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M L Walker

Publications and source records attributed to M L Walker.

8 recordsLinked to original sources
PubMed1992

The history of ventriculoscopy: where do we go from here?

With the availability of better endoscopes, improved lighting and increased instrumentation, the use of ventriculoscopy and ventriculostomy in the management of hydrocephalus is becoming increasingly more common. Neurosurgeons recognized the potential for endoscopic surgery early in this century, but were frustrated in many of their attempts at treatment due to the poor quality of the instruments available. Nevertheless, much progress has been made, and the stage was set for better results with modern instrument design. This paper reviews the history of endoscopes in neurosurgery and ponders the direction these instruments will take us in the near future.

Cerebral Ventricles↗
PubMed1992

On healing.

Explore the source record for details and available documents.

Culture↗
PubMed1992

The operative approach to pancreatic injury.

Major pancreatic trauma is uncommon and often challenging even for the most experienced trauma surgeon. An organized, well-rehearsed operative approach to these injuries represents the surgeon's best defense. This article highlights operative decision-making. Operative assessment is reliable. The integrity of the main pancreatic duct is the major discriminating variable in the management of pancreatic injury. Pancreaticoduodenectomy can be done safely for devitalizing injuries to the head of the pancreas associated with major duodenal and common bile duct injury. For selected cases, distal pancreatectomy with splenic preservation is realistic. The surgeon must have a wide array of procedures from which to select for major complicated pancreatic trauma.

Abdominal Injuries↗
PubMed1991

Trauma-adult respiratory distress syndrome.

Sixteen trauma victims with adult respiratory distress syndrome were retrospectively examined. High injury severity score (mean: 44), massive transfusion requirements, and prolonged ventilator days characterize this group. Persistent intra-abdominal infection accounted for two of three deaths in this series. Most of these patients were managed without paralysis using intermittent mandatory ventilation and positive-end expiratory pressure (PEEP). High frequency jet ventilation was necessary in one subject. Two patients exhibited early ARDS reversal, ie, clinical improvement, better chest x-ray and decreased shunt (within 72 hours) when an intra-abdominal septic focus was eradicated. Principles of critical care for these patients remain: an FiO2 less than .40, limiting barotrauma, using PEEP for alveolar recruitment and close monitoring of O2 transport.

Adolescent↗
PubMedDate not supplied

Intraoperative monitoring in selective dorsal rhizotomy.

The method used in the intraoperative portion of the selective dorsal rhizotomy procedure for the selection of abnormal circuits within the central nervous system of children with spasticity due to cerebral palsy is described. The decision to transect dorsal rootlets is made on the basis of electrophysiological, behavioral and medical criteria. In 100 cases the average number of rootlets transected was 64%. Of the total stimulated, 23.3% exhibited normal electrophysiological and behavioral responses. Decision making regarding the preservation or transection of the remaining 12.7% of the segments is described. This information is presented in an effort to increase understanding of this particular portion of the procedure and to encourage standardization of the procedure between centers in the future.

Child↗