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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

Roulhac 15 and Haynes. 11 Moreover, Rowe and Turner 14 have emphasized some of the important differences and peculiarities encountered in war wound infections of the brain. Table 3 presents some of the facts about the debridement, the presence of foreign bodies, and the incidence of epilepsy in this group of 47 patients with infections. TABLE 3 Infection No. Type Debrided (Hrs. after Injury) Epilepsy Foreign Bodies * 1 Superficial (W) 24 No M 3 Superficial (W) 15 No N 4 C.S.F. leak 36

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James L. Pool and Oscar A. Turner

Hospital overseas, where the following notes were made: 13 March 1945, normal reflexes of lower extremities; no Babinski. Lumbar puncture: Initial pressure 215 mm. CSF; no block; total protein 27 mg. per cent. X-rays of spine showed minimal osteoarthritic changes in the lower dorsal and upper lumbar vertebrae. 27 March, tests with a Richter neurodermometer showed no sensory loss, which together with the history and vague neurological findings led to a tentative diagnosis of conversion hysteria. On 28 March 1945 the tendon reflexes of the left arm were found slightly

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Franc D. Ingraham and Orville T. Bailey

F Neck pain, sudden quadriplegia. Cervical Occult spina bifida over lesion. Laminectomy. Evacuation of cyst. Removal solid tumor. Pseudostratified ciliated epithelium, mucous glands, cartilage, alveolar spaces lined by cuboidal epithelium, fat, nerve fibers, collagenous tissue. Living with no residual changes 10 years after operation. 11 R.M. 5 years M Back pain, paralysis lower extremities, C.S.F. block. Lumbar None Laminectomy. Incomplete removal cystic tumor. Stratified squamous epithelium, sebaceous glands, mucous glands

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Arthur A. Morris

smallest fragment of the tissue. The following case illustrates the importance of accurate histological diagnosis on a tiny fragment of tissue, which was too small to allow a frozen section to be attempted: A 46-year-old woman who had Jacksonian seizures for 2 years, was admitted for investigation. There were no neurological signs, except a questionable papilledema of the left eye. The CSF pressure was 220 mm. A ventriculogram revealed an expanding lesion of the left frontoparietal region. Plain X-rays of the skull were normal. A left frontoparietal osteoplastic

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John D. French and Paul C. Bucy

Case 15 Neither reported persisting. Dandy 14 Neither reported. II Involved septum pellucidum plus thalamus or basal ganglia Saltykow Neither reported. Cardona Case 2 No mental symptoms. Patient and mother had epilepsy. Riskaer Case 2 No mental symptoms. Long history of “spasms” of left side. Bailey 3 Neither reported. III Involved septum pellucidum plus corpus callosum. No obstruction c-s.f. Marchand Mental difficulties predominated. No epilepsy. Wolf Theatrical behavior

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William S. Keith

well as it could be carried out, was negative. C.S.F. pressure is not known. The fluid was clear. There were 4 cells and there was no growth on culture. By the evening of Oct. 13, when he was admitted to the Toronto Western Hospital, he was very drowsy. All speech was lost except for a muttered “yes” or “no,” and there was a profound weakness of the right arm. With the worsening of his condition it was essential to establish a pathological diagnosis. Three burr-holes were made under local anaesthetic in the left frontal and temporal regions. The tension of the

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Actinomycotic Brain Abscess

Complete Excision with Recovery

Richard C. Schneider and Robert W. Rand

for the first 4 days 50,000 units intrathecally, making a total of 4,440,000 units penicillin. The CSF was xanthochromic for a few days after operation but subsequent lumbar punctures showed a colorless fluid with a wbc. ranging from 0–10 lymphocytes. Three cultures were negative for pyogens, and smears of the sputum contained no fungi or tubercle bacilli. Direct culture from the abscess showed a dispersed “snow flake” growth on Brewer's thioglycolate broth and brain-heart infusion broth. Subcultures to blood agar plates when innoculated in 10 per cent CO 2

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Extradural Cerebellar Hemorrhage

Review of the Subject and Report of a Case

Frank M. Anderson

right cerebellar neoplasm was felt to be more probable than either of these. April 10, ventriculography was performed through posterior parietal burr holes, 40 cc. of CSF being removed and replaced with an equal amount of air. This study showed moderate internal hydrocephalus, and forward dislocation of the 4th ventricle with narrowing in its anteroposterior dimension ( Fig. 1 ). Fig. 1. Ventriculogram (retouched) after instillation of 40 cc. of air, some of which has escaped into the subarachnoid pathways. Moderate dilatation of the lateral ventricle is

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Extradural Spinal Cyst

A Case Report

Hannibal Hamlin, Richard W. Garrity and James B. Golden

Hospital for further study. His complaints on admission in late Jan. 1947 were obscure discomfort in the back, loss of spring in the legs and some slight gluteal pain on coughing. Examination . The physical and laboratory findings were normal and roentgenograms were reported as negative. CSF pressure was normal as were dynamics, cell count, Wassermann, protein and gold sol test. Subsequent study by the general, orthopedic, urologic and roentgen services arrived at no diagnosis and he was referred to the neurosurgical service. The only abnormal finding at this time was

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A New Operation for the Treatment of Communicating Hydrocephalus

Report of a Case Secondary to Generalized Meningitis

Donald D. Matson

a hospital in the midst of a generalized convulsion. She was subsequently transferred to the Neurosurgical Service of Duke University Hospital. On admission she was found to have staphylococcus meningitis, osteomyelitis of the frontal bone, and CSF rhinorrhea. A radical extirpation of the infected bone and frontal sinuses was carried out ( Fig. 1 ) and the dural defect repaired with a pericranial graft. Fig. 1. Extent of craniectomy for removal of infected bone and repair of the dural defect. After a stormy postoperative course, the infection