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Biomedical subjects

D A Bruce

Publications and source records attributed to D A Bruce.

At least 109 records · Page 6Linked to original sources
PubMed1979

Localized primary intracranial Ewing's sarcoma of the orbital roof. Case report.

A rare case of a primary Ewing's sarcoma arising from the intracranial portion of the right orbital roof is presented. Clinical presentation was that of a rapidly growing tender exostosis, associated with headaches. History indicated that the tumor may have been present for more than 1 year. Skull x-rays showed marked diastasis of the coronal suture and a "mottled" appearance on the right frontal bone suggestive of a sarcoma. Bone scan further confirmed the presence of a malignant bone tumor. Computerized tomography scan showed the intracranial extension of the tumor and a follow-up scan allowed us to see the response of the tumor to therapy. Only two other cases with details as to intracranial localization were found in the literature.

Child↗
PubMed1978

Vertebrobasilar spasm: a significant cause of neurological deficit in head injury.

Cerebral vasospasm in the anterior circulation has been recognized as a significant factor in the sequelae of head injury; however, vertebrobasilar spasm resulting from trauma has received much less attention. In the past year we have observed six patients where spasm in the major vessels of the posterior circulation was primarily or in part responsible for the neurological deficit. In such cases, the neurological examination may suggest a supratentorial mass with herniation and, in three of our cases, burr holes or carotid angiography were performed first. However, in every instance neurological signs present on admission indicated primary brain-stem dysfunction. In each of the six cases vertebral angiography demonstrated significant spasm in either the vertebral or basilar arteries. Intracranial pressure was monitored in each of the six patients and did not exceed 25 mm Hg in any. In cases of head injury where the neurological examination indicates brain-stem dysfunction inconsistent with or after a supratentorial mass has been excluded, vertebral angiography may aid in the diagnosis and subsequent management of such patients.

Adolescent↗
PubMed1978

Outcome following severe head injuries in children.

The outcome in 53 children following severe head injury is presented. All children were graded using the Glasgow Coma Scale; 90% made a good recovery or were moderately disabled, and 8% died or were left vegetative. All patients were treated with controlled ventilation and steroids; mannitol, and, if necessary, Nembutal (pentobarbital) were used to maintain the intracranial pressure below 20 torr. With this regimen, only one death occurred due to uncontrollable intracranial hypertension. All patients with a coma scale of 5 or greater recovered well. The worst prognostic sign was the presence of flaccidity: 33% of these patients died or were vegetative. Five of seven patients who were decerebrate or flaccid with bilateral fixed pupils and absent caloric responses made a good recovery or were moderately disabled. The relatively low incidence of mass lesions (23%) and high incidence of diffuse cerebral swelling (34%) suggest a different pathophysiological response of the child's brain to injury, which may play a role in the improved survival of children following severe head injury when compared to adults.

Adolescent↗
PubMed1976

Midline hamartomas masquerading as meningomyeloceles or teratomas in the newborn infant.

Congenital miline dorsal malformations in infants most commonly represent spina bifida cystica or teratoma. The five patients reported here are a distinct clinicopathologic entity. They presented at birth with a dorsal midline mass, with no neurologic impairment, and no hydrocephalus developed subsequently. The lesions were removed in all infants without significant mobidity. The masses were comprised prinicipally of mesodermal elements, i.e., bone, cartilage, fat, muscle, and fibrous tissue. The well-differentiated cellular components, forming mature structures and the lack of primitive organoid structures as well as the absence of neoplastic characteristics, favors a diagnosis of hamartoma rather than of teratoma.

Child, Preschool↗
PubMedDate not supplied

Complications of third ventricle surgery.

The anatomy and physiology of the structures in the region of the third ventricle are reviewed as they pertain to the various surgical approaches to this area. The peri-third ventricular area of the brain, an area less than 1% of the whole brain, is the center for a host of homeostatic mechanisms; temperature, osmolality, pituitary endocrine function, sympathetic and parasympathetic control, appetite and for a variety of behavioral drives, e.g. sex. In addition, memory circuits pass through this area, although current models exclude the immediate hypothalamus as playing a major role in memory. The various surgical approaches are reviewed and unavoidable injury as a result of the lesion or complications related to the surgery are considered in three categories: those that result from the surgical exposure itself; those that result due to maintaining the surgical exposure, e.g. retractor damage; and those that are unavoidable as a result of the infiltrative nature of the lesion itself. The causes of injury are further categorized into those due to arterial, venous, or direct cerebral tissue injury. Ways to minimize complications are presented.

Brain Damage, Chronic↗