摘要:

&NA;A case of intracranial saccular aneurysm occurring in early childhood and presenting with sudden dysphasia and hemiplegia is reported. A review of the literature emphasizes the rarity of this lesion. Despite a significant preoperative neurological deficit, the patient tolerated ancurysm clipping and recovered well. The majority of reported cases involve males under 2 years old. Aneurysms in infants have a distribution different from that seen in adults. Microscopic examination of these lesions fails to show any evidence of inflammation or atherosclerosis. The data suggest that the pathogenesis of these rare childhood lesions differs from that of adult saccular aneurysms.

ISSN:0148-396X    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Extensive, invasive neoplasms of the cranio‐orbital region are generally considered to be inoperable and are treated with local radiation therapy and occasionally with chemotherapy. Upon local recurrence of these neoplasms, further treatment efforts are usually deemed futile. Over the past 4 years, 10 patients with extensive neoplasms of the cranioorbital region that were previously thought to be inoperable were referred to us for further evaluation. Five of these patients had failed an intensive course of radiation therapy. Radical regional cranio‐orbital resection was performed. The resection included the skin, globe, sphenoid wings, and orbitofrontal bone. The maxillary sinus and nasal septum were left exposed. The exposed dura mater and the frontal and temporal bones were resurfaced with split‐thickness skin grafts. All patients in this series have survived free of local disease to date. Combined cranio‐orbital resection offers both palliation and a possible cure for patients with extensive, invasive neoplasms of the cranio‐orbital region. Reconstructive surgery can be performed using full‐thickness flaps after 2 years of observation for local recurrence.

ISSN:0148-396X    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Twelve patients with the clinical findings of spinal dysraphism form the basis for this report. In eight patients, physical findings, plain x‐rays, and unenhanced spinal computed tomography allowed for precise diagnosis and subsequent therapy, without contrast myelography. All patients in the study had intravenous pyelography, and this revealed evidence of renal deterioration in two. The other 10 patients had radiographically normal upper urinary tracts. Urodynamic assessment was performed in seven; three were abnorma. The pattern of the abnormal studies (three “flaccid type” with an adequate urethral pressure profile and one with detrusor‐sphincter dyssynergia) allowed for appropriate therapy to be employed for bladder emptying and continence. Both spinal computed tomography and urodynamic testing serve as noninvasive studies that can be employed in the follow‐up and management of patients with spinal dysraphism.

ISSN:0148-396X    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;The clinical experience with lumbar disc disease in 38 patients at a large children's hospital is reviewed. Thirty children underwent surgical treatment; eight patients were not operated upon. The surgical results were excellent, with 93% of the children cured or markedly improved on follow‐up. The main differential aspects of lumbar disc disease between children and adults are emphasized.

ISSN:0148-396X    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Differential spinal cord blood flow was measured in dogs by the radioactive microsphere injection method. The mean spinal cord blood flow was 10.8 ± 0.53 (SE) ml/100 g/minute. The flow values for the white and gray matter were 7.1 ± 0.65 (SE) and 26.3 ± 2.2 (SE) ml/100 g/minute, respectively.

ISSN:0148-396X    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Hemispheric cerebral blood flow was measured in the rhesus monkey before and after infusion of the hypotensive agents sodium nitroprusside and trimethaphan camsylate. The intracarotid injection of133Xe was utilized, and flow was calculated by the “flow initial” technique. Cerebral blood flow did not change significantly with the administration of trimethaphan camsylate. However, with a small reducation in blood pressure (10.6%) during the administration of sodium nitroprusside, the cerebral blood flow fell significantly (15.4%).

ISSN:0148-396X    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Intracranial pressure sensors with subdural and subgaleal sensing tambours were used to measure the pressure difference between the intracranial and subgaleal spaces in two monkeys. The pressure differential was transmitted to fluid bathing a piston, to which an isotope source (145Pm) was attached. The radiation signal emanating through a fixed collimator was detected transcutaneously by a sodium iodide crystal contained within a photomultiplier tube connected to a scintillation counter. Afterin vitrotesting of linearity,in vivoinfusion studies were performed. Linearity between intracisternal pressure and radioactivity (r= 0.99;p< 0.001) was established in the two experimental animals for an interval of 5 months and 1 year, respectively. Autopsy findings confirmed that the sensing tambours became encapsulated with a pseudomembrane that did not attenuate the pressure signal. The results of this investigation suggest that this method for measurement of intracranial pressure without transcutaneous connections may be suitable for long term monitoring of intracranial pressure.

ISSN:0148-396X    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Doppler ultrasonic cardiac monitoring of patients undergoing trans‐sphenoidal pituitary operations in the semisitting position has revealed the occurrence of venous air embolism in 3 of 31 consecutive cases. One such case is presented. Air may be drawn into the venous system whenever a gradient exists between the site of operation and the right heart. During trans‐sphenoidal operations the most likely portals of venous air entry include the intercavernous connections within the sella, venous channels through nonpneumatized bone, inadequately sealed subnasal vessels, and vascularized metastatic tissue in the pituitary. Because the potential for morbidity and mortality from air embolism is so great, rapid diagnosis with the Doppler unit and prompt treatment, including aspiration of air from the right atrial catheter, administration of 100% oxygen, performance of the Valsalva maneuver, saline irrigation of the wound, and hemostasis of open vessels, are essential. Technetium‐macroaggregated albumin (TEMAA) lung scans are helpful in postoperative verification of venous air embolism.

ISSN:0148-396X    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Most neurosurgical patients with permanent partial or complete respiratory insufficiency are managed with a mechanical ventilator and tracheostomy. This method presents many medical, technical, emotional, and social problems. A case report is presented that illustrates the potential usefulness of electrical stimulation of the phrenic nerve (“diaphragm pacing”) as an alternate method of therapy for respiratory insufficiency. This paper outlines the indications for, methods of, and problems with such a system and is intended to make its availability more widely appreciated among neurosurgeons.

ISSN:0148-396X    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Reports of melanotic nerve sheath tumors of Schwann cell origin are rare, only three having been found in the literature. Two new cases of spinal intradural melanotic nerve sheath tumors are reported and the literature is reviewed. Controversy has arisen in regard to the origin of melanin within these tumors. Electron microscopic study of one of our cases indicates that the Schwann cell is capable of producing melanin. The available evidence suggests that ultrastructural identification of the cell type in these pigmented tumors is essential in plotting the therapy and prognosis of patients with melanotic nerve sheath tumors.

ISSN:0148-396X    

出版商:OVID    

年代:1978

数据来源: OVID