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Biomedical subjects

R A Beatty

Publications and source records attributed to R A Beatty.

At least 19 recordsLinked to original sources
PubMed1999

Subdural haematomas in the elderly: experience with treatment by trephine craniotomy and not closing the dura or replacing the bone plate.

A surgical technique was devised to treat chronic subdural haematomas (SDH) in elderly patients. Initial good results encouraged the author to use this technique in elderly patients with acute SDH. This small group is also reported. The goal was to do definitive, not expectant or incremental surgery on these fragile patients who have a high incidence of co-morbid conditions and cerebral atrophy, and to obliterate the subdural space by allowing the skin to sink into the cranial defect. The surgical technique consists of trephine craniotomy and not closing the dura or replacing the bone plate. Experience with six elderly patients with acute SDH and 23 patients with chronic SDH is reported. Of six patients with acute SDH, mean age 80 years, 2 months, three died, all with a Glasgow Coma Score (GCS) less than 9. Three recovered to preoperative status, one with initial GCS of 7 and the other of 8. Of 23 patients with chronic SDH, mean age 77 years, 21 recovered to preoperative status. The two deaths were in patients with GSC of 5 and 7. There were no recurrent SDH or postoperative surgical or cosmetic complications. All patients were followed for at least 6 months. These excellent results suggest that the procedure could be considered as a first procedure in the elderly patient. At first glance, the operation appears to be overly aggressive, but it is an example of 'aggressive-conservative' treatment which produces good long-term results with few complications and no need for second operations.

Acute Disease↗
PubMed1999

Is fusion necessary?

Explore the source record for details and available documents.

Bone Transplantation↗
PubMed1996

Surgery for patients with central protruded lumbar discs who have failed conservative therapy.

The clinical presentation and results of surgery of patients with central protruded lumbar discs have not been well defined or distinguished from studies of patients with lateral herniated discs. Many patients are denied surgical treatment, even though they are incapacitated by pain, because they do not have the classic radiographic findings seen in patients with lateral disc herniation. Sixty-three symptomatic patients with radiographically documented central lumbar disc protrusion were analysed. All patients had failed at least 6 months of conservative therapy. Although lumbar spinal pain was the most common complaint, 24 patients also presented with bilateral leg pain and 33 with unilateral leg pain; 26 had unilateral limitation of straight leg raising. An interesting observation was that unilateral symptoms and dural tension signs can be seen in patients with central disc protrusion. After surgical follow-up for a mean of 51 months, 86% achieved good results when analysed by the Prolo Functional Economic Outcome Rating Scale. It is postulated that pain is mediated by neuropeptides and arachidonic acid degradation products which are a response to mechanical annular injury.

Adult↗
PubMed1994

The piriformis muscle syndrome: a simple diagnostic maneuver.

Current maneuvers to diagnose the piriformis syndrome are less than ideal. Freiberg's maneuver of forceful internal rotation of the extended thigh elicits buttock pain by stretching the piriformis muscle, and Pace's maneuver elicits pain by having the patient abduct the legs in the seated position, which causes a contraction of the piriformis muscle. This report describes a maneuver performed by the patient lying with the painful side up, the painful leg flexed, and the knee resting on the table. Buttock pain is produced when the patient lifts and holds the knee several inches off the table. The maneuver produced deep buttock pain in three patients with piriformis syndrome. In 100 consecutive patients with surgically documented herniated lumbar discs, the maneuver often produced lumbar and leg pain but not deep buttock pain. In 27 patients with primary hip abnormalities, pain was often produced in the trochanteric area but not in the buttock. The maneuver described in this report was helpful in diagnosing the piriformis syndrome. It relies on contraction of the muscle, rather than stretching, which the author believes better reproduces the actual syndrome.

Adolescent↗
PubMed1987

Sciatica and epidural gas.

Epidural gas in the patient with sciatica can sometimes provide a clue that there is a surgically treatable lesion. Our patient had the sudden onset of sciatica at night, which was relieved by walking. An intraspinal synovial cyst was associated with epidural gas.

Aged↗
PubMed1985

Myxomatous degeneration of the lumbar intervertebral disc.

Sixteen patients were operated on for lumbar pain and pain radiating into the sciatic nerve distribution. In all 16, when the anulus fibrosus was incised, soft, gray disc material extruded under pressure like toothpaste being squeezed from a tube. This syndrome of myxomatous degeneration is a distinct entity, different from classical fibrotic disc degeneration or herniated nucleus pulposus. Surgical removal associated with partial facetectomy produced excellent results. The concept of incompetence of the anulus fibrosis is discussed.

Adult↗
PubMed1985

Vocal cord paralysis associated with anterior cervical fusion: considerations for prevention and treatment.

In a series of 375 patients with anterior cervical fusions, long-term follow-up results complete with laryngeal examination were obtained in 102 patients. One patient was found to have an inferior laryngeal nerve palsy, and one had a superior laryngeal nerve palsy. Both deficits were thought to be the result of surgical trauma. Measures to minimize the incidence of vocal cord paralysis include careful surgical technique and knowledge of the surgical anatomy of the laryngeal nerves. Suggestions are given for the assessment of postoperative hoarseness, and for the management of vocal cord paralysis.

Cervical Vertebrae↗
PubMed1978

Problems in estimating non-disjunction rate from the F-bodies of two-headed human spermatozoa.

The F-bodies of two-headed human spermatozoa offer a unique potential for estimating non-disjunction rate of the Y chromosome. But there is an unexplained quantitative discrepancy: a gross deficiency of two-headed spermatozoa with no F-bodies, relative to the numbers with one F-body in each head. Any estimation of non-disjunction rate would be overshadowed by this and other major factors. Two-headed spermatozoa cannot be regarded as a random aggregation of haploid heads in pairs. DNA measurements confirmed that each head of 25 normal-sized two-headed spermatozoa was haploid. The distribution of F-body classes is independent of whether sperm tails are single or double. Donors with an exceptionally high incidence of two-headed spermatozoa exist.

Genetics, Medical↗