ABSTRACT
A series is presented of 20 craniopharyngioma patients who were treated between 1977 and 1981. All 20 cases underwent radical tumor resection via a frontotemporal craniotomy, with a concomitant temporal tip resection. All operations were performed by the senior author. The operative mortality rate was 5%, and the major morbidity rate 22.2%. The average follow-up period was 3.1 years. The role of radical surgical extirpation in adults is emphasized: the results compare favorably with the current radiotherapeutic and more conservative surgical statistics.
Subject(s)
Craniopharyngioma/surgery , Pituitary Neoplasms/surgery , Adolescent , Adult , Age Factors , Aged , Cerebral Angiography , Child , Child, Preschool , Combined Modality Therapy , Craniopharyngioma/diagnostic imaging , Craniopharyngioma/radiotherapy , Female , Humans , Male , Microsurgery/methods , Middle Aged , Pituitary Neoplasms/diagnostic imaging , Pituitary Neoplasms/radiotherapy , PneumoencephalographyABSTRACT
The authors' experience using the Debrun detachable balloon catheter system in occluding surgically-created carotid-jugular fistulas is described. Useful technical points in preparing and using the system are outlined. Technical failures were encountered both in creation of the fistula model and in use of the system, and their occurrence is documented. It is concluded that, when familiarization with the system's operation is attained, the detachable balloon catheter system promises to offer a valuable method of treatment of traumatic carotid-cavernous fistulas in humans.
Subject(s)
Arteriovenous Fistula/therapy , Carotid Arteries , Catheterization/methods , Embolization, Therapeutic/methods , Jugular Veins , Animals , Arteriovenous Fistula/diagnostic imaging , Carotid Arteries/diagnostic imaging , Catheterization/instrumentation , Contrast Media , Dogs , Jugular Veins/diagnostic imaging , RadiographyABSTRACT
The number and size of the axons in the later olfactory tract of the rat have been measured at several rostro-caudal levels, from material prepared for electron microscopy. Immediately caudal to the olfactory peduncle, an average of 42,000 +/- 3,000 axons were counted in the tract, while near the caudal limit of the tract an average of 32,000 +/- 2,800 axons were counted. The average internal cross-sectional area of axons measured at two levels of the tract was 1.6 +/- 1.3 mum2 and 1.1 +/- 0,9 mum2, corresponding to average internal diameters 1.4 +/- 1.3 mum and 1.2 +/- 1.1 mum, respectively. The axons in the lateral part of the tract were found to be significantly larger than those in the medial part of the tract; for one level the average cross-sectional area of axons in the lateral part of the tract was 1.6 +/- 1.0 mum2 (equivalent diameter 1.4 +/- 1,1 mum) while only 0.7 +/- 0.6 mum2 (equivalent diameter 0.9 +/- 0.9 mum) in the medial part of the tract. The thickness of the myelin sheath of the axons is generally related to axon diameter, increasing from 0.1-0.2 mum for axons 0.4 to 0.8 mum in diameter to 0.3-0.4 mum for axons greater than 2.0 mum in diameter. The ratio of the inside diameter to the outside diameter of the fiber (ratio "g") is between 0.7 and 0.8 for most axons in the lateral olfactory tract. The axons which leave the tract laterally and medially are substantially smaller than the axons within the tract (average cross-sectional area 0.55 +/- 0.35 mum2 on the lateral side) and probably are collaterals of the axons within the tract. Unmyelinated nerve processes, probably axons, were also found in the tract. Qualitative observations from light and electron microscopical material agree well with the quantitative data, and further suggest that mixing of axons from different parts of the olfactory bulb occurs in the rostral part of the tract. This is supported by experiments with injections of 3H-amino acids into localized portions of the olfactory bulb. These indicate that there is some degree of point-to-point organization in the most rostral part of the tract, but that this is lost in the caudal part of the olfactory peduncle.
