The meningiomas arising from the olfactory groove and their removal by the aid of electro-surgery / [Harvey Cushing].

  • Harvey Williams Cushing
Date:
1927
Catalogue details

Licence: In copyright

Credit: The meningiomas arising from the olfactory groove and their removal by the aid of electro-surgery / [Harvey Cushing]. Source: Wellcome Collection.

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    tedious procedure since it was necessary, after the removal of each fragment, to delay until bleeding from the raw surface could be checked. All told, an amount of tissue (Fig. 16) weighing 78 gm. was thus removed. The patient’s blood-pressure by this time had begun to fall off and it was deemed wise to postpone the attempt to dislodge the remaining mass of the growth for a third session. A sufficiently generous excavation of the tumour had been made to permit the firm encircling edges of the cavity to be collapsed and sewed together. The sutures were left long so that they could be tugged upon in the hope thereby of draw¬ ing the growth forward at the subsequent opera¬ tion should she survive to have one. In withdraw¬ ing from the incompleted enucleation not only was it impossible because of the contusion and oedema of the frontal lobe to re¬ suture the dura, but it was found that it would even be dangerous to re- o ]5 ?f i i i i«(l HT» 1 i ffTuTtYJh7f *; <! j * < > i j t s =«<* TiTsTTji ifTnCj 4* 5! 6 7 8! ' 9l Fig. 17.—Case I. Anterior view (nat. size) of posterior portion, weighing 126 gras., of large unilateral olfactory-groove meningioma removed at second session. Sutures close the cleft from which the fragments (cf. Fig. 16) had been previously removed. place the osteoplastic flap without risk of compres¬ sion. Consequently the cranial portion of the flap had to be sacrificed and the scalp alone was closed over the raw surface of the brain, protected merely by an intervening layer of gutta-percha tissue. At the conclusion of the operation, owing to loss of blood, transfusion was necessary, and it was some hours before she was regarded as out of danger. The convalescence was stormy. Owing to tension the wound barely held, and fearing that it might part and a fungus cerebri develop unless the remaining portion of the tumour was soon removed, we were forced into a final-stage operation on the ninth day. Accordingly, on February 6, ig22, the flap was again reflected and the tumour exposed. By drawing upon the previously-placed sutures c
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