Intracranial Diseases Research Articles

VALUE OF ANGIOGRAPHY IN THE MANAGEMENT OF TUMORS OF THE HEAD AND NECK.

Arteriography is a well established method of evaluating intracranial diseases, but in extracranial tumors its usefulness has not been fully explored. In the past five years we have found it to have many important and practical applications in the management of selected lesions in the region of the head and neck (2, 4). In this paper we wish to review some of the broad applications of arteriography in this area. Its indications may be divided into the following three groups: A. Preoperative B. Postoperative C. Regional infusion technics (intra-arterial) A. Preoperative 1. Masses of Uncertain Origin: Arteriography is of value in demonstrating the anatomical extent of the tumor, the feeding vessels, and the degree of vascularity. In certain cases, it may even aid in the diagnosis and subsequent management. This method is particularly useful in areas which are not readily palpable, such as the orbit and nasopharynx. A few tumors give rise to a characteristic pattern, for instance, carotid body tumors (5). A typical example of this was observed in a 46-year-old woman with a swelling of the left side of the neck, first noted about two years before admittance to the hospital because of syncopal attacks. Left carotid angiography demonstrated a vascular well circumscribed tumor. Characteristically, the origins of the internal and external carotid arteries are spread apart (Fig. 1). This vascular pattern and location are so highly specific that arteriography for all practical purposes replaces standard incisional biopsy (4). In the vast majority of cases, carotid body tumors are fed by branches of the external carotid artery. Occasionally, however, with large tumors there may be feeding vessels from the thyrocervical trunk. These will be overlooked with standard carotid angiography. We have had one proved case of a carotid body tumor which produced lateral displacement of the carotid bulb, but was completely avascular. This is comparatively rare. A localized aneurysmal dilatation of one of the larger arteries in the neck or a very tortuous vessel is commonly mistaken for a carotid body tumor. The two conditions are, however, easily differentiated by arteriography. This type of problem was seen in a 64-year-old woman, who presented with a large pulsating mass just above the medial end of the right clavicle. She was admitted to the hospital because of recent attacks of dizziness. Right brachial arteriography revealed a vascular “;mass” due to aneurysmal dilatation and tortuosity of the distal end of the innominate and the commencement of the subclavian and common carotid arteries (Fig. 2). As previously stated, a few tumors, like those of the carotid body, give rise to characteristic patterns, but others show little or no deviation from the normal. As a general rule, in a given tumor the more vascular areas are the more malignant. This may indicate the best site for biopsy (3).

J2. Surgical Treatment of Intracranial Vascular Diseases

J2. Surgical Treatment of Intracranial Vascular Diseases

The intracranial neoplastic diseases of childhood; a description of their natural history based on a clinico-pathological study of 129 cases.

The intracranial neoplastic diseases of childhood; a description of their natural history based on a clinico-pathological study of 129 cases.

Quick diagnosis of intracranial diseases by supravital staining of the squeeze preparations

Die mittels dessupravital gefarbten Quetschpraparates an zahlreichen Fallen durchgefuhrte und eingehend beschriebene Untersuchung aller wesentlichen normalen und pathologischen Gewebe des Schadelinnenraumes fuhrt zu nachstehenden Schlusfolgerungen:

THE NEUROLOGIC ASPECTS OF LOW BACK PAIN AND SCIATICA

There is an erroneous impression among physicians that many cases of chronic back pain are the result of disease of the spinal cord, spinal meninges or spinal nerves. The fact is that disease of these organs rarely causes back pain and, when it does, the pain is overshadowed by such symptoms as paralysis, anesthesia and pain at a distance from the spine. Probably less than 1 per cent of cases of back pain are caused by primary diseases of the central and peripheral nervous systems. These infrequent neurologic causes of back pain are classified and briefly discussed in the following paragraphs. INTRACRANIAL DISEASES CAUSING BACK PAIN Intracranial diseases causing back pain are rare and are mentioned here merely for the sake of completeness. Subarachnoid Hemorrhage.— Blood may enter the spinal subarachnoid space when the head is injured, when a brain tumor bleeds or when an intracranial aneurysm ruptures. Regardless of

Der Augenbefund in seiner diagnostischen und differentialdiagnostischen Bedeutung bei Tabes dorsalis, Lues cerebrospinalis, multipler Sklerose.

In this treatise Behr, one of the most competent and successful investigators in the bordering fields of neurology and ophthalmology, deals with the ocular symptoms of some diseases in which the former frequently not only precede the other neurologic signs and symptoms but are decisive for differential diagnosis. First there is discussed the anatomicophysiologic basis of the ocular symptoms of cerebral origin, especially the anatomic structure of the optic nerve and the pathways transmitting the different stimuli to the pupil. The typical Argyll Robertson phenomenon, which occurs solely in tabes and is therefore an unequivocal sign of this disease, presents a combination of absence of reaction to light with miosis, increased convergence reaction and absence (or decrease) of the sensory and psychic dilatation reflex. Absence of the light reflex without the other aforementioned characteristics is met with not only in tabes but in other intracranial diseases. Absence of

Intracranial Pyogenic Disease: A Pathological and Clinical Study of the Pathways of Infection from the Face, the Nasal and Paranasal Air-Cavities.

The studies which form the main excuse for this book have involved a stupendous amount of work in cutting serial sections, gross and microscopic, of many brains, together with the contiguous skull and soft tissues. It was the hope of the authors that in this manner they might add to our knowledge of the manner in which intracranial pyogenic diseases arise. The microscopic details and case reports, which are presented in tiresome and excessive detail, make up the bulk of the presentation. Nor is it possible to believe that anything of material value has been added by the microscopic investigations. From clinical and gross pathologic studies it is well known that pyogenic infections of the brain arise either by direct extension of contiguous infections or through the blood vessels, whether venous or arterial. As a matter of fact, the pathways of infections into the brain from venous sinuses or contiguous

Intracranial Pyogenic Diseases. By A. Logan Turner, M.D., LL.D., F.R.C.S.E., F.R.S.E., and F. Esmond Reynolds, M.D., M.R.C.P.E. Published by Oliver and Boyd, 33 Paternoster Row, London, E.C. Price 12s. 6d.

Intracranial Pyogenic Diseases. By A. Logan Turner, M.D., LL.D., F.R.C.S.E., F.R.S.E., and F. Esmond Reynolds, M.D., M.R.C.P.E. Published by Oliver and Boyd, 33 Paternoster Row, London, E.C. Price 12s. 6d. - Volume 47 Issue 6

Kurzes Handbuch der Ophthalmologie.

This volume on ocular neurology is introduced with a chapter on the pathology of the base of the brain by Prof. F. Wohlwill (Hamburg), in which the general relations of the base of the brain to the visual organs are taken up in turn: developmental disturbances, injuries, diseases of the bones, dura, pia, ventricles, basal arteries and brain, intracranial neoplasms and diseases of the hypophysis. Prof. R. Bing (Basel) and Dr. A. Franceschetti (Basel) treat of the pupil from an anatomic, physiologic, pharmacologic and pathologic standpoint. Prof. C. Behr (Hamburg) contributes the parts on diseases of the ocular nerves and the visual pathways upward from the chiasm; and the chapter on diseases of the higher optical centers is from the pen of Prof. F. Quensel (Leipzig). The important part on ocular changes in diseases of the central nervous system occupies nearly half of the volume, and the subject is divided

Intracranial Pyogenic Diseases. A Pathological and Clinical Study of the Pathway of Infection from the Face, the Nasal and Paranasal Air-Cavities.

Intracranial Pyogenic Diseases. A Pathological and Clinical Study of the Pathway of Infection from the Face, the Nasal and Paranasal Air-Cavities.

An Address ON CERTAIN INTRACRANIAL DISEASES ASSOCIATED WITH NASAL, AURAL, AND LARYNGEAL SYMPTOMS: Delivered at the Central, London, Throat and Ear Hospital on October 17th, 1910

An Address ON CERTAIN INTRACRANIAL DISEASES ASSOCIATED WITH NASAL, AURAL, AND LARYNGEAL SYMPTOMS: Delivered at the Central, London, Throat and Ear Hospital on October 17th, 1910

About the permanent drainage of the ventricle of the brain with its dropsy

In many intracranial diseases, it was precisely the symptoms of increased cerebral pressure that forced one to resort to surgical intervention, which gave excellent results: for example, removal of hematomas and ligation of the vessel in case of bleeding from the arteria meningea media or opening of brain abscesses.
 Equally severe symptoms of pressure on the brain can be caused by accumulations of cerebrospinal fluid in the ventricles of the brain, as is observed in cases of acute head dropsy (acutus int.) e.g. in meningitis serosa or tuberculosa, as well as in chronic congenital and secondary internal dropsy of the brain. The thought of surgeons has long been directed in this direction. Back in 1881, Wernicke experimentally proved the usefulness of ventricular puncture in such cases. Bergmann was the first to perform this operation in 1888. Since then, many surgeons with varying happiness have performed this operation.

A Treatise of Diseases of the Ear, Together with a Brief Sketch of the Anatomy and Physiology of This Organ.

The present tendency to eliminate specialists is well shown by the author in his preface when he says: "During the past few years the boundary lines of the territory which was formerly supposed to belong to the aural surgeon have been very materially extended. At first the larger part of the domain of rhinology was annexed, the legitimate right of such a transfer being recognized by all candid minds. Then later when it was discovered that many of the intracranial diseases of otitic origin previously looked upon as almost necessarily fatal were to a large extent curable, aural surgeons were obliged to decide promptly whether they should leave this new work entirely to the general surgeon or should assume all its grave responsibility themselves. The great majority of them accepted the trust without any hesitation, and the numerous reports of successful operations that have been published by them in recent

The new method of exposing intracranial diseases of otitic orgin

The new method of exposing intracranial diseases of otitic orgin

On the Causation and Significance of the Choked Disc in Intracranial Diseases

On the Causation and Significance of the Choked Disc in Intracranial Diseases

On the Causation and Significance of the Choked Disc in Intracranial Diseases

On the Causation and Significance of the Choked Disc in Intracranial Diseases