Browse

You are looking at 1 - 10 of 308 items for

  • By Author: Spetzler, Robert F. x
Clear All
Restricted access

Robert F. Spetzler, David Winestock, Hans T. Newton and Edwin B. Boldrey

✓ A case is reported in which a left frontopolar artery aneurysm was demonstrated, disappeared, and then reappeared in a series of angiographic studies obtained during the conservative management of two episodes of subarachnoid hemorrhage. Only 23 days separated the first and last angiograms; three days later the aneurysm was successfully clipped.

Restricted access
Restricted access

Robert F. Spetzler and Charles B. Wilson

✓ The authors present a case in which an enlarging arteriovenous malformation was documented angiographically. Enlargement of the malformation concurrent with the appearance of basilar artery insufficiency was ascribed to a sump effect (steal) by the arteriovenous shunt.

Restricted access

Robert F. Spetzler, Charles B. Wilson and John M. Grollmus

✓ The authors describe a new catheter for use in percutaneous lumboperitoneal shunting, designed to overcome the problem of kinking. They present their experience with the catheter in 14 patients.

Restricted access

Robert F. Spetzler, Philip R. Weinstein, Norman Chater and Charles B. Wilson

✓ The authors describe a shunt inserted by a percutaneous route to the cisterna magna for the treatment of various cerebrospinal fluid disorders.

Restricted access

Robert F. Spetzler and Charles B. Wilson

✓ The authors review 39 patients with cerebrospinal fluid (CSF) leaks originating from the middle or posterior fossa. They evaluate the usefulness of preoperative investigative procedures, including cisternal radionuclide scanning and the deliberate increase of intracranial pressure. The results in this series emphasize the important role that abnormal CSF dynamics play in the recurrence of problematic cases of rhinorrhea or otorrhea. The following guidelines are recommended by the authors on the basis of their recent experience: 1) if hydrocephalus is present, if the cisternogram is abnormal, or if the CSF leak is intermittent and slight, the initial treatment should be insertion of a lumboperitoneal shunt; 2) if the leak is localized in the sellar or parasellar area, a transsphenoidal approach to obliterate the leak is advised; 3) if the CSF leak originates through a dural opening into the middle ear, an intracranial repair is indicated.

Restricted access

Clinton F. Miller II, Robert F. Spetzler and Dennis J. Kopaniky

✓ A case is reported of successful anastomosis of the middle meningeal artery to a cortical branch of the middle cerebral artery. Based on the analyses of 50 random angiograms, the authors discuss the circumstances in which such an anastomosis might be practical and indicated.

Restricted access

Robert F. Spetzler and Hartmut Spetzler

✓ A laboratory technique that allows strain measurements of the skull is described. Holographic interferometry allows the entire surface displacement of the skull to be mapped within 1/10 of the wavelength of light. Holographic interferometric pictures are presented following various stress applications to the skull. The method, besides being exquisitely sensitive, allows strain measurements simultaneously in any desired direction over the entire skull. No physical contact with the skull is required, and the experimental set-up is simple.

Restricted access

Robert F. Spetzler, Herbert Schuster and Richard A. Roski

✓ Thirteen patients with giant aneurysms of the internal carotid artery (ICA) were treated with ICA ligation and an extracranial-intracranial arterial bypass. A method for establishing a proper superficial temporal artery to middle cerebral artery pressure gradient while maintaining partial flow through the ICA is presented. This procedure allows the anastomosis to become established before full occlusion of the cervical ICA. None of these patients suffered any immediate or delayed ischemic or rebleed complications over an average follow-up period of 18 months.

Restricted access