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.

Delayed cervical myelopathy caused by bomb shell fragment

1976 ◽  
Vol 44 (5) ◽  
pp. 626-627 ◽  
Author(s):  
Katsumasa Amitani ◽  
Yuichi Tsuyuguchi ◽  
Sinsuke Hukuda
Keyword(s):  
Foreign Body ◽  
Cervical Myelopathy ◽  
Rare Case ◽  
Foreign Body Reaction ◽  
Content Type ◽  
Shell Fragment ◽  
Fine Print

✓ A rare case of delayed cervical myelopathy caused by a bomb shell fragment is reported. The fragment lay intradurally with minimum foreign body reaction. Symptoms did not begin to occur until 17 years after injury.

Microblock for occlusion of small vessels

1976 ◽  
Vol 44 (6) ◽  
pp. 757-758 ◽  
Author(s):  
Sanford J. Wright
Keyword(s):  
Content Type ◽  
Small Vessels ◽  
Fine Print

✓ A small microvascular occluder termed a “microblock” is described. It has the advantages of controlled gentle occlusion and small size.

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.

Impaired microvascular filling after focal cerebral ischemia in monkeys

1972 ◽  
Vol 36 (3) ◽  
pp. 303-309 ◽  
Author(s):  
Robert M. Crowell ◽  
Yngve Olsson
Keyword(s):  
Cerebral Ischemia ◽  
Focal Cerebral Ischemia ◽  
Cerebrovascular Diseases ◽  
Subcortical Structures ◽  
Content Type ◽  
Microsurgical Technique ◽  
Small Vessels ◽  
Mca Occlusion ◽  
Vascular Channels ◽  
Fine Print

✓ Impairment of microvascular filling was demonstrated in relation to focal cerebral ischemia in the monkey. Temporary or sustained middle cerebral artery (MCA) clipping was achieved with a microsurgical technique. Animals were sacrificed by perfusion with a carbon black suspension. Brains were fixed in formalin, and the extent of microvascular carbon filling was estimated grossly and microscopically. In most animals, MCA occlusion of 2 hours to 7 days produced diminished filling in small vessels in the MCA territory of supply. The impairment of filling was most pronounced in the deep subcortical structures but also affected the cortex in some animals. Temporary and sustained occlusion of equal duration produced roughly equivalent areas of abnormal filling. The impairment of vascular filling tended to be more extensive with increasing duration of occlusion. Hypotension during MCA occlusion caused almost total non-filling of the microvasculature in the entire MCA territory. Impaired filling of vascular channels may play a role in the pathogenesis of some clinical cerebrovascular diseases.

Foreign-body granuloma as a complication of wrapping and coating an intracranial aneurysm

1990 ◽  
Vol 72 (2) ◽  
pp. 292-294 ◽  
Author(s):  
Toshihiko Haisa ◽  
Korehito Matsumiya ◽  
Norio Yoshimasu ◽  
Nobuo Kuribayashi
Keyword(s):  
Foreign Body ◽  
Rare Case ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Foreign Body Granuloma ◽  
Content Type ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Aron Alpha ◽  
Fine Print

✓ A rare case is presented in which a foreign-body granuloma developed at the site of muslin wrapping and Aron Alpha A coating of an internal carotid artery aneurysm. The importance of avoiding the use of muslin, especially close to the optic nerve and chiasm, is emphasized.

Immunocytochemical evidence of lymphocytic derivation of neoplastic cells in malignant angioendotheliomatosis

1991 ◽  
Vol 74 (5) ◽  
pp. 757-762 ◽  
Author(s):  
W. Craig Clark ◽  
F. Curtis Dohan ◽  
Timothy Moss ◽  
John B. Schweitzer
Keyword(s):  
Endothelial Cell Proliferation ◽  
Cell Of Origin ◽  
Content Type ◽  
Therapeutic Implications ◽  
Ulex Europaeus ◽  
Small Vessels ◽  
Immunohistochemical Techniques ◽  
Brain And Spinal Cord ◽  
The Brain ◽  
Fine Print

✓ Neoplastic angioendotheliomatosis is a rare disorder usually characterized by primarily cutaneous or neurological symptoms. Approximately 40 cases of malignant angioendotheliomatosis with primary central nervous system (CNS) symptoms have been reported. Some investigators have postulated a hematopoietic origin for this neoplasm. Most of the literature, however, has perpetuated the idea that the often bizarre symptoms seen with this entity result from neoplastic endothelial cell proliferation within the small vessels of affected organs, including the brain and spinal cord. This report describes the immunohistochemical examination and confirmation of the cell of origin of this neoplasm based on five previously unpublished cases of malignant angioendotheliomatosis with primarily CNS symptoms. It includes the first documentation of a T-cell lymphoma presenting as malignant angioendotheliomatosis. All cases include autopsy findings, and in four cases the diagnosis was made postmortem. One case was proven by stereotactic biopsy, but the patient succumbed as a result of severe intracranial bleeding that occurred at the time of biopsy. Tissues were studied with avidin-biotin peroxidase immunohistochemical techniques using a panel of monoclonal antibodies directed against the leukocyte common antigen, LN-1, LN-2, and anti-Factor VIII, and also using Ulex europaeus agglutinin 1. Based on the results obtained, the authors conclude that the proliferative cells seen within the vessel lumina are of lymphocytic origin and agree that the condition should more properly be designated intravascular lymphomatosis. The therapeutic implications of this conclusion point to the possible administration of chemotherapy and radiotherapy in an effort to achieve remissions in an otherwise relentlessly progressive neurological disorder.

Posterior atlantooccipital membrane for duraplasty

2002 ◽  
Vol 97 (2) ◽  
pp. 266-268 ◽  
Author(s):  
R. Shane Tubbs ◽  
John C. Wellons ◽  
Jeffrey P. Blount ◽  
W. Jerry Oakes
Keyword(s):  
Foreign Body ◽  
Postoperative Complications ◽  
Pediatric Patients ◽  
Chiari I Malformation ◽  
Posterior Cranial Fossa ◽  
Content Type ◽  
Chiari I ◽  
Cranial Fossa ◽  
Fine Print

✓ The authors describe the use of autogenetic posterior atlantooccipital (PAO) membrane for duraplasty following after posterior cranial fossa surgery. The PAO membrane is routinely exposed for procedures of the posterior cranial fossa and merely needs to be dissected free of the underlying dura mater. Recently this membrane was obtained in several pediatric patients following procedures of the posterior cranial fossa such as duraplasty in case of Chiari I malformation. No postoperative complications were found at 6-month follow-up examination. The advantages of this intervention include less manipulation of muscle and fascia than that involved in other procedures and, therefore, seemingly less postoperative pain and the negation of issues inherent with foreign-body graft sources. The authors believe this structure to be of use as a dural substitute in small dural openings of the posterior cranial fossa.

Intracranial foreign bodies: backfire

1973 ◽  
Vol 38 (1) ◽  
pp. 96-98
Author(s):  
B. A. Rocha Campos ◽  
N. Ballalai ◽  
J. Portugal Pinto
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Cranial Cavity ◽  
Content Type ◽  
Fine Print

✓ The authors report 14 cases of a foreign body that penetrated the cranial cavity due to backfire of an over-charged, home-filled metallic cartridge.

Cyst formation following gamma knife surgery for intracranial meningioma

2005 ◽  
Vol 102 ◽  
pp. 134-139 ◽  
Author(s):  
Takashi Shuto ◽  
Shigeo Inomori ◽  
Hideyo Fujino ◽  
Hisato Nagano ◽  
Naoki Hasegawa ◽  
...  
Keyword(s):  
Gamma Knife ◽  
De Novo ◽  
Cyst Formation ◽  
Tumor Location ◽  
Gamma Knife Surgery ◽  
Intracranial Meningioma ◽  
Content Type ◽  
Small Vessels ◽  
The Mean ◽  
Fine Print

Object.The authors conducted a study to evaluate the clinical significance of cyst formation or enlargement after gamma knife surgery (GKS) for intracranial benign meningiomas.Methods.The medical records of 160 patients with 184 tumors were examined for those with follow-up data of more than 2 years among 270 patients who underwent GKS for intracranial meningiomas between February 1992 and November 2001.Cyst formation or enlargement following GKS was observed in five patients, one man and four women (mean age 61.2 years). The tumor location was the sphenoid ridge in one case, petroclival in two, tentorium in one, and parasagittal region in one. All patients underwent surgery before GKS. The mean tumor volume was 10.5 cm3, the mean margin dose was 13.4 Gy (median 14 Gy), and the mean maximum dose was 27.5 Gy (median 24.1 Gy). At the time of GKS three tumors were associated with cyst, of which two enlarged after radiosurgery. Three cysts developed de novo after GKS. Three of the five patients needed surgery to treat the cyst formation or enlargement. Histological examination demonstrated various findings such as tumor necrosis, proliferation of small vessels, vascular obliteration, and hemosiderin deposits.Conclusions.New cyst formation following GKS for benign intracranial meningioma is relatively rare; however, both preexisting and newly developed cysts tend to enlarge after GKS and often require surgery.

Foreign-body granuloma simulating recurrence of falx meningioma

1983 ◽  
Vol 59 (6) ◽  
pp. 1085-1087 ◽  
Author(s):  
Shinichi Shimosaka ◽  
Shiro Waga
Keyword(s):  
Foreign Body ◽  
Foreign Body Granuloma ◽  
Total Removal ◽  
Content Type ◽  
Fine Print

✓ The authors report a case of foreign-body granuloma that developed 1½ years after total removal of a falx meningioma. Prior to surgery, it was thought to be a recurrence of tumor.

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