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. Wylie Michael F. Hein John E. Adams March 1964 21 3 212 215 10.3171/jns.1964.21.3.0212 Normal Angiographic Configuration of Carotid Siphon in the Pediatric Patient Edir B. Siqueira Luis V. Amador March 1964 21 3 216 218 10.3171/jns.1964.21.3.0216 Spontaneous Dislocation of the Atlas Paul Skok John Kapp Charles E. Troland March 1964 21 3 219 222 10.3171/jns.1964.21.3.0219 A Cyst of Rathke's Cleft B. Fairburn I. M. Larkin March 1964 21 3 223 225 10.3171/jns.1964.21.3.0223 A Case of

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Robert L. McLaurin and Kathleen S. McLaurin

was found in 5 of 6 patients in this series and possibly could have been found in all instances if a complete search had been made. Summary We have reported 6 pediatric patients who have been operated on for removal of calcified subdural hematomas. The most common presenting symptoms were seizures and mental retardation. We believe the symptoms are dependent on the accompanying underlying brain damage rather than the calcified mass, and that removal of such lesions is neither necessary nor beneficial. References 1. Afra , D

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Olfactory Neuroblastoma

Neurosurgical Implications of an Intranasal Tumor

Franklin Robinson and Gilbert B. Solitare

of Hutter et al. , 14 there is a 50% 5-year survival which is strikingly different from the 10% 5-year survival rate for pediatric patients with neuroblastomas in other sites. 6 There is presently little clinical information on the life expectancy after the onset of neurological involvement. Summary We have pointed out the fact that neuroblastomas may arise from the olfactory membrane as a primary tumor of the nasal cavity. Management at this stage consists of local resection and radiation therapy for this rather radiosensitive neoplasm. However, in

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Edward L. Seljeskog, Harry M. Rogers and Lyle A. French

method of determining the need for fluid replacement. This is particularly true of the pediatric patient when even a minimum overtransfusion can be hemodynamically catastrophic. In this clinic a small central venous polyethylene cannula is placed into the superior vena cava via a cephalic vein cut down, or into the inferior vena cava via a femoral approach. In adult patients the catheter can usually be inserted percutaneously through the subclavian vein. The catheter is left in place throughout the operative procedure and during the immediate postoperative period when

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Robert J. White, J. George Dakters, David Yashon and Maurice S. Albin

bilateral subdural hematomas were drained for an average time of 17 days. Average daily drainage approximated 40 cc per day (range 15 to 250 cc). Protein values varied from a maximum of 1300 mg/100 cc to a minimum of 176 mg/100 cc. In the pediatric patients, four required bilateral and two unilateral external drainage. The subdural external shunts were in place from 2 to 15 days, with daily fluid output ranging from 2 to 180 cc averaging 26 cc per day. One child eventually required the insertion of bilateral valve-regulated shunts into the peritoneal cavity to eliminate

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William J. McSweeney

use of gentle traction, the ventriculoatrial shunt has been properly positioned and is now disengaged from the Muller deflector system. Discussion Deflector guide systems have continuing use in angiography because they occasionally permit selective catheterization of vessels that otherwise could not be. The small thin-walled tubing used in our pediatric patients has poor “memory” in that appropriate curves for selective catheterization are often lost during the procedure. The Muller deflector system, which is capable of inducing a curve of 180° when

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Michael E. Miner and R. Neil Schimke

✓ Four pediatric patients with mucopolysaccharidoses and an associated carpal tunnel syndrome are presented. Findings in these cases were typical of the adult form of median nerve compression at the wrist, but the patients had minimal symptoms in view of these findings. The importance of careful clinical examination and early surgical decompression is emphasized.

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Kenneth Shapiro and Kenneth Shulman

✓ The authors describe two children with anomalous intracranial venous return associated with bilateral facial nevi, macrocrania, and cephalic venous hypertension. Both children had functional absence of the jugular bulbs, forcing the intracranial venous effluent to exit through persistent emissary pathways. Both children had sustained intracranial hypertension, with one child developing symptomatic communicating hydrocephalus that responded satisfactorily to shunting. The relationship between these patients and those with Sturge-Weber syndrome is discussed. The embryologic abnormality producing the anomalous venous return is characterized. The link between venous hypertension and the development of hydrocephalus is discussed. The increased cranial compliance seen in this age group may predispose certain pediatric patients to develop hydrocephalus when stressed by venous hypertension.

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Yutaka Maki, Yoshihiko Kokubo, Tadao Nose and Yoshihiko Yoshii

(cisternography) in pediatric patients. Ann Radiol (Paris) 14 : 591 – 600 , 1971 James AE, Hurley PJ, Heller RM, et al: CSF imaging (cisternography) in pediatric patients. Ann Radiol (Paris) 14: 591–600, 1971 2. James AE , Mathews ES , Drost JP : Technique of cerebrospinal fluid imaging in pediatrics , in James AE (ed): Pediatric Nuclear Medicine . Philadelphia : WB Saunders , 1974 , pp 144 – 158 James AE, Mathews ES, Drost JP: Technique of cerebrospinal fluid imaging in pediatrics, in James AE (ed