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Furthermore, possible correlations between white matter lesion scores, ventricular width, and age were investigated. Rats and dogs that were killed weeks to months after liver irradiation tended to have sharply demarcated lesions. Meningeal fibrosis andor obliteration of the subarachnoid space has been suggested as the pathoanatomic basis.

Eight patients reported excellent pain relief, and four patients described good results. . All 12 patients experienced relief of pain after trial stimulation and had their systems permanently implanted.

We have used epidural scs for pain control during the past 15 years. Scs is an effective treatment for the pain of rsd, including recurrent pain after ablative sympathectomy. The tissue temperature elevation 1 cm from the tip never exceeded 0.

Normal-pressure hydrocephalus (nph) is a potentially treatable syndrome with abnormal cerebrospinal fluid dynamics. The purpose of this study was to determine the efficacy of spinal cord stimulation (scs) in patients with symptoms of reflex sympathetic dystrophy (rsd), a disabling clinical condition with significant consequences of morbidity and loss of productivity. The results suggest that leptomeningeal fibrosis is not the only pathoanatomic basis of increased r(out) andor b-wave activity in patients with nph and that various degenerative changes in the parenchyma may be responsible for the altered cerebrospinal fluid dynamics characteristic of nph.

The purpose of the present study was to investigate whether meningeal fibrosis causes increased resistance to cerebrospinal fluid outflow (r(out)) andor increased b-wave activity and whether pathological changes in the brain parenchyma after brain compliance, causing increased b-wave activity. For 29 patients, hydrodynamic criteria of nph were fulfilled and a ventriculoperitoneal shunt was performed. The animals were killed at varying intervals of time, and histological examinations were performed.

The level of pain present pre- and postoperatively was determined by administering a modified mcgill pain questionnaire and a visual analog scale to each patient. The device is lightweight, handheld, and battery-powered, and it emits x-ray radiation from the tip of a probe 3 mm in diameter by 10 cm in length. The radiobiology was characterized by in vivo irradiation of rat liver, dog liver, and dog brain. Histological examination of the brains of dogs that were killed acutely after irradiation did not show evidence of inflammation, edema, or hemorrhage. At an average of 41 months follow-up, all patients were using their stimulators regularly and only two were receiving adjunctive minor pain medication.


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    The study involved a group of 38 consecutively studied patients with clinical and radiological evidence of idiopathic nph, for whom a frontal brain biopsy was obtained. The device is lightweight, handheld, and battery-powered, and it emits x-ray radiation from the tip of a probe 3 mm in diameter by 10 cm in length. For 29 patients, hydrodynamic criteria of nph were fulfilled and a ventriculoperitoneal shunt was performed. An analysis of our records revealed 12 consecutive patients diagnosed as having rsd before undergoing scs. Liver enzyme levels, measured serially in the dogs, did not give evidence of chronic inflammation.

    Normal-pressure hydrocephalus (nph) is a potentially treatable syndrome with abnormal cerebrospinal fluid dynamics. We have used epidural scs for pain control during the past 15 years. Scs is an effective treatment for the pain of rsd, including recurrent pain after ablative sympathectomy. C, thereby excluding hyperthermia as a significant contributor to the formation of lesions. The radiobiology was characterized by in vivo irradiation of rat liver, dog liver, and dog brain.

    Meningeal fibrosis andor obliteration of the subarachnoid space has been suggested as the pathoanatomic basis. Both dosimetric methods showed a steep dose-distance fall-off relationship (proportional to the reciprocal of the cube of the distance from the probe tip). The dosimetry was characterized by two independent methods thermoluminescent dosimeters and radiochromic film. The low morbidity of this procedure and its efficacy in patients with refractory pain related to rsd suggest that scs is superior to ablative sympathectomy in the management of rsd. The level of pain present pre- and postoperatively was determined by administering a modified mcgill pain questionnaire and a visual analog scale to each patient. The tissue temperature elevation 1 cm from the tip never exceeded 0. Eight patients reported excellent pain relief, and four patients described good results. Rats and dogs that were killed weeks to months after liver irradiation tended to have sharply demarcated lesions. Histological examination of the brains of dogs that were killed acutely after irradiation did not show evidence of inflammation, edema, or hemorrhage. Furthermore, possible correlations between white matter lesion scores, ventricular width, and age were investigated.

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