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Biomedical subjects

J W Correll

Publications and source records attributed to J W Correll.

At least 37 records · Page 2Linked to original sources
PubMed1983

Extended temporal bone resection.

A histologically benign tumor of the temporal bone became a life-threatening neoplasm. Previous surgical procedures and a course of radiotherapy failed to arrest the growth of the neoplasm. Our therapeutic objectives were fourfold: (1) ventilation of tumor histology; (2) total tumor removal without an increase of the neurological deficit; (3) watertight closure of the dural defect; and (4) aesthetically acceptable scalp reconstruction. These goals were achieved by performing temporal bone resection extending from the foramen lacerum to near the foramen magnum. The external soft-tissue defect was reconstructed with a contralateral scalp flap. The patient recovered satisfactorily from her surgery and achieved improvement of her ataxia and level of consciousness.

Cerebellar Ataxia↗
PubMed1983

Computerized electroencephalogram monitoring and carotid artery shunting.

During carotid artery surgery, ischemic electroencephalogram (EEG) changes were detected by computerized analysis in 27 of 225 carotid clamping intervals. All but 7 of these changes resolved spontaneously before the restoration of blood flow. Restored flow was associated, after variable delay, with an improved EEG pattern in 6 of 7 cases. Of 27 EEG episodes, there were 5 cases in which the EEG event persisted for 10 minutes or longer. All 5 patients developed new neurological deficits; none of the other patients did. It is suggested that all patients undergoing carotid artery surgery be monitored with EEG and that a shunt be placed if a persistent EEG change is noted.

Aged↗
PubMed1983

Prognostic value of computerized EEG analysis during carotid endarterectomy.

A single-channel EEG, analyzed in real time to produce a density spectral array (DSA) display was recorded during 111 carotid endarterectomies. A simple protocol that emphasized loss of high frequency activity was used to identify serious ischemic EEG events. In 70 patients (78 operations) with no preoperative neurologic deficits, new postoperative neurologic deficits appeared only in the seven patients who had ischemic EEG events that lasted 10 min or longer. The EEG was not predictive in the 31 patients (33 operations) who had preoperative neurologic deficits: one patient with no intraoperative change in EEG developed a new postoperative deficit, and one patient with EEG changes lasting 13 min had no demonstrable new deficit postoperatively. This EEG monitoring technique was simple and convenient to use, and appears to be predictive of gross neurologic outcome following carotid endarterectomy in patients without preoperative neurologic deficits.

Aged↗
PubMed1981

Bypass blood flow during carotid endarterectomy.

The relationship of bypass shunt blood flow to arterial pressure and stump pressure was studied in 12 informed patients undergoing carotid endarterectomy. These patients were anesthetized with halothane plus nitrous oxide. Systemic arterial blood pressure was measured with a radial artery catheter, and stump pressure as well as distal shunt pressure (carotid pressure distal to the shunt) were measured with a 25-gauge needle inserted cephalad to the bypass shunt. From the pressure drop across the bypass shunt, blood viscosity, geometry of the bypass tubing and the use of Poiseullie's law, the shunt blood flow can be calculated. The calculated shunt flow shows a close correlation with the difference between arterial pressure and stump pressure (r = 0.91) as well as with the slope of arterial pressure increase following carotid occlusion (r = 0.82); but it is poorly correlated with the stump pressure. Administration of 100 ml low molecular weight dextran solution does not improve the shunt blood flow, whereas 500 ml low molecular weight dextran significantly decreases blood viscosity. The patency of the carotid artery as assessed by angiogram does not give a proper indication of the need for a bypass shunt. The shunt flow as well as the need of such a shunt might be predicted by the use of the difference of arterial pressure and stump pressure. If the slope of arterial pressure increases rapidly following carotid occlusion, it can also be used to determine the necessity of such a shunt.

Adult↗
PubMed1980

Spinal extradural meningiomas.

Spinal meningiomas may be primarily extradural, leading to errors in diagnosis and management. Myelographic findings and the microscopic examination of fresh tissue at the time of operation often lead to the conclusion that the tumor is metastatic. Three patients with this type of meningioma have been encountered. Although extensive removal of the tumor was accomplished in each case, the correct diagnosis was difficult to establish at the time of the operation. A second operation was necessary in one patient because the true nature of the tumor was not recognized initially.

Epidural Space↗
PubMed1979

Management of extracranial carotid stenosis and intracranial aneurysms.

Twenty patients with extracranial carotid stenosis and intracranial aneurysms are reviewed. Fifteen of these patients had transient ischemic attacks (TIA's) and incidental aneurysms. The other five presented with symptoms referrable to an aneurysm, and angiography revealed significant carotid stenosis. None of the patients who presented with TIA's and underwent endarterectomy suffered subarachnoid hemorrhage. However, those patients who presented with symptoms referrable to an aneurysm and underwent endarterectomy seem to be at greater risk for subarachnoid hemorrhage.

Adult↗
PubMed1979

Reproductive function in temporal lobe epilepsy: the effect of temporal lobectomy.

We have examined sexual and reproductive changes in 25 patients (11 men and 14 women; mean follow-up 13 years) with temporal lobe epilepsy who underwent temporal lobectomy. Five men and two women had sexual dysfunction preoperatively, in particular, decreased libido. This improved after temporal lobectomy in three of these patients. One woman developed a partial Klüver-Bucy syndrome. Reproductive dysfunction was present in one man (oligospermia) and in ten women (four had the onset of seizures either at pregnancy or menarche; four had increased frequency of seizures during menarche or pregnancy, and two had amenorrhea). The man fathered two children post-operatively, and an appreciable improvement in both the seizure activity and the reproductive dysfunction was noted in the majority of the women.

Adolescent↗
PubMed1976

Cerebral emboli from intracranial aneurysms.

Cerebral vasospasm has been implicated as the major pathophysiologic mechanism responsible for the cerebral ischemia and infarction that sometimes follows the rupture of intracranial aneurysms. Two cases are reported in which aneurysms of the internal carotid arteries were the source of emboli resulting in infarctions. Embolic phenomena should be considered as a possible cause of the morbidity associated with intracranial aneurysms.

Carotid Artery Thrombosis↗