This article describes an "S"-shaped incision for the open approach of harvesting wide sheets of fascia lata with reference to the important anatomical landmarks. Forty-three patients required dural replacement in cases of tumors, trauma, or cerebrospinal fluid leak involving the anterior skull base. The extended anterior suberanial approach to the skull base was used for all patients.
View Article and Find Full Text PDFThe technical approach for anterior skull base tumors has progressed considerably during the last decade. In the classical combined craniofacial resection (CFR) technique, anterior skull base lesions have been approached through bi-frontal craniotomy coupled with Weber-Ferguson and related modifications incisions. The purpose of this work is to present our experience with the subcranial approach for treatment of anterior skull base tumors.
View Article and Find Full Text PDFCompared to either drug alone, therapy with the combination of ribavirin and interferon-alpha leads to improved rates of response in patients with chronic hepatitis C. Side effects often mandate downward dose adjustment or cessation of therapy, and the optimal dose of ribavirin has not been established. The aim of this study was to learn whether 600 mg ribavirin per day would prove as efficacious as 1,000-1,200 mg/day when combined with interferon (3 million units thrice weekly) for therapy of patients previously treated with standard interferon who had failed to respond or who had relapsed.
View Article and Find Full Text PDFJ Oral Maxillofac Surg
October 2001
Purpose: Because of the likelihood of meningitis and other intracranial complications, optimal treatment for a cerebrospinal fluid (CSF) fistula is to close the leak. The neurosurgical approach to the management of CSF rhinorrhea has been by intracranial access. Extracranial approaches are now gaining acceptance as the preferred method for initial treatment of CSF leakage, because the success rates are reasonable, and the morbidity is lower.
View Article and Find Full Text PDFWe reviewed the cases of 75 patients who underwent an extended subcranial approach to the anterior skull base for treatment of various tumors (35 patients), repair of craniofacial trauma injury (33 patients), or cerebrospinal fluid leakage (10 patients). Preoperative evaluation and surgical procedures were reassessed. Significant complications in the oncology group consisted of one hematoma requiring aspiration, 2 cases of transient pneumocephalus, 2 osteocutaneous fistulae and 2 epiphoras.
View Article and Find Full Text PDFMt Sinai J Med
September 2000
A left subfrontopolar lesion with marked edema was totally resected utilizing a minimally invasive approach. It was possible to expose and resect the lesion, which turned out to be a tuberculoma, through a burr hole placed supraorbitally through a glabellar incision. The development and significance of minimalization techniques for surgery in the skull base region are discussed.
View Article and Find Full Text PDFObjectives: To present the technique of the extended subcranial approach to the anterior skull base and to review the results in 55 patients who underwent the procedure.
Study Design: Retrospective review of the records of 55 patients who underwent the extended subcranial approach to the anterior skull base between 1994 and 1998 for the treatment of various neoplasms originating in the nasal cavity, nasopharynx, paranasal sinuses, orbit, or meninges, as well as for the repair of complex craniofacial trauma and/or cerebrospinal fluid (CSF) leak. Preoperative patient evaluation and the surgical technique are also reviewed.
Am J Gastroenterol
October 1998
A 46-yr-old man presenting with biliary obstruction from an intrapancreatic tumor underwent pancreaticoduodenectomy. The pathology report showed the tumor to be an enteric duplication cyst. Diagnostic imaging features and operative management are discussed.
View Article and Find Full Text PDFA man who previously had several episodes of upper gastrointestinal hemorrhage from erosive gastritis developed recurrent hemorrhage. Endoscopy showed punctate hemorrhages in the fundus and body of the stomach, plus a discrete area of thickened folds in the anterior wall. Biopsies revealed a dense mucosal infiltrate that included cytomegaloviral inclusions.
View Article and Find Full Text PDFThe records of 57 patients who were operated on at the Beilinson Medical Center from 1970 through 1982 for supratentorial low-grade astrocytomas were reviewed. The management of these patients was correlated with survival. Our study demonstrates that a younger age at onset and a negative radionuclide uptake on isotope scan, were the most important factors associated with a better survival rate.
View Article and Find Full Text PDFImmediate management of severe head injuries still poses a serious challenge. 50 patients with severe head injuries (Glasgow Coma Scale, 8 or less) were treated from February 1, 1989 to April 30, 1990. The effects of age, Glasgow Coma Score at admission, CT findings, pupillary reactivity to light and intracranial pressure on outcome, were evaluated.
View Article and Find Full Text PDFActa Neurochir (Wien)
March 1992
A case of an intracerebral bleeding from haemangiopericytoma is reported. To our knowledge it is the first published case. The literature concerning apoplectic presentation of brain tumours is reviewed.
View Article and Find Full Text PDFActa Neurochir Suppl (Wien)
May 1991
This study was undertaken in order to determine whether early administration of mannitol is different from late administration in its effect on brain oedema. Cold-induced brain oedema, which was confirmed by high resolution CT scan, was produced in 2 groups of cats. In group one mannitol was given early (90 minutes after injury); in group two 3-4 hours after the injury (late).
View Article and Find Full Text PDFWe assessed the effects of in vivo phototherapy of Gunn rats on the activity of hepatic microsomal mixed-function monoxygenases and on the in vivo pharmacokinetics of [14C]HB. In experiment 1 no serial changes were seen in activities of hexobarbital hydroxylase or benzo(a)pyrene hydroxylase in hepatic microsomes isolated after 2, 4 or 7 days from homozygous jaundiced female Gunn rats exposed to continuous phototherapy or in matched Gunn rats maintained under dim light. In experiment 2 homozygous jaundiced (jj) and heterozygous nonjaundiced (Jj) Gunn rats of both sexes each received i.
View Article and Find Full Text PDFGlioblastoma multiforme is a rapidly growing anaplastic primary tumor of the central nervous system. It is frequently associated with neurofibromatosis or other hamartomatous syndromes, and in such kindreds may be found in several generations. We describe a highly inbred family in which glioblastoma multiforme presents in males only as an isolated central nervous system neoplasm on the right side, without evidence of other underlying genetic disease.
View Article and Find Full Text PDFGastrointest Endosc
April 1984
To determine the optimal length of the flexible fiberoptic sigmoidoscope we performed a randomized, blinded comparison study of the standard 60-cm instrument with a prototype 30-cm instrument with identical design features. Ninety-six male patients referred for symptom evaluation underwent examination with both instruments in random order by different examiners; positive examinations were followed by colonoscopy or surgery. Performance of the 30-cm sigmoidoscope compared with the 60-cm instrument revealed that the former was significantly more likely to yield a complete examination (74 vs.
View Article and Find Full Text PDFA series of 74 consecutive cases undergoing craniotomy for single brain metastasis in the Beilinson Medical Center between October 1975 and October 1981 were reviewed. All patients underwent radiation therapy after craniotomy. The most common metastasis was that of unknown origin (35%), followed by lung (24%) and breast (16%).
View Article and Find Full Text PDFThe clinical and histopathological findings in a child suffering from both cerebral and spinal gliomas of differing histological types are described. There was a family history of von Recklinghausen's neurofibromatosis. The possibility of overlooking the symptoms and signs pointing to a spinal cord lesion in the presence of a known intracranial tumour is stressed.
View Article and Find Full Text PDFA new sequential pneumatic instrument for the prevention of deep vein thrombosis (DVT), the Lympha Press, was investigated in neurosurgical patients. In the control group, 50% of patients developed DVT and in the treated group only 4.3% were affected.
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