Shared governance in a rural health care setting.
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Biomedical subjects
Publications and source records attributed to T A Lyons.
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A 26-year-old woman with the syndrome of inappropriate antidiuresis demonstrated complete recovery following the resection of an olfactory neuroblastoma. Tissue arginine vasopressin levels by radioimmunoassay, immunohistochemical staining of the tissue arginine vasopressin, postoperative normalization of plasma arginine vasopressin levels, and the clinical resolution are evidence in support of a neurally derived tumor being the direct source of neurosecretion of arginine vasopressin rather than neurohypophyseal secretion or secretion from non-neural tissues, as reported to date in the etiology of the syndrome of inappropriate antidiuresis.
The disadvantages of external ventricular drainage are the threat of sepsis and the nuisance of dislodging a precarious system in routine care. The experience of the authors with nearly 200 cases using a long ventricular catheter demonstrates that a subgaleal tunnel can be easily made for the ventricular catheter using a sharp trocar. The resulting system is secured by the tunnel, easily dressed, and has a minimal likelihood of sepsis. Although external drainage has been maintained for longer than 3 weeks in some cases, the average duration is 6 days; and in the last 68 cases, there has been no incidence of sepsis and but one case of patient removal of the catheter. The device has been used for both monitoring, as well as ventricular decompression in a broad range of patients.