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Biomedical subjects

J G Galbraith

Publications and source records attributed to J G Galbraith.

At least 19 recordsLinked to original sources

Neuroendoscopic laser-assisted ventriculostomy of the third ventricle.

Hydrocephalus is caused by an imbalance between the production and absorption of cerebrospinal fluid. Ventriculostomy of the third ventricle now is an acceptable treatment alternative for this problem. This procedure reduces costs over the course of the illness because the patient does not require subsequent shunt revisions throughout his or her life. The specialized care and the fear associated with the dependency on mechanical hardware also are eliminated if shunt placement is avoided. Postoperative complications may include increased intracranial pressure, bleeding, infection, and pain.

Child↗

Appendicular tremor as a late complication of intracerebral hemorrhage.

A 23-year-old woman without demonstrable risk factors for cerebral hemorrhage was admitted after the acute onset of hemiparesis of the left side. A computed tomography scan showed a small right thalamic hemorrhage. Cerebral angiography was normal, and she was managed conservatively. Three months after the original ictus the patient developed severe tremor on the left side. Angiography again revealed no abnormalities and the tremor was successfully treated with a stereotaxic thalamic lesion superimposed on the area of the hemorrhage. The patient's disease, its treatment, and the current knowledge of the anatomy and physiology of movement disorders are reviewed.

Adult↗

Prediction of the needed level of sympathectomy for posttraumatic reflex sympathetic dystrophy.

The course of 2 patients with posttraumatic reflex sympathetic dystrophy is presented and discussed. The importance of determining the exact level of sensory blockade in order to know the necessary level of the sympathectomy is emphasized. It is suggested that in patients with reflex sympathetic dystrophy, the diagnosis should include the exact upper anatomical level of sympathetic truncus involvement, which can be easily achieved with sensory epidural blockade.

Adolescent↗

Some clinical aspects of superficial temporal-middle cerebral artery bypass surgery.

Carotid occlusive disease may occur at the base of the skull and siphon without evidence of atheroma in the neck. Careful search for lesions in this location should be undertaken in any patients with TIAs or neurologic deficit when the extracranial carotid arteries appear normal. Unilateral frontotemporal headache may be an early symptom of stenosis in this location. Inaccessible lesions are often bilateral, although the symptoms may be unilateral. Superficial temporal-middle cerebral artery bypass on the symptomatic side affords relief of symptoms. Bypass on the contralateral side should be considered when and if symptoms subsequently develop related to the lesion on that side. The configuration of a carotid thrombus may enable one to determine that it is a retrograde rather than antegrade occlusion and hence is not amenable to endarterectomy, even in the acute situation. The use of a Fogarty catheter in such a setting would be ill-advised and potentially hazardous. Current experience suggests that risk of subsequent stroke is reduced after EC-IC bypass operation.

Adult↗

Parasellar epidermoid tumor presenting as painful ophthalmoplegia.

In 1964, a 51-year-old man experienced a right abducens nerve palsy, which resolved spontaneously. In 1978, he developed painful ophthalmoplegia on the right with paresis of the right oculomotor and trigeminal nerves. Neuroradiographic evaluation was reported unremarkable, and the painful ophthalmoplegia was attributed to the Tolosa-Hunt syndrome. High-dose corticosteroids were administered with transient improvement of signs and symptoms. In 1979, cranial computerized tomography demonstrated a low-density lesion adjacent to the right cavernous sinus, which at operation proved to be an epidermoid tumor.

Brain Neoplasms↗

Multiple myeloma masquerading as chromophobe adenoma.

A 62-year-old woman presenting with intracranial lesion eroding the sella with compression of optic chiasma was found to have plasmacytoma of the pituitary area. At the time of initial surgery, the patient had no biochemical, immunologic or marrow findings of multiple myeloma. The intracranial tumor was interpreted initially as chromophobe adenoma on light microscopy, but the diagnosis of plasmacytoma was established by electron microscopic examination of the tumor. The case illustrates the usefulness of electron microscopy as a diagnostic tool.

Adenoma, Chromophobe↗