Biomedical subjects

R Voorhies

Publications and source records attributed to R Voorhies.

4 recordsLinked to original sources

PubMed2000

Osteochondroma of the C5 lamina with cord compression: case report and review of the literature.

STUDY DESIGN: Case report of a solitary osteochondroma of the cervical spine causing myelopathy in a 66-year-old woman. OBJECTIVES: To review the relevant literature and describe a highly unusual clinical manifestation of solitary osteochondroma. SUMMARY OF BACKGROUND DATA: Osteochondromas are common benign bony lesions that seldom occur in the axial skeleton. These lesions are more commonly reported with neural compression in cases of hereditary multiple exostoses (Bessel-Hagel syndrome, diaphyseal aclasis). METHODS: Chart review, review of relevant radiographic examinations and histopathologic specimens, clinical follow-up with examination, and literature review. RESULTS: Manifestation with new neurologic deficit in a 66-year-old patient was singular. CONCLUSIONS: Osteochondromas are unusual in the axial skeleton, and are rarely signaled by neural compression. Occurrence is generally in young adults in the second and third decades. Initial manifestation with a new neurologic deficit in a 66-year-old patient was highly unusual.

Aged↗

PubMed2000

Increased MRI signal intensity in association with myelopathy and cervical instability: case report and review of the literature.

BACKGROUND: Increased T2-weighted signal intensity in patients with cervical myelopathy has been extensively reviewed in the literature. A variety of etiologies with similar MRI appearances have been described; attempt at correlation of MRI findings with clinical presentation and outcomes after treatment has led to a limited consensus. METHODS: We present a case of cervical myelopathy with associated hyperintense T2-weighted signal characteristics, secondary to cervical spondylosis and instability. RESULTS: Rapid resolution of radiographic abnormalities after surgical decompression and fusion was noted. Clinical improvement did not parallel radiographic resolution. CONCLUSION: These findings are important in considering the pathophysiology of MRI changes in cervical myelopathy.

Aged↗

PubMed1981

Management of trigeminal neuralgia (tic douloureux).

The initial treatment of trigeminal neuralgia is accomplished with drugs, primarily carbamazepine and occasionally phenytoin sodium. However, many patients become refractory to treatment or side effects develop such as drowsiness or ataxia. In these circumstances, surgical therapy is appropriate. At our institution, microsurgical decompression has yielded good to excellent results in 29 of 32 patients and is currently recommended for persons in good general health who are younger than 70 years. Because of the notable incidence of unpleasant dysesthesias in the face, percutaneous radiofrequency rhizotomy is reserved for persons whose age or general medical condition precludes craniotomy.

Carbamazepine↗

PubMed1981

Hypothesis testing in neurosurgical trials.

Controlled clinical trials represent the most scientific methods of evaluating a new form of treatment. In designing such a trial, one must avoid committing two kinds of errors. The Type I error is defined as falsely concluding that a difference between two treatments exists, when they are equal. The Type II error is committed when one concludes that two treatments are the same, when a real difference exists. To reduce the probability of committing these errors, large sample sizes are required. A survey of neurosurgical trials showed that the majority of these trials have an unacceptably high probability of committing a Type II error because of inadequate sample size.

Clinical Trials as Topic↗