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William J. German

C erebrospinal rhinorrhea is a relatively common complication of craniocerebral injuries in the frontal region, especially when the site of impact is near the glabella. † Spontaneous arrest of the rhinorrhea may be expected within ten days in a large percentage of patients, and Adson 1 has noted spontaneous recovery as long as eight weeks after the injury. The problems and methods of surgical treatment of acute cerebrospinal rhinorrhea have been discussed by Dandy, 4 Teachenor, 11 Munro, 9 Cairns 2 and Coleman. 3 Cairns' 2 report leaves no doubt

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The Chemotherapy of Intracranial Infections

IV. The Treatment of Pneumococcal Meningitis by Intrathecal Administration of Penicillin

Cobb Pilcher and William F. Meacham

four groups, intracisternal injection of 50 units † of penicillin (dissolved in 1 c.c. of saline solution) twice daily was the therapy employed ( Fig. 1 ). In each of the four groups, results were slightly but definitely more favorable in the treated than in the untreated animals. Of 22 untreated dogs, only one survived, whereas four of 26 treated dogs recovered. Furthermore, the incidence of early death was distinctly higher among the control animals. Fig. 1. In the next two groups of 12 dogs each, treatment consisted of intracisternal administration of

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The Lucite Calvarium—A Method for Direct Observation of the Brain

I. The Surgical and Lucite Processing Techniques

C. Hunter Shelden, Robert H. Pudenz, Joseph S. Restarski and Winchell McK. Craig

used in the development of the method. Many difficulties were encountered, the outstanding of which were the clouding of the cerebral surfaces due to the deposition of fibrin on the leptomeninges, the obtaining of a secure fit of the plate to prevent leakage of cerebrospinal fluid, and the proper treatment of the skin. The formation of the filmy layer of fibrin over the surface of the brain has been prevented by meticulous hemostasis of the dura and bone and by drainage of the “subdural” space for several days following the second stage of operation. Daily

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Joseph A. Mufson and Leo M. Davidoff

a definite histological diagnosis could not be made. The final opinion, however, was fibrosarcoma . Because of this, thirty x-ray treatments had been given over the region of the tumor. Four years prior to admission, within a period of two weeks, the patient had two spells of unconsciousness of short duration. Neither was witnessed. In October, 1941, he developed progressive weakness of the right lower limb, affecting chiefly the foot. Two weeks before admission he noticed a hard lump over the vertex of the skull to the left of the midline. This had not been

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Gilbert Horrax

himself made the following statement, “In fact, the advance in technique of the surgical treatment of diseases of the brain and the spinal cord has been relatively less than the improvement in our knowledge of the seat and nature of the diseases for which surgical intervention is useful and necessary.” If this was true of Horsley's own work, it was even more so of the leading surgeons in Europe, notably Bergmann, Kocher, Krause, von Eiselsberg, Chipault, Broca and others, all of whom had made signal contributions and had written extensively on the subject of cranial and

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The Use of Products Prepared from Human Fibrinogen and Human Thrombin in Neurosurgery

Fibrin Foams as Hemostatic Agents; Fibrin Films in Repair of Dural Defects and in Prevention of Meningocerebral Adhesions

Franc D. Ingraham and Orville T. Bailey

not amenable to treatment by application of muscle. For example, one such instance was in dealing with a blood vessel malformation exposed in the course of an operation for focal epilepsy. The foam proved to be strikingly effective even when such large venous channels had been opened. The same result has been achieved in dealing with openings in dural sinuses. TABLE I Tumor, intracranial or intraspinal 42 Lead encephalopathy 3 Congenital anomaly (Arnold-Chiari, etc.) 21 Depressed fracture 2 Jacksonian epilepsy 7

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from front lines to base hospitals and touching postes de secours , ambulance trains, and casualty clearing stations. A grateful government is paying part of its debt to this great man by providing a permanent memorial in the utilitarian form Dr. Cushing would most desire. The beauty and permanence of this structure are secondary to its purpose—ministration to the sick and wounded. The glory of war is transitory, but the horror of war will live in the broken bodies of soldiers who are returned here for treatment. “For thence—a paradox which comforts while it

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Burton M. Shinners Wallace B. Hamby March 1944 1 2 117 122 10.3171/jns.1944.1.2.0117 Peripheral Nerve Surgery—Diagnostic Considerations Claude C. Coleman March 1944 1 2 123 132 10.3171/jns.1944.1.2.0123 Peripheral Nerve Surgery—Technical Considerations Lieut. Colonel R. Glen Spurling March 1944 1 2 133 148 10.3171/jns.1944.1.2.0133 Peripheral Nerve Surgery—Postoperative Rehabilitation Captain W. M. Craig March 1944 1 2 149 155 10.3171/jns.1944.1.2.0149 The Treatment of Painful Phantom Limb by Removal of Post

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Claude C. Coleman

civilian practice most frequently results from cuts by glass or sharp instruments. One of the most common peripheral nerve injuries in civilian practice is that of the median or ulnar or both of these nerves at the wrist. With such injuries there is usually a severing of important tendons. Unfortunately the treatment of these very serious injuries is often delegated to an inexperienced interne, notwithstanding the fact that proper repair of such lesions requires the services of an expert surgeon. In the treatment of these injuries by the inexperienced operator, the

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W. M. Craig

be accomplished I would like to refer to a case described in the British literature. Watson-Jones, 1 in discussing rehabilitation in the Royal Air Force, tells the following story: An air gunner of the Royal Air Force, a man of proved courage and determination, was admitted to a civilian orthopaedic hospital for the treatment of a torn and displaced semilunar cartilage. Ten months later he was still in the hospital and still totally incapacitated. He asked about the delayed recovery. The diagnosis had been correct and a skillful operation performed without