תוצאת חיפוש

Temporal Hemianopia And Diabetes Insipidus Following Head Injury

M. Zaaroor, D. Goldsher, M. Feinsod

Center for Treatment and Applied Research in Head Injuries, Dept. of Neurosurgery and Diagnostic Radiology Dept., Rambam Medical Center and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa

Bitemporal hemianopia and diabetes insipidus following head injury are caused by a lesion in the center of the optic chiasm, together with injury to the adjacent pituitary stalk or the hypothalamus. This combination was thought to be a rare complication of severe head injury. The case of a 16-year-old male is presented, which together with recent reports suggests that this relatively under-recognized syndrome is not infrequent, that it may follow even minor head injury, and that magnetic resonance imaging can demonstrate the chiasmal lesion.

Volume Reduction Surgery in Emphysema

M.R. Kramer, I. Bar, I. Eidelman, M. Bublil, I. Nitzan, C. Sprung, S. Godfrey, G. Merin

Depts. of Cardiothoracic Surgery and Anesthesiology, and Institute of Pulmonology, Hadassah-University Hospital and Hebrew University-Hadassah Medical School, Jerusalem

Volume reduction surgery (VRS) is a new procedure based on the concept that relieving hyperinflation in emphysema improves diaphragmatic and chest wall mechanics and ventilation perfusion mismatch. We present our early experience with 16 patients who underwent VRS from August 1995 to June 1996. Patient selection was based on: PFT, CT scan, V/Q scan, ABG's and 6-min walk. After pulmonary rehabilitation, operation was by median sternotomy and bilateral lung shaving. Pulmonary function improved significantly. FEV1 increased from 0.68 ± 0.2 to 1.0 ± 0.2 L (p<0.01) and FVC increased from 1.7 ± 0.5 to 2.7 ± 0.5 L (p<0.017). Total lung capacity decreased from 129% ± 24% to 108% ± 20% (p<0.03). 6-min walk increased from 221 ± 90 to 404 ± 123 meters (p<0.001). Complications included 1 death, prolonged air leak in 7 cases and infection in 2. Quality of life improved substantially in 12 of the 16 cases; in 3 cases there was only slight improvement and in 1 the condition became worse. Volume reduction surgery is a promising surgical solution in selected patients with advanced emphysema.