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Gilbert Horrax

other operative complications. Again in 1910, 15 Cushing reported upon his last 100 patients with brain tumor, saying, that in 30 instances there had been tumor extirpations or cyst evacuations with apparent cures, and 67 palliative procedures. There were only 11 deaths and none of the “oldtime postoperative complications.” These figures may not sound very optimistic now, but it must be recalled that the most eminent neurologists of those days (Starr, Knapp and Mills in this country, and others abroad) had estimated from collected operative and postmortem material

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Robert C. L. Robertson

diopters of papilledema, secondary retinal changes, etc.). The residual bulging decompression was disqualifying for full military duty. Because the need for decompression no longer existed the cerebral hernia was reduced at operation and a tantalum plate was fixed in position. POSTOPERATIVE COMPLICATIONS AND SEQUELLAE Postoperative complications have been few and none were ascribable to the presence of tantalum. One patient who had a severe, soiled, compound skull fracture containing much foreign material, a few days after operation developed impetigo contagioso

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Henry G. Schwartz and Joe M. Parker

, with resulting facilitation of nerve suture. Thus far, we have had occasion to perform radial nerve repair in three cases in which the nerve was prepared at the time of bone shortening and fixation. In all of these cases there was comminution, and in one there was bone loss of 2 inches. In none of the cases were there untoward postoperative complications. The first patient was operated upon in Italy, and the case is presented in some detail. Case 2 . A 23-year-old American soldier was wounded on 28 August 1944, sustaining a compound, comminuted fracture of the

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Charles W. Elkins and James E. Cameron

well. There have been few postoperative complications besides the infections mentioned, which could be related to either the procedure or the material used. One patient had his first convulsion 6 weeks following cranioplasty. This convulsion occurred approximately 16 weeks following the patient's injury and could conceivably be attributed to this. On a phenobarbital regime, there have been no further attacks. Two patients had mild postoperative headaches which were not incapacitating. The only other complication occurred in a patient who had had a severe head

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J. G. Chusid and C. G. de Gutiérrez-Mahoney

to the preoperative control records. CONCLUSIONS 1. In a patient on whom ligation of the internal carotid artery for an intracranial arteriovenous fistula was performed without clinical postoperative complications electroencephalography disclosed relatively minor, transient changes. 2. The final value of electroencephalography as an aid in evaluating cerebral collateral circulation in ligation of the carotid arteries must await further reports and study especially of those instances where complications such as hemiplegia arise

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Edgar F. Fincher

strips have been used routinely ( Fig. 5 ). In extensive laminectomies ( Fig. 6 ), where 4 to 10 laminal arches and posterior spines have had to be removed, certainly wound healing has been per primum . This has been true, both when the dura, by necessity of decompression efforts, was left open and when it was closed. In the former cases there have been no spinal fluid collections necessitating aspiration, nor have any fistulae developed. These are rare postoperative complications, but they have occurred in the past, and so far, in a statistically valueless number of

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Bronson S. Ray and Herbert Parsons

Normal Bone Of the total 100 cases, 89 were ones in which normal bone plates were immediately replaced at the close of the initial operation; included are 4 cases in which there were large bifrontal plates. Of the group there were but 3 cases in which there was a sufficient postoperative complication to necessitate the removal of the plate at a subsequent operation. In 1 of these the wound became infected and the plate was removed to avoid osteomyelitis and insure quick healing. In the other 2 the original craniotomy had been performed for chronic subdural hematoma

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Physiological Salt Solutions for Brain Surgery

Studies of Local pH and Pial Vessel Reactions to Buffered and Unbuffered Isotonic Solutions

K. A. C. Elliott and H. H. Jasper

I t is common experience that simple exposure of the pia-arachnoid surface of the cerebral cortex during prolonged neurosurgical procedures, such as for an exploratory craniotomy, results in the formation of adhesions between the dura and arachnoid. In certain cases there may be transitory aphasia or paresis during the first week following a simple exploratory procedure. These transitory postoperative complications are usually attributed to “edema.” This explanation has received support in the experiments of Prados, Strowger, and Feindel, 15, 16 who

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J. Le Beau

convenient to say that one excises “area 10.” This is a short term for area 10 as depicted in Brodmann's classical map, though we do not believe that we excise with precision delicately defined architectonic areas. We are to be blamed in using area numbers in such a loose sense, but we find it a very simple way of describing the operation. Figs. 1 and 2. Case 10. Side and front views of bilateral topectomy. POSTOPERATIVE COMPLICATIONS Thirty operations were performed on 25 patients, with 2 postoperative deaths: 1 from acute lung edema (carcinoma of

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Lennart Herlin

indication that exploration of the posterior fossa increases the disposition to postoperative complications, such as CSF cysts. Several of the patients in this material were in a poor condition on arrival at hospital, and most of them could not have been operated upon by more radical methods. The opinion that the Torkildsen procedure is a valuable palliative operation has therefore been confirmed at this clinic. SUMMARY The possibilities of surgical treatment for relief of hydrocephalus caused by blocked circulation of CSF within the ventricular system are