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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

cerebrospinal fluid and, possibly, to myelography in cases of root pain in which neurologic signs are scanty or absent. In this group of twenty-six cases of intraspinal tumor only one patient had paraplegia, with a sensory level discernible. In ten cases, the ankle jerks were diminished or absent and in five, abnormalities of the patellar reflex were found. One patient had bilateral foot drop. Neurologic examination of the other nine patients gave essentially negative results ( Table 3 ). TABLE 3 Intraspinal tumors masquerading as protruded inter vertebral disks

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Ventriculographic Diagnosis of Cysticercosis of the Posterior Fossa Roman Arana A. Asenjo May 1945 2 3 181 190 10.3171/jns.1945.2.3.0181 Cyst of the Sixth Ventricle (Cavum of Verga) Successful Removal through Transventricular Approach with Notes on Embryology and Histopathology Michael Scott May 1945 2 3 191 201 10.3171/jns.1945.2.3.0191 Peripheral Nerve Injury in Fractures and Dislocations of Long Bones E. S. Gurdjian H. M. Smathers May 1945 2 3 202 219 10.3171/jns.1945.2.3.0202 Pantopaque Myelography: Results

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William G. Peacher and Robert C. L. Robertson

R ecently a new contrast material, pantopaque, has been developed for myelography. Few detailed clinical reports are available. Spurling and Thompson 31 used it in 200 cases and found that it possessed the qualities of lipiodol and thorotrast, but, in contrast, small amounts were readily absorbed and it was easily removed. When removal was complete there were no sequelae. Partial withdrawal, however, was followed by about the same degree of irritation as after lipiodol. Ramsey, French and Strain 26 employed pantopaque in a series of 150 patients, 97 of which

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3 1 58 73 10.3171/jns.1946.3.1.0058 The Use of Curare in the Treatment of Spastic Paralysis Captain David F. James Lt. Col. Spencer Braden January 1946 3 1 74 80 10.3171/jns.1946.3.1.0074 Aneurysm of the Internal Carotid Artery Associated with Hypothalamic Fits Comdr. John T. B. Carmody January 1946 3 1 81 86 10.3171/jns.1946.3.1.0081 Pineal Teratoma: Report of Case George Ehni January 1946 3 1 86 94 10.3171/jns.1946.3.1.0086 Technique of Pantopaque Myelography Major Benjamin B. Whitcomb Captain George M

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Benjamin B. Whitcomb and George M. Wyatt

Pantopaque myelography is basically a simple procedure, consisting of the injection of contrast material into the subarachnoid space, fluoroscopy with spot films of the indicated levels, and removal of the contrast medium. Those who have had experience with the procedure, however, will agree that it involves many pitfalls and possibilities of error, all of which, it is believed, have been experienced by the authors. These misfortunes include bloody taps, formation of possible hematomata or collections of cerebrospinal fluid in the epidural or subdural spaces

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Henry A. Shenkin and Charles R. Perryman

pain. She was again readmitted in March 1945, because of back pain. Spinal fluid manometric studies were entirely normal as was the spinal fluid total protein. Pantopaque myelography was entirely negative. She was discharged, and a firm brace was recommended for her back. She was last seen on June 25, 1945 and her back pain was much relieved. Case 3 . H.R., an 8-year-old boy, was struck on the head 2 months before admission to the University Hospital. He was not unconscious but did complain of generalized headache immediately after the injury. He had occasional

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James L. Pool and Oscar A. Turner

. Myelography This revealed an almost complete central block at the level of the 10th thoracic vertebra. The patient was transferred to Neurosurgery for operation. Laminectomy Th. 8-Th. 10 inclusive. Anesthesia: Intratracheal gas-oxygen-ether. The spinal cord was swollen for a distance of, almost completely filling the intrathecal space. Its dorsal surface appeared somewhat irregular and blanched, and palpation suggested the presence of an intramedullary cyst, confirmed by midline aspiration of the distended cord with a fine hypodermic needle, which yielded

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The Posterior Tibial Reflex

A Reflex of Some Value in the Localization of the Protruded Intervertebral Disc in the Lumbar Region

R. M. Peardon Donaghy

muscle, innervated by the 4th and 5th lumbar roots, seems a likely choice. One hundred patients with no complaints referable to the back or lower limbs were tested. In 31 of these we could obtain no posterior tibial reflex on either side. In 28 of the remaining cases the reflex could be obtained only with reinforcement. In 41 there were active reflexes, easily obtainable. Twelve patients with protruded intervertebral disc at the L-4 to L-5 level were next examined. All had demonstrable defects by myelography. Eight of these had a depressed or absent posterior

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Robert C. Pendergrass, A. Earl Walker and John P. Bond

into the loin. The localization of the communication between the meningocele and the spinal subarachnoid space was made possible by pantopaque myelography. This knowledge made it possible to ligate the neck of the sac through a hemilaminectomy of only two vertebrae. Adequate treatment of such a condition appears to be the obliteration of the communication between the subarachnoid space and the sac. The fluid in the cyst seems to be more the result of the passage of spinal fluid from the lumbar subarachnoid space into the sac than to fluid secreted by the sac wall