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Gilbert Horrax

tumors in the series, and all but 3 of the 319 survivors were heard from after their discharge from the hospital. Since the last patient operated upon was in 1932, the follow-up period was from five to twenty-four years, as Henderson's data were obtained in 1936 to 1937. This report shows in convincing fashion Cushing's unexcelled supremacy in the surgical treatment of pituitary disorders. His total operative mortality for the chromophobe adenomas (260 patients) was 4.9 per cent, reduced to 2.4 per cent during his last ten years. For acromegalics (67 patients) the

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The Use of Products Prepared from Human Fibrinogen and Human Thrombin in Neurosurgery

Fibrin Foams as Hemostatic Agents; Fibrin Films in Repair of Dural Defects and in Prevention of Meningocerebral Adhesions

Franc D. Ingraham and Orville T. Bailey

were not implanted stained deep blue but otherwise had the same general characteristics described before. They appeared as networks of coarse fibers with clear interstices. In the specimen obtained at the end of 14 hours ( Fig. 7 ) the interstices were filled with blood clot. There was practically no detectable tissue reaction. It should be borne in mind that this patient, who had a radical removal of a pituitary adenoma, was rapidly failing during the 14 hours that the foam was in place. For this reason, the tissue reaction may have been less than it would have

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Edgar F. Fincher, Bronson S. Ray, Harold J. Stewart, Edgar F. Fincher, T. C. Erickson, L. W. Paul, Franc D. Ingraham, Orville T. Bailey, Frank E. Nulsen, James W. Watts, Walter Freeman, C. G. de Gutiérrez-Mahoney, Frank Turnbull, Carl F. List, William J. German, A. Earl Walker, J. Grafton Love, Francis C. Grant, I. M. Tarlov, Thomas I. Hoen and Rupert B. Raney

pituitary fossa when there is oozing from the cavity after partial removal of an adenoma. I have not found it to be highly useful in the larger tumor cavities because most bleeding in such cavities completely stops when arteries have been coagulated or clipped and the tumor entirely extirpated. It is of aid, also, in a tic operation, particularly in saving time by controlling troublesome dural sinus bleeding. I heartily endorse it as a useful adjunct in control of bleeding. Dr. William V. Cone : I can testify to the value of fibrin foam and thrombin. I have used it with

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Dean H. Echols

revealed a red blood cell count of 5,120,000, hemoglobin 97 per cent and white blood cell count of 7,350. Spinal fluid pressure was 140 mm. of spinal fluid. The total protein content was 32.4 mg. per cent. The gold-sol test was 2111100000. The Wassermann reaction was negative. Roentgenograms of the skull ( Fig. 1 ) revealed complete destruction of the sella turcica suggesting either a cerebellar tumor or a large adenoma of the pituitary gland. Fig. 1. Note destruction of sella turcica. This appearance is identical with that produced by cerebellar tumors of

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The Failure of Whole Fresh Homogenous Nerve Grafts in Man Col. R. Glen Spurling Captain W. R. Lyons Captain B. B. Whitcomb Major Barnes Woodhall March 1945 2 2 79 101 10.3171/jns.1945.2.2.0079 The Combined Use of Fibrin Film and Clot in End-to-End Union of Nerves Marcus Singer March 1945 2 2 102 125 10.3171/jns.1945.2.2.0102 Unusual Size and Extension of a Pituitary Adenoma Captain James C. White Lt. Comdr. Shields Warren March 1945 2 2 126 139 10.3171/jns.1945.2.2.0126 Depressed fractures of

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Unusual Size and Extension of a Pituitary Adenoma

Case Report of a Chromophobe Tumour with Unusually Extensive Compression of the Base of the Brain, and Review of the Literature on the Pathways of Extension of These Tumours

James C. White and Shields Warren

O wing to their classical symptoms, adenomas arising from within the sella turcica are rarely permitted to attain any considerable growth before being submitted to operation. This is particularly true of the secreting chromophil adenomata, * but the chromophobe variety may grow to a very large size and, in cases of unusual fixation of the optic chiasm, may do so without compressing the decussating optic fibres. 9 In the rare instances where operation has been overlong deferred these neoplasms tend to extend into unusual areas, with the result that diagnosis

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Marvin Posner and Gilbert Horrax

noted while reading that she would often be unable to see the next word. The history was otherwise negative. She had been seen at another clinic where a diagnosis of probable pituitary adenoma was made. On examination here, the pupils were normal in size and reacted normally to light and in accommodation. Ocular movements were normal in all spheres. There were a few slow, nystagmoid jerks to the right and to the left. Examination of the fundi revealed 4 to 5 diopters of choking bilaterally, with marked venous engorgement. Romberg's test was markedly positive, with a

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Gilbert Horrax and J. P. Wyatt

excavation appeared similar to that which is obtained by the intracapsular removal of a pituitary adenoma. The growth appeared to extend well down into the sella turcica. Course . The patient made an uneventful convalescence and was discharged on Nov. 8, 1945. He showed no great change in his general condition. Vision with the right eye was 20/200 and with the left he could read the largest letter on the chart at a distance of 3 feet. On Dec. 12, 1945 the patient reported for a check-up. He stated that he had had some slight temporary improvement in vision after the

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Herbert Olivecrona

, 1946 Glioma 1571 48.4% Meningioma 608 18.4% Neurinoma 296 9.1% Adenoma 295 9.1% Angioma 104 3.1% Arteriovenous aneurysm 61 1.8% Aneurysm 50 Craniopharyngioma 55 Cholesteatoma 25 Teratoma, chordoma 8 Papilloma 13 Granuloma 50 Metastatic 112 3.4% Miscellaneous 8 ____ 3256 The 295 meningiomas reported in Cushing's monograph represent 13.4 per cent of his 2203 verified intracranial tumors

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B. K. Bagchi and R. C. Bassett

these leads. When this sort of triangulation is simultaneously used in combination with the recording from an upper zygomatic arch lead led through the contralateral ear ground across the brain, the presence of a deep lesion in the frontal region may be revealed, if there is one present. Pituitary adenomas are difficult to localize even with the use of this technique. Rare or occasional changes in some cases of pituitary tumor, however, betray their presence when this technique is applied (see Fig. 8 ). In summary, the order of localizing work-up is as follows