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Rebecca W. Rimel, Albert B. Butler, H. Richard Winn, Tae Sung Park, George W. Tyson and John A. Jane

✓ New skeletal tongs have been designed which offer a significant design advance over previously available models. The University of Virginia tongs combine the ease of application and increased weight-handling abilities of the Gardner-Wells tongs with the patient mobility allowed by the Crutchfield tongs.

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Primary cerebellar nocardiosis

Report of two cases

George W. Tyson, Joseph E. Welsh, Albert B. Butler, John A. Jane and H. Richard Winn

✓ The authors describe two cases of primary cerebellar nocardiosis. Confinement of Nocardia abscesses to a localized, accessible portion of the central nervous system should favor surgical cure of this aggressive and often fatal disease. In our two cases multilocularity, tenuous encapsulation, and proximity to the brain stem prevented complete primary excision. Nevertheless, the infections were effectively treated by intensive postoperative antibiotic therapy and, in one case, a second operation to excise the residual abscess. The need for the latter was suggested by the results of sequential computerized tomographic brain scans that were used to monitor the response to antibiotic therapy.

In the absence of any apparent extracranial focus of infection and any overt condition that might impair immunological competence, nocardiosis is likely to be omitted from the preoperative differential diagnosis of a posterior fossa space-occupying lesion.

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George W. Tyson, John A. Jane and W. Ellis Strachan

✓ Documented rupture of venous aneurysms associated with arteriovenous fistulas is uncommon, and reports of the formation and rupture of venous aneurysms that are not associated with fistulas are distinctly rare. One case is presented in which spontaneous rupture of a saccular aneurysm on a vessel draining an arteriovenous fistula produced an intracerebral hematoma. A second case is described in which fatal intracerebral hemorrhage was produced by a traumatic aneurysm of an otherwise normal superficial cerebral vein.