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The authors of this report suggested that the amount of residual aluminum in public drinking water supplies should be limited symptoms weight loss topamax 100 mg with visa. Sometimes these people developed bone or brain diseases that doctors think were caused by the excess aluminum medicine for pink eye order genuine topamax online. Compare the three categories of metals shown Virtually all food medicine 3605 purchase generic topamax on-line, water symptoms 6 days after embryo transfer topamax 200 mg free shipping, air, and soil contain some in Table 6. Why is lead contamination a concern for envi Exposure comes from breathing higher levels of ronmental health experts? Name some of the portals of entry into the It also occurs from living in areas where the air is human body for toxic metals. Describe the dusty, where aluminum is mined or processed into methods by which these toxic metals may access aluminum metal, near certain hazardous waste specifc portals of entry. Give some examples of environmental sources In addition, you might be exposed from eating of exposure of populations to toxic heavy metals. Exposure to heavy metals presents a serious (such as antacids) especially when eating or hazard to children. Give an example of a heavy metal to which Children and adults may be exposed to small amounts of aluminum from vaccinations. Provide the following information regarding Many heavy metals and other metallic compounds cadmium: occur almost universally in the environment, either in a. Modes of entry into the body sequently, the entire human population is exposed at c. Name of an associated disease metals in trace levels are essential for human nutri 9. Provide the following information regarding tion, the same metals are toxic at higher levels. Where it occurs in the environment example, arsenic, lead, and mercury are among the b. Provide the following information regarding tions in the drinking water of some areas of the world. Adverse health efects of exposure to lead with neurologic disease, has been identifed increas ingly as a contaminant of fsh and other foodstufs. Provide the following information regarding An important role for environmental policy makers is nickel: to reduce the level of toxic metals in the environment a. Two adverse efects of exposure to nickel stitute an important avenue of exposure of the human 13. How can you reduce your exposure to copper Study Questions and Exercises in tap water? Renal function and historical environmental cadmium pollution from zinc References smelters. Available at: the prevalence of cardiovascular diseases, and exposure. Exposure cancer mortality associated with arsenic in drinking water in of children to lead and cadmium from a mining area of Brazil. Environ cadmium levels in house dust in industrial areas of eastern Health Perspect. For example, regarding benefts, some chemi Hazardous chemicals, omnipresent in the environ cals are essential to modern society. Others may present ment, are vital to society yet simultaneously raise hazards such as human reproductive difculties. One expert has stated, The ubiquity of accidents are confronted with the practical issue of how toxic substances in the environment continues to be to protect the environment, the public, and themselves a signifcant public health concern. The chapter concludes with which are used for storage of numerous potentially coverage of how organic chemicals that are released into dangerous chemicals. Some of the returning ing levels of exposure to environmental chemicals, soldiers developed symptoms of what came to be serious concerns remain regarding the exposure of known as the Gulf War Syndrome. On a typical day, people encounter numerous chemicals, many of which are One should take a balanced view of the advantages known to be injurious to human health and the and disadvantages of hazardous chemicals. A large percentage of these chemicals consider the advantages: Although chemicals have have not been tested at all. Possible adverse health the potential to cause harm, they are essential to consequences that have been linked to those chem the functioning of modern society. In fact, human icals that have been tested include impairment of ity could not live without them. One illustration is chemical incidents that our phones and computers, many building cause the dispersal of hazardous substances from materials, rugs and other furnishings?you industrial facilities and other sources. Surveillance data enable public health and safety professionals to better understand the patterns and causes of these incidents, which can improve prevention eforts and preparation for future incidents. During 1999?2008, a total of 57,975 chemical incidents occurred: 41,993 (72%) occurred at fxed facilities, and 15,981 (28%) were transportation related. The most common contributing factors for an incident were equipment failure (n = 22,535, 48% of incidents) and human error (n = 16,534, 36%). As shown in the table, carbon monoxide exposure was the source of the greatest numbers of injuries and deaths during the period of observation. During 2001?2012, a total of 1,325 meth-related chemical incidents were reported in the fve states. In 87 (7%) of the meth-related chemical incidents, 162 persons were injured, including at least 26 (16%) children. Among those injured, 136 (84%) were treated at a hospital, including 19 (73%) children; 36 (22%) injured persons, including 19 (73%) children, required hospital admission. Two adults died: one, who might have been a meth cook, was found dead in a meth laboratory; the second was a law enforcement ofcial. The most commonly reported injuries were respiratory irritation (44%), chemical and thermal burns (27%), and eye irritation (22%). Chemical and thermal burns signifcantly increased, from 7% during 2005?2007 to 44% during 2008?2012. Most injuries were to members of the general public (97) and law enforcement ofcials (42), followed by employees working in areas where meth contamination occurs, including hotels and motels, abandoned buildings, and treatment centers (14); and frefghters (7). The most commonly reported injuries among the general public were burns (43%) and respiratory irritation (37%); among injured law enforcement ofcials, respiratory irritation (64%), and eye irritation (38%) were most frequently reported. Among the 14 injured employees, nine reported headache, seven respiratory irritation, and seven eye irritation. Data from fve states suggest that, beginning in 2005, when state and federal legislative eforts to restrict meth precursors were enacted, meth-related chemical incidents temporarily declined in those states. However, in 2008, as meth producers learned to circumvent laws and obtain restricted precursor drugs, and introduced the hazardous shake-and-bake? meth-making method, such incidents began to rise, as did the percentage of events with injuries, particularly burns. Persistent organic Toxic chemicals that adversely afect human health and the environment around the world. They persist for long periods of time in the environment and can accumulate and pass from one species to the next through the food chain. Terms Used to Describe Organic Chemicals include benzo(a)pyrene (BaP), benzo(b)fuo ranthene, and dibenzo(a,h)anthracene. However, Sometimes the term pesticide is used interchange spraying also exposes the people who live in pesticide ably by the public with insecticide. During the Pests can be insects, rodents, weeds, and a host of middle of the 18th century, control of insects was other unwanted organisms. Pesticides are usually accomplished by manually removing them or by using divided on the basis of their target. The major classes inorganic poisons that frequently were not very efec are insecticides, herbicides, rodenticides, and fungi tive. Tese inorganic chemicals and natural substances Pesticides are applied by a number of methods formed the arsenal of pest control weapons. Although An example was the category of organophosphate highly efcient, these methods of spraying can pesticides. The Golden Age of Discovery? of insec cause pesticide drif and lead to contamination of ticides occurred in the mid-1900s, with the invention waterways. The family of pesticides includes herbicides, insecticides, rodenticides, fungicides, and bactericides. Most of the pes of consciousness; cramping of the abdominal area may ticides from the third group, organochlorines, have occur; and in extreme cases, death may ensue.

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Several psychological medications names and uses purchase topamax 100 mg on-line, psychiatric medications at 8 weeks pregnant cheap 100 mg topamax free shipping, contextual and work-related factors medicine lodge ks purchase discount topamax line, identified as yellow acute treatment cheap topamax 100 mg without prescription, orange, blue and black flags, should be included in the clinical decision-making process. A list of these flags is presented in the box 2 of the synthesis of this guideline. In the Belgian care pathway, it is proposed not to perform the risk stratification at the first contact, certainly if this one occurs before 48 hours after the pain onset, but rather during a second encounter (around 2 weeks). Therefore the management is based more on patients? needs than on the complaints characteristics. For the Orebro, the long version was considered not acceptable and the short version was preferred. The short version of the Orebro is also translated in French and Dutch although this versions were not formally validated yet. This risk stratification should not be performed during the first 48h after the pain onset*. The aim of the risk stratification is to inform shared decision-making about stratified management. Based on risk stratification, consider: particular the addition of the Orebro Musculoskeletal Pain Screening o simpler and less intensive support for people patients with low back Questionnaire as example and a specification regarding the timing for the pain with or without sciatica radicular pain likely to improve quickly first risk stratification. Minor changes are also presented for consistency in and have a good outcome (for example, reassurance, advice to the formulation of all recommendations (sein other topics). This risk stratification should not be performed during the first 48h intervention such as cognitive-behavioural approach). The aim of the risk stratification is to inform shared the reasons underlying these changes are described in Appendix 7. No clinically important difference was demonstrated in pain severity at > 4 months. This analysis was assessed as partially applicable with potentially serious limitations Conclusions No clear evidence favouring imaging (compared to no imaging or deferred imaging) was found in people with low back pain or radicular pain. In terms of healthcare utilization, no clinical difference or a clinical benefit favouring no imaging or deferred imaging was shown compared to imaging within the first 30 days (very low quality evidence). In the single cost-utility analysis, limited evidence suggested that early imaging was cost-effective to delayed imaging. The positive results observed in specialized setting maybe not generalizable to all patients with low back pain and/or radicular pain (more severe or chronic disease; more specialized clinicians with greater abilities to diagnose specific low back pain disease justifying an imaging). Moreover, unnecessary imaging may generate anxiety if benign findings are interpreted by the patient (or the clinician) as indicating a serious or clinically relevant pathology. In Belgium, since the primary care is not a gatekeeper and patients have direct access to physicians, specialized clinicians can be the first health care provider consulted by a patient with a first episode of low back pain. However, for most of the comparisons, evidence came from a small number of studies. However, many of the imaging findings one would associate with low back pain causation (for example; disc and joint degeneration) are frequently found in asymptomatic individuals and imaging is often unable to confirm or refute a provisional diagnosis. However, on the basis of the clinical and cost-effectiveness evidence reviewed, in instances where imaging was not likely to change management, it was considered that people might accept the decision not to receive imaging. This information could be provided during the encounter with the clinician but also, by some public health campaigns using different media. Only studies) prescribe imaging if its expected result may lead to change management. According to the International Association for the Study of Pain, chronic pain is typically managed, but not cured. In this shift in treatment paradigm, self management has been considered as a promising treatment package. No other on assessment and non-invasive treatments and the forest plots in Appendix outcomes were reported and the quality of the evidence was assessed K p. Only one study per seven studies looking at combinations of non-invasive interventions (with comparison was included. Different kinds of self-management programs (patient education and reassurance, advice to stay active, advice to bed rest and unsupervised exercise) were compared to placebo/sham, usual care, each other, any other non-invasive intervention or to combined interventions in order to assess the clinical and cost effectiveness of self-management. One economic evaluation including unsupervised exercise (exercise prescription) as a comparator has been included in this review. No relevant economic evaluations were identified that included self-management programmes, advice to stay active or advice for bed rest as a comparator. Only a small benefit in QoL was seen in favour of self benefit on short term pain (not on function). In the comparison to other non benefits (on pain and function) were seen in the combination of self invasive interventions, no clinical differences could be demonstrated. Patients who received the advice to stay Economic evidence active perceived an increased function, at short term. The economic evaluation showed that adding exercise prescription to other interventions was more cost effective than each intervention alone. However, if there was a lack of placebo or sham controlled evidence, evidence against usual care will be given priority when decision making. Healthcare utilisation was reduced by the use of self-management but this could be biased by taking part in a trial. Review showed that there was no evidence that bed rest in the short term was harmful, but also no evidence to suggest that is was beneficial to do so. The members suggested to add a box with good and harmful advice proposed in O?Sullivan et al, 201410. Promotion of self-management may incur some minimal costs, but is an essential part of good patient care to ensure patients are adequately informed. Recommendations Strength of Level of Evidence Recommendation Experts opinion Moderate to very. Include: o Information on the benign nature of low back pain and radicular pain o Encouragement to continue with normal activities, exercise included. The term exercise therapy? encompasses a wide range of different exercise types, environments and theoretical models. The focus may vary from interventions was included in the review in order to assess the clinical and exercise using specialist gym equipment to exercises conducted at home or cost-effectiveness of different types of exercise. Exercise may be directed at improving a variety was identified in patients with low back pain without sciatica and four of parameters of fitness and function including muscle strength, timing or economic evaluations were found in the mixed population (low back pain endurance, flexibility and range of motion, precision of movement, with or without sciatica). The same definition of acute has been unclear, resulting in a variety of practices. For clarity reasons, no distinction has been Definition of exercise therapies as included in the review made between acute and subacute low back pain. For pain and function the results are less complaints was not clearly stated in the study, therefore no distinction consistent but overall more beneficial in favour of biomechanical can be made between the efficacy in acute and chronic low back pain exercises for pain improvement than for function. No clinical differences were found at both time points for QoL were reported in the group undertaking the biomechanical exercises. In (except for long-term physical component in favour of biomechanical the pooled data, studies on acute and chronic low back pain patients exercises), pain and function when biomechanical exercises were were mixed. No evidence was found on pain and function was noted in a combined intervention of acute low back pain patients. In the retrieved studies either only chronic patients were (see Tables 9 and 17 in Appendix 7. No evidence was found on the efficacy of pain complaints was not clearly stated, therefore no separate statement individual aerobic exercises in patients with acute low back pain. One study comparing aerobic exercises to (group) patients with acute low back pain. No evidence was found on the efficacy of at long term a clinical improvement in favour of biomechanical group aerobic exercises in patients with acute low back pain. No evidence was found on acute low pain was not associated with an improvement in function. No evidence was found on the efficacy of mind-body exercises in patients with acute low back pain. Evidence from 1 small study showed short term clinical (at both time points) were found between aerobic or (group) benefit of yoga on pain and function, whereas a study on tai chi found biomechanical exercises, a clinical benefit in short-term pain was noted no clinically important differences on short-term pain (no data on in the aerobic exercise group compared to the group who received self function reported). No evidence was found on the efficacy of group aerobic exercises in patients with acute low back pain.

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When pain is persistent and/or severe treatment norovirus purchase cheapest topamax and topamax, it can be associated with a significant loss of function or disability medications you cant crush 100mg topamax amex. While back pain is not in itself fatal symptoms of pneumonia buy cheap topamax 200mg on line, the health burden is large when considered across the (6) population medications causing dry mouth buy discount topamax 200 mg on line. The patient groups considered are outlined in Table 2 and differ in terms of persistence and severity of clinical presentation. Prevalence increased with age such that 20% of those aged over 65 years were affected. However, back conditions are rarely a primary cause of death, with only 12 deaths reported in 2006. It also considered back pain from the context of chronic pain rather than acute episodes. In the United Kingdom, low back pain was identified as the most common cause of disability in young adults, with more than 100 million workdays lost per year. Including lumbago (low back pain), sciatica, other chronic back pain and chronic neck pain, and vertebral or disc related diseases. Source: New Zealand Burden of Diseases, Injuries and Risk Factors Study, 2006-2016(6) 2. In most cases the cause of the pain is non-specific and a conclusive diagnosis is not possible or useful. The exception to this is cases where Red Flags, indicative of a serious underlying pathology or other significant neurological deficits, are present; such cases require immediate evaluation and referral where appropriate (Table 4). Table 4: Summary of Red Flags? that indicate potentially serious conditions and Yellow Flags? that represent psychosocial barriers to recovery from acute low back pain Red flags for a high likelihood of a serious underlying pathology Sign/symptom Concern Signs or symptoms of cauda equina syndrome. Similar to acute back pain, the building blocks for the management of chronic back pain are clinical assessment to exclude Red Flags or other specific conditions, advice and information to promote patient self-management, including exercise and (11, 12) return to usual activities as much as possible. Analgesia is provided through a stepped approach, and combined with treatment programmes including exercise, spinal manipulation and/or acupuncture (Figure 3). Any psychological distress, or Yellow Flags, that present barriers to recovery must be addressed. For those patients who fail to respond, an intensive multidisciplinary pain programme, including physical and cognitive behavioural therapy, is recommended. Surgery may be considered for selected patients, who meet the criteria and are willing to consider surgery; indications and patient selection for spinal surgery are discussed further in Section 7. These are outlined in the pathway in Figure 3 which is derived two international guides; the National Institute for Health and Care Excellence. Patients are only prioritised for surgery once the clinician has determined that surgery is the best treatment option. This model focuses on improvements to the interface between primary and secondary care, both before (13) and after referral, and extending into the treatment phase. This pathway is a continuation of that shown in Figure 3, which focuses on the first 12 months of management. The validated tool is used to allocate patients with both acute and chronic pain to one of three groups based on an Page 19 National Health Committee Low Back Pain: A Pathway to Prioritisation (15) assessment of their prognosis. Risk is categorised using a 9 point scale that covers physical and 3 psychological function. If there is a failure to respond, the next step is: referral to secondary care for assessment by a multi-disciplinary team, access to imaging, specialist injections, pain management services and surgery. The commissioning guide also recommends audit and peer review measures and quality indicators to aid the implementation of high value pathways. The tool produces a final score that shows strong correlation with clinical rating and is based on a number of input components: ? It is envisaged that scores may show variation within providers initially as a result of differences in resources between sub-specialities. Overtime it is expected that the thresholds will equalise as local resources are adjusted. In the 2015 budget, the Minister of Health allocated an extra $98m for more elective surgery in order to improve the prevention and optimise the treatment of orthopaedic conditions. An expert multidisciplinary advisory group has been tasked by the Ministry of Health to provide advice on the approach, scope and scale of any projects undertaken. They will guide the electives team where priorities lie and how to undertake these community based projects. This establishment of the advisory group is in the early stages of establishment and the group is finalising their approach to the roll out of projects. Page 22 National Health Committee Low Back Pain: A Pathway to Prioritisation 7 Intervention points on the pathway 7. Approximately 90% of older adults have incidental findings on spine imaging that can (17, 19) lead to unnecessary interventions with associated morbidity. Muscle relaxants, such as orphenadrine, may be considered where pain is related to muscle spasms and simple analgesics are not adequate. Escalation of pain management in chronic pain to third-line medications includes alternative classes of medication; tricyclic antidepressants (at (20) lower doses than used for depression), other anti-depressants and anti-convulsants in patients who don?t respond to simple analgesics. Gastro protectant medication may be used for those who develop symptoms on treatment, or with a previously known Page 23 National Health Committee Low Back Pain: A Pathway to Prioritisation (12) sensitivity, and is recommended in those over the age of 45 years. Treatment with regular paracetamol and diclofenac acid with omeprazole (as a gastro protectant) could be expected to cost less than $20 to $50 per month, depending on formulation, while treatment with codeine and/or the tricyclic antidepressant amitriptyline could be expected to cost less than $20 per month. Pharmaceutical costs may be in the range of $30 to (22) $300 per month, depending on the choice of agent. Furthermore, there may be additional costs around managing opioid treatment to minimise the risk of dependence or abuse. However, the issues around prescribing of opioids are not back pain-specific and outside the scope of this report. Private treatment from a spinal manipulation practitioner is usually in the range of $50 to $75 per visit. However, guidelines for back pain limit the duration of spinal manipulation treatment, mitigating the risk of inappropriate expenditure in this area. For lower risk patients, fewer sessions may be required, but for higher risk patients the addition of psychological services is (14) recommended. Manual therapies show modest effect and are more cost effective when (12) combined with exercise programmes. Furthermore, the risk of inappropriate use will be further diminished by adherence to good practice guidelines that treatment should be discontinued and/or an alternative method employed if there is not a good response after an appropriate number of sessions. The stratified approach shows improvement in disability, quality of life and cost savings compared to (15) standard care. Guidelines recommend a treatment programme for up to 12 weeks, including a structured exercise programme (11, 12) and/or spinal manipulation and/or acupuncture. Where patients do not improve after at least one treatment programme, cognitive-behavioural therapy and/or multidisciplinary chronic pain programmes (in combination with exercise programmes) may be required. There is some evidence that comprehensive multidisciplinary pain programmes have good cost (25, 26) effectiveness and may even be cost saving. The Australian National Pain Strategy states that expert consensus and a growing body of research shows that best-practice pain management often requires interdisciplinary assessment and management, addressing physical, psychological and environmental factors. While this model of care is provided by comprehensive multidisciplinary pain programmes, these (27) programmes often have long waiting lists and are poorly integrated with other services. The use of epidural corticosteroid injections in spinal stenosis has limited benefit. The appropriate selection of patients is complex, and in order to avoid inappropriate use of surgery that is unnecessary, ineffective or a poor use of resources; it is critical that the patient is only prioritised for surgery once the clinician has determined that surgery is the best treatment option. Decompressive surgery is an option where the patient has sciatica or other radiculopathy (indicated by leg-dominant pain caused by compression or inflammation of spinal nerves or neurogenic (11) claudication) that does not resolve after 6? Surgery may also be appropriate where there is evidence of a defined disc lesion and ongoing pain beyond 6? Laminectomy is a decompressive surgery that is commonly used to alleviate pain associated with spinal stenosis, in which pressure on the nerves is created by enlargement of the facet joints and narrowing of the intervertebral foramina through which the nerves pass. Laminectomy removes a small portion of the vertebral bone over the nerve root and/or disc material, bone spurs and ligaments that are pressing on nerves. The majority of patients with spinal stenosis are treated non-operatively and report no substantial change in symptoms over a year period. Watchful waiting, for patients with intolerable (30) symptoms, is not appropriate as dramatic spontaneous improvement is uncommon. A trial of laminectomy versus usual care for spinal stenosis found surgical complications were rare but associated with increasing age, co-morbidity and when fusion had also been performed.

Surgery is indicated when re-bleedings are frequent and the mass-effect causes progressive neurological deterioration treatment yeast infection men buy generic topamax 100mg on-line. In our series medicine balls for sale best order topamax, surgical removal of the most active cavernoma usually the biggest lesion with signs of recent hemorrhage was safe and prevented further bleedings medicine lodge kansas cheap 200mg topamax with amex. However symptoms genital warts discount topamax 100mg otc, due to the remaining cavernomas, epileptogenic activity can persist postoperatively, frequently necessitating long-term use of antiepileptic drugs. Spinal cavernomas can cause severe neurological deterioration due to low tolerance of the spinal cord to mass-effect with progressive myelopathy. When aggravated by extralesional massive hemorrhage, neurological decline is usually acute and requires immediate treatment. Microsurgical removal of a cavernoma is effective and safe, improving neurological deficits by mass removal and preventing further hemorrhage, thereby arresting progressive myelopathy. Sensorimotor deficits and pain improved postoperatively at a high rate, whereas bladder dysfunction remained essentially unchanged, causing social discomfort to patients. Microsurgical removal of temporal lobe cavernomas is beneficial for patents suffering from drug-resistant epilepsy. In our series, 69% of patients with this condition became seizure-free postoperatively. The most frequent disabling symptom at follow-up was memory disorder, considered to be the result of a complex interplay between chronic epilepsy and possible damage to the temporal lobe during surgery. Mika Niemela, whose enthusiasm and patience in conducting this study was truly unlimited. Through our cooperation I?ve learned to concentrate only on the most important issues in writing scientific texts. Esa Kotilainen and Hannu Kalimo, reviewers of this thesis, for their valuable comments. Reza Dashti, who gave me some very important advices in the early days of the work. All my neurosurgical, neuroanesthesiological and neuroradiological colleagues who had influenced me in terms of rational clinical thinking and self-organization. My closest friends from very early childhood: Mihail, Vladimir, Maksim, Vadim, Pavel. Your kind hospitality and care helped me so much to go through numerous difficulties which I experienced, being all alone in a foreign country. All the crucial steps that I have taken in life were somehow overseen and predetermined by you. Ahyai A, Woerner U, Markakis E: Surgical treatment of intramedullary tumors (spinal cord and medulla oblongata). Aiba T, Tanaka R, Koike T, Kameyama S, Takeda N, Komata T: Natural history of intracranial cavernous malformations. Amagasa M, Ishibashi Y, Kayama T, Suzuki J: A total removal case of cavernous angioma at the lateral wall of the third ventricle with interhemispheric trans-lamina terminalis approach. Andoh T, Shinoda J, Miwa Y, Hirata T, Sakai N, Yamada H, Shimokawa K: Tumors at the trigone of the lateral ventricle-clinical analysis of eight cases. Bakir A, Savas A, Yilmaz E, Savas B, Erden E, Caglar S, Sener O: Spinal intradural-intramedullary cavernous malformation. Balak N: Unilateral partial hemilaminectomy in the removal of a large spinal ependymoma. Bellotti C, Pappada G, Sani R, Oliveri G, Stangalino C: the transcallosal approach for lesions affecting the lateral and third ventricles. Bellotti C, Medina M, Oliveri G, Barrale S, Ettorre F: Cystic cavernous angiomas of the posterior fossa. Bergstrand A, Olivecrona H, Tonnis W: Gefassmissbildungen und Gefassgeschwulste des gehirns in Germany, Leipzig, Georg Thieme, 1936. Bertalanffy H, Kuhn G, Scheremet R, Seeger W: Indications for surgery and prognosis in patients with cerebral cavernous angiomas. Bertalanffy H, Mitani S, Otani M, Ichikizaki K, Toya S: Usefulness of hemilaminectomy for microsurgical management of intraspinal lesions. Biluts H,Munie T: Intramedullary cavernous haemangioma of spinal cord: a case report and literature review. Bruni P, Massari A, Greco R, Hernandez R, Oddi G, Chiappetta F: Subarachnoid hemorrhage from cavernous angioma of the cauda equina: case report. Canavero S: Intramedullary cavernous angiomas of the spinal cord: clinical presentation, pathological features, and surgical management. Cansever T, Civelek E, Sencer A, Karasu A, Kiris T, Hepgul K, Can H, Canbolat A: Spinal cavernous malformations: a report of 5 cases. Cappabianca P, Alfieri A, Maiuri F, Mariniello G, Cirillo S, de Divitiis E: Supratentorial cavernous malformations and epilepsy: seizure outcome after lesionectomy on a series of 35 patients. Chauviere L, Rafrafi N, Thinus-Blanc C, Bartolomei F, Esclapez M, Bernard C: Early deficits in spatial memory and theta rhythm in experimental temporal lobe epilepsy. Churchyard A, Khangure M, Grainger K: Cerebral cavernous angioma: a potentially benign condition? Crivelli G, Dario A, Cerati M, Dorizzi A: Third ventricle cavernoma associated with venous angioma. Deletis V,Sala F: Intraoperative neurophysiological monitoring of the spinal cord during spinal cord and spine surgery: a review focus on the corticospinal tracts. Denier C, Labauge P, Bergametti F, Marchelli F, Riant F, Arnoult M, Maciazek J, Vicaut E, Brunereau L, Tournier-Lasserve E, Societe Francaise de Neurochirurgie: Genotype-phenotype correlations in cerebral cavernous malformations patients. Ericson K, von Holst H, Mosskin M, Bergstrom M, Lindqvist M, Noren G, Eriksson L: Positron emission tomography of cavernous haemangiomas of the brain. Fazi S, Menei P, Mercier P, Dubas F, Guy G: Cavernomas of the spinal cord: report of two patients. Ferroli P, Casazza M, Marras C, Mendola C, Franzini A, Broggi G: Cerebral cavernomas and seizures: a retrospective study on 163 patients who underwent pure lesionectomy. Finkelburg R: Differentialdiagnose zwischen Kleinhirntumoren und chronischen Hydrocephalus: Zugleich ein Beitrag zur Kenntnis der Angiome des Zentralnervensystems. Fukushima M, Nabeshima Y, Shimazaki K, Hirohata K: Dumbbell-shaped spinal extradural hemangioma. Furuya K, Sasaki T, Suzuki I, Kim P, Saito N, Kirino T: Intramedullary angiographically occult vascular malformations of the spinal cord. Hadlich R: Ein Fall von Tumor cavernosus des Ruckenmarks mit besonderer Berucksichtigung der neueren Theorien uber die Gene des Cavernoms. Hammen T, Romstock J, Dorfler A, Kerling F, Buchfelder M, Stefan H: Prediction of postoperative outcome with special respect to removal of hemosiderin fringe: a study in patients with cavernous haemangiomas associated with symptomatic epilepsy. Hashimoto H, Sakaki T, Ishida Y, Shimokawara T: Fetal cavernous angioma-case report. Karlsson B, Kihlstrom L, Lindquist C, Ericson K, Steiner L: Radiosurgery for cavernous malformations. Katayama Y, Tsubokawa T, Maeda T, Yamamoto T: Surgical management of cavernous malformations of the third ventricle. Kendall B, Reider-Grosswasser I, Valentine A: Diagnosis of masses presenting within the ventricles on computed tomography. Kharkar S, Shuck J, Conway J, Rigamonti D: the natural history of conservatively managed symptomatic intramedullary spinal cord cavernomas. Kitahara T, Miyasaka Y, Ohwada T, Yada K, Mera H: An operated case of cervical spontaneous hematomyelia. Koch-Wiewrodt D, Wagner W, Perneczky A: Unilateral multilevel interlaminar fenestration instead of laminectomy or hemilaminectomy: an alternative surgical approach to intraspinal space-occupying lesions. Kondziella D, Brodersen P, Laursen H, Hansen K: Cavernous hemangioma of the spinal cord conservative or operative management? Kudo T, Ueki S, Kobayashi H, Torigoe H, Tadokoro M: Experience with the ultrasonic surgical aspirator in a cavernous hemangioma of the cavernous sinus. Kunz U, Goldmann A, Bader C, Oldenkott P: Stereotactic and ultrasound guided minimal invasive surgery of subcortical cavernomas. Labauge P, Denier C, Bergametti F, Tournier-Lasserve E: Genetics of cavernous angiomas. Labauge P, Laberge S, Brunereau L, Levy C, Tournier-Lasserve E: Hereditary cerebral cavernous angiomas: clinical and genetic features in 57 French families.

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