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Biomedical subjects

C M van den Heever

Publications and source records attributed to C M van den Heever.

12 recordsLinked to original sources
PubMed1990

Incidence of extracranial injuries in fatal head injury patients.

The clinical notes of 148 patients who were admitted with head injuries and died were studied retrospectively and compared with the results of a postmortem examination. Risk factors predicting the presence of extracranial injuries were sought. Fourteen per cent of patients admitted with head injuries died. Two risk factors predicted the presence of extracranial injuries: 67% of the patients with an associated injury had been involved in a motor vehicle accident (MVA), compared with 32% of those with a head injury only. Shock was five times as common in the group with associated injuries than in those without. Associated injuries were present in 45% of patients, and 37% of these injuries were not diagnosed on admission. In 7% these injuries were the final cause of death. This study re-emphasises the fact that multi-organ trauma is common after MVA, and shock due to hypovolaemia is an unusual complication of head injury. Searching for associated injuries is mandatory in the head-injured patient. Since clinical examination is inaccurate, special investigations, such as peritoneal lavage or computed tomography, should be utilised for this purpose.

Adolescent↗
PubMed1989

Suprainguinal ligament approach for surgical treatment of meralgia paresthetica. Technical note.

For relief of meralgia paresthetica the authors have developed a suprainguinal ligament approach for decompression of the lateral femoral cutaneous nerve of the thigh. This proximal approach offers an alternative to the standard infraligament methods. Its chief advantage is that identification of the nerve trunk is easy and accurate. This avoids the tedious dissection involved in looking for small distal branches with their variable location. Lysis is easily performed, and angulation of the nerve in the iliac fossa is avoided. With this method, poor operative results can usually be eliminated.

Femoral Nerve↗
PubMed1989

Management of depressed skull fractures. Selective conservative management of nonmissile injuries.

The management of 319 cases with nonmissible depressed skull fractures is discussed. The majority of these injuries (75%) resulted from assaults and more than 90% were compound fractures. Of these, 35 cases were excluded from the series; these were patients who died before investigation or treatment could be instituted, or whose major injury was an intracranial hematoma or extensive traumatic hemorrhagic necrosis rather than a depressed fracture with underlying localized contusion. In the remaining 284 cases a comparison is made between the outcome in 124 (44%) patients treated by a conventional surgical method and 160 (56%) selected patients whose wound was only inspected, cleaned, and sutured in the emergency room. The nonsurgical group included 21 (9%) patients with simple depressed fractures and also patients without severe wound contamination, established infection, severe comminution of the fracture, or brain or cerebrospinal fluid in the wound. The results of management were assessed in relation to septic complications, the outcome of focal neurological abnormalities, and fatal complications. The group treated conservatively compared favorably with the surgical cases and also with previously reported series. The obvious bias in favor of the conservative group is admitted; however, it is clear that the majority of simple fractures and some compound depressed skull fractures can be managed safely without major surgical intervention. Socioeconomic implications are discussed.

Epilepsy, Post-Traumatic↗
PubMed1981

Intracranial mycotic aneurysms. A review of 9 cases.

Bacterial intracranial aneurysms are an important cause of mortality and morbidity in patients with infective endocarditis. Early recognition and appropriate treatment of these aneurysms can yield good results in an otherwise devastating and often fatal neurological illness.

Adolescent↗
PubMed1981

Paraganglioma of the orbit - an exercise in diagnosis. A case report.

A case is described of a child presenting with an extremely large orbital tumour, which had an alveolar pattern on histological examination. The differential diagnosis, which included alveolar rhabdomyosarcoma, alveolar soft-part sarcoma and non-chromaffin paraganglioma, could only be made on electron microscopic examination. Exact diagnosis was important because of prognostic and therapeutic implications. The presence of neurosecretory granules in tumour cells was demonstrated on electron microscopy, confirming the diagnosis on non-chromaffin paraganglioma, a benign tumour which is extremely rare in this site.

Child↗
PubMed1981

Wermer's syndrome. A case report.

Wermer's syndrome (or multiple endocrine adenomatosis type I) is a hereditary condition characterized by tumours or hyperplasia involving multiple endocrine organs. Most commonly the pituitary and parathyroid glands and the pancreas are involved. We record a further case, the patient presenting with acromegaly due to a pituitary adenoma, hypercalcaemia due to a parathyroid adenoma and peptic ulceration.

Acromegaly↗
PubMed1977

Treatment-orientated classification of subarachnoid haemorrhage.

The prognosis of patients with cerebral aneurysms has improved greatly with modern management, notably hypotensive and steroid therapy and microneurosurgical techniques. A new classification of subarachnoid haemorrhage is discussed to clarify the early management of patients and their referral to specialized units for intensive medical care and curative surgery.

Brain Edema↗
PubMed1977

Interhemispheral subdural empyema.

Five cases of localized interhemispheral suppuration are reported. A short description of the 'falx syndrome' is given. The angiographic features of the cases are described.

Adolescent↗
PubMed1976

Intraspinal lipoma. A case report.

A case of intraspinal lipoma is reported. The condition is discussed, the literature reviewed and the method of treatment described.

Adolescent↗