Biomedical subjects
Publications and source records attributed to I Z Kosary.
Severe dementia and ataxia in an elderly woman were related to hydrocephalus resulting from Paget disease of the skull, with basilar impression. Ventriculoatrial shunting resulted in dramatic improvement. This procedure, rather than suboccipital decompression, is probably the operation of choice, and should be carried out at an early stage.
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Arteriovenous malformations in the vicinity of the splenium are a rare cause of subarachnoid bleeding. They are usually unaccompanied by neurological deficits. Three such cases are described and methods of identification and surgical approach discussed. Total extirpation is believed to be the treatment of choice.
A case of acute flaccid paraplegia is reported, due to epidural bleeding in the dorso-lumbar region. A hitherto undiagnosed and asymptomatic hemangioma of a dorsal vertebra was considered to be the source of the haemorrhage. Recovery followed early laminectomy and evacuation of blood clots.
The laser beam can be adapted for use as a surgical cutting instrument. It was chosen for this purpose in the extirpation of an osteoma of the skull. Its removal by conventional means was believed to be too dangerous, because of surrounding vascularity. The nature and properties of the beam and its surgical applications are discussed briefly.
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Two cases are described presenting a clinical picture of sudden headache, fever and vomiting, accompanied by unilateral ophthalmoplegia and acute deterioration of visual acuity. In one this amounted to monocular blindness with a field defect in the other, indicative of chiasmal compression. Necrotic pituitary adenoma material was removed by the transphenoidal route in both cases. Recovery of eye movements was obtained and considerable improvement of visual acuity, which in one patient, was restored completely.
Removal of intervertebral discs and osteophytes with the aid of an operating microscope was performed in ten patients suffering from cervical spondylotic radicular or radiculomyelopathic syndromes, using an anterior approach. The method permits more complete removal of disc, posterior and lateral osteophytes, without the necessity of drilling or otherwise injuring the vertebral bodies. In five patients, a bone graft was inserted into the vacated space after disc removal. Clinical improvement in most cases was immediate and maintained during a two and a half year follow-up.
Electrocardiogram changes and pharmacologic responses were studied in 28 cases of brain death. Cardiac activity in this condition is possibly determined by the dynamic balance between the depressant action of hypothermia and the stimulating action of the sympathetic nervous system (without any vagal or central influence). The electrocardiographic alterations are the results of this dual influence, and are probably characteristic of this condition. In the initial stage of brain death the ECG shows J waves in the terminal part of the QRS, prolongation of the QT interval and the ST-T changes; in the advanced stages, progressive showing of the heart rate and the depolarization and repolarization processes are observed (manifested by gradual accentuation of the findings mentioned above); in the terminal stage dynamic electrocardiographic changes (among them, progressive depression of sinus activity, atrial fibrillation, atrioventricular and intraventricular conduction disturbances and severe ST-T changes) appear. It is possible that additional factors, like metabolic changes and possible myocardial damage in some instances, may have some influence on the electrocardiographic pattern. Final conclusions cannot be drawn from these preliminary observations. The atropine test was found to be an efficient and simple diagnostic aid in cases of brain death.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.