Survival following gunshot wound of the pons: neuroanatomic considerations

1971 ◽  
Vol 35 (3) ◽  
pp. 342-347 ◽  
Author(s):  
David G. Kline ◽  
Hector J. Leblanc
Keyword(s):  
Sleep Apnea ◽  
Successful Treatment ◽  
Gunshot Wound ◽  
Content Type ◽  
Operative Findings ◽  
Fine Print

✓ The successful treatment of a civilian gunshot wound of the vermis and pons is described. A large missile fragment was removed from a depth of 2 cm within the pons at the level of the facial colliculus. Despite initial coma and subsequent irregular respiration with sleep apnea, the patient survived. Neurological, radiographic, and operative findings are correlated with the anatomy of the pons.

Anatomical location of T2–3 sympathetic trunk and Kuntz nerve determined by transthoracic endoscopy

2002 ◽  
Vol 96 (1) ◽  
pp. 68-72 ◽  
Author(s):  
Yeou-Chih Wang ◽  
Ming-Hsi Sun ◽  
Chi-Wen Lin ◽  
Yen-Ju Chen
Keyword(s):  
Sympathetic Trunk ◽  
Anatomical Location ◽  
Content Type ◽  
Medial Border ◽  
Thoracic Sympathectomy ◽  
Operative Findings ◽  
The Right ◽  
Upper Thoracic ◽  
Rib Head ◽  
Fine Print

Object. Bilateral subaxillary transthoracic endoscopic sympathectomy (TES) is a popular procedure of upper thoracic sympathectomy. The anatomical locations of the T-2 and T-3 sympathetic trunks, as viewed under the endoscope, are varied in the rib head areas. In this study, the authors investigated the more visible anatomical locations of the T-2 and T-3 sympathetic trunks, the so-called nerves of Kuntz, and intercostal rami by performing transthoracic endoscopy. Methods. Seventy patients with palmar hyperhidrosis undergoing bilateral TES (140 sides) via the anterior subaxillary approach were included in this study. The operative findings and video images of the T-2 and T-3 sympathetic trunks and ganglia were recorded and analyzed. The anatomical locations of the T-2 and T-3 sympathetic trunks along the horizontal axes of the rib heads were determined using a three-region system constructed by the authors. The area between the rib neck and the medial border of the rib head was equally divided into Region E (external half) and Region M (medial half). The area between the medial border of the rib head and the paravertebral ligament was defined as Region I. The incidence of the T-2 and T-3 sympathetic trunks found in Regions E, M, and I were 31.4 to 42.9%, 50 to 57.1%, and 7.1 to 11.4%, respectively, on the left side, and 24.3 to 34.3%, 57.1 to 65.7%, and 8.6 to 10%, respectively, on the right side. One right (1.4%) and six left (8.6%) Kuntz nerves originating from the T-3 sympathetic trunk were found in seven patients (10%). The intercostal ramus was found around the T-2 rib neck in 24 patients (34.3%), with 18 cases (25.7%) for each side. The intercostal ramus around the T-3 rib neck was found in 17 patients (24.3%): 12 (17.1%) on the right and nine (12.9%) on the left. Conclusions. These results indicate that approximately 90% of the T-2 or T-3 sympathetic trunks are located on the rib head. These findings may also be used to assist the surgeon in fluoroscopic guidance for locating the T-2 and T-3 sympathetic trunks during posterior percutaneous sympathectomy.

Convexity leptomeningeal cysts diagnosed by scinticisternography

1975 ◽  
Vol 43 (2) ◽  
pp. 203-206 ◽  
Author(s):  
Dov Front ◽  
Hubert F.H.G. Defesche ◽  
Thian Siang Oen ◽  
Jan W.F. Beks ◽  
Lourens Penning
Keyword(s):  
Content Type ◽  
Operative Findings ◽  
Fine Print

✓The scintigraphic diagnosis of eight convexity leptomeningeal cysts is described; the cysts appear as a local collection of abnormal radioactivity, best seen at 48 hours. The correlation of the scintigraphic findings with clinical, radiological, and operative findings is discussed.

External carotid-cavernous fistula treated by arterial embolization

1974 ◽  
Vol 40 (1) ◽  
pp. 110-114 ◽  
Author(s):  
M. Stephen Mahalley ◽  
Stephan C. Boone
Keyword(s):  
Carotid Artery ◽  
Successful Treatment ◽  
Arterial Embolization ◽  
External Carotid Artery ◽  
External Carotid ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Unusual Occurrence ◽  
Fine Print

✓ The unusual occurrence of a carotid-cavernous fistula supplied entirely by branches of the external carotid artery is presented, and its successful treatment by arterial embolization described.

Hydrocephalus due to membranous obstruction of the fourth ventricle

1971 ◽  
Vol 35 (6) ◽  
pp. 672-676 ◽  
Author(s):  
A. Loren Amacher ◽  
Larry K. Page
Keyword(s):  
Posterior Fossa ◽  
Fourth Ventricle ◽  
Clinical Findings ◽  
Posterior Fossa Tumor ◽  
Cerebellar Development ◽  
Rare Entity ◽  
Content Type ◽  
Operative Findings ◽  
Membranous Obstruction ◽  
Fine Print

✓ Four patients with hydrocephalus due to membranous obstruction of the fourth ventricle are presented. This rare entity produced radiographic and clinical findings suggestive of posterior fossa tumor. Operative findings included normal cerebellar development and a translucent membrane just above the foramen of Magendie. Etiological possibilities are discussed.

Irregular-shaped ruptured aneurysms: pseudoaneurysm formation in a thrombus at rupture site

2000 ◽  
Vol 93 (6) ◽  
pp. 998-1002 ◽  
Author(s):  
Motohiro Nomura ◽  
Sinya Kida ◽  
Naoyuki Uchiyama ◽  
Tetsumori Yamashima ◽  
Jun Yoshikawa ◽  
...  
Keyword(s):  
Open Surgery ◽  
Cerebral Aneurysms ◽  
Endovascular Embolization ◽  
Endovascular Procedure ◽  
Pathological Examination ◽  
Content Type ◽  
Pseudoaneurysm Formation ◽  
Aneurysm Embolization ◽  
Operative Findings ◽  
Fine Print

Object. The authors describe the clinical, radiological, and pathological findings of ruptured cerebral aneurysms with irregular configurations.Methods. Eight patients with subarachnoid hemorrhage due to ruptured irregularly shaped aneurysms were examined. The preoperative radiological findings in these cases were compared with the pathological and operative findings of endovascular or open surgery.All of the aneurysms exhibited delayed opacification and delayed washout of contrast medium from the irregularly shaped portion of the aneurysm on digital subtraction angiography and/or helical computerized tomography scanning. Endovascular embolization with platinum coils was attempted in the first four patients who underwent treatment. In three of these patients the aneurysm ruptured again during the endovascular procedure. In the fourth patient an intraaneurysm thrombus was observed during the procedure and clipping was performed. In the subsequent four patients, three underwent clipping without complication and one underwent partial aneurysm embolization because of poor general status. A thrombus adjacent to the aneurysm dome was observed in the patients who underwent open surgery. Pathological examination of the operative specimens revealed a pseudoaneurysm-like cavity in the thrombus that was adherent to the aneurysm.Conclusions. Ruptured irregularly shaped aneurysms may be accompanied by fragile pseudoaneurysm-like cavities located at the rupture point. Because these aneurysms have a high risk of repeated rupture during an endovascular procedure, advancing microinstruments to the weaker portion of the aneurysm should be avoided.

Lymphatic fistula following myelomeningocele repair

1976 ◽  
Vol 45 (4) ◽  
pp. 452-454
Author(s):  
Lawrence C. Dempsey ◽  
Byron C. Pevehouse
Keyword(s):  
Successful Treatment ◽  
Content Type ◽  
Lymphatic Fistula ◽  
Myelomeningocele Repair ◽  
Fine Print

✓ The authors report a lymphatic fistula as a complication of myelomeningocele repair and discuss its pathophysiology and successful treatment.

Aneurysms of the ophthalmic segment

1990 ◽  
Vol 72 (5) ◽  
pp. 677-691 ◽  
Author(s):  
Arthur L. Day
Keyword(s):  
Carotid Artery ◽  
Ophthalmic Artery ◽  
Anterior Clinoid Process ◽  
Content Type ◽  
Visual Deficits ◽  
Clinical Presentations ◽  
Female Predominance ◽  
Operative Findings ◽  
Ophthalmic Segment Aneurysms ◽  
Fine Print

✓ The clinical, radiographic, and anatomical features in 80 patients with ophthalmic segment aneurysms were reviewed, and were categorized according to a presumed origin related to the ophthalmic (41 cases) or superior hypophyseal (39 cases) arteries. There was a marked female predominance (7:1) and high incidence of multiple aneurysms (45%) within this population. Clinical presentations included subarachnoid hemorrhage in 23 cases (29%) and visual deficits in 24 (30%); five patients exhibited both hemorrhage and visual loss. Twenty-eight aneurysms were incidentally identified. Ophthalmic artery aneurysms arose from the internal carotid artery (ICA) just distal to the ophthalmic artery, pointed superiorly or superomedially, and (when large) deflected the carotid artery posteriorly and inferiorly, closing the siphon. Abnormalities relating to vision were not identified until the aneurysm realized giant proportions. The optic nerve was typically displaced superomedially, which restricted contralateral extension until late in the clinical course; unilateral nasal field loss was seen in 12 patients. Nine patients had bilateral ophthalmic artery aneurysms which were often clipped via a unilateral craniotomy. Superior hypophyseal artery aneurysms arose just above the dural ring from the medial bend of the ICA, at the site of perforator origin to the superior aspect of the hypophysis, and had no direct association with the ophthalmic artery. The carotid artery was usually located lateral or superolateral relative to the aneurysm. These lesions could extend medially beneath the chiasm (suprasellar variant), producing a clinical and computerized tomography picture similar to a pituitary adenoma, or they could extend ventrally to burrow beneath the anterior clinoid process (paraclinoid variant). Preoperative categorization of these lesions according to their likely branch of origin provides excellent correlation with visual deficits and operative findings, and has allowed the author to clip 52 of 54 lesions, with very low operative or visual morbidity.

Ossification of autologous pericranium used in duraplasty

2001 ◽  
Vol 95 (2) ◽  
pp. 350-352 ◽  
Author(s):  
Devon A. Hoover ◽  
Asim Mahmood
Keyword(s):  
Computerized Tomography ◽  
Gunshot Wound ◽  
Osteogenic Potential ◽  
Review Of The Literature ◽  
Content Type ◽  
Dural Closure ◽  
The Many ◽  
Tomography Scanning ◽  
Fine Print

✓ Pericranium is frequently used in duraplasty and is considered superior to the many other alternatives because of its easy availability and because it offers a watertight dural closure while minimizing the problems of adhesion, infection, and rejection. Although the osteogenic potential of all periosteal tissues is recognized, a review of the literature did not reveal a reported case of osseous formation following use of pericranium for duraplasty. The authors report the case of a 17-year-old man who presented with a self-inflicted gunshot wound to the head. He was obtunded, but moving all extremities purposefully. Computerized tomography scanning demonstrated bifrontal injury. A bicoronal craniotomy with debridement was performed on an emergency basis, with vascularized pericranium used for a duraplasty. Follow-up cranioplasty demonstrated significant ossification of the pericranium 5 months after the original surgery. Pericranium is an attractive material for duraplasty; however, its osteogenic potential may interfere with future cranioplasty and cosmesis. This may be especially relevant in young persons.

Abnormal origin of bilateral ophthalmic arteries

1991 ◽  
Vol 74 (2) ◽  
pp. 287-289 ◽  
Author(s):  
Jun-ichiro Hamada ◽  
Isao Kitamura ◽  
Masahito Kurino ◽  
Nobuyuki Sueyoshi ◽  
Shozaburo Uemura ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Intracranial Aneurysms ◽  
Ophthalmic Artery ◽  
Internal Carotid ◽  
Content Type ◽  
Multiple Intracranial Aneurysms ◽  
Operative Findings ◽  
Ophthalmic Arteries ◽  
Fine Print

✓ The case of a 64-year-old woman with multiple intracranial aneurysms and abnormal ophthalmic arteries arising from the bifurcation of the internal carotid artery is described. It is believed that this type of anomaly of the ophthalmic artery has not previously been reported. The neuroradiological and operative findings of this case are presented.

Clinical characteristics and CT findings in lipoma of the cerebellopontine angle

1982 ◽  
Vol 57 (6) ◽  
pp. 839-841 ◽  
Author(s):  
Virgil B. Graves ◽  
George W. Schemm
Keyword(s):  
Computerized Tomography ◽  
Cerebellopontine Angle ◽  
Rare Case ◽  
Clinical Characteristics ◽  
Content Type ◽  
Ct Findings ◽  
Operative Findings ◽  
Fine Print

✓ The authors present a rare case of symptomatic lipoma of the cerebellopontine angle, and describe the computerized tomography and operative findings. These are tumors of maldevelopmental origin, and the three cases reported to date have shown many similarities.

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