HOMEPAGE AND INTRODUCTION


CURRICULUM VITAE

WARFARE

LETTERS AFTER LOOK

MY PATIENTS

LETTERS FROM PATIENTS

NARRATIVE IN PROGRESS 







 

MY PATIENTS AND OUR SHARED ODYSSEY

 

 

The following is somewhat late in my life to be recalling, but the many patients and the variety of ailments that I've encountered during my medical career have given me ample time to reflect on much that may be of some interest to others.  In this very preliminary abbreviated tally are random conditions and patients that are the beginnings of what I hope to organize and in time mold into a coherent narrative.

da
67 year old woman
marked memory and intellectual impairment secondary to normal pressure hydrocephalus
right ventriculoperitoneal shunt with Uni-Shunt
slight improvement in cognition

ma
32 year old woman
ruptured intervertebral disc, L5-S1
Chymopapain injection into ruptured intervetebral disc
good recovery

ea
63 year old man
spinal canal narrowing secondary to epidural granulation formation
C6-C7 and L2-L4 laminectomies with decompression and removal of epidural exuberant granulations
good recovery

ma
63 year old woman
metastatic squamous cell right parietal tumor
fair recovery, limited by primary illness

va
69 year old woman
blunt head injury and cerebral contusion after auto accident
post-traumatic unsteadiness, confusion and speech impairment
good recovery

sa
40 year old man
left carpal tunnel syndrome
section of left transverse carpal ligament
good result

lb
82 year old man with garbled speech and drowsiness after fall
shuffling gait with assistance
CT scan showed large right-sided subdural hematoma
craniotomy and removal of acute and subacute subdural hematomas
transfer to rehabilitation
readmitted with septicemia and family opted to forgo antibiotics because of physical and mental decline after fall
death five weeks after initial injury - the difficult decisions, ultimately the family's, of when not to intervene

mb
53 year old man with increasing back and left leg pain despite bedrest
metrizimide myelogram and CT scan showed L2-L3 disc
microdiscectomy and satisfactory recovery

jb
11 year old boy
basilar skull fracture with otorrhea after falling through floor of an abandoned factory
right temporal craniotomy with galea graft over petrous ridge
complete recovery

sb
33 year old man
subarachnoid hemorrhage from ruptured anterior communicating aneurysm
Encasement of bilobed aneurysm with aneuroplastic
complete recovery

cb
56 year old woman
subarachnoid hemorrhage and intracerebellar hematoma from ruptured left posterior inferior cerebellar artery aneurysm
evacuation of hematoma, clip obliteration of aneurysm, ventriculo-peritoneal shunt
feeding jejunostomy
discharge to rehabilitation facility
permanent partial disability

dc
41 year old man with ruptured L5-S1 disc
Laminectomy and disc removal
good recovery, but recurrent symptoms and scar tissue formation 2 1/2 years later
2nd laminectomy
good recovery

rc
65 year old woman
head and neck pain, increasing torticollis and left leg weakness
bilateral C2 and C3 rhizotomies
good result

pc
44 year old man
subarachnoid hemorrhage, bilateral middle cerebral aneurysms
Aneuroplastic encasement of ruptured right middle cerebral aneurysm
subsequent clipping of unruptured left cerebral aneurysm
fair recovery with residual psychological and cognitive deficits
unable to return to full time employment

ac
50 year old woman
multiple injuries in auto accident
basilar skull fracture, cerebral contusions; fractures of left humerus, radius and ulna
intracavernous right internal carotid aneurysm
Poppen clamp occlusion of right internal carotid artery
good recovery

mc
32 year old woman
C5-C6 ruptured intervetebral disc
hemi-laminectomy and removal of ruptured disc
good recovery

bc
27 year old woman
T7 arachnoidal cyst
T6, T7 and T8 laminectomy with removal of arachnoidal cyst
good recovery

rc
36 year old man
removal of exuberant lumbar epidural scar tissue 8 years after lumbar disc surgery
good recovery

dc
35 year old man
ruptured lumbar intervetebral disc, L5-S1
hemilaminectory and removal of ruptured disc
good recovery

sc
64 year old woman
carpal tunnel syndrome
section of right transverse carpal ligament
good recovery

cc
21 year old woman
ruptured intervetebral disc, central and right-sided
bilateral partial hemilaminectomies and removal of ruptured disc
good recovery

md
35 year old man
ruptured central intervetebral disc, L4-L5
bilateral partial hemilaminectory and removal of ruptured disc
good recovery

ld
46 year old man
left-sided acute epidural, subdural and intracerebral hematomas
left frontal temporal craniotomy, subsequent bifrontal craniotomy and decompression
placement of a bifrontal methyl methacrylate plate four months later
good recovery

vd
85 year old man
left-sided intracerebral hemorrhage, aspiration tracheobronchitis
left-sided parietal occipital craniotomy with evacuation of intracerebral hematoma
death after nine days


jd
69 year old man
right-sided acute subdural hematoma
right frontal temporal parietal craniotomy with evacuation of subdural hematoma
ventriculoperitoneal shunt for normal pressure hydrocephalus
pneumonia, pulmonary edema, coronary artery stenosis
death after three months

jd
28 year old man
left internal carotid-posterior communicating aneurysm
left frontal temporal craniotomy with clipping of cerebral aneurysm
good recovery

md
27 year old man
multiple injuries after auto accident
facial lacerations, fractures of mandible, maxilla, and orbit
intracerebral hematoma
bifrontal decompression and decompression
subsequent methyl methacrylate cranioplasty
discharge to rehabilitation facility
discharged to home eight months after injury (after six months in rehabilitation)
likely totally and permanently disabled

pd
31 year old man
cervical fracture with C6 fracture and distraction
cervical traction with Vincke tongs
application of halo traction and immobilization vest
good recovery

jd
14 year old boy
right posterior epidural hematoma
right posterior fossa epidural hematoma
craniotomies and removal of hematomas
subsequent staphylococcal infection with osteomyelitis of bone flap
removal of bone flap
antibiotic treatment and recovery
subsequent methyl methacrylate cranioplasty
good recovery

je
73 year old man
subarachnoid hemorrhage from ruptured left internal carotid aneurysm
Poppen clamp application and serial closure of left common carotid artery
good recovery

ne
52 year old woman
subarachnoid hemorrhage from ruptured left middle cerebral artery aneurysm
 coma following rupture
aneuroplastic encasement of ruptured aneurysm
death from respiratory failure two weeks after hemorrhage

re
subarachnoid hemorrhage from ruptured right internal carotid-posterior communicating aneurysm
craniotomy and ligation of internal carotid-posterior communicating artery aneurysm
good recovery

if
66 year old woman
right-sided frontal parietal parasagittal meningioma
craniotomy and removal of 30 gram meningioma
good recovery

df
60 year old man
olfactory groove meningioma
craniotomy and removal of meningioma
good result

mf
65 year old woman
recurrent oral carcinoma
right internl carotid aneurysm
application of Poppen clamp and progressive closure of right common carotid artery
good result

vf
64 year old woman
right sphenoid ridge meningioma
right frontal temproal craniotomy with removal of sphenoid ridge meningioma
good result


df
49 year old woman
left anterior communicating and left middle cerebral aneurysms
right frontal craniotomy and clipping of right anterior communicating artery aneurysm
placement of Poppen clamp and tantalum band around left common carotid artery
death

sf
50 year old woman
cerebrospinal fistula after removal of a large left acoustic neuroma
repair of dural defect with fascial graft
good result

ef
64 year old woman
right internal carotid artery stenosis
right carotid endarterectomy with insertion of vena saphena magna graft
good result

pf
29 year old man
left parietal sinus pericranii
excision of sinus pericranii and methyl methacrylate cranioplasty
good result

dg
18 year old man
acute alcoholic intoxication
single vehicle auto accident
multiple lacerations
diffuse intracranial contusions
subdural and intracerebral hematomas
massive cerebral edema
bifrontal craniotomy with decompression and removal of frontal bone flap
death

mg
42 year old man
ruptured intervetebral disc, L4-L5, left
hemilaminectomy and removal of ruptured disc
temporary good result, but
recurrence of disc protrusion in midline and right side
laminectomy and removal of residual disc fragments
good result

nh
27 year old man
left sided subdural and intracerebral hematomas
evacuation of hematomas and cranial decompression
two months in rehabilitation unit
subsequent left frontal temporal methyl methacrylate cranioplasty
partially disabled

jh
17 year old man
passenger in roll-over automobile accident
fracture-dislocation at C5-C6 with central cervical cord injury
cervical traction with Vinke tong skeletal fixation
posterior cervical fusion with methyl methacrylate fixation
good result

ph
18 year old woman
auto accident with severe head injury, cerebral contusions, diffuse brain swelling, ,subdural hematoma
post-traumatic communicating hydrocephalus
tracheotomy
left frontal temporal craniotomy with evacuation of subdural hematoma
right temporal craniotomy and decompression with removal of bone flap
posterior fossa craniectomy and decompression
right parietal occipital craniectomy and section of tentorium cerebelli
insertion of ventriculo-atrial shunt with Holter valve
death after eight months

sk
46 year old woman
metastatic pulmonary adenocarcinoma to right occipital lobe
right occipital craniotomy with subtotal removal of metastatic adenocarcinoma
subsequent radiation therapy to residual tumor
eventual death with multiple metastases

fl
68 year old woman
trigeminal neuralgia
right temporal craniectomy with retro-Gasserian rhizotomy and ganglion compression 
good result with relief of facial pain

ml
55 year old woman
right parietal glioblastoma multiforme
right parietal craniotomy and partial removal of infiltrating glioblastoma multiforme
death in post-operative period

al
33 year old woman with widespread metastatic carcinoma
T2-T-4 laminectomy with decompression and partial removal of metastatic breast carcinoma
eight months later alcohol nerve root denervation at L-2 and L-3 to relieve right hip pain
eventual death with extensive metastases

ll
56 year old woman
right-sided parietal-occipital astrocytoma, Grade II-III
right-sided parietal-occipital craniotomy with subtotal removal of infiltrating tumor
discharged ro undergo radiation and chemotherapy therapy
eventual death

ml
61 year old woman
at age 61 cervical radiculitis treated successfully with cervical traction at home
at age 71
normal pressure hydrocephalus
right ventriculo-peritoneal shunt
good recovery

gl
67 year old man
coma after fall down flight of stairs
right parietal-temporal skull fracture
right frontal subdural and intracerebral hematomas
right frontal-temporal craniotomy with removal of subdural hematoma and portion of macerated frontal lobe
tracheotomy
eventual transfer to chronic hospital care and death one year after injury

al
61 year oldan
coma after auto accident
extensive deep left-sided intracerebral henorrhage
death

ll
20 year old woman
coma after auto accident
multiple lacerations and fractures
right frontal subdural and intracerebral hematomas
right frontal-temporal craniotomy with right frontal lobectomy and evacuation of intracranial hematoma
encephalomacia and extensive cerebral edema ex
death two days after injury

wl
49 year old woman
right parietal occipital convexity meningioma
craniotomy and excision of right parietal occipital convexity meningioma
postoperative meningitis
good result but with residual left homonymous hemianopsia

il
75 year old woman
cervical osteoarthritis and occipital neuralgia
bilateral occipital nerve block with xylocaine
bilateral occipital neurectomy
good result with relief of symptoms

el
72 year old  woman
normal pressre hydrocephalus
ventriculoperitoneal shunt
minimal improvement in memory

vl
56 year old woman
subarachnoid hemorrhage secondary to a ruptured left posterior inferior cerebellar artery aneurysm
transfer to Dr. Charles Drake in London, Ontario - the neurosurgeon with extensive experience in treating aneurysms in this location
aneurysm successfully clipped by Dr. Drake
excellent recovery

dl
84 year old woman
left-sided subdural hematoma
left temporal craniectomy and removal of chronic subdural hematoma
good recovery

ml
78 year old woman
left-sided frontal parasagittal meningioma
chronic obstructive pulmonary disease
urinary tract infection
left frontal parietal craniotomy with removal of parasagittal meningioma
good result

al
56 year old man
midline ruptured intervertebral disc, L4-L5
diabetes mellitus
paroxysmal atrial tachycardia
plasma cell myeloma

al
64 year old man
calcified ruptured right-sided intervetebral disc, C4-C5
partial hemilaminectomy, C4-C5 with foraminotomy and C5 nerve root decompression
good result

jl
48 year old man
ruptured right-sided intervertebral disc, C4-C5
osteoarthritic spurring C5-C6, bilaterally
partial hemilaminectomies, C4-C5 and C5-C6, right with foraminotomies of C5 and C6 nerve roots
good result for thirteen years, then recurrent right arm smptoms
extension of partial hemilaminectomy, C4-C5, with decompression and removal of osteoarthritic spurs
good result

dl
13 year old boy
struck by automobile
right occipital skul fracture
right-sided subdural and intratemporal hematomas with macrated right anterior tempoal lobe
right frontl-temporal-parietal craniotomy with evacuation of hematomas and macerated brain tissue
urinary tract infection
parameningeal infection
good recovery

ml
28 year old woman
multiple sclerosis, diagnosed at age 19
struck by automobile
severe head injury with multiple cranial fractures, cerebral anoxia and accompanying brain swelling
right-sided subdural and intratemporal hematomas
closed right femorral fracture and open fractures of right tibia and right forearm
death

fl
71 year old woman
C6-C7 subluxation after fall at home
Halo ring application and initiation of skeletal traction
two months after injury, posterior wire and bone autograft fusion, C6-C7
good recovery

tl
22 year old man
automobile accident
anoxic encephalopathy with markedly increased intracranial pressure
death

il
32 year old woman
L4-L5 right-sided disc removal three years earlier in Switzerland, increasing symptoms in recent months
ruptured intervertebral disc, L4-L5, central and right-sided
complete laminectomy, L4-L5 with dural decompression and excision of epidural scar tissue and residual disc tissue
good result

dm
21 year old woman
progressive stupor and coma during delivery of a healthy infant
large left frontal intracerebral hematoma
left frontal-temporal craniotomy and removalof intracerebral hematoma and subtotal frontal lobectomy of macerated brain
good recovery

jm
61 year old man
left frontal glioblastoma multiforme
Left frontal craniotomy with removal of infiltrating glioblastoma multiforme
post-operative radiation therapy
death after nine months

am
79 year old man
epidural metastatic carcinoma to mid-thoracic area
complete laminectomy, T3, T4 and T5with subtotal removal of epidural tumor
discharge to nursing home
eventual death

mm
18 year old woman
post traumatic perineural cyst of the left lateral antebrachial cutaneous nerve
excision of perineural cyst
good result

km
5 year old boy
neuroblastoma in thoracic-lumbar area
Laminectomy at T11, T12, L1, and L2, with subtotal removal of infiltrating rhabdomyosarcoma
metastatic lesions in follwoing months treated with radiation and chemotherapy
death with metastases 22 months later

sm
22 year old man
motorcycle accident with multiple injuries
basilar skull fracture,
coma
compound femral fracture
hemopneumothorax
death

dm
28 year old man
ruptured intervetebral disc, L5-S1 left
partial hemilaminectomy L5-S1 with removal of ruptured intervertebral disc
good result

em
55 year old woman
coma following rupture of right middle cerebral artery aneurysm
right frontal-temporal craniotomy with evacuation of intracranial hematoma and ligation of aneurysm
persistent coma and death three weeks after hemorrhage

rm
58 year old man
metastatic pulmonary oat cell carcinoma with hydrocephalus secondary to cerebellar metastases
right ventriculo-peritoneal shunt
satisfactory initial recovery but eventual death secondary to multiple metastases

jm
64 year old man
cervical spinal cord contusion after fall with resultant quadriparesis
slow recovery with transfer to rehabilitation facility three weeks after injury

km
7 year old boy
20 foot fall from a tree with open, depressed left temporal-parietal skull fracture and intracerebral hematoma
debridement and craniectomy with removal of intracerebral hematoma and necrotic cerebral tissue
good recovery

wm
45 year old man
ruptured intervetebral discs, L3-L4 and L5-S1, right side
partial hemilaminectomies, L3-L4 and L5-S1, right side, with removal of ruptured intervetebral discs
post-operative epidural blood clot and complete laminectomies, L3-L5 with removal of clot
good recovery

am
69 year old woman
left subdural and intratemporal hematomas with encephalomalacia after fall
left temporal craniotomy with evacuation of subtemporal and intratemporal subdural heatomas and subtotal  temporal lobectomy
fair recovery with residual dysphasia

fm
32 year old man
dumbell neurofibroma, T4-T5 level, right upper thorax and intraspinal exrension
right-sided thoracotomy with removal of large right upper neurofibroma
complete laminectomy, T4-T6, with removal of intraspinal component of neurofibroma
good result

jm
51 year old man
metastatic renal cell carcinoma with two distinct cerebral metastases
x-ray or chemotherapy recommended
eventual death

rm
34 year old woman


em
54 year old man
auto accident
left basilar skull fracture
left-sided subdural hematoma
diffuse, sever cerebral contusions with anoxic encephalopathy
multiple abrasions and contusions
left-sided frontal-temporal-parietal craniotomy with evacuation of extensive subdural hematoma and decompression markedly contused left cerebral hemisphere
death

dm
22 year old man
auto accident
right sided subdural and intracerebral hematomas; diffuse cerebral contusions
right frontal temporal-parietal craniotomy with evacuation of subdural and intracerebral hematomas
aspiration pneumonitis, penicilln allergy
six week hospitalization, 8 week convalescence in a rehabilitation facility
eventual good recovery with return to employment

mm
18 year old man
blunt head injury with severe cerebral contusions, cerebral edema
multiple lacerations
fractures of transverse processes, L1 through L4, right
renal contusion
right subtemporal craniotomy and decompression
tracheototmy
bifrontal craniotomy and decompression, anterior right temporal lobectomy
constant CSF monitoring
insertion of vetriculo-peritoneal shunt
multiple carotid arteriograms
pneumencephalogram
persistent coma and eventual death three months after injury

sm
29 year old woman
back and left leg pain of undetermined etiology
normal lumbar myelogram
unchanged

mm
thoracic arachnoidal cyst, T8
laminectomy, T8 and partial laminectomies, T7 and T9 with removal of arachnoid cyst
good result

cm
53 year old man
metastatic transitional cell carcinoma (original bladder cancer) in left frontal lobe
left frontal craniotomy and excisional biopsy of infiltrating metastatic carcinoma
subsequent radiation therapy
intractable left facial and forehead pain
posterior fossa craniectomy and infratentorial section of trigeminal neve
good initial recovery, but death after some months after continued tumor growth

cm
65 year old woman
right acoustic neurinoma
right suboccipital craniectomy and partial removal of acoustic neurinoma
fair recovery with residual right facial weakness

rm
34 year old woman
right frontal-temporal glioblastoma multiforme with intracerebral hemorrhage
right temporal lobectomy and subtotal removal of infiltrating glioblastoma multiforme
radiation therapy
headache and recurrent seizures
death within two years


mm
80 year old woman
diabetes mellitus, arteriosclerotic cardiovascular heart disease, chronic obstructice pulmonary disease
post-herpetic neuralgia with intractable right upper chest and right arm pain
stereotactic cervical cordotomy
good initial relief of pain
two years after stereotactic procedure recurrent pain
Laminectomy at T1-T4 with right-sided posterior rhizotomy, T1-T4
Good relief of preoperative pain
Discharge to rehabilitation facility


om
60 year old woman
neural hearing loss, left ear; olfactory perversions, multiple somatic and psychologic complaints -
under long-standing psychiatric care

at age 71
massive left-sided intracerebral hemorrhage
death

pm
2 year old female infant
right-sided temporal parietal skull fracture with epidural hematoma after fall down stairs
right frontal-craniotomy with removal of epidural hematoma
good recovery

am
68 year old man
progressive paraplegia
thoracic laminectomy T-9 and T-10 with subtotal removal of epidural metastatic carcinoma and spinal cord decompression
transfer to referring hospital in stable condition with persistent paraplegia

wm
68 year old man
right-sided subdural hygroma, left-sided temporal lobe contusion
right-sided burr holes with removal of subdural hygroma; left temporal craniectomy and subdural exploration
good recovery


mm
55 year old woman
subarachnoid hemorrhage following rupture of left cerebellar arteriovenous malformation
left posterior fossa craniectomy and evacuation of hematoma
subsequent (4 weeks after initial craniectomy) obliteration and excision of arteriovenous malformation in left cerebellar hemisphere
good recovery

rm
38 year old woman
head trauma following altercation with intoxicated husband
right-sided subdural hematoma
right frontal-temporal-parietal cranitotomy with evacuation of subdural hematoma
good recovery

km
78 year old woman
trigeminal neuralgia
alcohol block of second division of trigeminal nerve in foramen rotundum
right infraorbital neurectomy five years later for recurrent paingood result

jm
69 year old man
right parietal glioblastoma multiforme
right frontal-temporal craniotomy with subtotal of an infiltrating glioblastoma multiforme
continued deterioration until death

an
63 year old woman
spinal meningioma, T9-T10 level
Laminectomy, T9-T10 with total removal of intradural meningioma
good result

cn
60 year old woman
intractable left-sided pain
C1-C-2 laminectomy and anterolateral cordotomy
good result

hn
73 year old man
left-sided subdural hematoma after falling and striking head
left temporal-parietal craniotomy and removal of subdural hematoma
epidural and recurrent subdural hematoma eight days after initial surgery
pneumonitis
poor long term recovery
transferred to chronic care

co
17 year old boy
compression fracture and disloction, C5, following dive into shallow water
acute central cervical cord injury with quadriparesis
application of halo and subsequent posterior cervical fusion, C3 through C6
good result

lo
15 year old boy
blunt trauma to head
left frontal skull fracture with epidural and intracerebral hematomas
craniotomy and evacuation of hematomas
good result

do
76 year old woman
left-sided glioblastoma multiforme
left parietal craniotomy with subtotal removal of infiltrating malignant tumor
limited recovery
transfer to nursing home care

vo
74 year old woman
left-sided subdural hematoma
left temporal-parietal craniotomy with remvoal of subdural hematoma
good result

so
7 month old girl
left parietal epidural and subdural hematomas after fall from dressing table
left parietal craniotomy and evacuation of epidural and subdural hematomas
good result

jo
7 year old boy
open comminuted depressed skull fracture and epidural hematoma
right frontal craniectomy, debridement and removal of epidural hematoma
good result

jo
22 year old man
head trauma after after ejection from automobile in accident
multiple injuries including intra-abdominal bleeding; multiple lacerations, open comminuted skull fracture,
right-sided epidural hematoma
splenectomy
right-sided frontal-temporal-parietal craniotomy with evacuation of an epidural hematoma; removal of bone flap to accommodate cerebral swelling
methylmethacrylate cranioplasty
limited recovery after three months' hospitalization, then transfer to rehabilitation unit for surgeryan additional three months, and later to facility for extended care

ep
54 year old man
subarachnoid hemorrhage following rupture of a left anterior cerebral artery aneurysm
craniotomy with clipping of aneursym and subtotal frontal lobectomy of swollen infarcted brain
death three days after surgery

mp
63 year old woman
right temporal subarachnoid and intracerebral hemorrhage with massive brain swelling
bilateral carotid arteriograpahy with scant intracranial filling
suspected ruptured right middle cerebral artery aneurysm
conservative management
death on initial day of sdmission
ap
60 year old woman
intractable pain secondary to widespread metastatic carcinoma of the colon
bilateral cordotomy
death three weeks after surgery

wp
28 year old man
right temporal-parietal skull fracture and fracture of odontoid process and posterior rim of C1 after trauma
posterior cervical fusion
1 1/2 years later removal of superficial chronic abscess and foreign body reaction
good result

jp
68 year old man
found unconscious in apartment
left-sided subdural and intracerebral hematomas with subsequent coma
left sided frontal-temporal craniotomy and evacuation of subdural and intracerebral hematomas and
   subtotal left frontal lobectomy
death five days after admission to hospital

sp
56 year old woman
torticollis and cervical spondylosis
C1-C5 laminectomy and section of spinal accessory nerves and C1-C3 anterior roots bilaterally
respiratory arrest on second post-operative day with brain stem infarction and post-anoxic encephalopathy
death seven weeks after surgery

ap
66 year old woman
subarachnoid hemorrhage secondary to ruptured left internal carotid posterior communicating artery aneurysm
craniotomy and clip obliteraton of ruptured aneursym
vasospasm and ceebral infarction
paroxysmal atrial tachycardia
death seven days after initial subarachnoid hemorrhage

pp
59 year old woman
T1-T2 intraspinal meningioma
T1-T2 laminectomy and complete removal of anterolateral meningioma
good result

gp
45 year old woman
right frontal glioblastoma multiforme
right frontal craniototmy and subtotal removal of infiltrating glioblastoma multiforme
post-operative radiotherapy
initial good result, but slow decline and eventual death within two years

mp
65 year old woman
metastatic epidural thoracic adenocarcinoma
complete laminectomy, T2, T3 and T4 with subtotal removal of epidural metastatic adenocarcinoma
death two months after surgery

jp
33 year old woman
hydrocephalus secondary to posterior fossa medulloblastoma
ventriculoperitoneal shunt
posterior fossa craniectomy and subtotal removal of malignant tumor
post-operative radiotherapy
good result for three years after surgery, "lost" to follow-up thereafter

hp
55 year old man
subarachnoid hemorrhage after rupture of posterior communicating aneurysm
diffuse vasospsm
left frontal temporal craniotomy and clip obliteration of aneurysm
subarachnoid bolt and intracranial pressure monitoring
death one week after initial hemorrhage

lp
65 year old man
essential hypertension
right-sided intracerebral hematoma
right frontal temporal craniotomy and evacuation of intracerebral hemtoma
good recovery with transfer to rehabilitation facility, and then to home

jp
21 year old man with multiple injuries after auto accident
right carotid arteriogram revealed no intracerebral circulation
death on day of injury - anoxic encephalopathy

lp
62 year old woman
essential hypertension and arteriosclerotic cardiovascular disease
subarachnoid hemorrhage after rupture of left posterior communicating aneurysm
left frontal temporal craniotomy with clip obliteration of aneursym
massive left-sided cerebral infarction on sixth post-operative day
death twelve days after initial hemorrhage

gp
55 year old woman
right parietal meningioma
right parietal craniotomy and total removal of an 80 gram meningioma
good recovery

dr
28 year old woman
multiple injuries after auto accident, including pelvic and rib fractures
protruding central intervertebral disc revealed by myelogram
conservative management
good recovery

er
59 year old woman
left internal carotid posterior communicating artery aneurysm
coma after initial hemorrhage
recurrent massive hemorrhage four days after initial rupture of aneurysm
death

pr
48 year old woman
cerebellar vascular hamartoma
posterior fossa craniectomy and partial removal of hamartoma
good initial recovery, but
massive right-sided frontal intracerebral hemorrhage two months after cerebellar bleeding
death

dr
49 year old man
right-sided intraventricular ependymoma
right-sided parietal craniotomy with total removal of ependymoma
post-operative meningitis
transferred to Veteran's Hospital for ongoing care

dr
40 year old man
multiple deep left and right-sided intracerebral abscesses
right frontal-temporal craniototomy and decompression
eventual death

dr
18year old woman
coma after blunt head injury in auto accident
subdural hematoma, severe cerebral edema
left frontal-temporal craniotomy
tracheotomy
persistent coma and arteriography two days after injury showed no intracranial circulation
death on third day after injury

fs
57 year old man
severe head injuries and coma after being struck by automobile
basilar skull fracture, right-sided epidural and subdural hematomas
right-sided frontal-temporal-parietal craniotomy with evacuation of epidural and subdural hematomas
tracheotomy
persistent unconsciousness and death on eighteenth post-injury day

js
65 year old man
cervical spondylosis and quadriparesis
cervical laminectomy C3 through T1 with section of dentate ligaments
benign prostatic hypertrophy
duodenal ulcer
good result with lessening of quadriparesis

gs
21 year old man
multiple injuries after motorcycle accident
post-traumatic coma, blunt head injury with scalp lacerations, subdural hematoma, multiple cerebral contusions
right radius fracture
multiple facial fractures
right frontal-temporal craniotomy with evacuation of subdural hematoma
repair of limb and facial fractures
transfer to rehabilitation hospital five weeks after injury
Discharge to home after five weeks rehabilitation
Return to full-time employment
 
as
76 year old man
left-sided temporal-parietal intracerebral hematoma
left-sided temporal-parietal craniotomy and evacution of intracerebral hematoma
good result

hs
72 year old man
long-standing hypertension
massive right-sided frontal-temporal intracerebral hemorrhage
extensive gout
right-sided frontal temporal craniotomy and evacuation of intracerebral hematoma
death on first post-operative day

ms
69 year old woman
malignant left-sided astrocytoma (Grade II-III)
left frontal-temporal craniotomy and subtotal removal of infiltrating malignant tumor
chronic obstructive pulmonary disease
good temporary result with transfer to an extended care facility

ms
60 year old woman
left basilar skull fracture, subdural hematoma and cerebral contusions after falling down stairs, coma
right frontal-temporal-parietal craniotomy with evacuation of extensive subdural hematoma
death two days after admission and urgent surgery

ns
69 year old woman
coma after extensive right-sided cerebellar and midline vermis intracerebral hemorrhage
posterior fossa craniectomy nd evacuation of right-sided and midline vermis hemorrhage
death on third post-operative day

cs
27 year old man
post-traumatic ulnar nerve neuroma and external scar tissue formation
exxision of scar tissue and neurolysis
good result with gradual return of function

cs
15 year old girl
anoxic encephalopathy secondary to blunt trauma after fall on ice
parietal occipital fracture
no operative intervention
death two days after injury

js
32 year old man
self-inflicted gunshot wound to the head
left frontal craniotomy with left frontal lobectomy and removal of necrotic brain and bullet fragments
fascia lata repair of dural lacerations
death two days after injury

es
80 year old womn
normal pressure hydrocephalus. diabetes, essential hypertension
hepato-cellular carcinoma
right-sided ventriculo-peritoneal shunt
stable course and discharge to nursing home care

as
79 year old woman
pituitary chromophobe adenoma
communicating hydrocephalus
right frontal-temporal craniotomy and removal of suprsellar tumor
insertion of right ventriculoperitoneal shunt
recurrent pulmonary embolism secondary to illiofemoral phlebothrombosis
death

gs
61 year old woman
coma after rupture of left middle cerebral aneurysm and resultant temporal lobe hematoma
left temporal craniectomy and evacuation of intracerebral hematoma
death two days after initial hemorrhage

ds
17 year old girl with C4 compression fracture and C3-C-4 subluxation after auto accident
cervical fusion from C2 through C6 with methyl methacrylate dowel fixation
good result

js
73 year old man
right-sided internal carotid cavernous sinus fistula following auto accident
right-sided frontal temporal craniotomy with embolization of internal carotid artery and ligation of internal,         external and common carotid arteries
good result

as
79 year old woman
trigeminal neuralgia
alcohol injection of left foramen rotundum and infrorbital foramen
good result with relief of pain

ms
50 year old woman
chronic alcoholism
acute extensive left-sided subdural hematoma after fall
post-operative recurrent subdural and epidural hematomas
successive craniotomies with removal of hematomas and dural decompression
tracheotomy
atelectasis and tracheobronchitis
death three weeks after injury

gs
36 year old man
thrombosis of the left internal carotid artery with cerebral infarction
massive left-sided cerebral swelling
craniotomy and decompression
postoperative subgageal abscess
reopening of craniotomy and drainage of abscess
limited recovery before transfer to VA hospital for continued care
 
ks
3 year old child
open, depressed left frontal skull fracture after fall
left frontal craniectomy with elevation of open depressed skull fracture, evacuation of epidural hematoma and     repair of forehead laceration
good result

ms
47 year old woman
paraplegic patient with increasingly severe right hip pain
history of two previous thoracic cordotomies for pain relief
unsuccessful left-sided anterolateral stereotactic cordotomy
Laminectomy, T1-T2 with anterolateral cordotomy at the T2 level
good result

is
64 year old woman
right-frontal parietal astrocytoma
right-sided craniotomy and subtotal removal of infiltrating glioma
fairreult and discharge to nursing home care

vs
44 year old man
coma following multiple skull fractures after falling from steam roller
right temporal craniectomy with temporal lobectomy and fascia lata graft of multiple dural lacerations
tracheotomy
limited recovery before transfer to rehabilitation facility
death two months after injury

cs
65 year old man
right frontal astrocytoma, grade II
right frontal craniotomy and subtotal removal of infiltrating astrocytoma
fair recovery and transfer to rehabilitation facility, discharged therefrom after one month
patient moved to California to be with family
lost to follow-up

bs
18 year old woman
left frontal-parietal ganglioglioma
obstructive hydrocephalus
history of ventriculo-atrial shunting
ventriclocisternosotomy
death two months after hospital admission

bs
25 year old woman
self-inflicted gunshot wound through right temporal area
bifrontal craniotomy, decompression and subtotal right frontal lobectomy
death

es
53 year old woman
widespread metastatic breast carcinoma with right frontal lobe metastasis
left frontal-temporal craniotomy with total removal of metastatic tumor
discharge to home for chemotherapy

ds
38 year
old man
basilar skull fracture after fall from truck
bilateral epidural hematomas
biparietal craniotomies with evacuation of epidural hematomas
good result

ps
6 year old child
depressed right temporal parietal skull fracture and epidural hematoma
elevation and debridement of right-sided comminuted temporal parietal skull fracture with evacuatpsion of epidural hematoma and replacement of bone fragments
good result

ps
43 year old woman
coma after being struck by truck
right-sided basilar skull fracture with associated subdural hematoma, cerebral contusions and massive cerebral edema
right-sided frontal-temporal-parietal craniotomy with decompression and evacuation of subdural heatoma
death in post-operative period

rs
34 year old man
calcified ruptured intervertebral discs, C5-C6 and C6-C7
hemilaminectomies and nerve root decompressions
good result

cs
50 year old woman
right frontal glioblastoma multiforme
right frontal temporal craniotomy with subtotal removal of infiltrating tumor
death 2 1/2 months after initial diagnosis

ss
55 year old man
right-sided glioblastoma multiforme
right-sided parieral occipital craniotomy with partial excision of an infiltrating glioma and decompression
acute massive pulmonary embolism and death 2 1/2 weeks after surgery

ms
44 year old woman
calcified ruptured intervertebral disc, T9-T10
urinary tract infection
T8-T10 complete laminectomy and dural decompression
good result

bs
42 year old woman
arachnoidal cyst, T-2 level
laminectomy at T-2 with removal of arachnoidal cyst and dural decompression
post-operative epidural hematoma
re-opening of laminectomy with removal of epidural clot and bipolar coagulation of epidural venous varicosities
good result

ms
42 year old woman
single vehicle auto accident, striking a tree after sliding off ice-covered road
left-sided basilar skull fracture with associated left facial nerve paresis
right-sided subural and intracerebral hematomas
transient diabetes insipidus
conservative non-operative management with eventual good recovery 6 months after injury

cs
54 year old man
left-sided C6-C7 ruptured intervertebral disc
C6-C7 hemilaminectomy and removal of ruptured disc
good result

ds
18 year old man
cervical spinal cord contusion following head and neck impact during football game
cervical traction and conservative management
good result

es
60 year old man
metastatic esophageal carcinoma and intractable right sided pain
percutaneous radiofrequency cervical cordotomy
limited pain relief

fs
77 year old man
left-sided subdural hygroma
left-sided burr holes and temporal craniectomy with evacuation of subdural hygroma

ms
74 year old woman
right parietal-occipital glioblastoma multiforme
right parietal-occipital craniotomy with subtotal removal of infiltrating glioma
limited recovery and transfer to extended care facility

ms
55 year old woman
ruptured intervetebral disc, L5-S1, left
partial hemilaminectomy, L5-S1, with removal of ruptured intervertebral disc
good result

os
50 year old man
right frontal glioblastoma multiforme
right frontal temporal craniotomy with subtotal removal of infiltrating glioblastoma multiforme
initial good result, but eventual deterioration and death

ps
35 year old man
left-sided subdural hematoma following karate session
left temporal-parietal craniotomy with evacuation of subdural hematoma
good result

rt
27 year old man
self-inflicted gunshot wound to the head
death soon after admission to hospital

jt
81 year old man
right-sided intracerebral hemorrhage and hematoma
right-sided frontal craniotomy with evacuation of intracerebral hematoma
generalized sepsis
death ten days after onset of illness

rt
37 year old woman
right-sided astrocytoma
right-sided frontal-temporal-parietal craniotomy with subtotal removal ofinfiltrating tumor
good initial result with post-operative radio- and chemotherapy

st
21 year old woman
C-2 bilateral posterior arch fracture with C2-C-3 subluxation
Vinke tong cervical traction followed by neck brace for three months
good result

ht
49 year old man
coma following subarachnoid hemorrhage and massive cerebral swelling
bifrontal craniotomy with decompression and subtotal left frontal lobectomy
death

mt
18 year old man
leftparaplegia following T4 fracture dislocation after motorcycle accident
skeletal traction
stable and eventual transfer to extended care facility

bt
67 year old man
Paget's Disease and associated osteogenic sarcoma arising from frontal bone
bifrontal craniotomy and subtotal removal of osteogenic sarcoma
subsequent radiation and chemotherapy
eventual death with extension of tumor

jt
20 year old man
"old" comminuted supracondylar fracture with median nerve contusion, left arm
left antecubital exploration and external neurolysis of median nerve
stable post-operative condition

it
57 year old woman
right-sided subdural hematoma after fall
craniotomy and evacuation of subdural hematoma
recurrent subdural and associated epidural hematomas
2nd craniotomy and removal of hematomas and bone flap
good recovery and subsequent replacement of bone flap with methyl methacrylate cranioplasty

rt
72 year old woman
hypothyroidism
left-sided parietal occipital hematoma
left parietal-occipital hematoma with evacuation of extensive intracerebral hematoma
good recovery

jt
79 year old man
left frontal-parietal convexity meningioma
left frontal-parietal craniotomy and removal of large convexity meningioma
good result

dt
29 year old man
post-traumatic communicating hydrocephalus
ventriculo-atrial shunt with Hakim valve
revision of malfunctioning ventriculo-atrial shunt
good result

fu
35 year oldman
protruding left-sided intervertebral disc, C5-C6
conservative cervical traction at home
good result

vu
32 year old woman
multiple neurologic symptoms and signs
multiple sclerosis final diagnosis

wu
55 year old man
left ulnar neuropathy
external neurolysis and anterior transplantation of left ulnar nerve
recurrent symptoms four months after surgery
partial residual left ulnar nerve entrapment
2nd operation to extend decompression both proximally and distally
good result

av
68 year old man
normal pressure hydrocephalus
ventriculoperitoneal shunt
limited improvement of gait and dementia

pv
32 year old woman
carpal tunnel syndrome
section of right transverse carpal ligament
good result

jv
54 year old man
history of subdural hygroma treated with bilateral burr holes
chronic alcoholism
metastatic pulmonary carcinoma with thoracic cord compression and paraplegia
Laminectomy, T1-T-3, with subtotal removal of medastatic epidural carcinoma and spinal cord decompression
death twelve days after surgery

jv
67 year old man
cerebral astroyctoma
left-sided parietal craniotomy and subtotal removal of infiltrating asgrocytoma
death two weeks after surgery

sv
34 year old woman
ruptured intervertebral disc, L4-L5, left
good result

bv
18 year old man
L3 compression fracture with cauda equina compression
Oainectomy, L2-L3, with wired fixation of L1 to L4
good result

jw
12 year old girl
severe head trauma after being struck by automobile
anoxic encephalopthy following frontal parietal skull fracture
"expectant" treatment
death on day after injury

ew
75 year old man
carpal tunnel syndrome
section of right tansverse carpal ligament
good result79 year old woman

ew
41 year old woman
epidural metastatic carcinoma to C7-T1 vetebral level with spinal cord compression
Laminectomy and subtotal removal of metastatic epidural carcinoma
death five weeks after surgery

gw
79 year old woman
bilateral chronic subdural hematomas
left temporal-parietal craniotomy and right-sided burr holes with evacuation of chronic subdural hematomas
good result

ww
29 year old man
C-5 compression fracture with C5-C6 displacement after diving accident
Vinke tong application
posterior cervical fusion
good result

fw
32 year old woman
carpal tunnel syndrome
section of right transverse carpal ligament
good result

lw
65 year old woman
normal pressure hydrocephalus with accompanying dementia
ventriculo-peritoneal shunt
good result

mw
31 year old man
ruptured intervetebral disc, C6-C7, left
partial hemilaminectomy, C6-C-7, with removal of ruptured intervertebral disc
good result

ew
47 year old man
protruding right-sided intervetebral disc, C5-C6
good result with cervical traction

tw
17 year old man
diving accident with fracture at C6-C7, cervical contusion and quadriparesis
Application of Vinke tongs
posterior cervical laminectomy, C5-C7, and spinal cord decompression
anterior cervical fusion C6-C7 for C6 tear drop fracture
moderate recovery of function before transfer to rehabilitation unit

cw
65 year old man
coma
ruptured right internal carotid-posterior communicating artery aneursym and intracerebral hemorrhage
right frontal-temporal craniotomy, evacuation of intracerebral hematoma
tracheotomy
death two weeks after initial hemorrhage

rw
44 year old man
quadriplegia secondary to C-5 compression fracture and dislocation following diving accident
Vinke tong stabilization
Stable deficit, transferred ro rehabilitation facility

cw
75 year old woman
trigeminal neuralgia
left foramen rotundum alcohol block
good result

lw
60 year old woman
diabetes mellitus
ulnar neuropathy secondary to entrapment at the elbow
ulnar nerve transposition
good result

gw
19 year old man
right-sided intratemporal and infrafrontal hematomas after falling and striking head
right frontal temporal craniotomy and removal of hematomas and encephalomacic anterior temporal lobe
good result

gw
87 year old man
metastatic epidural carcinoma, T-4 level
Laminectomy, T3-T4 with dural decompression and subtotal removal of metastatic epidural carcinoma
stable follwoing decompression, discharged to home care

ew
63 year old woman
degenerative cervical disc disease
conservative management with traction and collar
moderate diminution of symptoms

rw
18 year old man
frontal-temporal skull defect following "out-of-town" cranial surgery in month preceding office visit
Initial surgery for post-traumatic epidural hematoma with removal of bone flap
left frontal-temporal methylmethacrylate cranioplasty
post-operative subgaleal hematoma aspiration x2
good result

mw
36 year old woman
degenerative cervical arthritis
conservative management with traction
limited improvement

gw
53 year old man
bilateral subdural hygromas
bilateral burr holes with evacuation of subdural hematomas
good result

rw
55 year old woman
thoracic arachnoidal cyst
Laminectomy of T4-T-8 with dural decompression and removal of arachnoidal cyst
good result

jw
57 year old man
basilar arachnoiditis with non-communicating hydrocephalus
ventriculo-atrial shunt with Holter valve
good result

iw
71 year old man
intractible pain associated with recurrent right-sided tonsillar carcinoma
posterior fossa craniectomy and infratentorial section of glossopharyngeal and two root heads of vagus nerves
death six days after surgery

sw
78 year old woman
normal pressure hydrocephalus
right-sided ventriculo-peritoneal shunt
good result

hw
74 year old man
right-sided cerebellar hemorrhage
posterior fossa craniectomy and evacuation of intracerebellar hematoma
good result

kw
4 year old girl
history of open fracture of right frontal bone after a fall
subsequent subgaleal abscess
drainage of abscess and antibiotic treatment
good result

rw
46 year old man
intractable neck pain secondary to recurrent tonsillar carcinoma
posterior fossa craniectomy and left hemilaminectomy, C1-C2, with glossopharynrgeal rhizotomy, upper left rootlets of left vagus nerve and posterior rhizotomies at C2 and C3 levels
pain relief, but death one month after surgery

hw
83 year old woman
post-anoxic encephalopathy following cardiac arrest
expectant treatment
death

fw
75 year old woman
right-sided cerebral glioblastoma
right temporal-parietal craniotomy with subtotal removal of infiltrating glioblastoma multiforme
limited recovery before transfer to nursing home 

sw
42 year old woman
protruding cervical disc, C5-C6
treated with cervical traction and cervical collar
good result

rw
68 year old man
carotid artery stenosis
right carotid endarterectomy with vena saphena magna patch graft
good result

cw
77 year old woman
cerebral infarction following spontaneous internal carotid artery occlusion
death

gw
79 year old man
Left-sided epidural and subdural hematomsa
left frontal-temporal parietal craniotomy with evacuation ofepidural and subdural hematoms
good result

cw
19 year old woman
passenger on motorcycle
C4-C5 fracture dislocartion
C3-C6 posterior cervical fusion with autogenous iliac bone graft
Crohn's disease
good result

fw
52 year old man
right sided astrocytoma
right-sided craniotomy with subtotal removal of infiltrating tumor
discharged one month after surgery for continued supportive care
death seven months after initial diagnosis

jw
51 year old woman
hypertensive cardiovascular disease
coma following massive right-sided intracerebral hemorrhge and tonsillar herniation
right carotid arteriogram
death soon after hospital admission

jw
71 year old woman
massive left-sided intracerebral hemorrhage and resultant coma
left carotid arteriogram
expectant care
death soon after hospital admission

bw
81 year old woman
fall with C5-C6 fracture dislocation and resultant
Vinke tong application and closed reduction of cervical dislocation
anterior cervical fusion, C5-C6, with dowel insertion from right iliac crest
revision of fusion with wire and methylmethacrylate fixation to remedy previous postoperative movement of dowel

sw
68 year old woman
temporal arteritis
superficial temporal artery biopsy
good result

aw
45 year old man
subarachnoid hemorrhage following rupture of left-posterior communicating-internal carotid aneurysm
craniotomy and clipping of aneurysm
good result

pw
62 year old woman
left-sided subtemporal hygroma
leftisided craniotomy and removal of hygroma
good result

mw
68 year old woman
coma following subarachnoid hemorrhage following rupture of left-posterior communicating-internal carotid aneurysm
craniotomy and clipping of aneurysm
death three days after initial hemorrhage

dw
19 year old man
auto accident with multile injuries, including severe head injury and anoxic encephalopathy
no intracranial circulation seen on right carotid arteriogram
death within hours after admission to hospital

ew
68 year old woman
left carpal tunnel syndrome
section of left transverse carpal ligament
good result

ez
66 year old woman
coma following rupture of left middle cerebral aneurysm with large intratemporal hematoma
craniotomy with evacuation of hematoma and clip obliteration of multilobulated middle cerebral artery aneurysm
death on first post-operative day

hz
56 year old man
cervical spondylosis
C3-C7 laminectomy with dural decompression
good result

rz
42 year old man
pain secondary to malignant hepatoma with infiltration of sacrum
L4-L5 laminectomy with subtotal removal of epidural infiltrating metastatic carcinoma extending into right sacrum
post-operative radiotherapy
eventual death

  






 







 

 
 



pv