

[Whiplash trauma of the cervical spine from the neurosurgical, traumatologic and psychologic viewpoint].

Since the early 50's, whiplash injury has been a subject of intensive study in order to find out the genesis of this disease. Unfortunately, most of the studies were planned retrospectively and were based on inhomogeneous groups of patients. In our prospective study, we tried to keep the patient group homogeneous.

Somatosensory and auditory brainstem evoked potentials during choroid plexus angioma removal.

Intraoperative combined SEP and BAEP monitoring provides a high level of safety for patients undergoing high risk intracranial surgical procedures. We performed this type of monitoring in a rare case of choroid plexus angioma, embedded into the pulvinar of the right thalamus, which was resected via a transcallosal approach. The SEP pattern deteriorated during parietal brain retraction and thalamic dissection, but never completely disappeared.

Peri-operative elastase-alpha-1 proteinase inhibitor in patients with postoperative intervertebral discitis.

In a prospective study of 251 patients operated upon for lumbar disc herniation it has been investigated whether the preoperative and early postoperative values of Elastase-alpha-1 Proteinase Inhibitor (EPI)-an indicator of inflammatory processes-and C-reactive Protein (CRP)-a well known predictor of some postoperative complications-were correlated to the later development of discitis. Postoperatively discitis developed in 14 patients. A randomly chosen group of 15 complication-free patients out of the total of 251 cases was used as control group.

Development of supratentorial astrocytomas.

Six cases of supratentorial astrocytomas are presented in this study in order to demonstrate the typical development of this kind of tumors. All patients were controlled regularly by CT scan. Five of them were operated two times, one patient three times.

Microthrombi formation after severe head trauma.

This study was undertaken to look for trauma-related fibrinous microthrombi in traumatized human brains. Fifty brains from patients with variable time intervals between trauma and death were fixed in 10% formaldehyde. Sections from the contusioned area and from the corresponding area of the contralateral hemisphere were embedded in paraffin and 50 non-traumatized brains were used as controls.

[Percutaneous lumbar thermal sympathectomy: method, indications and results].

Thermal lumbar sympathectomy has been the method of choice since the 'eighties in the treatment of reflex dystrophy. We are using this method since January 1990. First results are presented and critically analysed.

[Spontaneous healing of a carotid-cavernous sinus fistula].

After a fall, a 67-year-old patient was admitted to our hospital. The unique clinical sign was an exophthalmus, which led to the diagnosis of carotid-cavernous sinus fistula. During his stay in our clinic the fistula was verified by CT and angiography.

Clinical and electrodiagnostic findings, nerve biopsy and blood group markers in a family with hereditary neuropathy with liability to pressure palsies.

Clinical, electrophysiologic and biopsy findings as well as studies of blood group markers in a family with hereditary neuropathy with liability to pressure palsies (HNPP) are reported. There was an autosomal dominant trait without genetic linkage between the HNPP gene and blood group markers controlled by chromosome 1. Reduced motor and sensory nerve conduction velocity was found in clinically affected and unaffected nerves.

Free sequestered disc herniation at the S2 level misdiagnosed as neuroma.

The case of a 38 year-old-man with a mass at the S2 level similar to a benign nerve root tumor (neuroma) is reported. The CT scan examination revealed the mass close underneath but not in connection with a disc herniation at the L5/S1 level. During operation the mass was not encountered as tumor but as free sequestered disc herniation, which was confirmed by histological examination.

The prognostic value of somatosensory evoked potential monitoring and tumor data in supratentorial tumor removal.

The aim of this study was to find appropriate somatosensory evoked potential (SSEP) and tumor data that would predict immediate postoperative outcome. Seventeen patients were evaluated, all with supratentorial mass lesions. Intraoperative SSEP monitoring was carried out, and central conduction time, N20 amplitude, and N20 to N13 amplitude ratio were recorded throughout the operation.

Changes of somatosensory evoked potentials with increase of intracranial pressure in the rat's brain.

Somatosensory evoked potentials (SEPs) to various combinations of two independent brain compression modalities (localized epidural pressure and intracerebral pressure evoked by an inserted balloon) were investigated in 24 rats. The SEP pattern in response to gradually expanding volume without additional epidural pressure remained unchanged for a certain period. SEP changes occurred only shortly prior to death.