By order of the Head Injuries Committee of the W.F.N.S. the author and his coworkers give definitions of consciousness, clouding of consciouness and unconciousness or coma. Furthermore, they suggest a definition of the termination of unconsciousness, with particular reference to the transition into a stage of clouding of consciousness. Any statistical evaluation and comparison of different materials depend on the use of identical definitions. As an example, it has been shown that the duration of aa uninterrupted coma, which can be survived, becomes relatively short if in accordance with the proposed definitions the various stages of clouding of consciousness are excluded from "coma".
This report covers 38 Cases of intradural dermoids (4 cases) and epidermoids (34 cases). In most cases the clinical course extended over several years. At the time of admission to the clinic only 9 patients had purely local symptoms; symptoms from adjacent areas were present in 15 cases and elevated intracranial pressure in 13. Of the 35 operated patients, 16 were able to work again, and 7 died after the operation. Best results are achieved in cases involving young patients, in cases where the tumor is situated in the cerebral hemisphere, and in cases where the tumor can be totally removed. In recent years advances in diagnostic, surgical and anaesthetic techniques have lowered the lethality rate. Computed tomography is especially useful for an early diagnosis.
Based on the catamnestic evaluation of our own case material and the compilation of recent series from the literature, the indication for surgical intervention in spinal metastases is considered in the light of factors influencing the prognosis of the underlying malignant disease.
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