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Claude C. Coleman

( left ). High combined lesion of the right ulnar and median nerves, showing typical appearance of hand. Note the deformity of the right hand as compared with the left. ( right ). Complete paralysis of the right median and ulnar nerves from division of the nerves in the upper arm by a fragment of glass. Note flexion of the wrist by substitutionary action of the extensor osseus metacarpi pollicus supplied by the musculospiral. The tendon of this muscle can be seen. The scar of incision is also shown. It was necessary to transpose the ulnar nerve to get satisfactory

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W. M. Craig

required depends also upon the time which has elapsed between the original injury and the institution of treatment. When a purely motor or mixed motor and sensory nerve has been divided and its conductivity lost, the muscles supplied by it lose their tone. This allows the joint on which they normally act to assume an abnormal position due to the action of the opponent muscles. The deformity is not due to the loss of tone of paralyzed muscles but rather to a combination of this with the force of gravity. In injuries to the radial nerve there is a very characteristic

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R. Glen Spurling

the most favorable circumstances, progresses at not more than 2 inches each month. As an example, a sciatic nerve, severed in the midthigh, requires a minimum of 15 months for regeneration of fibers to their distant terminations. After anatomical restoration of the nerves, comes the long period of reeducation and strengthening of muscles so necessary to full functional activity. Deformities can be prevented by properly applied braces, and, in many instances, the patient can do productive work during the convalescent period. However, care of the paralyzed muscles

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Abraham Kaplan

paraldehyde and bromides for restlessness. 50 mg. of ascorbic acid twice a day, as well as daily intravenous fluids. On July 27, 1943 his condition permitted his transfer to a nearby Naval Hospital and after two days' observation there he was transferred to this hospital. Examination . He was a critically ill, dehydrated young man who could hardly be aroused and who, most of the time, was uncommunicative. At times he was very irritable and abusive. There was a conspicuous depression and deformity involving the right frontal bone and orbit. The lower jaw was so swollen and

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J. Grafton Love

more than 40 mg. per 100 c.c. of protein. Frequently a subarachnoid block is demonstrable by Queckenstedt's test if the needle is below the level of the tumor. If a contrast medium is used intraspinally, characteristic defects ( Fig. 6 ) are observed and the defect rarely mimics that of the anterior extradural deformity seen opposite the interspace in cases of protruded intervertebral disk. Fig. 6. Postero-anterior roentgenogram of the lumbar region of the spinal column after subarachnoid injection of lipiodol. There is a defect in the column of lipiodol

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Edgar F. Fincher

and objective evidence of blindness, irrespective of a history of birth injury, was used as a definite contraindication for any investigative or surgical consideration. Plain X-ray films of the skull when they revealed any changes ( Fig. 1 ) other than premature bony closures were utilized in excluding further investigations. In pneumo-encephalographic experiences in an older group of microcephalics prior to 1935 various ventricular enlargements and deformities had been noted—in this same group the failure to visualize the subarachnoid spaces ( Fig. 2 ) occurred in

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Henry T. Wycis

B asilar impression had been known to the German pathologists for some time. Rokitansky 11 apparently was the first to mention the deformity in 1844. Boogaard, 1 in 1865, described the condition and related its causes and consequences. Virchow 14 submitted more detailed descriptions of the condition in 1876. Grawitz, 4 in 1880, made careful anatomical studies of six skulls with basilar impression. Homén, 5 in 1901, was the first to correlate the neurological abnormalities with the postmortem findings. He demonstrated the local pressure effects of the

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Wallace B. Hamby

T he use of the beveled Gigli saw-cut in performing a craniotomy allows replacement of the flap with a minimum of deformity. In the average case no mechanical restraint of the flap is necessary since closure of the overlying tissues fixes it securely. In some instances, however, the flap must be wired into place. If the lower end of a frontal flap be cut with a De-Vilbiss rongeur the resulting defect often is wide enough to produce an unsightly ridge. Wiring usually does not prevent depression of such a flap. A simple clip to prevent depression of the bone

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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

roentgenogram. I am certain we see a great many of these anomalies in the spine without neurological signs and symptoms. It is difficult to know how much the deformity has to do with the neurological symptoms. As roentgenologist to the Children's Hospital I see a good many roentgenograms of spines in consultation with Dr. Schreiber, and without knowing anything about the clinical signs or symptoms it is difficult to fully appreciate the possibilities of associated cord lesions in such cases. Many of these lesions appear slight and seemingly are unimportant anomalies. Dr. A

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Axel Olsen and Gilbert Horrax

not of diagnostic value as to the side of the lesion. VENTRICULOGRAMS In 8 cases a ventriculogram was considered necessary to determine definitely the need of a suboccipital approach or to differentiate tumor from some other condition. In only 1 patient did the air study lead us to suspect an acoustic neuroma by deformity of the occipital horn of the lateral ventricle, as described by Stone and Schulze. 10 A summary of this case follows: Case 1 . M. B., a 51-year-old white woman, was admitted to the New England Deaconess Hospital on September 21, 1940