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Arthur Ecker

the posteroinferior portion of the 3rd ventricle with complete blockage of the aqueduct at its origin ( Fig. 1 ). Third ventriculostomy was performed, but no tumor was seen in the floor of the 3rd ventricle. Fig. 1. Lateral ventriculogram, Case 1, illustrating an apparent mass in posteroinferior portion of 3rd ventricle, obstruction of aqueduct near its upper end, and diminution of the angle of Wilson and Lutz. On Oct. 25, 1946, cervico-occipital exploration was made and a solid cerebellar tumor, 5×4×4 cm., was seen in the midline between the

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The Torkildsen Procedure

A Report of 19 Cases

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

puncture of the lamina terminalis. It is possible that to those who consider the problem of ventriculostomy, puncture from within the ventricle outward might be the superior technique. However, in the hands of the senior author the entrance into the floor of the third ventricle from below has been easier for accurate orientation. Mixter 14 accomplished an intra-third ventricle rupture by means of a cystoscope and a flexible sound introduced through the foramen of Monro. In 1936 Stookey and Scarff 23 advocated a double third ventriculostomy, puncturing the lamina

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. Lisle Jr. January 1949 6 1 74 78 10.3171/jns.1949.6.1.0074 Cerebellar Extradural Hematoma Arthur Bacon January 1949 6 1 78 81 10.3171/jns.1949.6.1.0078 Meningeal Meningiomatosis Alfred Uihlein Edward M. Gates Robert G. Fisher January 1949 6 1 81 89 10.3171/jns.1949.6.1.0081 Third Ventriculostomy Proven Patent After Fifteen Years Ira Cohen January 1949 6 1 89 94 10.3171/jns.1949.6.1.0089 The Cranial Localizer Alfred Uihlein Dana A. Rogers January 1949 6 1 94 96 10.3171/jns.1949.6.1.0094 J

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Everett F. Hurteau

cranial nerve palsies did not recur. Aspiration of CSF from the suboccipital wound repeatedly relieved her headache temporarily. A third ventriculostomy was done on Nov. 27, 1948. The right transtemporal route was used and an opening was made in the lateral wall of the 3rd ventricle, just anterior to the 3rd cranial nerve. Indigo carmine injected into the right lateral ventricle promptly escaped from the ventriculostomy opening. Following this procedure headache and bulging of the suboccipital wound improved for 5 days, then recurred. On Dec. 8, 1948 indigo carmine

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John E. Scarff

the floor of the middle fossa. There are no case reports of this operation by Dandy. In 1936, Stookey and the present writer 3 reported a different method for third ventriculostomy, which they described as “puncture of the lamina terminalis and floor of the third ventricle.” The technique of this operation is here given. TECHNIQUE A coronal incision is made, following which a small right frontal osteoplastic flap is turned up. This is carried down as low onto the brow as the frontal sinus will permit, and directly to the midline. A dural flap is then

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Eldridge Campbell

“idiopathic” hydrocephalus. This disorder was thus reclassified, upon a solid basis of anatomical and physiological study and of clinical observation, into communicating and non-communicating types. The operations of choroid plexectomy and third ventriculostomy were logical sequences of these discoveries. Dandy's reputation had become international. Dr. E. A. Park, a lifelong friend, wrote that not long after this first publication (1913), Professor Halsted, who was exceedingly proud of his pupil, remarked, “Dandy will never do anything equal to this again. Few men make

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Donald D. Matson

the first few months of life, the surface subarachnoid pathways, particularly at the base of the brain, may also be obliterated, either because they have been involved in the same post-inflammatory process that has obstructed the aqueduct or because they have simply failed to develop since they have never had a normal amount of spinal fluid reaching them. In any case, third ventriculostomy by the subfrontal or subtemporal route and ventriculo-cisternostomy (Torkildsen procedure) are of no avail because the surface pathways cannot handle the fluid even though the

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Robert W. Rand and Lloyd J. Lemmen

-Months Third ventriculostomy 1 9 No irradiation therapy 1 0 Irradiation therapy (measured in air) Less than 5000 r 1 139 5000–6000 r 5 126, 82, 64, 55, 23 More than 6000 r 3 87, 62, 16 * Torkildsen operation 0 3 No irradiation therapy 0 Irradiation therapy (measured in air) 5000–6000 r 1 82 More than 6000 r 2 9, * 6 * Surgical removal 17 0 No irradiation therapy 12 Immediate postoperative death in 11

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P. Descuns, H. Garré and C. Phéline

operations are performed, such as third ventriculostomy for a tuberculoma of the brain stem (protuberance for instance), or the Torkildsen procedure when the tumor is in the thalamus, the pineal body, and even extends to the third ventricle, so that a third ventriculostomy would not be effective. After these palliative operations we have seen many patients live much longer than expected and even heal completely when Streptomycin acted well. RESULTS One has to remember that most of our patients were admitted to the hospital with a marked increase in intracranial