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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

. In view of this, large pieces may be left if the occasion demands. We have used fibrin foam clinically and experimentally in conjunction with such bactericidal agents as sulfadiazine and penicillin. The evidence indicates that no change in the properties of the foam or in the tissue reactions occurs under such circumstances. PART II—FIBRIN FILMS A suitable substitute for normal human dura mater is highly desirable for two primary reasons: first, the dura may have to be removed because of its involvement in a disease process; and second, the dura may be

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A. Earl Walker, Jerry J. Kollros and Theodore J. Case

blow delivered by a weight falling through a glass tube upon a column of water in contact with the intact dura mater. Of these methods, which could be made to give identical clinical and physiological results, the last was found to produce the most predictable results, and to cause the least disturbance to apparatus attached to the head. Early in this study it was found essential to determine the severity of a blow that consistently would produce concussion. This was accomplished by anesthetizing the animal with vinethene (vinyl ether) during the preparation of the

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Intracranial Dural Cyst

With Report of a Case

Webb Haymaker and Miles E. Foster Jr.

C ysts located solely within the dura mater are a rarity. Apparently the only one on record was situated in the spinal canal. The case in point, described by Voss, 9 concerned a boy aged sixteen who over a period of about three months had developed symptoms of compression of the lower thoracic cord. Myelography disclosed subarachnoid block at the levels of the fifth and the eighth thoracic vertebrae. There was also a uniform dilatation of the spinal canal in this region. At operation a non-pulsating, pale cystic structure extending from the sixth to the tenth

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J. Grafton Love

. The operation was carried out with the patient under ether anesthesia, and the site of operation was between the points of introduction of two lumbar puncture needles. A huge tumor, which arose from the filum terminale, was found to have produced complete block. The cauda equina, which completely surrounded the tumor, was separated from it and the filum terminale was doubly silver-clipped above and below and divided, thus freeing the tumor for complete removal. The dura mater was closed with continuous silk sutures; the wound was closed in layers. One strip of gauze

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Norman C. Delarue, Eric A. Linell and Kenneth G. McKenzie

bone was elevated, exposing, symmetrically, the dura mater covering the vertices of both cerebral hemispheres. The dura was incised at 2 to 4 widely separated points and the underlying cortical tissue was traumatized to an approximate depth of 5 mm. At first two areas of cortex were damaged in each hemisphere but, as it was noted that these animals rapidly developed epileptic seizures, only 2 traumata, one in each hemisphere, were inflicted on the later animals of the series. The usual plan of dealing with these symmetrically placed and approximately equal cortical

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Edgar F. Fincher

intracranial pressure, and the earlier explanations of pachymeningitis hemorrhagica on inflammatory bases, it occurred to mind that the chronic inflammatory changes described by Brushfield and Wyatt might well have been the result of subdural bleeding from birth trauma. Lannelongue 6 in 1891, before the 5th French Congress of Surgery, reported his results in 25 cases of craniectomies on microcephalics. He referred to them as obstetrical compressions due to forceps deliveries or difficult labor. He advocated linear or flap craniectomy and “detached the dura mater and

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Orville T. Bailey and Franc D. Ingraham

C onsiderable confusion exists in regard to the classification and clinical behavior of malignant connective-tissue tumors of the dura mater. These neoplasms are infrequent in occurrence, bizarre in clinical behavior, and obscure in histogenesis. Since they are rare, opportunities for study and comparison of different examples are unusual, while the difficulties in establishing the precise site of origin and method of growth make such comparisons desirable. When a patient with one of these dural tumors enters the hospital, there is not sufficient understanding

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Intracranial Fibrosarcomas of the Dura Mater in Childhood: Pathological Characteristics and Surgical Management Orville T. Bailey Franc D. Ingraham January 1945 2 1 1 15 10.3171/jns.1945.2.1.0001 Giant Cell Tumor of the Sphenoid Bone Report of a Case Dean H. Echols January 1945 2 1 16 20 10.3171/jns.1945.2.1.0016 The Technique of Tantalum Plating of Skull Defects Lt. Col. Arthur J. Hemberger Capt. Benjamin B. Whitcomb Major Barnes Woodhall January 1945 2 1 21 25 10.3171/jns.1945.2.1.0021 Functional and

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Paul C. Bucy and Ben W. Lichtenstein

magnum were proposed as well as the diagnosis of a neurinoma arising from the right hypoglossal nerve. Roentgenograms of the skull, the foramen magnum and the cervical spine failed to reveal significant alterations. A suboccipital exploration was performed on Nov. 26, 1943 under local anesthesia. Upon removal of the central portion of the occipital bone overlying the cerebellum and including the posterior part of the foramen magnum, the dura mater was found to be taut and bulging. The posterior arch of the first cervical vertebra was then removed. Upon incision

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Stuart N. Rowe and Oscar A. Turner

dependent to a large extent upon the course of the missile and it is convenient to consider separately those cases in which the wound involved the vault of the skull alone and those in which there was associated perforation of the orbit or the paranasal sinuses. An infected wound may serve as the source of meningitis in the presence of an open dura mater, particularly when there is direct communication with the subarachnoid space or ventricular system (Case 1). Infection in the wound even with exposed cortex is rarely followed by meningitis or extensive cerebritis