摘要:

&NA;After an “occipital lobectomy” that resulted in a severe dyslexia and a moderate dysgraphia‐dyscalculia, anatomical study showed damage to the posterior extremity of the angular gyrus and degeneration in the posteroinferior pulvinar. This is in contrast to an earlier case that had degeneration in the anterosuperior pulvinar associated with a small anterior temporoparietal infarct and a well‐documented receptive‐expressive aphasia. However, the role of the pulvinar in speech function remains uncertain. The surgeon should be aware of the short distance between the angular gyrus and both the midline and the occipital pole because a lesion here during an “occipital lobectomy” produces a distressing and durable speech impairment.

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;Biopsies can be performed directly with computerized tomography (CT) head scanners with some difficulty. The small scanning orifice does not allow enough room for needle placement; therefore, biopsy is difficult. In contrast, the scanning orifice of the CT body scanner is large enough to permit biopsies without hindrance. Over 300 CT‐guided abdominal biopsy procedures have been performed at the Cleveland Clinic Foundation. We are reporting the technique and the results of 14 CT‐guided brain biopsies. There were no complications in the series and an accurate diagnosis was made for 13 of the 14 patients.

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;Samples of ventricular cerebrospinal fluid, tumor cyst fluid, and subdural fluid were obtained from 30 patients at operation. The protein concentration and the specific gravity of each sample were measured and the corresponding mean absorption numbers were calculated from the numerical printout of the preoperative computerized tomogram. For fluids with a specific gravity greater than 1.005, a linear relationship was demonstrated between protein concentration and specific gravity. For protein concentrations greater than 300 mg/dl, there was a linear relationship between protein concentration and the mean absorption number. As the precision of present instrumentation improves, it is expected that a noninvasive technique for estimating intracranial protein concentration will have a number of clinical applications.

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;Eleven patients with lesions of the internal carotid and middle cerebral arteries that could not be treated by direct approach are presented. Major vessel occlusion was chosen as definitive therapy. Prophylactic extracranial‐intracranial bypass was employed in an attempt to reduce the incidence of ischemic complications. Emphasis is placed on complications, from which several important lessons were learned. Our best results occurred in patients with carotid artery lesions treated with bypass and immediate internal carotid ligation. We believe this to be an effective and safe mode of therapy in cases in which direct approach is not feasible. The low risk and high potential benefit of prophylactic bypass justifies its use before major vessel occlusion in selected cases.

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;We investigated the mechanism of damage to the corpus callosum in a study of 46 brains obtained at the autopsies of patients with head injuries. After correlating the gross findings with the site of impact on the head, we think that such lesions in the corpus callosum are caused by stretching of callosal fibers and/or shearing forces in cases in which lateral movement or twisting of the brain occurs. This mechanism of the dynamic development of callosal injuries is also supported by the retraction bulb formation of axons found histologically in the corpus callosum.

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;Although the measurement of intracranial pressure (ICP) is gaining widespread acceptance, the most desirable method of measurement is disputed. Subdural fluid‐coupled techniques are associated with an increased risk of infection, and epidural techniques are associated with decreased accuracy. We investigated epidural measurement techniques and suggest that the necessary and sufficient criteria for accurate epidural measurement of ICP are adequate transducer size and stiffness, transducer‐dura coplanarity, transducer‐guard ring coplanarity, complete dural contact, and rigid fixation. An epidural transducer design was developed and prototypes were constructed using these principles. The transducer requires no percutaneous connections, fluid coupling, or batteries. Transducer accuracy was ±2.2 torr in bench stability studies lasting up to 198 days, ±3.0 torr in acute animal studies of less than 24 hours, and ±7.9 torr in chronic animal studies lasting up to 112 days. Error bounds are expressed such that 95% of individual measurements are expected to have error less than the bound; average error is one‐third of the bound. Average transducer drift was 0.1 torr per day; our reported accuracy in chronic studies used drift correction from preimplantation data. We conclude that accurate measurement of ICP using an epidural transducer is feasible.

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;Sarcoma metastatic to the central nervous system is generally considered to be rare. In this report three cases of sarcoma with metastasis to the central nervous system are presented. The case of rhabdomyosarcoma of the lung probably represents the first reported instance of such tumor metastatic to the central nervous system. The case of fibrosarcoma of the thigh is thought to be the first report of metastatic sarcoma with leptomeningeal dissemination. The metastatic brain lesions of the alveolar soft part sarcoma were incidental findings at autopsy. A summary of 22 cases previously reported and a brief discussion of the mode of metastasis of sarcoma, as compared to that of carcinoma, are also presented.

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;We present two patients with brain abscess who underwent complete excision with a satisfactory clinical outcome although serial computerized tomography (CT) scans in the early postoperative period seemed to indicate a large residual abscess in each case. We recommend treatment based on the clinical course rather than the CT scan appearance, indicate that earlier reports on this topic may be misleading, and suggest an explanation for these findings.

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;A case of symptomatic cyst of the choroid plexus of a lateral ventricle in a child is reported. The characteristics of the case are compared with those of the other three cases in the literature.

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;Interhemispheric subdural hematomas are rare. Bilateral interhemispheric subdural hematomas in a patient with a ventriculoperitoneal shunt for hydrocephalus were diagnosed by computerized tomographic (CT) scan after mild head trauma. The value of CT scanning, the clinical presentation and treatment, and a review of the literature are presented.

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID