Documented rupture of venous aneurysms associated with arteriovenous fistulas is uncommon, and reports of the formation and rupture of venous aneurysms that are not associated with fistulas are distinctly rare. One case is presented in which spontaneous rupture of a saccular aneurysm on a vessel draining an arteriovenous fistula produced an intracerebral hematoma. A second case in described in which fatal intracerebral hemorrhage was produced by a traumatic aneurysm of an otherwise normal superficial cerebral vein.
SununaryA retrospective analysis is presented of 46 patients with cervical spondylotic myelopathy treated by anterior cervical decompression and fusion. In each case the spondylosis was localised and a maximum of two intervertebral levels was fused.Operation had been carried out 7.0 to 14.4 years (mean 10.0 years) previously and the mean age at surgery was 60 years. Disability was such that no patient was able to work prior to operation and only 10 patients (22° 0) could walk unaided. The functional results, in terms of walking ability, show that 36 patients (78°0) have been improved, six (13°0) remain unchanged and in 4 patients (9°0) the disease has progressed. Twenty nine patients (63 0 0) were able to walk without aid at the time of review. On a subjective basis 30 patients (65°0) felt that they had benefitted from surgery.
Spinal epidural abscess is seldom encountered in children and rarely occurs in the absence of spinal pain. A case is described in which a child with a thoracic epidural abscess presented with abdominal rather than spinal pain. Thoracolumbar radicular inflammation and visceroparietal reflexes initiated by a s'spinal ileus' probably produced the symptoms and signs of acute intra-abdominal disease. Consideration of intraspinal disease is advisable in all cases of acute abdomen which exhibit atypical features.
We describe two patients with neurofibromatosis, each of whom was found to have an arteriovenous malformation (AVM), an uncommon manifestation of the disease, presenting as an extradural space-occupying lesion in the cervical spine. In one patient the finding of an unsuspected AVM at operation led to massive blood loss; in the other magnetic resonance imaging (MRI) of the neck allowed the diagnosis to be made and the hazard of an operation to be avoided. Solid tumours that may occur in the disease of neurofibromatosis are known to cause neurological deficits as the result of space occupation. We wish to draw attention to another pathological entity which may cause neurological deficits: that of AVMs. We also propose that in the investigation of such a patient MRI be borne in mind as a non-invasive radiological tool, particularly as, hopefully, its cost reduces and its availability becomes more widespread.
level, pupil reaction, and corneal reflex. However, there were many discrepancies in individual patients so that the vestibulo-ocular reflex afforded useful information additional to that obtained from traditional tests. Bilateral abnormal motor activity or absent pupil reactions were often associated with relatively unimpaired vestibulo-ocular reflex responses. There was no correlation between abnormal
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