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E. S. Gurdjian and H. R. Lissner

was incised in the midline and the masseter muscles reflected and excised. After all bleeding points had been stopped, a small area of the skull was carefully dried and polished in preparation for the application of an electric strain gage. The strain gage was cemented to the polished surface of the skull with methyl methacrylate cement and this was allowed to dry under a heat lamp for approximately two hours. The strain gages used in these experiments were Baldwin Southwark SR-4 resistance wire gages, type C-5, having a half-inch gage length and a resistance of 350

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Eldridge Campbell and Christian Keedy

temporarily and slightly lessen it. The movements were never observed to spread to muscles other than those supplied by the left facial nerve. Fig. 1. Case 2. Photograph made during hemifacial spasm. The left temporal and masseter muscles were markedly atrophic and the jaw on opening deviated to the left. The incisional scar in the left temple was well healed and the scalp somewhat sunken in over the decompression. Laboratory Data . RBC: 4,900,000; WBC: 7,900; blood non-protein nitrogen: 41 mgm. per cent; blood chlorides: 450 mgm. per cent. Operation

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A. Earl Walker

quite approximate when an attempt was made to close them. The masseters, however, contracted well. The corneal sensation was good. The right ear was completely deaf. Otherwise the neurological findings including the gait were normal. The patient has written several times since her discharge stating that she has been quite well and has had no further complaints. DISCUSSION There seems little doubt that the cerebrospinal fluid leak in this case resulted from the extensive erosion of the tumor into and the subsequent operative opening of the mastoid air cells

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Carl H. H. Baumann and Paul C. Bucy

he was accidentally struck in the right eye by a twig but noticed no pain, in spite of denudation of the cornea. This was the first time that he realized that the eye was anesthetic. A few months prior to admission he began to notice impaired vision in the right eye which progressed to an inability to recognize people at close range. Recently at irregular intervals he had had sudden but not severe twinges of pain in the right side of the face. Examination . There was complete paralysis with atrophy of the right temporal and masseter muscles. The jaw deviated to

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David D. Daly, J. Grafton Love and Malcolm B. Dockerty

the petrous tip. Electromyography revealed the motor-unit potentials in the right masseter muscle to be large in amplitude and reduced in number and occasional fibrillation potentials were observed. This was felt to be indicative of neurogenic atrophy. Because of the history, and neurologic and roentgenographic findings, we made a diagnosis of a tumor involving the right gasserian ganglion. Although the pain that the patient had was of the type usually associated with trigeminal neuralgia, which of course has an unknown etiology, the objective neurologic findings

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Ignacio Olive and Hendrik J. Svien

masseter, pterygoid and temporal muscles on the left was noted. There was also moderate diminution of taste on the left side of the tongue. Ophthalmologic examination disclosed slight weakness of the left external rectus muscle. The ocular fundi and the visual fields were normal. Moderate hypoactivity of the left labyrinth was found. Hearing was within normal limits. Roentgenograms of the skull revealed the left anterior clinoid process to be decalcified from below and elevated, together with a sharp area of decalcification at the tip of the left petrous apex. A

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Hypothermia Anesthesia in the Sitting Position

Report of two Cases of Acoustic Neurinoma

Robert W. Rand

the face, together with suggestive weakness of the left temporalis and masseter muscles. A partial peripheral type of left facial weakness was observed. The left labyrinth was completely unresponsive with almost total deafness on that side. The pharyngeal reflex was absent on the left and the patient's speech was markedly slurred. The tongue tended to deviate to the left. Marked ataxia in the left upper and lower extremities with other signs of dyssynergia were found; motor strength was unimpaired. She walked on a broad base and staggered to the left. The deep

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Harold Haft, Bernard E. Finneson, Harry Cramer and Rosa Fiol

facial muscles, the right masseter muscle and right palate was noted, as well as deviation of the tongue to the right. On Dec. 27, 1955, the patient complained of diplopia on right lateral gaze. At this time blood pressure was 160/95, and pulse rate 127. Hemoglobin was 10 gm.; there were 3.3 million red blood cells, 18,000 white blood cells with 24 per cent eosinophils, 16,500 platelets, 0.3 per cent reticulocytes, and blood urea nitrogen was 17. On Jan. 3, 1956 the patient showed nuchal rigidity and petechiae were found on his back and chest. A Jacksonian seizure

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Leonard T. Furlow

and remaining in the area of the 1st division, so she was told that a complete section of the root would be necessary. She absolutely refused to open her mouth sufficiently to test the motor division, but there was no apparent atrophy of the temporal or masseter muscle. It was recognized that she might be a problem postoperatively because of numbness, but this was fully discussed and she begged for relief. On Aug. 12, 1947 a complete section of the left sensory root was done, sparing the motor root. On one occasion, about a month postoperatively, she scratched the

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Jacques P. Schaerer and Robert D. Woolsey

of contraction of the left masseter muscle it was difficult for her to open her mouth. The jaw jerk was absent. She had no pyramidal tract signs. Her cerebellar function was severely disturbed. When admitted to St. Joseph's Hospital in February, 1958, she was unable to stand. Otherwise the picture had remained very much the same. In view of the long history the diagnosis of glioma of the pons seemed to be no longer tenable. Plain films of the skull did not reveal any abnormalities. Pneumoencephalography was done on Feb. 6, 1958, with air entering the cisterna