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Franklin Robinson

, Oblique view showing brackets for application of the stand to the bed. B, 18 gauge intravenous needle inserted into the ventricular catheter serving as the connecting piece for the adapter of the lead-off tubing. C, Alternate positions of stopcocks 1 and 2, respectively: 1, For ventricular drainage to the collecting bottle. 2, For manometric determination of the ventricular pressure. 3, For continuous intraventricular drip therapy. 4, Apparatus excluded functionally from the lead-off tubing. Ventricular fluid is thus allowed to drain slowly at a constant

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Meningeal Meningiomatosis

Report of Case

Alfred Uihlein, Edward M. Gates and Robert G. Fisher

primary growth. No evidence of metastatic lesions could be found anywhere outside of the central nervous system. The brain and spinal cord weighed 1,175 gm. ( Fig. 1 ). There was a well-healed scar, 8 cm. long, over the spinous processes in the midline extending from the level of the 9th thoracic spine to the level of the 1st sacral vertebra. A small right occipital trephine opening where a ventricular catheter had previously been in place was noted. The calvarium over its entire extent was unusually thin. Fig. 1. a . Gross appearance of the brain and spinal

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Edgar A. Bering Jr.

following parts: (A) an ordinary graduated 1 liter Fenwal intravenous bottle which is held inverted by a ring attached to the head of the patient's bed; (B) a “J”-shaped double lumen glass tube which fits the standard Fenwal single hole rubber stopper and extends into the bottle about 22 cm.; (C) connecting rubber tube attached to the glass tube at one end and a glass adapter and standard intravenous needle at the other; (D) a 12-inch length of small-caliber polyethylene tubing, 2 which is used as the ventricular catheter. All of this except the polyethylene tubing is

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Frank M. Anderson

passed downward via the internal jugular vein into the right atrium; its position is determined by injecting the tube with Hypaque while a roentgenogram of the chest is taken in surgery. Through a parieto-occipital incision in the scalp a burr hole is placed, silicone rubber ventricular catheter is inserted and the proximal end of the cardiac tube is passed upward beneath soft tissues of neck and scalp into the incision in the scalp where it is coupled to the ventricular tubing. Ends of a snug ligature about the cardiac tube at its point of entrance into the vein are

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Pedro C. Caram, Paul C. Sharkey and Ellsworth C. Alvord Jr.

. Postoperative Course . During the 1st postoperative day, the blood pressure fluctuated between 154/60 and 184/80, the pulse rate from 96 to 104/min., and the respiratory rate from 18 to 26/min. On the 2nd postoperative day the patient vomited a small amount of “coffeeground” material at 8:00 a.m. and was found to have a paralytic ileus. His pupils were dilated and fixed at 3:00 p.m. Cheyne-Stokes respirations started. The ventricular catheter was opened and 30 cc. of xanthochromic fluid were removed. External ventricular drainage was instituted, resulting in transient

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Jacob Abraham and Jacob Chandy

cent. Death usually is caused by increased intracranial tension which, although continually present, is at its worst during the second and third day after operation. In an attempt to reduce this elevated pressure many centers use continuous ventricular drainage before, during and after operation. Because of the danger of infection associated with indwelling ventricular catheters, our practice has been to rely more heavily upon intermittent ventricular punctures. Ventriculo-atrial shunt with the Pudenz-Heyer or Spitz-Holter valve offers a safe method for

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Eldon L. Foltz and David B. Shurtleff

. Replacement of the catheter into the right atrium has been achieved by extracting the old valve and placing a new one down through that same tract after the use of appropriate dilators, or else by putting a new valve into the jugular vein and threading it down into the appropriate position. Distraction of the ventricular end in which the ventricular catheter apparently was distracted from the ventricle by either returning thickness of the overlying mantle of brain or by elongation of the neck in growth with fixation of the shunt in the neck occurred in 6 cases. Other

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Don M. Long, Richard A. DeWall and Lyle A. French

pumping device. The remainder of the catheter was absent from the neck, while the pumping device and ventricular catheter were still in place and functioning. Forward angiocardiography revealed the catheter lying in the right atrium and ventricle in both instances. The catheters were recovered by cardiotomy without incident. After a suitable convalescent period, the shunts were reconstituted and have continued to function. In neither case were there symptoms referable to the cardiac embolus. A detailed presentation of each case follows. Case Reports Case 1 . U

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S. Obrador

then ready for making injections through the silicone diaphragm with a fine needle. The ventricular catheter is directed towards the 3rd ventricle and the foramen of Monro and its proper situation can be checked radiographically by injecting a small amount of air or a few drops of a radiopaque solution ( Fig. 2 ). Fig. 1. Apparatus for intraventricular therapy. Stainless metal chamber with attached catheter (A) is inserted into a frontal burr hole and directed towards the ventricle with an adjustable stylet (C). When cerebrospinal fluid is obtained the stylet

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Ventriculo-venous Shunts for Infantile Hydrocephalus

A Review of Five Years' Experience with this Method

M. C. Overton III and S. R. Snodgrass

superior vena cava. A second patient with superior vena cava obstruction has a functioning shunt positioned in the right atrium through the inferior vena cava. In 4 patients infection wascaused by staphylococcus aureus; in 2 staphylococcus albus, and in 1 escherichia coli. The single patient that survived had a staphylococcus albus infection. Separation or Breakage of Shunting Tube Three ventricular catheters were lost in the cerebral ventricle due to disconnection or breakage of the catheter from the Pudenz-Heyer flushing device. All of these patients are dead