Faculty Bibliography

The frequency and degree of gastrointestinal (GI) bleeding were examined in 131 patients with spinal cord injuries. All patients were randomly assigned to either high- or low-dose steroid regimens and some form of GI prophylaxis. The latter consisted of antacids alone or antacids supplemented with cimetidine when this medication became available. Segments of the population were treated with mini-dose or full-dose heparin. The incidence and degree of GI bleeding did not appear to be affected by steroid dose level, regimen of prophylaxis, or mini-dose heparin. Only full heparinization was found to significantly increase bleeding. These results place in question the benefits of adding cimetidine to antacids as a prophylactic atreatment in patients with no history of ulcer

The New York University Spinal Cord Trauma Center recently completed an evaluation of 200 patients seen over a period of four years, from 1974 to 1978. A unique group of 23 patients with cervical spinal stenosis and myelopathy without fracture or dislocation was isolated. The presence of a narrow canal significantly influenced morbidity and prognosis. Based on a review of plain roentgenograms and myelograms, there were seven patients with an average age of 41 who had absolute low levels of narrowing of the spinal canal without evidence of degenerative changes. The remaining 16 patients, averaging 61 years of age, had superimposed spondylosis. In both groups, patients with the lowest anteroposterior diameters of the spinal canal had the most severe myelopathy after trauma. Patients with absolute stenosis were more susceptible to traumatic myelopathy than were those with relative stenosis. Varying the dose of steroids to maximal levels had no effect on prognosis. Patients showing improvement during the initial 48 hours had the greatest degree of eventual recovery

A patient with osteoblastoma of the T-11 vertebral body presented with symptoms of spinal cord compression. Six weeks after an emergency laminectomy and subtotal removal, spinal computerized tomography disclosed residual tumor, which was totally removed via a combined anterior transthoracic approach and posterior laminectomy

The computed tomographic (CT) scan has replaced angiography in the preoperative neurodiagnostic evaluation of the common pediatric posterior fossa tumors. This case report illustrates that rarely an atypical vascular anomaly may masquerade as a neoplasm and angiography must not be dismissed if the CT scan is any way atypical of the suspected neoplasm.