Enoxaparin combined with compression stockings is more effective than compression stockings alone for the prevention of venous thromboembolism after elective neurosurgery and does not cause excessive bleeding.
20 medulloblastomas in children were treated at the Neurosurgical Department of Perugia over the last 6 years. The age ranged between 1.2 and 15 years, with a mean of 8 years. The ratio between males and females was 3/1. Only three tumors were localized within one cerebellar hemisphere. A shunt was performed before the removal of the tumor in 12 cases. Radical resection was completed in 15 cases, whereas a subtotal removal was performed in the cases with involvement of the brain stem. The postoperative mortality rate was 5%. The 3-year survival rate was 40% and the 5-year 25%. The postoperative radiotherapy was given at lower doses than usually reported by other authors: this seems to reduce the neuropsychological and endocrinological sequelae. CCNU or BCNU were given after radiotherapy, but this monochemotherapy seems to be less effective than polychemotherapy with CCNU, vincristine, procarbazine and dexamethasone, used in this series when relapse occurred. Radical resection improved the prognosis. The opportunity of using different protocols for ‘low risk’ and for ‘high risk’ patients is finally discussed.
Clinical and radiological data are reported concerning 44 patients suffering from cervical spondylotic myeloradiculopathy, and operated by the posterior approach; late results are evaluated. Type of onset, signs and symptoms are specified. Myeloradicular involvement was present in 52% of cases, medullary in 41%, radicular in 7%. Congenital stenosis was present in 68% of patients. Laminectomy was performed at 2-3 levels in 4 cases, at 4 levels in 10 cases, at 5 levels in 14, and extended to 6 or more levels in 16 patients. Posterior foraminotomy was performed 28 times. At follow-up evaluation (6 months to 8 years) results were "excellent good" in 46% of cases, "fair" in 34%, "unchanged" in 9%, and "worse" in 11%. First symptoms appeared more than 2 years before surgical treatment in 22 patients, between 2 years and 6 months in 15, and less than 6 months before in 7 patients. In this study a statistically significant inverse relation is demonstrated between: 1. results and duration of the disease, 2. results and gravity of motor deficits.
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