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James S. Heiden, Martin H. Weiss, Alan W. Rosenberg, Theodore Kurze and Michael L. J. Apuzzo

were treated with tetanus prophylaxis and massive systemic antibiotics; some were treated with skeletal fixation when cervical stability was in doubt. Surgical exploration of penetrating missile injuries to the neck was performed only when esophageal lacerations were verified by hypaque esophagrams or endoscopy, and in cases with angiographic evidence of contrast extravasation from carotid or vertebral artery injury or arteriovenous fistula. Results Group A The operative findings revealed dural lacerations in 77% of the cases in Group A. The cervical

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.1977.46.3.0391 Changing venous pattern in a hemangioblastoma resembling an arteriovenous malformation Alvin Thaggard Stanley Handel Milam E. Leavens George Isaacs March 1977 46 3 394 397 10.3171/jns.1977.46.3.0394 Neurosurgical endoscopy using the side-viewing telescope Michael L. J. Apuzzo Milton D. Heifetz Martin H. Weiss Theodore Kurze March 1977 46 3 398 400 10.3171/jns.1977.46.3.0398 J Neurosurg Journal of Neurosurgery 0022-3085 Journal of Neurosurgery Publishing Group 1 3 1977 March 1977 46 3 10.3171/jns.1977

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Michael L. J. Apuzzo, Milton D. Heifetz, Martin H. Weiss and Theodore Kurze

absorption through a traditional small telescope is very high, and this light loss limits the efficiency of most endoscopy units; however, the Hopkins unit has a higher percentage of light transmission resulting in a much brighter image. A significant step forward in obtaining improved illumination was provided by Lamm 4 with the development of small flexible fiberglass threads for the transmission of light. Because of the small diameter of the Hopkins lens system, it is possible to place a thin layer of lighttransmitting optical fiber bundles around the rod lenses to

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Anthony E. Gallo Jr. and James D. Smith

. The estimated blood loss was 70 cc. The pathological report was similar to that on the intracranial portion, and included gliotic brain, choroid plexus, and oral mucosa. The patient was discharged 8 days later on a liquid diet, and continued to do well with the decrease of intraoral swelling. Five weeks postoperatively the patient was taking adequate nutrition orally and the feeding gastrostomy was removed. Twelve weeks post-operatively after endoscopy the tracheostomy tube was removed. Six months later a small persistent tracheocutaneous fistula was excised with

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Henry D. Messer, Gregory S. Lenchner, John C. M. Brust and Stanley Resor

sepsis, or, less likely, heroin nephropathy. On the third hospital day, the patient developed melena, orthostatic changes in blood pressure and his hematocrit dropped to 17%. Endoscopy revealed a duodenal ulcer and he was transfused with 6 units of whole blood. Because of his active gastrointestinal bleeding and renal failure, as well as sepsis, and possible acute endocarditis, surgery for his spinal abscess was withheld. Under close observation and receiving antibiotics, he remained afebrile and asymptomatic. As iodophendylate was still present in the spinal canal

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Takanori Fukushima

E ndoscopic techniques allow examination of areas inside the body with minimal trauma and play an important role in almost every medical field. Endoscopy of the central nervous system has also been employed since the early days of neurosurgery. Ventriculoscopy has been reported by many authors. 2, 4, 8, 10, 11, 17, 18, 20 Burman, 1 Stern, 19 and Pool 15 performed myeloscopy or “spinascopy.” Since the development and clinical application of the new model of the cerebral ventriculofiberscope in 1968, 5, 6 it has been the author's purpose to develop an

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.48.2.0289 The angiographically occult cerebrovascular malformation James B. Golden Richard A. Kramer February 1978 48 2 292 296 10.3171/jns.1978.48.2.0292 Cervical myelopathy due to spondylosis John C. Hawkins III F. Yaghmai R. Arthur Gindin February 1978 48 2 297 301 10.3171/jns.1978.48.2.0297 Endoscopy of Meckel's cave, cisterna magna, and cerebellopontine angle Takanori Fukushima February 1978 48 2 302 306 10.3171/jns.1978.48.2.0302 Embolization of cerebral vessels with inflatable and detachable balloons Lauri Laitinen Antti Servo February 1978 48 2

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Francis W. Gamache Jr. and Rand M. Voorhies

midline with a hard palpable mass between the soft tissue of the sternocleidomastoid laterally, and the trachea and esophagus medially. Horner's syndrome or recurrent nerve paralysis has been reported in some cases. 16, 26 Indirect laryngoscopy with a tongue depressor and mirror discloses high cervical lesions. Lower lesions of the cervical spine are more simply elucidated with lateral spine films and an esophagram. Although some clinicians have recommended endoscopy, this may in fact prove dangerous and has been a common cause of esophageal perforation. 44, 45 A

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W. Lynn Stringer, David L. Kelly Jr., Frank R. Johnston and Robert H. Holliday

of C-5 and C-6 ( Fig. 1 ). The sagittal diameter of the cervical canal measured 10 mm at that level. The patient was transferred to the North Carolina Baptist Hospital where pneumomediastinum was detected on a chest film. After skeletal traction of 5 lb had been applied, repeat roentgenography showed normal vertebral alignment with a pocket of prevertebral air. Endoscopy showed anterior and posterior tears of the esophagus 1 to 2 cm above the sternal notch. Fig. 1. Flexion and extension views showing separation of vertebral bodies of C-5 and C-6

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Erik-Olof Backlund, Arne Grepe and Dade Lunsford

depended upon the length of the demonstrated obstruction. The normal adult cerebral aqueduct varies from 11 to 20 mm. 25 Optimal prosthesis placement, verified by skull roentgenograms and postoperative encephalography, ultimately was obtained in four cases. Four patients underwent stereotaxic reoperations to move the prosthesis to a better position. Image intensification using the C-arm fluoroscope was valuable in two cases in repositioning the prosthesis correctly. Ventricular endoscopy was used as an adjunct in one case. While the flexible fiberoptic endoscope could