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Mucocele of the Sphenoid Sinus

Report of a Case with Autopsy Findings

F. H. Linthicum, Carl W. Rand and David L. Reeves

conclusion concerning the age of development, for the reason that the progress is markedly slow and innocent, essentially chronic, and some patients have gone as long as 18 years after the appearance of a swelling before considering it necessary to consult a doctor. Even in the less easily diagnosed and quite infrequently observed sphenoid mucoceles, it is difficult to know the period of the onset of the condition. ETIOLOGY The origin of mucoceles of the accessory sinuses has been the subject of much controversy; and although in certain cases the explanation has

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Radical Surgery and Penicillin in Brain Abscess

A Method of Treatment in One Stage with Special Reference to the Cure of Three Thoracogenic Cases

Jacques LeBeau

for abscesses which otherwise could not have been cured. The method that we advocate, and that we have used in the treatment of every brain abscess encountered during the past fifteen months, may be summed up thus: Complete extirpation of the abscess, no matter what its form, whether acute or chronic, single or multiple, even though this may mean opening up a communication between the abscess and the ventricle. We have operated upon 17 brain abscesses in this way. In the first 3 cases, when penicillin was not available and when complete extirpation could not be

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Raymond K. Thompson

wound closed in layers with interrupted cotton sutures. Fig. 2. Arachnoidal cyst as seen at operation. Postoperative Course . The patient did very well. The papilledema began to recede almost immediately and all symptoms except his rectus paresis were gone. During the course of the next 2 weeks the diplopia and rectus paresis disappeared and he was asymptomatic. Pathological Report . The cyst wall consisted of thin fibrous tissue showing invasion of small round cells plus an occasional polymorphonuclear leukocyte and eosinophile. Impression: Chronic

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J. Lawrence Pool and John A. Brabson

) that every precaution was taken so that no spread of electrical current should occur; (2) that no motor response followed stimulation of the distal nerve segments described; and (3) that the area supplied by each severed nerve described was totally insensitive to all forms of cutaneous stimulation as tested clinically prior to neurorrhaphy, with the possible exception of Case 2. From these and similar cases it is clear therefore that stimulation of the distal, chronically isolated segment of a completely divided nerve “A,” may result in pain referred to the area

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William G. Kuhn Jr.

lies in between these two extremes would have a diet interpolated between these two examples. Anyone having had experience with chronically ill or emaciated individuals will be well acquainted with the difficulties encountered in getting a patient to ingest 280 grams of protein. Therefore, portions of food are weighed accurately and from the portion left uneaten on the tray, one can determine how far short the patient has come from the goal prescribed for him. This deficit is made up by supplementary feedings of a milk formula complemented by eggs, skimmed milk

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Robert C. Pendergrass, A. Earl Walker and John P. Bond

. Had the latter been the case the first operation should have cured the condition since a great part of the sac wall was removed at that time; the second operation, not involving the cyst wall, should not have had any effect upon the condition. That the sac was not due to a chronic increased intracranial pressure which caused a tear in the dura mater seems evident since the closure of the neck of the sac eliminating the absorbing mechanism within the sac, however slight it might have been, did not precipitate a chronic intracranial hypertension. The patient

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J. H. Drew, C. E. Koop and R. P. Grigger

._ Type of Feeding Cumulative Nitrogen Balance † control E.C. 45 M Left parietal glioblastoma multiforme Ventriculogram. Temporoparietal craniotomy. Partial removal. 64.2 Oral − J.J. 17 M Left parietal osteoma Craniotomy. Removal. 58.0 Oral − D.F. 15 M Chronic subdural hematoma Right frontoparietal craniotomy. Removal. 47.0 Oral & Tube − D.W. 36 M Chiasmal arachnitis Right transfrontal craniotomy 70.0 Oral − J.R. 50 M Suspected cerebellar tumor

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Cerebrospinal Rhinorrhea by Way of the Eustachian Tube

Report of Cases with the Dural Defect in the Middle or Posterior Fossa

Arthur Ecker

left anterior fossa and found no place of leakage. The rhinorrhea continued a few days. She then developed meningitis from which she died. There was a history of previous mastoiditis. Post-mortem showed some chronic infection of the mastoid cells and an infection spreading along the fracture and intracranially. The dura had been torn over the posterior surface of the petrous. The fluid had been escaping into the middle ear and thence along the eustachian tube into the pharynx and was appearing at the left nostril.” Case 3 . This patient, reported by Schroeder 6 in

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W. James Gardner, Averill Stowell and Robert Dutlinger

or about any of the pain-sensitive structures of the head; and (6) direct pressure by tumors on the cranial and cervical nerves containing many pain afferent fibers from the head. Of these six mechanisms, only one can conceivably be responsible for any significant proportion of cases of chronic recurring headache. That mechanism is distention and dilatation of intracranial arteries, which is the theme of this paper. In the latter part of November 1940, 3 patients with a strikingly similar clinical picture were observed simultaneously. These patients were

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J. Grafton Love and James R. Gay

cortex incident to removal of the tumor. He suggested that resection of the sinus in these cases was achieved without appreciable loss of motor function because the chronic compression or occlusion of the sinus had allowed sufficient time for the development of adequate collateral circulation. Since no one has reported extensive resection of a normal patent sinus, his conclusions cannot be proved or disproved. MacLean 2 studied 6 cases of primary thrombosis of the longitudinal sinus with chronic obstruction from the clinical and pathologic standpoint. In these cases