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Biomedical subjects

J C Maroon

Publications and source records attributed to J C Maroon.

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

Microsurgical approach to orbital tumors.

Neurodiagnostic techniques now permit precise localization of intraorbital tumors relative to the optic nerve and intracranial compartment. With such localization, surgical procedures may be planned along more anatomical lines. Those circumscribed tumors may be planned along more anatomical lines. Those circumscribed tumors lateral, superior, and inferior to the optic nerve may well be approached by a lateral orbitotomy using microdissecting techniques. Those tumors medial to the optic nerve deep in the apex and those with possible intracranial extension should be approached transfrontally. In both surgical approaches, precise anatomical knowledge and microdissecting techniques are needed.

Biopsy↗
PubMed1979

Calvarial hemangioendothelioma with intracranial hemorrhage: case report.

A case of a hemangioendothelioma of the occipital bone that presented clinically as an acute epidural hematoma is reported. The literature regarding this rare bone tumor is reviewed. The treatment of choice seems to be wide surgical excision, but life-threatening hemorrhage may occur due to extreme tumor vascularity. The role of radiotherapy remains uncertain.

Adult↗
PubMed1979

Subdural tension pneumocephalus. Report of two cases.

Two patients developed subdural tension pneumocephalus after undergoing posterior fossa surgery performed in the sitting position. The mechanism for entry of air into the intracranial compartment is analogous to the entry of air into an inverted soda-pop bottle. As the fluid pours out, air bubbles to the top of the container. We have thus referred to this as the "inverted pop-bottle syndrome." Computerized tomography provided prompt diagnosis and confirmed brain displacement. Twist-drill aspiration of the air resulted in improvement in both patients, although one patient subsequently died from an intracerebellar hemorrhage. Tension pneumocephalus appears to be another potential complication of posterior fossa surgery in the sitting position. This condition is easily diagnosed and treated, and should be considered whenever a patient fails to recover as expected following posterior fossa surgery.

Aged↗
PubMed1979

Anterior skull base surgery for benign and malignant disease.

Teamwork between the head and neck surgeon and the neurosurgeon utilizing the craniofacial resection technique greatly extends the frontiers of surgery for tumors of the anterior half of the skull base. Tumors for which this technique may be used include benign and malignant tumors arising in the frontal bone or frontal sinus, nasal vault, ethmoid, maxilla, sphenoid or orbit. Selected nasopharyngeal lesions such as angiofibromas with anterior or middle fossa extensions and sphenoid or clival chordomas may also be approached in this manner. This report evaluates the surgical techniques currently in use for managing these tumors, by discussing the benefits of combined resection, technical modifications of the techniques, and the results of using these techniques in 12 patients. The initial results are encouraging.

Adolescent↗
PubMed1978

Hemifacial spasm. A vascular cause.

A review of the literature as well as recent surgical observations indicate that hemifacial spasm may be caused by normal or pathological vascular structures that cross-compress the facial nerve. The critical area of compression is invariably found at the brain stem exit zone of the seventh cranial nerve. In this area the central glial investment of the facial nerve changes to peripheral or schwannian myelin. It is suspected that this anatomical junction zone may be of pathophysiologic significance when directly compressed or irritated. A retromastoid craniectomy and vascular decompression operation is highly successful in relieving hemifacial spasm while at the same time preserving facial nerve function. This is in contrast to most commonly used destructive operations for hemifacial spasm. Microsurgical techniques, however, must be employed or high morbidity and mortality may occur from the retromastoid approach.

Cerebrovascular Disorders↗
PubMed1978

Hemifacial spasm due to aneurysmal compression of the facial nerve.

Hemifacial spasm developed in a woman as the only symptom of an aneurysm of the posterior inferior cerebellar artery. Using microdissecting techniques, the aneurysm was clipped and moved from its distorting position at the brain stem exit zone of the seventh nerve. After surgery, she experienced immediate relief of her facial spasm of six years' duration. This case supports the finding that hemifacial spasm may be caused by vascular lesions of the seventh nerve at the brain stem junction. Recent surgical experience indicates that the majority of the hemifacial spasm cases may be due to normal but ectatic blood vessels that cross-compress the most proximal portion of the seventh nerve. Relief may be affected without facial paralysis by a retromastoid microvascular decompressive procedure.

Arteries↗
PubMed1978

Clinical evaluation of intravenous nitroglycerin for neurosurgery.

Moment-to-moment control of blood pressure is important in the management of the neurosurgical patient. The ideal agent to control blood pressure or induce hypotension should be non-toxic, maintain cerebrovascular autoregulation, and not alter cardiac output or change intracranial pressure. Intravenous nitroglycerin has been used to control blood pressure in 54 neurosurgical cases. This agent produces a rapid, controllable, but not precipitous fall in blood pressure without rebound, is non-toxic, may not alter cerebrovascular autoregulation, and does not raise intracranial pressure. Our clinical experience with intravenous nitroglycerin indicates that it has an important role as a hypotensive agent for the neurosurgical patient.

Blood Pressure↗
PubMed1978

Symptomatic pituitary tumor enlargement after induced pregnancy. Case report.

A case is presented and 11 others are reviewed in which symptomatic pituitary tumor enlargement occurred during pregnancies that resulted from induced ovulation. The syndrome is usually characterized by headache and visual disturbances with bitemporal visual field abnormalities, but may present with ocular muscle palsies. The cases are divided into two groups. The patients in one group had a shorter duration of amenorrhea (3.8 years), developed symptoms before the 14th week of pregnancy, and were usually treated by tumor removal. Patients in the second group had a longer period of amenorrhea (10.2 years), developed symptoms after the 24th week of pregnancy, and their symptoms regressed with delivery of the infant. Tumor removal or termination of the pregnancy both resulted in resolution of symptoms. All pregnancies resulted in normal infants. This series provides guidelines for management of future cases.

Adenoma, Chromophobe↗
PubMed1978

Protective effects of methyl prednisolone and dimethyl sulfoxide in experimental middle cerebral artery embolectomy.

Acute arterial embolism continues to be a major cause of stroke morbidity in children and young adults. Potential therapy modalities include medical management and/or cerebral revascularization. The canine middle cerebral artery (MCA) was embolized by means of a pliable cylinder, 8 mm long by 1.6 mm in diameter, via the internal carotid artery. Control and experimental embolectomies were performed 6 hours following embolization. The experimental animals were treated with either dimethyl sulfoxide (DMSO) or methyl prednisolone. In the control animals, the average area of infarction in the brain was 1.45 cu cm. The animals treated with methyl prednisolone (2 mg/kg) or DMSO (2 gm/kg) showed no infarction of the brain, whereas methyl prednisolone (30 mg/kg) did not prevent infarction.

Animals↗
PubMed1978

Supratentorial intracerebral hemorrhage following posterior fossa surgery.

Five cases of supratentorial intracerebral hemorrhage following posterior fossa surgery are reported. Possible etiologies are discussed, but in only one case can a definite etiology (hypertension) be found. The differential diagnosis of declining level of consciousness after posterior fossa surgery must include supratentorial intracerebral hemorrhage, and computerized tomography seems to be the diagnostic method of choice.

Aged↗
PubMed1978

Galactorrhea, amenorrhea, hyperprolactinemia, and an empty sella.

Increased serum prolactin (hPRL) and increased volume of the sella turcica as detected by roentgenography are compatible with a pituitary adenoma. The empty sella syndrome can increase sella volume, but is usually associated with minimal, if any, endocrine dysfunction. The present case details a young woman with amenorrhea, galactorrhea, elevated serum hPRL, and roentgenographic evidence of an enlarged sella turcica. Pneumoencephalography with hypocycloidal polytomography is interpreted as both an empty sella, and evidence of a pituitary adenoma. The etiology and endocrine findings in the empty sella syndrome are discussed.

Adenoma↗
PubMed1978

CT scan appearance of dysthyroid orbital disease.

Two cases of dysthyroid orbital diseases are presented which on CT scan had the characteristic appearance of intraorbital tumors. An operation was performed on one of these patients based on the CT scan appearance. This entity should not be confused with true intraorbital neoplasms. One must not rely exclusively on the CT scan in questionable cases as with any other ancillary diagnostic acid and one must bear in mind that dysthyroid disease in evolution may exactly mimic the CT scan appearance of an intraorbital tumor.

Diagnostic Errors↗
PubMed1977

'Burning hands' in football spinal cord injuries.

Central spinal cord injury in two high school football players caused only complaints of burning paresthesias and dysesthesias in the hands at the time of injury. Strength was affected only in the upper extremities where it was slightly reduced. Failure to recognize the relationship of "burning hands" as a symptom of cord injury can result in injudicious management of unstable cervical fracture dislocations with disastrous consequences.

Acute Disease↗