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John P. Kapp

✓ The author presents a safe method of endotracheal intubation for anesthesia without moving the neck in patients with fractures of the cervical spine.

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John P. Kapp, James T. Robertson and Isaac Gielchinsky

✓ A technique is described for closure of intracranial arteriotomies in areas of difficult exposure, using wire sutures that can be twisted rather than tied.

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John P. Kapp, Joga R. Pattisapu and J. Larry Parker

✓ A carotid-cavernous fistula which had recurred after trapping, embolization, intracranial packing with muscle, and excision of the cervical carotid bifurcation was successfully closed with a Fogarty catheter introduced through the fibrous remnant of the cervical internal carotid artery.

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Spontaneous Dislocation of the Atlas

Report of a Case Simulating Syringomyelia with a Discussion of Etiology and Methods of Treatment

Paul Skok, John Kapp and Charles E. Troland

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Isotope sinograms

Technical note

John P. Kapp, Harry C. Alfred and Terri Jones

✓ A technique is described for examination of the dural venous sinuses using isotope angiography.

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John P. Kapp and Robert R. Smith

✓ The authors review the literature concerning spontaneous resolution of occlusive lesions involving the carotid artery. They add four cases illustrating three pathological vascular processes that may resolve spontaneously, namely, arterial dissection, atheromatous lesions at the carotid bifurcation, and an arteriopathy involving the intracranial vessels which is poorly understood at this time.

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John P. Kapp, George W. Paulson and Guy L. Odom

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Dominic M. Cannella, Anthony P. Prezyna and John P. Kapp

✓ The authors report the fourth case of primary intracranial plasma-cell granuloma. The patient was a 16-year-old girl who presented with loss of vision as the major clinical feature. The tumor resembled a meningioma both preoperatively and grossly at surgery. Because the tumor did not respond to steroid treatment following subtotal surgical excision, radiation therapy was administered to the affected area. Major considerations in the differential diagnosis of this neoplasm are discussed.

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Supraophthalmic carotid infusion for brain chemotherapy

Experience with a new single-lumen catheter and maneuverable tip

John P. Kapp, J. Larry Parker and Elton M. Tucker

✓ A single-lumen catheter with a maneuverable tip which does not incorporate a balloon has been developed for supraophthalmic intracarotid infusion of chemotherapeutic agents for central nervous system neoplasms. Supraophthalmic carotid catheterization was accomplished in 48 (96%) of the first 50 consecutive infusions in which this catheter was used. None of the 31 patients who underwent this procedure developed optic neuropathy or loss of vision. Ten patients developed Marcus-Gunn pupils, ipsilateral to the infused carotid artery in two and contralateral to the infused carotid artery in eight. Thrombosis of the carotid artery occurred after infusion in one patient. Problems associated with the technique include a tendency for the catheter to retract proximally during infusion in some patients, and the necessity for surgical exposure of the carotid artery. The infusion technique protects the eye from the high-concentration first-pass of chemotherapeutic agents administered via the carotid artery. Since the tip of this catheter can be hydraulically guided, it may prove to be useful in other areas of transarterial neurosurgical procedures.