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Biomedical subjects

J L Stone

Publications and source records attributed to J L Stone.

122 records · Page 7Linked to original sources
PubMed1983

Excision of a large pineal region hemangiopericytoma (angioblastic meningioma, hemangiopericytoma type).

A large hemangiopericytoma was located posterocentrally. The patient presented with headaches and papilledema. Surgical management consisted of total gross excision by a combined right occipital transtentorial and right occipitoparietal transfalcine approach under magnification in three stages over a 6-week period. Removal was aided by dilatation of the right temperooccipital horn ("trapped ventricle") and meningioma-like encapsulation allowed separation of the tumor from the brain and surrounding structures after internal debulking of the tumor. Subsequent peritoneal shunting of the trapped ventricular horn and 5000 rads of radiotherapy were given to the patient. She remains well with an inferior quadrantanopsia on the left side more than 1 year after treatment. Meningiomas of the pineal region, the relationship of meningioma to hemangiopericytoma and malignant mesenchymal tumors (sarcomas) are considered in reference to presumed cells of origin.

Adult↗
PubMed1983

Subdural hematomas. I. Acute subdural hematoma: progress in definition, clinical pathology, and therapy.

A series of 206 patients with clotted subdural hematomas operated within 3 days of closed head injury is presented. Sixty-two percent (128) were operated within 24 hours of trauma (acute subdural hematoma) carrying a high incidence of sterotypic motor posturing, impaired oculomotor reflexes, and unilateral dilated fixed pupil. A functional recovery occurred in 27% and a vegetative state or death resulted in 62%. The remaining 38% were operated after 24 but within 72 hours from injury (early subacute subdural hematoma) and generally had less severe neurologic dysfunction. A functional recovery occurred in 54% and vegetative state or death in 34%. The 128 acute cases are presented in detail to establish a logical basis for time differential. The cases requiring operation within 12 hours of injury were the most challenging. Improved outcome is felt to result from prompt referral and large craniotomy in the earliest hours after injury, combined with careful postoperative monitoring. Clinical, operative and autopsy findings are presented and discussed in relation to pathogenesis.

Acute Disease↗
PubMed1983

Bilateral parietal arteriovenous malformations: report of a case.

A patient with bilateral parietal arteriovenous malformations (AVMs) is reported. The clinical presentation included seizures, coma, and signs of tentorial herniation. After the evacuation of a large left intraparietal hematoma, cerebral angiography identified a small left parietal AVM, which was excised. Mass effect and increased intracranial pressure were present at the time of the initial angiography, and the presence of a right parietal AVM was not appreciated. Postoperative cerebral angiography to document excision of the left parietal AVM then disclosed the small right parietal AVM, which was later excised. The patient has recovered very well. The natural history of AVMs and the occurrence of multiple AVMs are discussed.

Adult↗
PubMed1981

An unusual case of penetrating head injury with excellent recovery.

We report the remarkable case of the passage of a heavy metal rod through the head of a 42-year-old man. The patient had an excellent outcome because of prompt and efficient rescue efforts combined with transport to a major neurosurgical trauma center. Reference is made to a somewhat similar case publicized over 130 years ago.

Accidents, Occupational↗
PubMed1981

Traumatic subdural hygroma.

The authors report a series of 80 cases of traumatic subdural hygroma and discuss the clinical and radiological features, management, surgical results, and pathogenesis. Changes in mental status without focal signs of brain damage were noted in over 50% of the cases. A clinical course marked by stabilization without complete recovery of neurological function was found in over 40% of the cases of "simple hygroma." The lumbar cerebrospinal fluid often showed hemorrhage and elevation of the protein content. Skull fractures were found in 39% of the cases, and subdural hygromas were associated with cerebral atrophy, cortical contusions, subdural hematomas, and overlying epidural hematomas. The characteristic angiographic and computed tomographic scan findings are discussed, as are surgical pathology and outcome. Several theories of pathogenesis are presented. The authors advocate simple burr hole drainage as the treatment of choice. Significant reaccumulation may occur occasionally.

Adolescent↗
PubMed1979

Mixed malignant mesenchymal tumor of the cerebellar vermis.

In an example of mixed malignant mesenchymal tumor of the cerebellar vermis, striking osteoblastic differentiation was present along with extensive intradural spinal invasion. The CNS sarcomas and their variants are discussed as well as the extraskeletal osteosarcomas. Comparison is made to the teratoid tumors and other mixed and unusual posterior fossa tumor elements, and the capability of midline posterior fossa tissues for multipotential differentiation is considered.

Cerebellar Neoplasms↗
PubMed1979

Epidural hematomas of the posterior fossa.

The authors report four cases of epidural hematoma of the posterior fossa. The presenting signs and symptoms are discussed. Emphasis is placed on the need for early recognition and treatment and the fact that concomitant supratentorial lesions may be present. The radiologic findings are discussed, and special note is made of the value of computed tomographic (CT) scanning. Suboccipital craniectomy may result in complete recovery, even in moribund cases, once the lision is suspected and treated.

Adult↗
PubMed1978

Fluent aphasia after closed head injury.

A case of post-traumatic, contre-coup Wernicke's aphasia resulting from left posterior temporal hemorrhagic contusion localized by angiography and CAT scan is reported. Categorization of aphasia is reviewed, emphasizing that a fluent language disorder can be elusive to laymen and non-neurologically oriented physicians.

Adult↗
PubMed1974

Cultivation and survival studies of Neisseria gonorrhoeae in a human diploid cell strain.

Neisseria gonorrhoeae was cultivated in a human diploid cell strain (WI-38). Eighty percent of the cultures contained viable gonococci for at least 4 m at 36°C, as evidenced by subculture to brain heart infusion broth. Monthly subcultures of bacteria could be made to fresh WI-38 cultures for at least 11 monthly passages with a 69% survival rate. The identity of gonococci was confirmed by morphology, gram staining, oxidase testing and fermentation reactions. Viability in brain heart infusion broth, minimum essential medium (Eagle), and WI-38 spent fluid was of much shorter duration. The organisms grown in WI-38 cultures appeared to orient largely in the vicinity of the WI-38 cells as well as within the cytoplasm of the cells.

Animals↗
PubMedDate not supplied

A comparative analysis of enflurane anesthesia on primate motor and somatosensory evoked potentials.

The effect of increasing enflurane concentration on magnetic-induced myogenic cranial (Cr) and peripheral (Pr) motor evoked potentials (MEPs), and electrically induced median (MN) and posterior tibial (PTN) somatosensory evoked potentials (SEPs) was studied in 10 monkeys. MEP, recorded from abductor pollicis brevis and abductor hallucis muscles, and SEP (short- and long-latency scalp recorded potentials) variables were examined at 0.25, 0.5, 0.75, 1.0 MAC enflurane concentrations. Cr-MEPs progressively attenuated (P less than 0.01) with 0.25 MAC and were abolished (greater than or equal to 0.75 MAC) by graded enflurane concentration. Stimulation threshold for Cr-MEP was progressively elevated (P less than 0.01), and eventually reliable responses were lost (greater than or equal to 0.75 MAC). Marked scalp zone reduction to obtain Cr-MEP responses was noted with increasing enflurane concentration. Pr-MEPs and most SEP peaks maintained good replicability but showed significant amplitude reduction (P less than 0.01). MEP and SEP latency values were not significantly delayed as long as the wave form remained identifiable. We conclude that enflurane has a differential influence on Cr-MEPs and SEPs. Administration of enflurane should be discouraged while monitoring myogenic Cr-MEPs since even a subanesthetic concentration is profoundly detrimental.

Analysis of Variance↗