Biomedical subjects
Publications and source records attributed to N Garvan.
Brainstem abscesses are rare and until recently were uniformly fatal. The case of a 49 year old lady with an abscess extending through the midbrain, pons and cerebellar peduncle is presented. She survived following stereotactic aspilation; only the seventh such case. The report is illustrated with very rare preoperative MRI scans.
Fourteen cases of thoracic intervertebral disc prolapse are reported and analysed. Eleven were women, 3 men, and the peak incidence was in the 5th decade. No trauma was reported in our cases. The T8/9 interspace was the most frequently involved. A sensory level was noticed in 6 cases and in four a clear cut sensory level at T10 was observed. Results of surgical treatment show that using microsurgical techniques costotransversectomy and its modifications are equally effective; laminectomy is contraindicated.
Hypothalamic-hypophyseal insufficiency has been found in seven of eight patients with so-called benign intracranial hypertension, of whom four showed an inadequate adrenal response to stress. The syndrome of benign intracranial hypertension cannot therefore be considered entirely benign and patients should receive full endocrinological assessment and follow up.
Hypothalamic hypopituitarism has been associated with the intermittent intracranial hypertension of "normal-pressure" hydrocephalus. Six patients with this condition were studied endocrinologically; five showed evidence of hypothalamohypophyseal insufficiency, and, though only one needed treatment, all needed continued assessment of their endocrine state during follow-up. Thus, hypothalamohypophyseal dysfunction is more common than might be expected. Tests of anterior pituitary function should be preformed before surgical intervention, as such dysfunction may adversely affect survival and the response to ventricular shunting.
Explore the source record for details and available documents.
Carotid bifurcation aneurysms have, as a group, certain characteristics. They account for about 7% of all intracranial aneurysms. They appear to be mostly leftsided and there does not seem to be any particular sex predominance. When associated with other aneurysms, the carotid bifurcation aneurysm was the symptomatic lesion. Demonstration of small aneurysms may be difficult and accurate definition of the neck may not be possible at angiography. They appear to associate themselves with one or the other division of the internal carotid artery. With careful exposure and appropriate positioning of the head it is possible to occlude these aneurysms with a clip, but we feel that the inexperienced surgeon should not tackle these cases. Carotid artery ligation may not prevent rebleeding in this group of aneurysms.
Explore the source record for details and available documents.