Posttraumatic anterior cervical osteophyte and dysphagia: surgical report and literature review.

Degenerative changes in the cervical spine can produce osteophytes and other hypertrophic abnormalities. Asymptomatic osteophytes of the anterior margins of the cervical vertebrae may occur in 20-30% of the population. Occasionally, dysphagia or dysphonia may be caused by such cervical osteophytes pressing against the esophagus or trachea. Recently, the authors treated a patient with posttraumatic dysphagia and dysphonia secondary to osteophytic spurring of the anterior cervical spine. This 43-year-old man presented 2 years after sustaining a flexion/extension soft tissue injury to his cervical spine. Radiographic studies depict the progression of his osteophyte growth, which resulted in surgical intervention to relieve his inability to swallow solid foods. One year follow-up studies demonstrate normal alignment and no instability. A search of the literature revealed approximately 75 previously reported cases of anterior osteophyte-induced dysphagia, with the majority secondary to diffuse idiopathic skeletal hyperostosis. The literature briefly mentions trauma as a possible etiology of anterior osteophytosis; however, our case is unique, as it documents the time course and progression of the pathologic process.

Gravitational fields and aging.

Alteration of the ambient gravitational field and aging are both accompanied by a variety of physiological changes, but at present it is not possible to estimate how aging and alteration of gravitational fields would interact. The time will undoubtedly come when it will be advantageous to expose individuals of older ages to the altered gravitational fields. Consequently it is timely to know in advance the limitations and special maintenance requirements, if any, that may apply. The importance of such studies has been recognized by Comfort (3) in a chapter entitled "A special application: Aerospace Gerontology." Initially there should be a series of experiments in which animals of increasing ages are exposed to the weightlessness of spaceflight, and to increased fields provided by centrifugation. Also of interest would be the study of the effects of long-term exposure to moderately increased acceleration fields (1/2-1 G) to determine the gravitational effects on the aging process. In addition to its application toward improving the maintenance of aging astronauts/cosmonauts, such information also should contribute to the general understanding of gravitational physiology. Conversely, the effects exposure to the unconventional stress of altered gravitational fields, and the nature of any counter-measure developed, would be valuable contributions to the understanding of aging and the management of the elderly. It appears only logical that at least as much attention be given to gravitational fields and aging, as is given to gravitational fields and development.

Computer assisted ventriculography.

Computed tomography was performed following iothalamate meglumine (Conray) ventriculography in two cases of colloid cyst of the third ventricle. The application of this technique in the diagnosis of intraventricular mass lesions is discussed.

Delayed evolution of posttraumatic subdural hygroma.

Five hundred and forty-six patients in a consecutive series of 1,601 patients with craniocerebral trauma had computed tomography. One hundred and ninety-six patients had a follow-up CT scan. Thirteen patients (6.6%) developed apparently "silent" subdural hygromas of delayed evolution noted from six to 46 days after injury (average 22 days). Three of 10 patients (30%) improved after operation. No patient with a severe cerebral deficit (decortication or decerebration) improved. The three unoperated hygromas and the six that persisted after operation tended to resolve spontaneously. The infrequent and modest improvement following surgical treatment and the tendency to spontaneous resolution suggest that operation may be unnecessary in many patients with posttraumatic subdural hygroma of delayed evolution.

Timing of pentobarbital administration for brain protection in experimental stroke.

Significant reduction of experimentally induced cerebral infarction was associated in the canine model with the administration of pentobarbital at one hour postocclusion but not thereafter.