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Interfascicular neurolysis of the ulnar nerve at the elbow was performed in nine consecutive patients with moderate to severe ulnar palsy. Sensory and motor conduction velocities were determined before and up to six times after the operation, and a follow-up period of three years or more in all but two patients. None of the patients recovered after the operation, and all developed severe and sometimes persistent paraesthesiae. Electrophysiologically there was no evidence of improvement immediately following the operation. On the contrary in some patients there were changes suggesting deterioration. At the final investigation most electrophysiological parameters were still abnormal. The only significant change was an increase in the amplitude of sensory action potentials at the wrist and just below the elbow. Only one patient showed a more synchronised sensory potential after operation. It is our conclusion that interfascicular neurolysis of the ulnar nerve should be abandoned. [ABSTRACT FROM AUTHOR]

The amount of 6-sulphatoxymelatonin, the chief metabolite of melatonin, in the urine was measured in nine patients, who were subjected to bilateral sympathectomy at the second thoracic ganglionic level for treatment of hyperhidrosis of the palms. All patients showed before surgery a normal 6-sulphatoxymelatonin excretion with a peak in the excretion during the night time. After the sympathectomy, the high night time excretion was clearly abolished in five patients but remained high in four patients. This indicates that the segmental locations of the preganglionic sympathetic perikarya in the spinal cord, stimulating the melatonin secretion in the pineal gland in humans, vary between individuals. An increase in daytime melatonin excretion was observed in the patients responding to the sympathectomy with an abolished 6-sulphatoxymelatonin rhythm. This increase could indicate that the final sympathetic neurons innervating the pineal gland might have a both stimulatory and inhibitory function.

During a four year period, 21 patients with intracranial arteriovenous malformations, and six with cavernous angiomas, were operated at Hvidovre Hospital. Of these, 16 had ruptured. There was one operative death, and five displayed normal perfusion pressure breakthrough during the post-operative course, one of these disabling. Radical surgery was performed in 21 cases, for the main part of the ruptured cases with ensuing good quality of life, and for the unruptured cases with elimination of the risk of bleeding, in addition to seizure control.

Clinical signs of ulnar nerve involvement at the wrist level were found in a 51-year-old man. The electrophysiological changes were indicative of a median nerve involvement in the carpal tunnel. At operation, the compressed ulnar nerve was found in the carpal tunnel, together with the median nerve. This localization of the ulnar has not been described previously.

Of ten patients with iatrogenic lesion of the accessory nerve in the posterior triangle of the neck, nine underwent secondary reconstructive surgery, with direct end-to-end nerve suture or with nerve grafting. In the six patients whose operation was performed within 4 months from the injury recovery was satisfactory, but the three with longer delay did not recover. Reconstructive surgery as soon as possible after the injury is advocated.

Two cases of femoral nerve lesions are reported, one in the pelvic region, and one in the femoral triangle. In both cases, secondary microsurgical autografting resulted in a good functional and electrophysiological recovery.