Biomedical subjects
Publications and source records attributed to M S Albin.
The biomechanical criteria for standardization of experimental impact injury to the spinal cord are derived. The theory is verified experimentally using cats. The undesirable effect due to heavy impounders is discussed. A falling mass of 20 gm and a small impounder 5 mm in diameter with a mass of 0.1 gm are recommended, leaving the momentum of the falling body to be controlled for different degrees of trauma.
Does cerebellar retraction during operations in the posterior fossa contribute to increased morbidity and mortality, and if so, what are the critical factors involved? In order to answer these questions, graded retractor pressures of 10, 20, and 30 mm Hg were applied for one hour to the cerebellar hemispheres of dogs in the sitting position. It was noted that the amount of mechanical pressure and the difference between systemic perfusion pressure and retractor pressure were important determinants of the outcome. The mechanism of damage from retractor pressure is discussed.
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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.
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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.
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Embolism of air into the venous system occurs during approximately 25% of neurosurgical operations performed with the patient in the sitting position. The present report calls attention to an unusual entry site for such air embolism-the punctures in the scalp made by a neurosurgical pin-type head holder.
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The use and construction of a simple device to illuminate air bubbles in an intravenous tubing connected to the right atrial catheter when air embolism is suspected is described. This had been effective in clearly demonstrating even small air bubbles in more than 25 cases.