Search Results

You are looking at 1 - 10 of 30 items for

  • Author or Editor: Thomas H. Milhorat x
Clear All Modify Search
Full access

Experimental Hydrocephalus

Part 1: A Technique for Producing Obstructive Hydrocephalus in the Monkey

Thomas H. Milhorat

Full access

Thomas H. Milhorat

✓ The author reviews modern information concerning the formation, flow, and functions of the cerebrospinal fluid. Particular attention is given to the lymphatic-like features of the third circulation and to its importance as an internal milieu for nervous tissue.

Full access

Thomas H. Milhorat

✓ Ventricular collapse following intraventricular surgery is a formidable complication. In patients with significant dilation of the lateral ventricles, the operative mortality may exceed 40%. In the current report, a technique for closing cerebral incisions is described which has prevented this complication in 18 intraventricular operations in which it has been used. The essential steps include: 1) linear incision of a cerebral gyrus; 2) closure of the incision using bordering vessels for traction; 3) inflation of the ventricles with saline; and 4) attachment of the incision to the overlying dura.

Full access

Thomas H. Milhorat

Syringomyelia poses special challenges for the clinician because of its complex symptomatology, uncertain pathogenesis, and multiple options of treatment. The purpose of this study was to classify intramedullary cavities according to their most salient pathological and clinical features.

Pathological findings obtained in 175 individuals with tubular cavitations of the spinal cord were correlated with clinical and magnetic resonance (MR) imaging findings in a database of 927 patients. A classification system was developed in which the morbid anatomy, cause, and pathogenesis of these lesions are emphasized.

The use of a disease-based classification of syringomyelia facilitates diagnosis and the interpretation of MR imaging findings and provides a guide to treatment.

Full access

Experimental Hydrocephalus

Part 3: Light Microscopic Findings in Acute and Subacute Obstructive Hydrocephalus in the Monkey

Ronald G. Clark and Thomas H. Milhorat

Full access

Thomas H. Milhorat and James E. McClenathan

✓ The authors describe a technique for direct cardiac shunting in which an adult-size ventriculoatrial catheter is coiled in an intrathoracic Silastic pouch and implanted in infants with hydrocephalus. In three patients so treated, serial chest films have shown progressive uncoiling of the catheter over a follow-up interval of 6 to 14 months.

Full access

Thomas H. Milhorat and René M. Kotzen

✓ The central canal of the human spinal cord is partially or completely occluded in the vast majority of individuals by the early years of adult life. The authors describe an experimental lesion following virus-induced ependymitis that bears a striking resemblance to the condition in man. Suckling hamsters were inoculated with 0.06 ml of 10−3 infectivity titer of reovirus type I between the 2nd and 5th days of life. The pathological events consisted of necrotizing ependymitis, healing of the ependyma by gliovascular scarring, and obstruction of narrow bottlenecks such as the central canal. Histological findings were characterized by disorganization of the ependyma, formation of ependymal rosettes and microtubules, subependymal gliovascular scarring, and intracanalicular gliosis. These features are the same as those encountered clinically and provide strong evidence that stenosis of the central canal in man is a pathological lesion involving ependymal injury and scarring.

Full access