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Biomedical subjects

D M Tilghman

Publications and source records attributed to D M Tilghman.

9 recordsLinked to original sources
PubMed1989

Separation of craniopagus Siamese twins using cardiopulmonary bypass and hypothermic circulatory arrest.

Occipitally joined craniopagus Siamese twins were separated with the use of cardiopulmonary bypass and hypothermic circulatory arrest. The 7-month-old infants shared a large sagittal venous sinus that precluded conventional neurosurgical approach because of risk of exsanguination and air embolism. After craniotomy and preliminary exposure of the sinus, each twin underwent sternotomy and total cardiopulmonary bypass with deep hypothermia. Hypothermic circulatory arrest allowed safe division and subsequent reconstruction of the sinus remnants. Several unusual problems were encountered, including transfusion of a large blood volume from one extracorporeal circuit to the other through the common venous sinus, deleterious warming of the exposed brain during circulatory arrest, and thrombosis of both pump oxygenators. Both infants survived, although recovery was complicated in each by neurologic injury, cranial wound infection, and hydrocephalus. This case demonstrates the valuable supportive role of cardiopulmonary bypass and hypothermic circulatory arrest in the management of complex surgical problems of otherwise inoperable patients.

Brain Injuries↗
PubMed1980

Ludwig angina, empyema, pulmonary infiltration, and pericarditis secondary to extraction of a tooth.

A case of Ludwig angina after extraction of a mandibular third molar, progressing to pleural effusion and empyema, pericarditis, pulmonary infiltration, and pericardial effusion has been presented. The importance of early diagnosis and treatment as well as appropriate antibiotic and surgical therapy have been discussed. The practice of empirically prescribed antimicrobial agents has also been discussed, and the relevance of the organism E corrodans in oral infections has been emphasized.

Adult↗