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The series studied comprises all 851 patients with symptom-producing intracranial saccular aneurysms admitted to the departments of neurosurgery in Denmark in the five-year period of 1970-1974. The series was divided into seven clinical stages according to Hunt's classification. More than half of the patients were grouped in stages IV and V (Hunt grade 2-3). Of the patients, 76% were found primarily suitable for operation. The mortality within the individual stages was to a great extent independent of the time of operation. A total of 94% of the aneurysms were localized within the region of the carotid artery, with a roughly equal distribution among the internal carotid, anterior communicating, and middle cerebral arteries. Multiple aneurysms were found in 19% of the patients subjected to panangiography. There was a distinct correlation between the severity of the spasms and the clinical condition. The course of operation was complicated in 49% of the patients, the complications being equally distributed within the various clinical stages. The mortality for the patients who underwent operation (total 567) was 32%, and 80% of the deaths were due to direct or indirect consequences of aneurysmal bleeding. At the follow-up performed two to seven years after operation, 52% of the survivors were fully capacitated, 20% were partly capacitated, and 28% were incapacitated. Based on a retrospective analysis, we have started a comprehensive prospective study with registration of available parameters in patients with saccular aneurysms admitted to all departments of neurosurgery in Denmark. [ABSTRACT FROM AUTHOR]

Herniation of an intervertebral disc and spondylotic affection of a spinal nerve root can give rise to pain, the site of which depends on the nerve root affected. In order to define the clinical configuration of the pain, 239 patients having monoradicular spinal root compression, were interviewed with regard to the type and site of the accompanying pain. An endeavour was made to avoid suggestion of a fixed type of pain pattern. 6th and 7th cervical nerve roots: With compression of these approximately 75% of the patients had neck and shoulder pains, and approximately 25% had areas free from pain between two regions of pain. The peripheral distribution of the pain to the digits and hand was only slightly compatible with the general conception of radicular pain distribution. 5th lumbar and 1st sacral nerve roots: It was impossible, with any certainty, to distinquish between affection of these two roots from the pattern of pain in the lower extremities. Pain in the hip was, however, more frequent with involvement of L as compared to S. Pain in the great toe, medial margin and dorsum of the foot was somewhat more frequent following compression of L in relation to S, which produced pain in the small toes, lateral margin and sole of the foot, and in the heel; but there was considerable over-lapping between the two configurations. Approximately a third of the patients with low lumbar nerve root compression were free from pain in the foot and toes, and approximately a tenth stated that there were areas free from pain in the leg, i.e., the pain was not a continuum. The present investigation would suggest that classical sciatic pain or radicular pain is rather infrequent; further, that it is difficult to determine, with any certainty, the nerve root affected from the site of peripheral pain. [ABSTRACT FROM AUTHOR]

For the purpose of examining the significance of a pain focus in the maxillary air sinus denervation of the mucosa of the sinus by transantral maxillary nerve section was performed. The material comprises 20 patients with pain in the distribution of the infraorbital nerve and previous disease of the relevant sinus. All patients had been treated previously without any benefit from peripheral surgery of the infraorbital nerve. Only 20% had any benefit of the proximal avulsion for more than three months. It is concluded that impulses from the mucosa of the maxillary sinus do not play any part in the occurrence or persistence of facial pain in this highly selected material. [ABSTRACT FROM AUTHOR]

The results of scanning in 981 patients admitted to neurosurgical and neurological departments are reported. Scanning was positive in 77% of the 501 patients with verified pathological intracranial lesions. The accuracy was greatest (over 90%) in malignant gliomas and meningiomas and lowest (53%) in benign gliomas. There was a high accuracy (81%) in lesions with supratentorial localisation, and a low accuracy (42%) in patients with lesions in the posterior fossa. On comparing the results of EEG and brain scanning it was found that there was a close correlation in 47%, doubtful correlation in a further 21%, while in 3% both investigations were negative. There was a close correlation between arteriography and scanning in 59%, and the accuracy of both these investigations in combination was 88%. There was close correlation between PEG and scanning in 39%, and a total accuracy for these investigations of 84%. In one-quarter of the patients investigated scanning could be considered to be the best method of investigation for the diagnosis of the extent and localisation of the pathological process. Scanning is a very suitable investigation for the diagnosis of meningiomas, malignant gliomas, and to assess the multiplicity of metastases. Consecutive scanning can also be used as a means of checking the course of the pathological process in the brain tissue in patients with infarct and localized encephalitis. It may be concluded that while the accuracy of scanning does not exceed that of other methods of investigation it provides a valuable supplement and increases the accuracy of diagnosis. [ABSTRACT FROM AUTHOR]