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Robert C. L. Robertson and William G. Peacher

. The membrane removed consisted of a loose, wavy, fibrous tissue. There was no significant chronic inflammatory or foreign body reaction. Case 2 . Skull Pathology . Compound, comminuted, depressed fracture, mastoid and squamous portions of the left temporal bone. Mode of Injury . Patient's injuries were incurred in a truck accident on 26 March 1944. Associated Injuries . Patient was unconscious for 48 hours. There were compound, comminuted fractures of the left humerus, radius and ulna, all at the junction of the middle and distal thirds of the bones. There

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Frank J. Otenasek and John W. Chambers

committee 11 states that practically all head injuries were infected. Of 300 cases 11.2 per cent were infected with gas-producing anaerobes (94 per cent Cl. perfringens or welchii). Cl. perfringens was usually found in combination with putrefactive anaerobes, aerobes, and streptococci. The authors describe four forms of anaerobic brain infection, depending upon the clinical course—(1) acute, (2) subacute, (3) chronic, and (4) latent. In the acute form eight out of ten patients died and these clearly had all the criteria necessary for establishment of the diagnosis of

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Arthur B. Soule Jr.

been reported as having produced Charcot joints are tabes dorsalis, syringomyelia, trauma to the spinal cord, cauda equina, dorsal nerve roots and peripheral nerves, congenital malformations of the spine (such as spina bifida), myelitis, lead poisoning, hemiplegia following cerebral hemorrhage, pressure on the cord or cauda equina from tumors or tuberculosis of the spine, progressive muscular atrophy (both the Aran-Duchenne type or chronic poliomyelitis and the spastic type or amyotrophic lateral sclerosis), typhoid fever, leprosy and peripheral neuritis. 1, 2, 4, 11

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Harold C. Voris

variously referred to as “pseudo-tumors,” serous arachnoiditis, serous meningitis, chronic arachnoiditis, toxic hydrocephalus, otitic hydrocephalus, meningitis sympathica, aseptic meningitis and so on. The wide variety of terminology clearly indicates the general confusion regarding them. Quincke 10 reported ten cases of serous meningitis and emphasized the spinal fluid findings and the increase of intracranial pressure. Passot, 9 in a thesis, distinguished between the purulent and non-purulent complications of otitis media. He differentiated them by spinal fluid

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John T. B. Carmody

other relevant history was that of a penile lesion acquired while in the Service. It was not a proven chancre, and antiluetic therapy was never given. Examination The patient was a rather poorly developed and poorly nourished chronically ill white male. He was rational and oriented, but exhibited some evidence of memory impairment. His gait was normal, but he walked with obvious fatigue and his head was tilted and fixed to the right. Neurological examination showed the following positive findings: There was atrophy of the left disc, but fingers could be

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Intracranial Angiography

I. The Diagnosis of Vascular Lesions

Carl F. List and Fred J. Hodges

parasellar region were exposed. No neoplasm was found. There was no evidence of abnormal bulging of the cavernous sinus, and the internal carotid from its dural entrance to the origin of the cerebral branches appeared normal. One year later, spontaneous disappearance of the presenting symptoms and physical findings had occurred while primary optic atrophy with reduction of visual acuity to 1/60 had developed on the right side. Final diagnosis: Coarctation of the internal carotid, possibly associated with occlusion of the ophthalmic artery. In chronic encephalopathies, it

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Alfonso Asenjo and Enrique Uiberall

vessels were revealed to be arteries or undifferentiated vessels. Remains of old hemorrhage as well as of chronic arachnoiditis were evident. This report proves the existence of true arterial angioma. REFERENCES 1. Asenjo , A. , and Uiberall , E. Afecciones vasculares quirúrgicas del encéfalo. Santiago : Central de Publicaciones , 1945 , 308 pp. Asenjo , A., and Uiberall , E. Afecciones vasculares quirúrgicas del encéfalo. Santiago: Central de Publicaciones , 1945, 308 pp. 2. Bergstrand , H. , Olivecrona

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Penetrating Craniocerebral Injuries

Evaluation of the Late Results in a Group of 200 Consecutive Penetrating Cranial War Wounds

George L. Maltby

not been done on soldiers injured in the second world war, more “chronic” studies have been made in a similar group of injuries in the first world war by Ascroft, 1 Cushing, 6 Wagstaffe and Adie, 17 Wagstaffe, 16 and Goldstein. 10 The basic criterion in the selection of the present group of patients was dural penetration. All the injuries were incurred in combat. Slightly over 90 per cent of this group were injured in either the European or Mediterranean theaters of operation. The remaining 10 per cent were wounded in the South Pacific theater. The original

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John E. Scarff and James L. Pool

S ince the first World War the idea has become prevalent that when the spinal cord has been completely transected in man, after a brief period during which the reflexes are abolished, there develops, inevitably, a chronic state of heightened reflex activity in the isolated cord, leading gradually to mass reflex spasms, which are considered to be the result of “release” of the isolated portion of the cord from the influence of the brain. These current views were foreshadowed by those of Romberg, 14 Charcot, 5 Gowers, 7 Riddoch, 13 and others. Romberg 14

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A Contribution Related to Treatment

Olan R. Hyndman

cistern was filled with clear fluid under tension. The cistern was ruptured and the foramen of Magendie found to be patent. Saline injected into a ventricle flowed freely through the foramen. A section of the arachnoid revealed microscopically the evidence of chronic inflammation. After this operation he became much clearer mentally and began to walk well. He was discharged on October 18 greatly improved. For 3 weeks the improvement continued and he then began to lose ground again. He was readmitted on Nov. 25, 1941, and presented about the same findings as on the