E Thomas Chappell

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OBJECT Sedation regimens for head-injured patients are quite variable. The short-acting sedative-anesthetic agent propofol is being increasingly used in such patients, yet little is known regarding its safety and efficacy. In this multicenter double-blind trial, a titratable infusion of 2% propofol accompanied by low-dose morphine for analgesia was compared(More)
OBJECTIVE To compare a novel diagnostic radiological technique, computed tomographic angiography (CTA), with the standard method, namely digital subtraction angiography (DSA), in the diagnosis of cerebral aneurysms. METHODS A comprehensive search of the world literature on CTA was performed. Articles that reported on prospective comparisons of CTA and DSA(More)
A novel complication of the illicit use of cocaine, a spontaneous acute subdural hematoma, is described. This case represents another addition to the growing literature on the negative effects of cocaine on the central nervous system. Photographic documentation of the lesion responsible for the hematoma is presented, along with a discussion of the possible(More)
OBJECT This study was conducted to review the presentation and management of patients with coccidioidomycosis involving the spine. METHODS The authors reviewed 23 cases of spinal coccidioidomycosis treated at their institutions. There were 20 males and three females who ranged in age from 9 to 62 years. Non-Caucasian individuals were disproportionately(More)
In a canine model of global cerebral ischemia, 6 dogs received a saline placebo prior to the event and 5 received 12.5 mg/kg ibuprofen. Cerebral venous outflow from the confluence of the sagittal and transverse sinuses, systolic and diastolic arterial pressure, cardiac output, pH, Paco2, Pao2, and arterial and sagittal sinus thromboxane B2 and 6-keto-PGF1(More)
BACKGROUND While watertight closure of the dura is a long-standing tenet of cranial surgery, it is often not possible and sometimes unnecessary. Many graft materials with various attributes and drawbacks have been in use for many years. A novel synthetic dural graft material called GORE PRECLUDE MVP dura substitute (WL Gore & Associates, Inc, Flagstaff,(More)
Blood coagulation and hemostasis issues are important aspects of patient care in acute neurosurgical patients. Coagulopathy often complicates the already difficult management of cerebrovascular and intracranial hemorrhagic disease and injuries, adding to the already high associated morbidity and mortality. Common causes of coagulopathy, as well as its(More)
With the advent of frameless stereotaxy and its application to the spine, more precise and less invasive spinal procedures are possible. In addition to being less invasive, these techniques may increase surgeon confidence and allow shorter operating times. Described here is a case of Pott's disease of the thoracolumbar spine and how intraoperative image(More)