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Michael E. Carey, Francis C. Nance, Homer D. Kirgis, Harold F. Young, Lloyd C. Megison Jr. and David G. Kline

tenderness, and an unremarkable abdomen. A C5–6 motor level and a T2–3 level of hypalgesia were evident, but the patient could perceive deep pain in his calves. He had a history of mild diabetes but not alcoholism or pancreatitis. Dexamethasone (4 mg intramuscularly immediately and 2 mg every 8 hours) was started, and morphine was given for pain. A myelogram showed blocks at C4–7, so the cord was decompressed. Within 8 hours of surgery, the patient's abdomen was distended and rigid with low pitched bowel sounds. X-ray films revealed ileus and nasogastric suction was begun

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found a significant relation between epidural empyema after bone flap reimplantation and the presence of a VP shunt at the time of cranial vault reconstruction, the implantation of a VP shunt together (p=0.001) with the bone flap and the implantation of fragmented bone flaps (p=0.016). We also found a significant relation between aseptic necrosis and an open traumatic brain injury (open TBI) as primary diagnosis (p=0.004). Further alcoholism was identified as a risk factor for aseptic bone flap necrosis (p=0.010). Conclusions In order to avoid infectious