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Joseph A. Mufson and Leo M. Davidoff

base of the skull. Further search revealed a fifth and even larger tumor attached to the tentorium in the region of the petrous bone. This mass was found to extend medially through the tentorium into the posterior fossa ( Fig. 6 ). Chronologically this tumor was removed first separating it from the surface of the cerebellum and pons. Then the three superficial tumors were removed. Finally the fourth, extending through the base of the skull, was attacked. This could not be removed cleanly but what shaggy remains were seen were thoroughly coagulated. Fig. 6

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Gilbert Horrax

able very early in his career to surpass the efforts of all those who had preceded him in dealing successfully with intracranial neoplasms. As far back as 1909, 13 he reported what were then brilliant results in a series of thirty-five suboccipital operations for presumed cerebellar tumors. Operations on the cerebellum in those days were thought to be the most dangerous of all intracranial procedures, and many authorities felt that cerebellar tumors were practically inoperable. Cushing, however, reported 13 successful tumor extirpations, 17 palliative suboccipital

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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

, the classical clinical syndrome of cerebellar tumor. At operation, the muscles were found to be densely adherent to the scarred cerebellum and there was finally exposed a large tumor mass replacing almost the entire right hemisphere. This mass was gradually freed from the surrounding cerebellar tissue, mobilized, and removed en masse . As the tumor was delivered there was free bleeding from its bed. Foam corresponding in aggregate to the size of the tumor was immediately introduced into the depths of the wound. This was held in place by lintene strips which were

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Intracranial Dural Cyst

With Report of a Case

Webb Haymaker and Miles E. Foster Jr.

) and tentorium are displaced anteriorly. The wall is intact except for an aperture ( A ) on the left side which is lateral to the falx cerebelli and beneath the lateral sinus. The dural wall was intact except beneath the tentorium on the left side where there was a spherical aperture which measured 3.0 cm. in diameter. Snugly herniated into the cyst through this aperture was a portion of the ansiform lobule of the cerebellum ( Fig. 4 ). The leptomeninges covering the protruded portion of the cerebellum were intact. At the periphery of the cerebellar

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Franc D. Ingraham, Orville T. Bailey and Frank E. Nulsen

where a small number of polymorphonuclear leucocytes were found. In the monkey sacrificed after 24 hours there were two small foci of polymorphonuclear leucocytic infiltration, one in the meninges over the cerebral cortex and the other in the meninges of the cerebellum. All other sections of the brain and spinal cord showed no evidence of change. The sections of the monkey sacrificed six days after the injection of the thrombin showed as their only abnormality a minute collection of lymphocytes with a very few eosinophiles in the meninges overlying the cornu Ammonis

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Franc D. Ingraham and Orville T. Bailey

earlier stages of this exploration it was possible to get the cerebellum again well reexposed and it was only when she had an attack of vomiting from manipulations in the region of the fourth ventricle that ether was temporarily given. “There had been a good deal of new bone formation in the defect, which made the reflection of the flap somewhat difficult.The cutting current was used with the new apparatus which had just arrived. I finally got down into the posterior cistern in the region of the foramen and found the upper part of the cord and the calamus quite normal

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W. K. Welch and Margaret A. Kennard

. Arch. Neurol. Psychiat., Chicago , 1940, 43: 736–764. 4. Demange , E. Contributions à l'étude, 1. des tremblements prae- et posthémiplégiques, 2. des hémiplégies bilatérales par lésions cérébrales symmétriques. Rev. Médecine , 1883 , 3 : 371 – 404 . Demange , E. Contributions à l'étude, 1. des tremblements prae- et posthémiplégiques, 2. des hémiplégies bilatérales par lésions cérébrales symmétriques. Rev. Médecine , 1883, 3: 371–404. 5. Fulton , J. F. The interrelation of cerebrum and cerebellum in the

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Henry T. Wycis

the consistency of cheese and was extremely vascular. It appeared so soft that the laminectomy could have been completed with a stout pair of scissors. The laminae of the first five cervical vertebrae were removed. The bone over the cerebellar hemispheres was then rongeured away. The dura was thickened and deeply indented over the cord in the region of the atlas. The dura was opened over the upper cervical segments and over both cerebellar hemispheres. It was noted that the tonsils of the cerebellum were herniated through the foramen magnum for a distance of

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Daniel Weller

concerning her course is not available. DISCUSSION Although tumors of the fourth ventricle do not produce a typical clinical syndrome, they seldom present such a misleading sign as bilateral deafness. In most instances, regardless of the initiating symptoms, signs of increased intracranial pressure, with or without involvement of the pons, medulla or cerebellum, appear. Craig and Kernohan 2 list headache, choked disk, vomiting, ataxia, diplopia, stiff neck and hiccup as predominant in their series of 82 cases. All these symptoms result from either obstruction to

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Frank Turnbull

ventriculogram revealed an internal hydrocephalus of moderate extent. A few bubbles of air were seen to have passed through the aqueduct of Sylvius and lay on the left side of the cisterna magna. There was no evidence of fracture of the skull in the X-ray films. Operation . This was performed (assisted by Capt. P. Lehman, R.C.A.M.C.) on October 23, 1943, nine months after the first head injury and three weeks after the second. The cerebellum was approached by a vertical midline incision. A burr hole over the left cerebellar hemisphere disclosed normal dura; on the right side