Résumé
Of all the potentially lethal complications of the head injury, extradural hemorrhage is the most readily diagnosed and remediable, yet the mortality rate remains distressingly high. The authors report on 58 consecutive patients with extradural hematoma. The mortality was 31%. The classical clinical course with a lucidal interval was seen in three patients only. The classical neurological signs of an extradural hematoma, contralateral hemiparesis, and ipsilateral third nerve palsy were seen in 9 patients(15.5%). The main factors associated with increased mortality were concomitant brain injury, rapid development of the hematoma and unconsciousness at the time of operation. In almost half of the fatal cases, there was a delay in the diagnosis and operation. Consequently better results are possible with better organization of the supervision and treatment of brain injured patients.
Sujets)
Humains , Encéphale , Lésions encéphaliques , Traumatismes cranioencéphaliques , Diagnostic , Hématome , Hémorragie , Mortalité , Atteintes du nerf moteur oculaire commun , Organisation et administration , Parésie , Perte de conscienceRésumé
The authors describe a case of large dermoid cyst of the scalp which removed surgically and cosmetically. Dermoid cyst is derived from epiblastic cells predestined to form skin which become detached from their neighbours and included in mesenchyme at about third to the fifth week of feral life, when the neural tube is closing. The contents of the cyst are thus mixtures of keratin, sebum, and hair, according to the proportionate development of these elements. It is usually a single tumor and may develop almost anywhere in the subcutaneous tissue, being of variable size.
Sujets)
Kyste dermoïde , Feuillets embryonnaires , Poils , Mésoderme , Tube neural , Cuir chevelu , Sébum , Peau , Tissu sous-cutanéRésumé
The authors report a case of tuberculoma of the cerebral hemisphere, which has been excised under the operating microscope. With the references reviewed, this case is interesting one in supratentorial location.
Sujets)
Cerveau , TuberculomeRésumé
The authors describe a case of tuberculous epidural granuloma at the level of the 4th thoracic spine in a 27-year-old woman. Extraosseous origin of tuberculous granuloma has been rarely reported. With the references reviewed, the pathogenesis of Pott's paraplegia is discussed.
Sujets)
Adulte , Femelle , Humains , Granulome , Rachis , Tuberculose vertébraleRésumé
The authors report a case of malignant brain-stem glioma with typical clinical signs in which successful surgical decompression and biopsy were obtained under the surgical microscope, and factors favoring surgical removal of such lesion are discussed.
Sujets)
Biopsie , Décompression , Décompression chirurgicale , GliomeRésumé
With the establishment of the anterior cervical approach as the procedure of choice for cervical fracture-dislocation, attention has now turned to refinements of Cloward technique. The purpose of application of the Cloward technique is to achieve early stabilization of the fracture-dislocation, to shorten the recumbency period, and to promote rehabilitation. Recently the authors have experienced with the Cloward technique in the treatment of cervical fracture-dislocation. Our results indicated that anterior interbody fusion has been a satisfactory method for stabilizing one or more segment of the cervical fracture-dislocation. The prevention of dowel fracture or extrusion following fusion has been a important factor in the success. Another advantage obtained is to use the operating microscope for decompression of nerve roots. The chronic locked facets have not been reduced by the application of Cloward technique, but have been managed to achieve stabilization with Smith-Robinson technique. The lateral cervical pucture technique(C1-C2) for pantopaque myelography has been shown to be a valuable adjunct of acute injuries of the cervical spinal cord. A new technique for wiring and fusion of atlanto-axial dislocation has been performed with satisfactory results.
Sujets)
Décompression , Luxations , Iofendylate , Myélographie , Réadaptation , Moelle spinaleRésumé
The authors describe a new technique for the reduction and wiring of atlanto-axial dislocation. More strong supporting effect has been achieved by double wiring of the posterior arch of the cervical vertebrae. Various techniques for the fixation of the atlanto-axial dislocation have been discussed.olved.