The surgical treatment of brain abcess by exposure and enucleation / Robert A. Groff and Francis C. Grant.

  • Groff, Robert A. (Robert Armand), 1903-
Date:
[1940?]
Catalogue details

Licence: In copyright

Credit: The surgical treatment of brain abcess by exposure and enucleation / Robert A. Groff and Francis C. Grant. Source: Wellcome Collection.

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    VOL. Ill JUNE, 1940 No. 6 THE SURGICAL TREATMENT OF BRAIN ABSCESS BY EXPOSURE AND ENUCLEATION Robert A. Groff, M.D. and Francis C. Grant, M.D. Philadelphia, Pa. FROM THE NEUROSURGICAL SERVICES OF THE HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA AND GRADUATE HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA, PHILADELPHIA, PA. The procedure of enucleation of an “encapsulated” brain abscess was considered, by Sargent,1 to be the best method of treatment. He reported, in 1928, without giving details, five patients successfully treated in whom the abscess had been removed. More recently, Vincent2 has renewed the interest in this method of treatment and has proved its value. Up to the present time, he has reported five patients. The abscess, in each instance, was exposed and removed without rupture. By our successful use of this method of treatment for brain abscess in six of seven patients, we wish to add further support to the procedure of complete enucleation, and from the experience gained, out¬ line the surgical management of a patient in whom the diagnosis has been made. Case 1.* *—Synopsis: Intracranial symptoms for six weeks. Signs of intracranial hypertension and bilateral sixth and seventh cranial nerve involvement. Ventriculogram: Lesion in right frontoparietal lobes. Craniotomy and complete removal without rup¬ ture of a walled abscess. Recovery. E. S., Hosp. No. 125122, female, age 20, was admitted to the Graduate Hospital, September 12, 1936, having been referred by Dr. J. C. Yaskin, Philadelphia, Pa. About three months prior to admission, the patient had had a tonsillectomy performed, under local anesthesia, without any untoward effects. Six weeks later she began complaining of headache and somewhat later of diplopia, loss of vision and vomiting. During the few days preceding admission to the hospital the pain in the head had become more severe. Physical Examination.—Temperature 99.30 F., pulse 64, respirations 22. Neurologi- cally, she was mentally clear, had some rigidity of the neck, a bilateral Kernig, a bilateral papilledema of about three to four diopters, a cut in the left temporal field, weakness of both external recti muscles, more marked on the left than on the right, a paralysis of both seventh nerves, more marked on the right than on the left, and no significant changes in the extremities. The spinal fluid pressure was 350 Mm. of water, and the spinal fluid showed five lymphocytes. Submitted for publication June 8, 1939. * Previously reported as Case 1, Brain Abscess of Undetermined Etiology, J. C. Yaskin, F. C. Grant, and R. A. Groff, Annals of Surgery, 107, 492, April, 1938.
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