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Griffith R. Harsh III

into the peritoneum. In 2 cases reported, the first patient died shortly, and the second after 3 months' improvement. In 1905 Nicoll 16 attempted a peritoneal shunt by attaching omentum, which was brought through a paravertebral opening, to a defect in the spinal dura mater. Ventriculoperitoneal shunt was attempted with a rubber tube by Kausch 13 in 1905 and with a silver wire by Hartwell 7 in 1910. The latter's patient is particularly interesting in that he survived for 2 years. After death from a brain stem tumor without evidence of increased pressure, a patent

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Michael Scott, Henry T. Wycis, Frederick Murtagh and Victor Reyes

. We do not use it intraperitoneally but connect it directly to the stainless steel button or anastomose it via a small stainless steel tube to a length of polyethylene tubing, 1 mm. in diameter, which may be inserted into the peritoneal cavity. In 1 case in which we used the above technique for a left ventriculoperitoneal shunt, blockage occurred in 2 months because of a “migration” of the entire length of tubing into the contralateral ventricle. The material was removed, the choroid plexuses were coagulated and the hydrocephalus was controlled ( Fig. 7 ). Fig

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Ira J. Jackson and S. R. Snodgrass

. Ransohoff 15 has utilized the pleural cavity in 6 patients with promising results. As early as 1898 Ferguson 5 drained the spinal fluid from the lumbar area into the peritoneal cavity. The patient died shortly afterwards and the surgeon was of the opinion that the fatality was caused by the sudden loss of fluid. Perhaps the first recorded case of a ventriculoperitoneal shunt was performed by Kausch 11 in 1905. His patient's demise took place 17 hours later. Cushing 3 reported some success in 12 patients by allowing the excess fluid from the lumbar theca to escape

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Norman H. Horwitz

air study was not done. However, the Pantopaque study was repeated on Dec. 25, 1955 ( Fig. 4b ), which revealed increased distortion of the 4th ventricle. The tube was removed. After the drainage from the wound ceased, a ventriculoperitoneal shunt was done. The patient still failed to improve and finally expired on March 1, 1956. At autopsy a large cystic tumor, measuring 4 cm. in diameter, was found extending from the lower end of the pons to the cerebral peduncle on the left. Pathologic Diagnosis . Glioblastoma multiforme. Comment . As sometimes happens, it

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Astrocytoma of the Brain and Spinal Cord

A Review of 176 Cases, 1940–1949

Laurence F. Levy and Arthur R. Elvidge

times as frequent in midline cases; however, examination of the age incidence suggests that this is probably attributable to chance selection. All 41 patients underwent surgical intervention. There were 4 postoperative deaths, a case mortality of 9.7 per cent. Five patients had further surgical procedures as follows: No. 1 Re-operation after 7½ years for recurrence of symptoms, but no tumour was present. Cysts were excised from both hemispheres. Nos. 18, 25, 26 Plastic repair of subcutaneous cerebrospinal fluid cysts. No. 30 Ventriculoperitoneal shunt

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Harold C. Voris, Wayne B. Slaughter, Joseph R. Christian and Edward R. Cayia

—general anesthesia. 6. 7-21-55 Ventriculography—local anesthesia. 7. 7-28-55 Ventriculocisternal shunt (Torkildsen)—general anesthesia. 8. 8- 2-55 Re-exploration of ventriculocisternal shunt—local anesthesia. 9. 8-16-55 Ventriculography—local anesthesia. 10. 8-25-55 Takedown of ventriculocisternal shunt and ventriculoperitoneal shunt—general anesthesia. 11. 9- 1-55 Re-exploration of ventriculoperitoneal shunt—general anesthesia. 12. 9-20-55 Takedown of ventriculoperitoneal shunt and ventriculoantral shunt

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Robert L. Bell

alteration of the ventriculosubarachnoidal hydrodynamics, the introduction of a chemically inert radioactive substance, and the identification of the position of this tracer substance by means of an external Geiger-Müller counter. Here then was a method for the study of obstruction to flow within the spaces containing cerebrospinal fluid without side effects. Moreover the procedure offered a means of determining patency of tubes used in ventriculoperitoneal shunts. METHOD In the present study, radio-iodinated (I 131 ) human serum albumin (RISA) was introduced into

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

revealed dilated lateral and 3rd ventricles, and failure of oxygen to pass through the aqueduct of Sylvius. The ventricular fluid was slightly xanthochromic and the protein was 100 mg. per cent. A diagnosis of noncommunicating, internal hydrocephalus was made and a right ventriculoperitoneal shunt was performed on the 33rd day of life. He was discharged, improved, on the 12th postoperative day ( Fig. 1 ). A revision of the ventriculoperitoneal shunt was necessary on Aug. 11, 1951. The inferior end of the tube had escaped from the peritoneal cavity and symptoms of

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Emile C. Berger and Arthur R. Elvidge

1 underwent twist-drill biopsy followed by right ventriculoperitoneal shunt. Of the 88 patients suffering from medulloblastoma and surviving longer than 1 month after operation, 7 had radical removal without radiotherapy, 47 had radical removal with radiotherapy, 7 had partial removal without radiotherapy, 11 had partial removal with radiotherapy, 10 had biopsy followed by radiotherapy, 1 of whom had a biopsy by craniotomy and the other 9, twist-drill biopsies, and 1 patient was treated by ventriculoperitoneal shunt. Of the 20 patients with cerebellar sarcoma

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A. Kagen, G. Tsuchiya, V. Patterson and O. Sugar

A lthough the presence of a “pump” often makes it easy to determine if a ventriculovascular shunt is functioning, there are occasions when there is some doubt as to its function. Tests of the patency of the valve system in vivo have therefore been undertaken, using radioactive iodinated serum albumin (RISA). Bell 2 injected RISA into the ventricular system in 30 adults, and followed the passage of the radioactive material in the tubing of ventriculoperitoneal shunts, using a Geiger counter. The abstract of Schlesinger et al. 8 deals with much the same