A case is reported of a tumor composed of both oligodendrogliomatous and sarcomatous elements. The interpretation is offered that the sarcoma arose secondarily by neoplastic transformation of the hyperplastic blood vessels formed in response to the presence of the oligodendroglioma. This tumor may be considered analogous to the astrocytoma-sarcoma, which is much more common, and to the metastatic carcinoma with secondary sarcoma, of which one case has been reported.

Brain Neoplasms↗

PubMedDate not supplied

Somatosensory evoked potentials during decompression and stabilization of the spine. Methods and findings.

As part of a study to determine if decompressive surgery benefits patients who have incomplete lesions of the spinal cord, the somatosensory evoked potential (SEP) has been employed as an intraoperative spinal cord monitor. This procedure was used to see if decompression results in any rapid changes in spinal cord conductivity and to correlate these findings with the patient's subsequent clinical course. In addition to trauma, however, other factors also affect the SEP, and these must be recognized if intraoperative monitoring is to be successful. Frequency of stimulation, wakefulness, and anesthetic agents alter the wave-form and amplitude of the SEP. Using nitrous oxide, oxygen, meperidine (or morphine), and a muscle relaxant for anesthesia, and stimulating at frequencies of 1 or 2 per second, 11 patients with cervical or upper thoracic lesions have been monitored. There was no loss or diminution of an SEP and no patient was neurologically poorer afterwards. In 4 patients, the SEP "improved" soon after decompression. Clinical outcome, however, was not related to whether the SEP changed or remained the same. In total, 8 patients subsequently improved functionally and 3 did not.

Anesthesia↗

PubMedDate not supplied

Traumatic myelopathy in patients with cervical spinal stenosis without fracture or dislocation: methods of diagnosis, management, and prognosis.

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.

Adult↗