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Biomedical subjects

R F Spetzler

Publications and source records attributed to R F Spetzler.

At least 289 records · Page 16Linked to original sources
PubMed1979

Extracranial-intracranial arterial bypass to a single branch of the middle cerebral artery in the management of a traumatic aneurysm.

This case required the clipping of a single branch of the middle cerebral artery for the treatment of a traumatic aneurysm. To ensure an adequate blood supply distal to the occlusion, we anastomosed the superficial temporal artery to that branch of the middle cerebral artery (MCA) distal to the aneurysm. Despite the low flow required to irrigate only one branch of the MCA, the anastomosis remained patient. This case demonstrates the feasibility of performing small vessel anastomoses in spite of low flow demand.

Adult↗
PubMed1979

Computerized tomographic diagnosis: pitfalls for neurosurgeons.

Computerized tomography as a diagnostic procedure is characterized by its high sensitivity but limited specificity. This lack of specificity may result in an erroneous diagnosis and, possibly, in ill-advised therapy unless clinical and objective data are carefully considered in interpreting the study. The most common pitfalls encountered are the phenomena of contrast enhancement of infarcts and mass effect associated with infarcts. Many different pathological processes can have similar enhancement patterns. The evolution of high density, acute hemorrhage to isodense areas in the chronic hematoma can become a serious diagnostic problem unless an appropriate history is available. The authors discuss 30 cases in which misinterpretation of CT scans resulted in erroneous diagnoses. Seventeen of these patients underwent operation.

Adult↗
PubMed1979

Vermian hematoma in a four-year-old child.

An unusual case of a vermian hematoma from the rupture of an angioma in a four-year-old child is presented. The lesion was treated successfully with complete recovery.

Cerebellar Neoplasms↗
PubMed1978

Management of recurrent CSF rhinorrhea of the middle and posterior fossa.

The authors review 39 patients with cerebrospinal fluid (CSF) leaks originating from the middle or posterior fossa. They evaluate the usefulness of preoperative investigative procedures, including cisternal radionuclide scanning and the deliberate increase of intracranial pressure. The results in this series emphasize the important role that abnormal CSF dynamics play in the recurrence of problematic cases of rhinorrhea or otorrhea. The following guidelines are recommended by the authors on the basis of their recent experience: 1) if hydrocephalus is present, if the cisternogram is abnormal, or if the CSF leak is intermittent and slight, the initial treatment should be insertion of a lumboperitoneal shunt; 2) if the leak is localized in the sellar or parasellar area, a transsphenoidal approach to obliterate the leak is advised; 3) if the CSF leak originates through a dural opening into the middle ear, an intracranial repair is indicated.

Adolescent↗
PubMed1975

Acute, Post-Traumatic Subdural Hygroma. Natural Course with Angiographic Documentation.

Acute, post-traumatic subdural hygromas, in contrast to benign chronic subdural hygromas, may be life-threatening. Two cases are presented in which a rapidly enlarging subdural hygroma either prevented improvement over a 1-2 week period or resulted in rapid deterioration of the patient. Angiographic documentation and the natural course of this condition are revealed.

Aged↗
PubMedDate not supplied

Elective EC-IC bypass for unclippable intracranial aneurysms.

Ligation of the carotid artery in the neck has become part of the surgical armamentarium for treating inaccessible or technically difficult intracranial aneurysms. Obliteration of an aneurysm by sacrificing the parent vessel has also been employed for the treatment of unclippable posterior circulation and middle cerebral artery aneurysms. Because parent vessel occlusion is not well tolerated by all individuals, the use of an extracranial-intracranial bypass has been advocated in order to improve the safety of this procedure. The purpose of this report is to detail our methods and results with the use of extracranial-intracranial bypass for the treatment of giant internal carotid and middle cerebral artery aneurysms in 35 patients and review the literature to determine the status of the use of the bypass for other intracranial aneurysms.

Adult↗
PubMedDate not supplied

Transoral microsurgical odontoid resection and spinal cord monitoring.

Four patients underwent transoral resection of the odontoid with utilization of microsurgical technique and spinal cord monitoring of somatosensory cortical evoked responses. All patients improved following surgery, and no operative morbidity or mortality was encountered. Spinal cord monitoring enhances the safety of the procedure and, reapplied at a later date, detects information of prognostic value.

Cerebral Cortex↗