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Biomedical subjects

D B Kirkpatrick

Publications and source records attributed to D B Kirkpatrick.

9 recordsLinked to original sources
PubMed1990

Lessons from the masters: professional and ethical advice from senior neurosurgeons.

This paper is a collection of professional and ethical advice from 10 senior neurosurgeons. Each of these gentlemen was asked to summarize the best and most important of the lessons he had learned from a long and distinguished career in neurosurgery. This information has been expressed in the form of advice to a young neurosurgeon about to embark on his or her career. The collected wisdom of these surgeons is summarized and salient points emphasized.

Disclosure↗
PubMed1989

Familial trigeminal neuralgia: case report.

Trigeminal neuralgia in its classic form is usually an isolated disease that occurs in sporadic fashion without epidemiological or genetic significance. This paper discusses a family with three nontwin sisters, all of whom have classic trigeminal neuralgia occurring in early middle age with symptoms severe enough to require medical and surgical treatment. These three sisters also have one aunt with a history of severe facial pain, although this has not been medically documented. Clustering of such cases in a given family has been reported before, but is rare. The pathophysiological implications of this genetic clustering are discussed.

Adult↗
PubMed1984

The first primary brain-tumor operation.

On November 25, 1884, Mr. Rickman J. Godlee performed the first recognized resection of a primary brain tumor. This operation was carried out at the suggestion of Dr. A. Hughes Bennett, a neurologist at The Hospital for Epilepsy and Paralysis, Regents Park, London, England. Other operations for intracranial tumor had been performed but were for extracerebral meningeal or osseous tumors. The "first" operation for a primary cerebral tumor by Godlee was meticulously described and well documented in the medical and popular press of the day and stimulated both professional and lay discussions of the topic that directly and indirectly led to further surgery on the cerebrum itself and the advent of modern neurosurgery. The original patient of Mr. Godlee died on the 28th postoperative day of apparent meningitis and secondary complications, but postmortem examination revealed no remnant of the excised glioma.

Brain Neoplasms↗
PubMed1980

Elevation of pain threshold to tooth shock by brain stimulation in primates.

Electrical stimulation of the brain (ESB) for modulation of pain has been previously demonstrated in primates, but many of the sites which yield stimulation-produced analgesia (SPA) also elicit aversive side effects. In order to examine the aversive as well as analgesic effects of brain stimulation, nine rhesus monkeys (Macaca mulatta) were first trained to press a lever to escape or titrate noxious tooth shock. Stimulating electrodes were placed under the frontal cortex in 4 monkeys and were implanted in the diencephalon, brain stem, and cerebellum of five remaining monkeys. Diencephalic stimulation sites resulted in marked elevations of tooth shock threshold at ESB intensities which did not elicit aversive behaviors. The analgesic effects lasted up to 2 h past ESB offset. Moderate elevations of tooth shock threshold were also observed with orbital cortex stimulation. The midbrain central gray and the nucleus raphe magnus, however, did not greatly alter tooth shock level and typically resulted in aversive reactions. The diencephalic sites which elicited SPA also led to self-stimulation behavior, whereas stimulation of the brain stem or cerebellum usually resulted in escape responses. These findings thus indicate that, in primates, more effective relief of pain can be achieved with electrical activation of the medial diencephalon than with brain stem stimulation.

Animals↗
PubMed1977

The craniotubular bone modeling disorders: a neurosurgical introduction to rare skeletal dysplasias with cranial nerve compression.

The craniotubular bone modeling disorders are a group of skeletal dysplasias which involve predominantly the skull and long bones. The cranial involvement includes both external facial deformities and internal bony overgrowth about the cranial foramina and fissures. The latter commonly leads to cranial nerve compression, particularly of the optic nerve. Craniotomy and cranial nerve decompression can give substantial benefit to selected patients with these diseases but the severe bony abnormalities create technical problems which prevent surgery in some extreme cases. These disorders are genetically determined but the basic pathophysiologic mechanism has been delineated for only a few types and non-surgical treatment remains supportive.

Bone Diseases, Developmental↗
PubMed1975

Metastatic carcinoid presenting as a spinal tumor.

A case of carcinoid tumor metastatic to the thoracic spine with associated myelopathy is described. Multiple posterior explorations were singularly unsuccessful in locating and indentifying the metastasis, but an anterior transthoracic exposure allowed identification of the tumor, removal of the osteoblastic epidural mass, and fusion of the spine with a rib graft. The patient's myelopathy improved steadily following surgery without evidence of tumor recurrence or regression of neurologic status. The reasons for the relative absence of central nervous system carcinoid metastases are not known.

Carcinoid Tumor↗