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Eldon L. Foltz and Arthur A. Ward Jr.

and the neurological deficits could not be reversed by cerebrospinal fluid shunts, or repeated lumbar punctures. The clinical signs and symptoms that accompany this delayed hydrocephalus are varied. Table 2 compares the signs and symptoms in this group. There is no constant syndrome caused by the hydrocephalus, though headache was the most common symptom. Increased spinal fluid pressure was present in all rapidly progressing cases. Although the signs and symptoms are variable and possibly confusing, they would all appear to be secondary to dysfunction of basal

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Robert H. Pudenz, Findlay E. Russell, Arthur H. Hurd and C. Hunter Shelden

-functioning. It was concluded that if the flow of cerebrospinal fluid had been more copious the outcome might have been successful. The technique was tried in a 10-month-old infant, using a cephalic vein removed from the child's father. Unfortunately the infant died several hours after surgery of a “central thermic disturbance.” In 1913 Haynes 7 published the first of a series of papers characterized by a progressive loss of enthusiasm for establishing a cerebrospinal fluid shunt into the venous system. In his first paper, this author described 2 unsuccessful attempts to

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Fred D. Fowler and Donald D. Matson

inoperable intracranial mass causing increased intracranial pressure by blocking the anterior portion of the third ventricle, a cerebrospinal fluid shunting procedure may give symptomatic relief. This was done in 1 of our patients by performing a bilateral ventriculocisternostomy. The use of roentgen therapy in these lesions is a subject of some debate. Evaluation of any such therapy is difficult because many of these tumors grow very slowly even without any definitive treatment. Thus, length of survival cannot in itself be used as a criterion of the efficacy of roentgen

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Franklin J. Keville and Burton L. Wise

lesion of the upper cervical spinal cord. The tumor was removed without opening it in 1 patient, who is living without evidence of recurrence 5½ years postoperatively. The tumor was incompletely removed in 1 patient, who had an early recurrence of increased intracranial pressure and died in spite of re-exploration and ventriculocisternostomy. In the third patient the cyst, which had become infected via the dermal sinus, was opened in the process of removal; this caused a progressive, adhesive process about the cerebellum and brain stem. Several cerebrospinal fluid

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Michael S. Mason and John Raaf

T he management of increased intracranial pressure remains a challenge to the neurosurgeon. Surgical decompression, cerebrospinal-fluid shunts and numerous diuretics have been in vogue at different times. Every diuretic available has been evaluated and used with some degree of success; however, most are too slow-acting and therefore of limited value when a prompt reduction of intracranial pressure is essential. Some diuretics produce disturbances of electrolytes and are thus not suitable for long-term use. Hypertonic solutions of glucose, sucrose and Sorbitol

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Giovanni Di Chiro and Arthur S. Grove Jr.

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Thalamic Syndrome and Its Mechanism Thomas A. Waltz George Ehni April 1966 24 4 735 742 10.3171/jns.1966.24.4.0735 Evaluation of Surgical and Spontaneous Cerebrospinal Fluid Shunts by Isotope Scanning Giovanni Di Chiro Arthur S. Grove Jr. April 1966 24 4 743 748 10.3171/jns.1966.24.4.0743 Nocardia Asteroides Meningitis Robert B. King William L. Stoops John Fitzgibbons Paul Bunn April 1966 24 4 749 751 10.3171/jns.1966.24.4.0749 Brain Abscess Due to Gas Bacillus Infection Aldo Morello Nicola Bettinazzi April 1966 24 4 752 754 10.3171/jns.1966

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Darrel Weinman and A. T. S. Paul

reintroduced into the right auricle with good results. None of the other cases, of which 18 have now been followed for over 1 year, has needed reoperation. Summary Accurate placement of the cardiac end of a ventriculoauricular cerebrospinal fluid shunt can be ensured by the use of a transthoracic direct cardiac approach. The results obtained in 42 cases with this method have justified continued use. So far, annual revisions have been unnecessary when a sufficiently large loop has been left in the cardiac tube to accommodate future growth of the child

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Richard H. Ames

suggest that the abdominal cavity might indeed be a satisfactory shunt receptacle. Realizing that the newer techniques of shunting into the blood stream involved certain inherent problems, we decided to try the abdominal cavity once more, this time using silicone tubing because of its inert properties, along with a slit valve at the distal end to prevent reflux of fluid from the abdominal cavity. The first such shunt was done in 1958. It soon became obvious that the peritoneal cavity was admirably suited for cerebrospinal fluid shunting. Nothing has occurred since

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Franklin Robinson, Jacques B. Lamarche and Gilbert B. Solitare

combat, 7, 16 compound fracture of the skull, 32 or contamination of the cerebrospinal fluid during lumbar puncture. 12, 17 The clinical findings in three adults with E. coli meningitis are presented with emphasis upon certain neurosurgical implications arising during the course of the illness. Two of these patients died, one entirely unsuspected of harboring this intracranial infection; the third developed persistent hydrocephalus, which was ultimately relieved by a cerebrospinal fluid shunt. Postmortem observations are also presented to further our awareness of