Search Results

You are looking at 1 - 10 of 46 items for :

  • "multiple craniotomies" x
Clear All
Restricted access

William E. Hunt, John N. Meagher and James E. Barnes

reasons, results will unavoidably be less satisfactory. Probably the grading of risk should take age and hypertension into account. An older patient with severe cerebral reaction to hemorrhage from an anterior communicating aneurysm, for instance, should be allowed to recover a little longer before being subjected to the additional insult of surgery. In the 8 multiple craniotomies, there were 4 instances of secondary craniotomy when postoperative angiography showed the sac still filling. One of these had bled, and the patient expired. The others are well. In 1

Restricted access

D. P. McNeel and M. E. Leavens

alive at 6 and 14 years. 3 We did not encounter in the literature any reported cases of long-term survival with multiple craniotomies for recurrent metastatic malignant melanoma. A number of factors make the evaluation of this single case difficult. The natural course of malignant melanoma is variable and unpredictable from patient to patient. The tumor may show varying growth rates at different times in the same individual. 6 The patient may be asymptomatic for years; then, with recurrence, death may ensue in a few months. This case is presented to illustrate

Restricted access

Robert A. Beatty and Alan E. Richardson

aneurysms, and thus present a significant problem to the neurosurgeon. 4 The traditional plan of treatment has been to attack each of the aneurysms directly by, of course, treating the ruptured aneurysm first. If the surgeon is unable to treat all of the aneurysms in a single approach, then he generally performs multiple craniotomies. 3, 7 This tactic often seems to have been dictated by the lack of evidence as to which aneurysm has bled rather than because of fear that the remaining aneurysms might rupture. However, as McKissock and associates 5 have shown, subsequent

Restricted access

Michael E. Carey, Harold F. Young, Berkley L. Rish and Jacob L. Mathis

; neither was associated with retained bone fragments, and both were successfully treated by excision in Japan. One case ended fatally because of an associated pulmonary embolus. Positive cultures were obtained from both brain abscesses; one grew klebsiella alone, while the other yielded aerobacter arogenes and enterococci . Both epidural abscesses were associated with multiple craniotomy reopening for retained bone. One was caused by staphylococcus, the other by staphylococcus and an enterobacteria species. During World War I, evacuation of the wounded was often

Restricted access

Frederick J. Buckwold, Roger Hand and Robert R. Hansebout

in the remaining seven, the clinical course was consistent with death from meningitis. Of the patients who died, seven were males and five were females with an average age of 41.5 years. Associated Factors Comparison of associated factors and mortality is shown in Table 2 . The most common factor was craniotomy. Eighteen of 23 patients underwent craniotomies and five of these had multiple craniotomies. One patient had a laminectomy, three had placement of ventricular drainage tubes only, and one patient (unoperated) had a skull fracture. Other commonly

Restricted access

Intracranial pressure: to monitor or not to monitor?

A review of our experience with severe head injury

Raj K. Narayan, Pulla R. S. Kishore, Donald P. Becker, John D. Ward, Gregory G. Enas, Richard P. Greenberg, A. Domingues Da Silva, Maurice H. Lipper, Sung C. Choi, C. Glen Mayhall, Harry A. Lutz III and Harold F. Young

dural tear, one had multiple craniotomies, and one had craniotomy wound infection). Two patients were excluded because no organism could be cultured from the ventricular CSF, although there was a pleocytosis suggestive of an infectious process. Thus, 13 of the 207 patients (6.3%) who were monitored developed ventriculitis with or without meningitis, that could be directly related to the monitoring device. Of the 207 patients monitored, only 19 (9%) had subarachnoid screws placed. Of these, only one developed a device-related meningitis, giving an infection rate of 5

Restricted access

Jay Max Findlay, Bryce K. A. Weir, David Steinke, Takamura Tanabe, Philip Gordon and Michael Grace

drainage, reduces the risk of vasospasm and/or delayed ischemic neurological defect. In most of these reports surgery was performed within 3 days after SAH, and Suzuki, et al. , 37 stated that surgery with clot evacuation performed later than 48 hours following hemorrhage was not effective in preventing vasospasm. However, even in these optimistic early reports, important drawbacks to this approach were evident, such as severe brain swelling and cerebral hemorrhage related to retraction of an already damaged brain 29 and the need for multiple craniotomies in some

Restricted access

Douglas Kondziolka, L. Dade Lunsford, Robert J. Coffey and John C. Flickinger

consistent with intratumor necrosis. Nine patients (38%) showed no change in tumor size and only one showed loss of central contrast enhancement. Two patients had growth of the tumor outside the radiosurgical treatment volume: both of these patients had tumors that we believe were treated subtotally. The first patient had a recurrent invasive malignant torcular meningioma and had undergone three prior operations and conventional radiation therapy. The second patient had a large upper clivus and cavernous sinus region tumor that had recurred after multiple craniotomies

Restricted access

Fernando Viñuela, Jacques E. Dion, Gary Duckwiler, Neil A. Martin, Pedro Lylyk, Allan Fox, David Pelz, Charles G. Drake, John J. Girvin and Gerard Debrun

the two techniques in four patients (4%). The preference for the transfemoral technique avoided the need for multiple craniotomies in large or giant AVM's. The transfemoral technique is now successful due to the availability of a new generation of microcatheters that allows distal intracranial navigation as well as safe catheterization of perforators. In our series, it was possible to catheterize 537 AVM feeders, with an average of 5.3 feeders/AVM. In some large or giant AVM's, it was necessary to embolize as many as 23 feeders in multiple stages. No technical

Restricted access

J. Herbert van den Berge, Gerhard Blaauw, Wout A. P. Breeman, Ali Rahmy and Rinia Wijngaarde

malaise, apathy, and hemiparesis shortly before death. One patient's death was related to uncontrollable epileptic seizures. The fifth patient had previously undergone multiple craniotomy procedures and died suddenly and unexpectedly 2 months after yttrium-90 treatment. The prognosis for cystic craniopharyngioma may be volume-related, as four of the nine patients who had large cysts (> 30 ml) eventually died. A prognostic correlation probably also exists in multicystic cases, as three of the five deaths occurred in this group. We could not determine a relationship