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Biomedical subjects

J C Maroon

Publications and source records attributed to J C Maroon.

At least 127 records · Page 7Linked to original sources
PubMed1977

"Failure to thrive" due to pontine glioma.

A 14-year-old boy with a five-year history of diencephalic syndrome was found to have a pontine astrocytoma. We review case reports of five similar children with diencephalic syndrome secondary to posterior fossa tumors. We also describe the clinical features, investigative procedures, and therapy of these tumors. These cases emphasize the minimal neurological findings that may be associated with brain stem gliomas and the need for consideration of these tumors in the syndromes of "failure to thrive," anorexia nervosa, and the diencephalic syndrome of infancy.

Adolescent↗
PubMed1977

Posterior fossa extraaxial cyst: diagnosis with metrizamide CT cisternography.

This study describes a new technique for the study of posterior fossa extraaxial cysts. Using metrizamide (Amipaque) CT cisternography, a rapid, simple, low morbidity method is now available which gives both anatomic and physiologic information that may obviate the need for pneumoencephalography and angiography. Two cases are reported; in a third the diagnosis was definitively excluded. By doing serial CT scans following the intrathecal introduction of metrizamide, data concerning the diffusion characteristics of these cysts as well as the accompanying hydrocephalus are obtained.

Adult↗
PubMed1977

Intracranial biopsy assisted by computerized tomography.

A technique is described for biopsying intracranial tumors and aspirating cysts or abscesses using flexible non-metallic needle guides and computerized tomography a guidance system. Three cases are described in which this technique was used.

Adolescent↗
PubMed1977

Etiology and definitive microsurgical treatment of hemifacial spasm. Operative techniques and results in 47 patients.

The clinical and operative findings are reviewed in 47 patients with intractable hemifacial spasm. The syndrome was classical in its features in 45 patients and atypical in two. Mechanical compression distortion of the root exit zone of the facial nerve was noted in all 47 patients. In 46 the abnormality was vascular cross-compression, usually by an arterial loop. In one patient, a small cholesteatoma was discovered and removed. Morbidity and postoperative results are discussed.

Adult↗
PubMed1977

Localization of velum interpositum AVM with metrizamide ventriculography and simultaneous stereoangiography. Case report.

The combination of metrizamide (Amipaque) ventriculography and vertebral angiography with stereoradiography provided precise localization of an arteriovenous malformation of the velum interpositum and an associated hematoma in the lateral ventricles that had not been detected by computerized tomography. This dual technique is recommended for precise localization of suspected intra- or periventricular lesions before surgery.

Adult↗
PubMed1977

Electronic radiography in neurosurgery.

The authors describe the use of electronic radiography or short-exposure fluoroscopy with concurrent video recording of images in neurosurgery. The technique is applicable to all neurosurgical procedures in which fluoroscopy is used, such as transphenoidal surgery, trigeminal RF rhizolysis, percutaneous cordotomy, etc. With the use of subtraction techniques and intra-operative angiography, vascular maps of the cerebral vascular system can be made that allow the surgeon to puncture or to avoid vascular structures during stereotaxic procedures. Besides a great reduction in radiation exposure, this technique offers new advantages and potential for neurosurgical and neuroradiological interventional procedures.

Cerebral Angiography↗
PubMed1977

Intracranial hemorrhage in achondroplasia.

The neurological manifestations of achondroplasia include megalencephaly, hydrocephalus, and progressive myelopathy or radiculopathy secondary to spinal stenosis. Subarachnoid and intracerebral hemorrhage have not been previously reported in association with achondroplastic dwarfism. This report describes two patients with achondroplasia who have died secondary to intracranial hemorrhage. At autopsy, the source of hemorrhage was found to be an arteriovenous malformation of the choroid plexus in one case and a ruptured aneurysm of the left middle cerebral artery in the other.

Achondroplasia↗
PubMed1976

Microsurgical approach to intraorbital tumors. Technique and instrumentation.

We believe that, with the modified Krönlein lateral orbitotomy microsurgical approach, most orbital tumors can be successfully removed with reduced morbidity and complications, compared with the frontotemporal craniotomy or the standard Krönlein lateral orbitotomy. The cosmetic result is quite satisfactory, and the hospital stay should be brief. The use of the operating microscope and the specifically designed and modified instruments for retraction and dissection in the orbit, combined with the efficiency of the self-irrigating bipolar coagulating forceps, add a new dimension to the safety and efficiency of orbital surgery.

Electrosurgery↗
PubMed1976

Anesthetic management of posterior fossa surgery in the sitting position.

From the surgical aspect, the sitting position gives good surgical access to the operative site, improves venous drainage, gives a better view of facial area for monitoring evoked responses from cranial nerve stimulation and allows for better ventilation. Conversely, the sitting position can present complications such as air emboli, postural hypotension and serious cardiac arrhythmias due to surgical stimulation of cranial nerves and brainstem. This paper presents our clinical experience in 180 neurosurgical procedures on the posterior fossa in the sitting position. The standardized anesthetic technique consisted of narcotic, muscle relaxant, nitrous oxide and controlled ventilation. All patients were monitored with ECG, direct arterial and venous pressure, discontinuous blood gases, and expiratory CO2 and urinary output. Air embolism was detected via Doppler ultrasonic detector and evacuated through a right atrial catheter. Air was detected, visualized and aspirated in 45 cases for an incidence of 25%, with most episodes occurring early in the procedure. In 11 cases (6%) air was detected on closure. There were no deaths in this series. Fifty-eight patients (32%) had a 10-20 mmHg drop in blood pressure on reaching the sitting position, 19 became temporarily hypertensive (10.5%), and the remainder were normotensive. In 46 patients (25%), bradycardia developed during retraction-manipulation-stimulation of structures on or adjacent to brainstem as well as to cranial nerves. Surgical stress also accounted for the 13 patients (7%) having frequent premature ventricular extrasystoles. One case of profound hypotension and another case of virtual cardiac standstill were noted during the use of the bipolar electrocautery at or near the fifth nerve exit from brainstem. Additional hemodynamic data, the physiopathology, diagnosis and treatment of air embolism is discussed.

Adolescent↗
PubMed1976

Chymopapain in the treatment of ruptured lumbar discs. Preliminary experience in 48 patients.

The results of chemonucleolysis in 48 patients with lumbar disc disease revealed marked improvement in 58%, slight improvement in 23%, and no improvement in 19%. Serious anaphylactic reactions occurred in two patients. These results and those of other neurosurgical and orthopaedic studies are summarized and compared with the 70% improvement rate obtained with a placebo in a recent double blind controlled cooperative study. Only those few investigators participating in the double blind study are now permitted to use intradiscal chymopapain. It is concluded that the ultimate place of chemonucleolysis, if any, in the treatment of ruptured lumbar discs remains to be determined.

Adult↗
PubMed1976

Lateral microsurgical approach to intraorbital tumors.

The authors describe their microsurgical lateral orbital approach to intraorbital tumors. In seven patients ultrasonic scanning, computerized axial tomography, polytomography, orbital venography, and arteriography have allowed precise intraorbital tumor localization relative to the optic nerve. The authors believe that circumscribed tumors superior, lateral, or inferior to the optic nerve can be safely and completely removed through a 30-35-mm lateral skin incision with microsurgical dissecting techniques. A combined neurosurgical-ophthalmological team approach is emphasized.

Humans↗
PubMed1976

Preferential cerebral hypothermia with elective cardiac arrest: resection of "giant" aneurysm.

The technique of preferential cerebral hypothermia is reported in its application to a patient with a "giant" anterior communicating artery aneurysm. The method utilizes elective ventricular fibrillation and differential or "preferential" hypothermia induced by a combination of external skin cooling and perfusion of core organs with 0 degree buffered electrolyte solution. The value of the technique lies in its provision of a period of safe circulatory arrest approaching one hour without the need for anticoagulation, heart-lung bypass, open chest resuscitation or major vessel clamping. Because of the absence of blood flow and because of the clear fluid washout of the cerebral vessels, it was possible to open the aneurysm, evacuate its contents and resect it in several sections. It was not necessary to clip the feeding arteries until all dissection and total removal of the aneurysm were completed. The application of the technique to neurosurgery and cardiovascular surgery is discussed.

Heart Arrest, Induced↗