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William J. German

concerning the serious potentialities of chronic leak of cerebrospinal fluid into the nose. A series of twenty-one cases from the literature was reviewed by Johnston; 8 injury was an etiologic factor in six instances. The rhinorrhea persisted in nine cases and the patients were alive at the time of report; the flow had ceased in six cases. Six of the patients were dead when the reports were published. Chronic cerebrospinal rhinorrhea may appear after an interval of several weeks following the injury. Gissane and Rank 6 designated this type as “delayed post

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Andrew J. Akelaitis

report on 5 chronic schizophrenics. Amer. J. Psychiat. , 1942 , 98 : 524 – 532 . Strecker , E. A., Palmer , H. D., and Grant , F. C. A study of frontal lobotomy. Neurosurgical and psychiatric features and results in 22 cases with a detailed report on 5 chronic schizophrenics. Amer. J. Psychiat. , 1942, 98: 524–532. 13. Van Wagenen , W. P. Personal communication. Van Wagenen , W. P. Personal communication. 14. Van Wagenen , W. P. , and Herren , R. Y. Surgical division of commissural pathways in the

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Paul Weiss

view. The ends of each sleeve had become walled off by rings of connective tissue continuous with the epineurium, undoubtedly due to the chronic irritation set up by the sharp rims. However, since these scars formed at a safe distance from the nerve gap, did not penetrate into the nerve, and had not given rise, at least not at this stage, to lateral adhesions, they do not seem to present a serious hazard. After slitting the thin cover membrane, the sleeve was grasped by its overlapping edge and stripped off, or rather unwound, from the nerve. It had lost none of its

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Abraham Kaplan

, thereby establishing a sinus through which there is an exchange of fluid and air. The air may then be trapped in the subdural, subarachnoid, or ventricular spaces. Air may even pocket itself within the brain substance. Not infrequently the dural tear and sinus tract may be so small as to escape detection at operation. Coleman 9 states that cerebrospinal rhinorrhea occurs in about 2 to 5 per cent of skull fractures. Other and more unusual causes of cerebrospinal rhinorrhea and pneumocephalus are intranasal manipulation, 5 chronic infection in the region of the

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Jurgen Ruesch

0 to 4 times the probable error of the coefficient of correlation were considered negligible, from 4 to 6 times as indicating a slight relationship, and above 6 times as expressing a substantial relationship. CASE MATERIAL Twenty-five unselected patients with recent head injuries (acute cases) were compared with 32 patients (chronic cases) who suffered from prolonged post-traumatic syndromes. In this latter group the accidents dated back from 6 months to more than 5 years. No diagnostic selection of cases was made except for the fact that the patients had

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Edgar F. Fincher

of chronic inflammatory changes… the dura was thickened and sometimes adherent to the pia arachnoid” microscopically… “the cerebral cortex showed a definite paucity of neurones; in the precentral gyrus for instance there were areas almost devoid of healthy pyramidal cells, etc.… Some brains under consideration showed definite evidence of a slight degree of atrophic sclerosis affecting both hemispheres.” Recalling the numerous instances in which dural-arachnoidal adherences in cases of tumor have been mistaken as the sole cause of the clinical symptoms of increased

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Daniel Weller

motor power in the right side definitely had improved. However, the right hemianesthesia persisted in all modalities. The operative area was well healed and not bulging. Fourth Admission . The patient returned to the hospital on October 21, 1942 for further radiation therapy. The neurologic status was essentially the same. Her facies was pale and gave the impression of chronic ill health. After every radiation treatment she had a respiratory crisis characterized as follows: Within a few hours she began to breathe rapidly. The respirations were shallow, often

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Frank Turnbull

be described as a subacute, or as a chronic, extradural cerebellar hematoma is a debatable point. CASE REPORT Mrs. T.A., age 38, referred by Dr. R. Woodworth of Kimberley, B.C., was admitted to the Vancouver General Hospital on October 19, 1943. She complained of headache, diminished vision in the left eye, and unsteady gait. Her past and family history were not relevant. She led an active life as the mother of five children. Her symptoms commenced in December 1942, when she fell on some ice and suffered a blow across the left eyebrow which caused a deep

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Histologic Studies of the Brain Following Head Trauma

IV. Late Changes: Atrophic Sclerosis of the White Matter

Joseph P. Evans and I. Mark Scheinker

gold curve reactions. Blood urea nitrogen was 18 mg. per 100 cc. Roentgenograms of the skull showed a large linear skull fracture in the right parietal region. This was the only frank sign of trauma obtained. The convulsions ceased shortly after admission. His level of consciousness improved and after two weeks' hospital stay he was discharged with the diagnosis of chronic alcoholism associated with mental deterioration and convulsive seizures. On March 14, 1941 he was readmitted in shock and died two hours thereafter. The diagnosis made at the autopsy table

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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

made. We have also made observations with an instrument made by Geohegan at the New York Hospital and have not found it very satisfactory. We were not able to outline the area of anesthesia following chronic or acute peripheral nerve palsies. On thinking the matter over I assumed it was probably because the weather was very dry and cold in New York. When the weather is dry and cold the resistance of normal areas is very high. We intend to take the study up again when the hot weather is on us and attempt to duplicate the observations made below the Mason and Dixon