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Gilbert Horrax

suboccipital decompression and exploration. 8 Reference was made earlier to the importance of the refined and meticulous technic which Harvey Cushing inaugurated in neurosurgery. The many and intimate features of this technic constitute one of his major contributions to the subject, in fact, it was largely because of his extreme attention to details that he was able to accomplish so much for patients with disorders of the nervous system. In an address before the St. Louis Surgical Society in 1908, 9 Cushing set forth at considerable length the methods which he had

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Franc D. Ingraham and Orville T. Bailey

receiving roentgen therapy. Several treatments were given, the last one at the end of March, 1926. In March, 1927, a single additional treatment was administered. Unfortunately, it has been impossible to determine what dosage was used in these treatments. Second Admission . She reentered the hospital May 16, 1927, for recurrent headache of 4½ months' duration. During the 18 days preceding admission she had noticed slight unsteadiness of the right hand. Physical examination showed fulness of the suboccipital decompression, slight tenderness in that region, unequal

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Henry T. Wycis

odontoid process on the medulla oblongata. It was not until 1911 that the condition was recognized as a clinical entity. At this time Schlüller 12 made the first premortem diagnosis, describing the effects of the bony deformity on the central nervous system. Since that time, clinico-pathologic reports have appeared by Sinz, 13 Kecht, 7 Krause, 8 Juhlin-Dannfelt, 6 Merio and Risak, 10 and Ebenius. 3 In 1939, Chamberlain 2 described four cases of basilar impression with bizarre neurological abnormalities. In two cases, suboccipital decompression, carried out by

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Roman Arana and A. Asenjo

; racemose cysticercosis. Case 3 . R.H.S., female, aged 45. Admission: Aug. 15, 1941. For 11 years, vertigo, tinnitus and diminution of visual acuity. For 5 years, vomiting. For 3 years, headache. Left eye: optic atrophy; right eye: choked disc. Ventriculogram: Picture similar to Cases 1 and 2 with air passage to the posterior fossa and poor visualization of the aqueduct. Operation: Aug. 26, 1941. Suboccipital decompression. Disclosure of racemose cysticercosis. Discharge: Oct. 21, 1941. Case 4 . R.S.Z., male, aged 38. Admission: Oct. 9, 1941. For 2 years

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Harold C. Voris

manometric pressures ranging from 190 to 400 mm. of water. The total protein was 100–120 mg. and there was a persistent pleocytosis of 140–416 cells which were all lymphocytes. Repeated cultures failed to show any bacterial growth. She was finally dismissed on the 40th postoperative day. She has been seen at frequent intervals. There has never been any bulging of the suboccipital decompression. The papilledema slowly receded but slight elevation of the discs has persisted and is still present. The spinal fluid pleocytosis finally disappeared. After 8 months the patient

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Franc D. Ingraham, Eben Alexander and Donald D. Matson

average-sized dogs were used. Anesthesia was maintained satisfactorily with intravenous nembutal. The animal was placed on his abdomen with the chest and neck well elevated from the operating table, and the head strongly flexed and held securely in a head rest. Careful attention to the maintenance of a clear airway was always observed. A midline incision was made caudally from the prominent external occipital protuberance and the muscles separated to expose the occipital bone, atlas, and atlanto-occipital membrane. A suboccipital decompression was performed, including

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Lyle A. French

both synthetic and analytical ability. Therefore, it can be used as a diagnostic test for mental deterioration. The patient's performance on it not only indicated that she is probably of above average intellectual capacity but that there are probably no disturbances in the higher perceptual processes. Case 3 . (695413) C.A.H. was a 14-year-old Indian boy with a tuberculoma in the left cerebellar hemisphere upon whom a suboccipital decompression was performed in May, 1940. Ventriculograms performed preoperatively revealed large symmetrically dilated lateral and

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Arne Torkildsen

of partial or total extirpation of the tumor. Ventriculocisternostomy in Cases of Craniopharyngioma Neoplasms of this nature have been looked upon with great concern by most neurosurgeons because hardly any one has ever succeeded in his attempt at complete removal of the neoplasm, and the surgical attacks are combined with a high mortality. Transfrontal or transventricular partial removal, as a rule, is followed by signs of recurrence after a limited time. Subtemporal or suboccipital decompressions result in very limited relief only, and after a relatively

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The Torkildsen Procedure

A Report of 19 Cases

Edgar F. Fincher, Gordon J. Strewler and Homer S. Swanson

followed 2 to 4 years subsequent to suboccipital decompression, short-circuiting the spinal fluid, and X-ray treatment in Cases 3 and 6. Penfield 17 in 1942 reported a case of infiltrating glioma of the posterior part of the third ventricle arising from the right thalamus with relief of pressure symptoms following a Torkildsen procedure. A follow-up study was not reported. During the shunting procedure Penfield manipulated the patient's head in all possible directions to determine the effects of this movement on the catheter. Since the tube is entirely above the

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Two Cases of Cerebral Abscess of Unusual Nature

Tuberculous Abscess and Suppurated Hydatid Cyst

S. Obrador and P. Urquiza

the disease. In Case 1 streptomycin was not available to initiate a protective treatment once the microscopical examination gave evidence of the tuberculous nature of the abscess. We were anxious about this because of our bad experience in dealing with tuberculomas. Two patients with tuberculoma of the cerebellum died of tuberculous meningitis several weeks after suboccipital decompression in 1 case and partial removal in the other. A 3rd patient with tuberculoma of the cerebellum, who was in a very poor condition with active generalized lesions, was also treated by