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Everett F. Hurteau

injected through the suboccipital scalp into the pseudo-meningocele appeared in the lumbar subarachnoid space only after 21 minutes, and even then only in very small amounts. CSF withdrawn prior to these injections contained 173 mg. per cent of protein. Re-exploration of the suboccipital area was performed on Dec. 11, 1948, this time through a midline incision and with the patient in a prone position. The cerebellar hemispheres were found to be firmly attached to the margin of the dural opening. As a result the CSF upon leaving the 4th ventricle was prevented from

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Arthur R. Elvidge, Charles L. Branch and Gordon B. Thompson

much more effective. The late Doctor Settlage of the Department of Anatomy at the University of Wisconsin and I used this agent for the last 3 years. Effectiveness of urea was compared with other hypertonic solutions and urea was found to be far superior. On this basis I feel the whole question of the use of hypertonic solutions in neurosurgery should be re-evaluated. As far as Diamox is concerned, in one patient with a “pseudomeningocele,” on comparing the effect of urea, Diamox, 50 per cent sucrose, 50 per cent glucose and mercury, I found the result with urea

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Intracranial Tumors with Extracranial Metastases

Case Report and Review of the Literature

Franz E. Glasauer and Robert H. P. Yuan

some vision. Since the middle of September, a pseudomeningocele developed over a part of the incision line. He had intermittent vomiting. Examination . As an additional neurological deficit, the right limbs were almost completely paralyzed, and the ataxia of the left limbs had increased. The pseudomeningocele presented itself as a shiny, translucent mass, projecting about 2 cm. above the level of the scalp at the vertex. Films of the skull demonstrated again marked separation of the sutures, and for the first time films of the chest showed faint rounded densities

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Paul H. Crandall and Ulrich Batzdorf

that laminectomy with the addition of a dural graft decompression is a useful procedure when multiple interspaces and numerous transverse ridges in a narrow cervical canal are involved. Complications included 8 instances of increased neurological deficit immediately following operation, 5 after laminectomy with the dura closed and 2 after laminectomy with the dura open. Three wound infections occurred, 2 of them associated with cerebrospinal fluid leakage. One patient developed a pseudomeningocele. A small number of patients had only minimal improvement following

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.1969.30.5.0585 Evaluation of Radiotherapy of Tumors in the Pineal Region by Ventriculographic Studies with Iodized Oil Jiro Suzuki Shigeaki Hori May 1969 30 5 595 603 10.3171/jns.1969.30.5.0595 The Management of Chronic Interstitial Cystitis by Differential Sacral Neurotomy Arnold M. Meirowsky May 1969 30 5 604 607 10.3171/jns.1969.30.5.0604 Basilar Aneurysm Associated with Agenesis of the Left Internal Carotid Artery Peter D. Moyes May 1969 30 5 608 611 10.3171/jns.1969.30.5.0608 Traumatic Orbital Pseudo-Meningocele Y. S. Bhandari May 1969 30

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Y. S. Bhandari

-encephalocele of the orbit was reported by MacCarty and Brown, 3 in a series of 186 cases of orbital tumors. Taptas 4 has reported a case of a 6-year-old boy who developed an orbital pseudo-meningocele after a fall. The meningocele was bilobular; one lobe was behind the orbit and the other in the frontal region. In our case the meningocele was unilocular, and the proptosis was not progressive. One can only speculate on the probable mechanism of its formation. Cerebrospinal fluid probably leaked into the orbit through the torn dura and the fracture, and may then have become

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Harold A. Wilkinson, Ernest J. Ferris, Albert L. Muggia and Robert C. Cantu

-fast organisms. He became progressively more obtunded and required tracheostomy. On June 22, bilateral small sterile subdural hygromas were evacuated, but there was no clinical improvement. Lumbar pressures remained elevated (200 to 300 mm). By this time the patient was unresponsive to painful stimuli. Second Operation The posterior fossa was reexplored on June 27. A pseudomeningocele was encountered and repaired. The patient remained comatose, and on June 30 a ventriculoatrial shunt was placed. Pneumonia and pyrexia gradually improved under vigorous therapy. By July 4

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Bennett M. Stein, Michael S. Tenner and Richard A. R. Fraser

., 10 have recorded the complication of a bulging posterior fossa following the removal of cerebellar astrocytomas in children. This complication has been variously labeled as “pseudomeningocele,” “postoperative hydrocephalus,” or “post-operative Dandy-Walker syndrome.” These authors emphasized that this condition follows multiple operative procedures in the posterior fossa, suggesting a progressive arachnoiditis secondary to the trauma and bleeding coincident to numerous surgical procedures. McLaurin and Ford 9 stressed that the development of a pseudomeningocele

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Edward P. Hoffman, John T. Garner, David Johnson and C. Hunter Shelden

Pantopaque without block. There is no evidence of the preoperative arachnoid cyst. Note the absence of pedicles on the left side. Discussion The traumatic diverticula seen on myelography have been important aids to confirmation of avulsion injuries of the brachial plexus. 1, 2, 7–10, 14–18, 20–22 They have been given various names including traumatic meningocele, 9–11, 15, 16, 22 posttraumatic meningocele, 17 pseudomeningocele or false meningocele, 2 traumatic diverticle or traumatic diverticulum, 11, 15, 20 arachnoidal diverticulum, 16 dural sac, 1

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Samuel H. Greenblatt and Donald H. Wilson

petrous portion of the temporal bone, extending between the vestibule and the cochlea. The leak persisted and further radiographic and isotope studies were not helpful. On October 8, 34 days after the injury, a right lumboperitoneal shunt was performed using a high-pressure Hakim valve. The rhinorrhea stopped promptly. However, a pseudomeningocele developed along the subcutaneous tract of the tubing. This was attributed to the fact that the dural opening had not been closed around the Silastic tubing because of the very short length of the dural incision. The complete