Of all the potentially lethal complications of the head injury, extradural hemorrhage is the most readily diagnosed and remediable, yet the mortality rate remains distressingly high. The authors report on 58 consecutive patients with extradural hematoma. The mortality was 31%. The classical clinical course with a lucidal interval was seen in three patients only. The classical neurological signs of an extradural hematoma, contralateral hemiparesis, and ipsilateral third nerve palsy were seen in 9 patients(15.5%). The main factors associated with increased mortality were concomitant brain injury, rapid development of the hematoma and unconsciousness at the time of operation. In almost half of the fatal cases, there was a delay in the diagnosis and operation. Consequently better results are possible with better organization of the supervision and treatment of brain injured patients.
Brain ; Brain Injuries ; Craniocerebral Trauma ; Diagnosis ; Hematoma* ; Hemorrhage ; Humans ; Mortality* ; Oculomotor Nerve Diseases ; Organization and Administration ; Paresis ; Unconsciousness

The authors describe a new technique for the reduction and wiring of atlanto-axial dislocation. More strong supporting effect has been achieved by double wiring of the posterior arch of the cervical vertebrae. Various techniques for the fixation of the atlanto-axial dislocation have been discussed.olved.
Cervical Vertebrae ; Dislocations* ; Female ; Odontoid Process*

With the establishment of the anterior cervical approach as the procedure of choice for cervical fracture-dislocation, attention has now turned to refinements of Cloward technique. The purpose of application of the Cloward technique is to achieve early stabilization of the fracture-dislocation, to shorten the recumbency period, and to promote rehabilitation. Recently the authors have experienced with the Cloward technique in the treatment of cervical fracture-dislocation. Our results indicated that anterior interbody fusion has been a satisfactory method for stabilizing one or more segment of the cervical fracture-dislocation. The prevention of dowel fracture or extrusion following fusion has been a important factor in the success. Another advantage obtained is to use the operating microscope for decompression of nerve roots. The chronic locked facets have not been reduced by the application of Cloward technique, but have been managed to achieve stabilization with Smith-Robinson technique. The lateral cervical pucture technique(C1-C2) for pantopaque myelography has been shown to be a valuable adjunct of acute injuries of the cervical spinal cord. A new technique for wiring and fusion of atlanto-axial dislocation has been performed with satisfactory results.
Decompression ; Dislocations* ; Iophendylate ; Myelography ; Rehabilitation ; Spinal Cord

The authors report a case of malignant brain-stem glioma with typical clinical signs in which successful surgical decompression and biopsy were obtained under the surgical microscope, and factors favoring surgical removal of such lesion are discussed.
Biopsy* ; Decompression* ; Decompression, Surgical ; Glioma*

Fibrous dysplasia of bone is an uncommon condition of unknown etiology in which the bones become progressively thicker and lose their normal structure. The skull and the bones in other parts of the body are involed in a process characterized by small areas of bone destruction or massive sclerotic overgrowth. They appear denser, although actually are softer, and give a rather homogenous, smeary impression. There may be cyst like areas within the large, dense, homgenous-appearing amorphous bone. Although the skull may be the only area of involvement it is not uncommon to have similar but more cystic appearing lesions in many other bones. The authors report two cases of fibrous dysplasia involving frontal, orbital roof, ethmoid, zygoma and sphenoid bone in the left by which disfiguration of appearance of the face was resulted in association with exophthalmus.
Fibrous Dysplasia of Bone ; Orbit ; Skull ; Sphenoid Bone ; Zygoma

BACKGROUND: Prolonged extracorporeal circulation entails tremendous threats of red cell lysis, severe bleeding problems due to platelet injury and activation, and endothelial damages by sequestered leukocytes. In consideration of these problems, a new centrifugal pump was developed and tested clinically to evaluate its effectiveness. METHODS: We compared the effects of a centrifugal pump with those of a roller pump on hematological responses during cardiopulmonary bypass (CPB) in 20 coronary artery bypass surgery patients. The patients were divided into two groups of 10 each. The studied parameters included WBC counts, platelet counts, plasma Hb and D-dimer. Blood samples were taken after sternotomy, at 60 min, 120 min and 180 min after CPB start, and at 2 hr after CPB stop. RESULTS: No differences between the groups were found in bypass time, aortic cross clamp time, extracorporeal circulation flow and hematocrit. The centrifugal pump group demonstrated less platelet depletion (p<0.05), hemolysis (plasma Hb, p<0.05) and fibrinolysis (D-dimer, p<0.05). These differences were CPB time dependent and became statistically significant after 120 min bypass. CONCLUSION: We conclude that roller pump still can be safely used for standard cardiac procedures with bypass time less than 120 minutes and the centrifugal pump has significant potential to be safely applied to CPB for long ypass time in order to avoid postperfusion syndrome.
Blood Platelets ; Cardiopulmonary Bypass* ; Coronary Artery Bypass ; Extracorporeal Circulation ; Fibrinolysis ; Hematocrit ; Hemolysis ; Hemorrhage ; Humans ; Leukocytes ; Plasma ; Platelet Count ; Sternotomy

The authors describe a case of tuberculous epidural granuloma at the level of the 4th thoracic spine in a 27-year-old woman. Extraosseous origin of tuberculous granuloma has been rarely reported. With the references reviewed, the pathogenesis of Pott's paraplegia is discussed.
Adult ; Female ; Granuloma* ; Humans ; Spine ; Tuberculosis, Spinal

The authors report a case of tuberculoma of the cerebral hemisphere, which has been excised under the operating microscope. With the references reviewed, this case is interesting one in supratentorial location.
Cerebrum* ; Tuberculoma*

The authors describe a case of large dermoid cyst of the scalp which removed surgically and cosmetically. Dermoid cyst is derived from epiblastic cells predestined to form skin which become detached from their neighbours and included in mesenchyme at about third to the fifth week of feral life, when the neural tube is closing. The contents of the cyst are thus mixtures of keratin, sebum, and hair, according to the proportionate development of these elements. It is usually a single tumor and may develop almost anywhere in the subcutaneous tissue, being of variable size.
Dermoid Cyst* ; Germ Layers ; Hair ; Mesoderm ; Neural Tube ; Scalp ; Sebum ; Skin ; Subcutaneous Tissue

No abstract available.