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)
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 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)
A 58-year-old male who had been diagnosed as having polymyositis was found to have a mass in the fourth ventricle. This mass showed features of an inflammatory pseudotumor. This lesion has been described in many parts of the body including the central nervous system. This case showed some features different from the previously reported cases in the central… (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)
Massive hematoma of the corpus callosum caused by blunt head trauma is an extremely rare lesion. Most frequent traumatic lesions involve the corpus callosum are diffuse axonal injuries. They might be associated with small hemorrhagic foci in the hemispheric and brain stem white matter, intraventricular hemorrhages, subarachnoid hemorrhages, traumatic… (More)
Synovial cysts presenting within the cervical spine are rare. We describe a case of a synovial cyst presenting as a tumour and the successful management.