- Full text PDF available (0)
MRC CRASH is a randomised controlled trial (ISRCTN74459797) of the effect of corticosteroids on death and disability after head injury. We randomly allocated 10,008 adults with head injury and a Glasgow Coma Scale score of 14 or less, within 8 h of injury, to a 48-h infusion of corticosteroid (methylprednisolone) or placebo. Data at 6 months were obtained… (More)
BACKGROUND Corticosteroids have been used to treat head injuries for more than 30 years. In 1997, findings of a systematic review suggested that these drugs reduce risk of death by 1-2%. The CRASH trial--a multicentre international collaboration--aimed to confirm or refute such an effect by recruiting 20000 patients. In May, 2004, the data monitoring… (More)
We describe four cases of fracture of the occipital condyle. In all cases plain cervical spine films were normal. The fracture was diagnosed on the lowest section of a routine CT examination of the head. Further detail was then obtained with high-definition CT and coronal reconstructions. All the patients were found to have a small atlanto-occipital… (More)
OBJECTIVES To test the design and feasibility of a large scale multicentre randomised controlled trial evaluating the efficacy and safety of a high dose corticosteroid infusion after head injury. To assess whether large numbers of patients could be enrolled and treated within eight hours from injury and then followed up at six months. METHODS Randomised… (More)
Analyses of a multi-centre database of 71 patients at risk of raised ICP showed that in head injured patients (n = 19) and tumour patients (n = 13) clear inverse relationships of ICP vs compliance exist. SAH patients (n = 5) appear to exhibit a biphasic relationship between ICP and compliance, however greater numbers of patients need to be recruited to this… (More)
We describe a case of spontaneous spinal extradural haematoma presenting as cardiac chest pain. Although a neurosurgical emergency, the diagnosis is initially missed until neurological deficit develops. Prompt MRI scans of the spine followed by rapid transfer to a neurosurgical unit for definitive intervention increase the chances of full recovery.
Syringomyelia is known to occur secondary to compression of the spinal cord. We report the case of a female patient who underwent removal of a spinal meningioma. She re-presented 30 years later with multiple meningiomas causing cord compression. After a 4 year interval she was found to have developed a syrinx proximal to the site of compression. Comparison… (More)