New lumboperitoneal shunt for communicating hydrocephalus

1976 ◽  
Vol 44 (2) ◽  
pp. 258-261 ◽  
Author(s):  
Harold J. Hoffman ◽  
E. Bruce Hendrick ◽  
Robin P. Humphreys
Keyword(s):  
Communicating Hydrocephalus ◽  
Content Type ◽  
T Tube ◽  
The Past ◽  
Lumboperitoneal Shunt ◽  
Tube Type ◽  
Shunting Procedure ◽  
Fine Print

✓ The authors describe a T-tube Silastic shunting device which has been used for lumboperitoneal shunting in 62 patients with communicating hydrocephalus during the past 3 years. In 38 patients it was inserted as a primary shunting procedure; 24 patients had the shunt inserted following problems secondary to arachnoiditis created by a polyethylene-type lumboperitoneal shunt. The shunt described here has not led to arachnoiditis when inserted as a primary shunting procedure. In 61% of patients no operative revisions of their shunt has been required to date, and 81% continue to do well on their T-tube type shunt.

Prognosis in subarachnoid hemorrhage of unknown etiology

1986 ◽  
Vol 64 (3) ◽  
pp. 359-362 ◽  
Author(s):  
Roar Juul ◽  
Torbjørn A. Fredriksen ◽  
Rolf Ringkjøb
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Mortality Rate ◽  
Tranexamic Acid ◽  
Complete Recovery ◽  
Unknown Etiology ◽  
Communicating Hydrocephalus ◽  
Content Type ◽  
Repeat Angiography ◽  
Shunting Procedure ◽  
Fine Print

✓ Thirty-two patients with subarachnoid hemorrhage of unknown etiology were followed for periods from 1 to 6½ years. Two more patients had normal initial angiograms, but were excluded when repeat angiography revealed an aneurysm. The mortality rate in this series was 6%. There was one possible early and no late episode of rebleeding. One patient developed epilepsy. Five patients developed communicating hydrocephalus and underwent a shunting procedure. A complete recovery was observed in 12 patients. An additional eight had minimal disability, seven were more severely disabled, and three patients were totally disabled. Antifibrinolytic treatment (tranexamic acid) was given in a nonstandardized regimen to 14 patients who showed a poorer result than did the 18 untreated patients.

Communicating hydrocephalus associated with deficient dysplastic parasagittal arachnoidal granulations

1971 ◽  
Vol 35 (4) ◽  
pp. 421-426 ◽  
Author(s):  
Floyd H. Gilles ◽  
Robin I. Davidson
Keyword(s):  
Sufficient Evidence ◽  
Communicating Hydrocephalus ◽  
Content Type ◽  
The Past ◽  
Marked Diminution ◽  
Fine Print

✓ Marked diminution of arachnoidal granulations with abnormality of those remaining is presented as a cause of communicating hydrocephalus in two children. Although this underlying abnormality has been alluded to in the past, it has not been adequately documented. The authors believe their observations constitute sufficient evidence to warrant consideration of this entity as one of the causes of communicating hydrocephalus.

Cervical-peritoneal shunt in the treatment of pseudotumor cerebri

1982 ◽  
Vol 57 (6) ◽  
pp. 853-855 ◽  
Author(s):  
Robert A. Beatty
Keyword(s):  
Cerebrospinal Fluid ◽  
Pseudotumor Cerebri ◽  
Content Type ◽  
Lumboperitoneal Shunt ◽  
Cerebrospinal Fluid Shunting ◽  
Shunting Procedure ◽  
Fine Print

✓ Pseudotumor cerebri occasionally requires a cerebrospinal fluid shunting procedure, usually placement of a lumboperitoneal shunt, to preserve the patient's vision. This paper describes a cervical-peritoneal shunt which is simple to insert and effective, and which can be directly evaluated by palpation.

Microvascular patch technique with and without Silastic T-tube bypass

1984 ◽  
Vol 60 (2) ◽  
pp. 287-295 ◽  
Author(s):  
Peter C. Haines ◽  
R. M. Peardon Donaghy
Keyword(s):  
Foreign Body ◽  
Suture Material ◽  
Vascular Occlusion ◽  
Current Data ◽  
Content Type ◽  
Small Vessels ◽  
T Tube ◽  
Patch Closure ◽  
Patch Technique ◽  
Fine Print

✓ Poor patency results in the surgery of small vessels operated on between 1959 to 1964 was demonstrated to be in part due to the long period of occlusion of the operated vessel during surgery and the presence of a foreign body (suture) in the lumen of the vessel postoperatively. New suture techniques and T-tube bypass were introduced at that time. New experimental data have not been extensively sought since that time. To provide further current data regarding the above observations, 110 arterial vessels (60 carotid arteries 1.1 to 1.3 mm in outside diameter (OD) and 50 femoral arteries 0.6 to 0.7 mm OD) were operated on in rats to compare the bypass versus non-bypass and vein patch closure techniques. In 1-mm vessels, patency rates 1 month after surgery were 100% regardless of the use of bypass or type of closure. Improved visualization, better suture material, and improved surgical skill were probably chiefly responsible for this success. The success rate was not as encouraging, however, in vessels of 0.6 mm OD. The following points are brought out: 1) The presence of the bypass causes damage to the intima in 0.6 mm OD vessels and should not be used. Smaller bypasses do not conduct blood well. 2) Bypass is not required in 1-mm vessels as the patency rate is satisfactory and not altered by its use. 3) The major indication for T-tube bypass is in vessels of 1 mm OD and larger, that nourish tissue which would be damaged by vascular occlusion for 20 to 40 minutes. 4) Foreign body (suture) in the lumen is poorly tolerated in 0.6 mm vessels, but can be tolerated more easily in larger vessels. 5) Techniques that limit the amount of suture material in the lumen are indicated in 0.6-mm vessels. 6) After 1 month, suture material has an epithelial covering and if patency has been maintained for that period of time it is likely to remain.

Minds and brains: angels, humans, and brutes

1982 ◽  
Vol 57 (3) ◽  
pp. 309-315
Author(s):  
Mortimer J. Adler
Keyword(s):  
Nervous System ◽  
Animal Behavior ◽  
Personal Experience ◽  
Human Beings ◽  
Content Type ◽  
The Past ◽  
Wide Range ◽  
Conceptual Thought ◽  
The Brain ◽  
Fine Print

✓ In his 1982 Cushing oration, a distinguished philosopher, author, and discerning critic presents a distillate of his phenomenally wide range of personal experience and his familiarity with the great books and teachers of the present and the past. He explores the differences and relationships between human beings, brute animals, and machines. Knowledge of the brain and nervous system contribute to the explanation of all aspects of animal behavior, intelligence, and mentality, but cannot completely explain human conceptual thought.

Evaluation of the central canal of the spinal cord in experimentally induced hydrocephalus

1978 ◽  
Vol 48 (6) ◽  
pp. 970-974 ◽  
Author(s):  
A. Everette James ◽  
William J. Flor ◽  
Gary R. Novak ◽  
Ernst-Peter Strecker ◽  
Barry Burns
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Experimental Model ◽  
Alternative Pathway ◽  
Central Canal ◽  
Communicating Hydrocephalus ◽  
Csf Flow ◽  
Content Type ◽  
Histological Appearance ◽  
Fine Print

✓ The central canal of the spinal cord has been proposed as a significant compensatory alternative pathway of cerebrospinal fluid (CSF) flow in hydrocephalus. Ten dogs were made hydrocephalic by a relatively atraumatic experimental model that simulates the human circumstance of chronic communicating hydrocephalus. The central canal was studied by histopathology and compared with 10 normal control dogs. In both groups the central canal of the spinal cord was normal in size, configuration, and histological appearance. In this experimental model dilatation of the canal and increased movement of CSF does not appear to be a compensatory alternative pathway.

The right hemisphere: neuropsychological functions

1986 ◽  
Vol 64 (5) ◽  
pp. 693-704 ◽  
Author(s):  
Kenneth M. Heilman ◽  
Dawn Bowers ◽  
Edward Valenstein ◽  
Robert T. Watson
Keyword(s):  
Emotional Disorders ◽  
Right Hemisphere ◽  
Content Type ◽  
Reading And Writing ◽  
The Past ◽  
Right Hemisphere Damage ◽  
Right Hemisphere Dysfunction ◽  
Neuropsychological Functions ◽  
The Right ◽  
Fine Print

✓ In the past two to three decades, clinicians and neuroscientists have been studying the functions of the right hemisphere. Neither hemisphere seems to be dominant in the absolute sense. Each appears to be specialized and is dominant for different functions. However, most functions require the cooperation of both hemispheres. When one is damaged, the other can often compensate for the damaged one. Lesions of the left hemisphere are associated with language (speech, reading, and writing) and praxic disorders, and lesions of the right hemisphere can result in visuospatial, attentional, and emotional disorders. The authors review some of the major behavioral disorders associated with right hemisphere dysfunction and concentrate on three major types of disorders — visuospatial, attentional, and emotional. Although not all the behavioral defects associated with right hemisphere damage can be subgrouped under these three types, they are the ones most often associated with right hemisphere lesions.

Cervical spinal cord in experimental hydrocephalus

1972 ◽  
Vol 37 (5) ◽  
pp. 538-542 ◽  
Author(s):  
George J. Dohrmann
Keyword(s):  
Spinal Cord ◽  
Brain Stem ◽  
Cervical Spinal Cord ◽  
Central Canal ◽  
Content Type ◽  
Experimental Hydrocephalus ◽  
Physiological Pressure ◽  
The Brain ◽  
Shunting Procedure ◽  
Fine Print

✓ Adult dogs were rendered hydrocephalic by the injection of kaolin into the cisterna magna. One group of dogs was sacrificed 1 month after kaolin administration, and ventriculojugular shunts were performed on the other group. Hydrocephalic dogs with shunts were sacrificed 1 day or 1 week after the shunting procedure. All dogs were perfused with formalin at physiological pressure, and the brain stem and cervical spinal cord were examined by light microscopy. Subarachnoid granulomata encompassed the superior cervical spinal cord and dependent surface of the brain stem. Rarefaction of the posterior white columns and clefts or cavities involving the gray matter posterior to the central canal and/or posterior white columns were present in the spinal cords of both hydrocephalic and shunted hydrocephalic dogs. Predominantly in the dogs with shunts, hemorrhages were noted in the spinal cord in association with the clefts or cavities. A mechanism of ischemia followed by reflow of blood is postulated to explain the hemorrhages in the spinal cords of hydrocephalic dogs with shunts.

Facial nevi associated with anomalous venous return and hydrocephalus

1976 ◽  
Vol 45 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Kenneth Shapiro ◽  
Kenneth Shulman
Keyword(s):  
Pediatric Patients ◽  
Venous Return ◽  
Venous Hypertension ◽  
Communicating Hydrocephalus ◽  
Age Group ◽  
Content Type ◽  
Weber Syndrome ◽  
Sturge Weber Syndrome ◽  
The Relationship ◽  
Fine Print

✓ The authors describe two children with anomalous intracranial venous return associated with bilateral facial nevi, macrocrania, and cephalic venous hypertension. Both children had functional absence of the jugular bulbs, forcing the intracranial venous effluent to exit through persistent emissary pathways. Both children had sustained intracranial hypertension, with one child developing symptomatic communicating hydrocephalus that responded satisfactorily to shunting. The relationship between these patients and those with Sturge-Weber syndrome is discussed. The embryologic abnormality producing the anomalous venous return is characterized. The link between venous hypertension and the development of hydrocephalus is discussed. The increased cranial compliance seen in this age group may predispose certain pediatric patients to develop hydrocephalus when stressed by venous hypertension.

Families, brain death, and traditional medical excellence

1984 ◽  
Vol 60 (6) ◽  
pp. 1192-1194 ◽  
Author(s):  
Rosa Lynn Pinkus
Keyword(s):  
Brain Death ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Personal Beliefs ◽  
Content Type ◽  
The Past ◽  
Transplant Center ◽  
Fine Print

✓ Staff neurosurgeons and residents at a tertiary care hospital designated as a transplant center were surveyed regarding personal opinions concerning brain death and family conferences. Compared to an extensive survey done in 1976, the responses indicated that, while a professional consensus regarding the definition and meaning of brain death has emerged in the past 10 years, a range of personal beliefs and opinions regarding the concept still exists. In spite of the professional consensus, it is still difficult for the physician to communicate gently, yet firmly, to families both the scientific groundwork that validates the determination of brain death, the concept, and the finality of the information.

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