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Case \". — Cerebral Sinus Following Operation for Cyst. J. Order Lotrisone A. P., Lotrisone Generic aged 30 years, was operated upon three months before by Dr. Floyd W. Mc- Rae, for Jacksonian epilepsy, resulting from a compound fracture just behind the angular proc- ess of the frontal, with resulting brain cyst. By some means his wound was badly infected, and some months afterwards continued to discharge from the Lotrisone Price sinus extending down to the brain. For this condition he was sent to me by Dr. McRae with the request that I operate upon him, and in- sert a plate. Operation July 7, 1904, St. Joseph's Infirmary. An incision was made encircling the former one, exposing quite an area of Betamethasone Cream bone around the seat of the former opening. The bone was cut away to a circle about one and three quarter inch in diameter, adhesions between the scalp and dura, especially at the point of entrance of the sinus, being dissected away as well as pos- sible. The dura was not opened except at the point of the Purchase Lotrisone Online sinus. The plate was inserted in the usual manner, but in spite of all precautions there was a certain amount of infection along the suture openings, though there was apparently no 1I04 NICOLSOX: CELLULOID PLATES L\' SKULL OPERATIONS. deep Lotrisone Uses infection in the wound. As before, there persisted a sinus which discharged cerebrospinal fluid, which was treated first by Dr. McRae and then Lotrisone Lotion myself for several months. Attempts were made to close the tract by application of pure car- bolic acid, passing' it from the lower angle across the plate to the upper edge. This was success- ful and finall}- the sinus closed, Buy Lotrisone but a few days afterwards the patient called at my office com- plaining of headache. Two days later I saw him at home, suffering with intense headache and very stupid. His relief through the treatment was only temporary', his stupor increased steadih', and three or four Purchase Lotrisone days later, when seen by my assist- ant Clotrimazole And Betamethasone during my illness, he was found profoundly comatose, with a pulse of Order Lotrisone Online 45 to the minute. He was moved at once to the infirmar}-. and a diag- nosis was made of brain abscess. In pressing against the plate it was found to be somewhat pushed outward by the intracranial pressure. Operation, Sunday morning, October St. Joseph's Infirmary. Under ether the Lotrisone Otc scalp incision was opened about along the former line, and the plate quickly uncovered. There was no evidence whatever Buy Lotrisone Online of any irritation or in- fection around the plate, but one of the wires which anchored it had been broken. Removing the plate showed the dura, which was rough at the time of the operation, to be perfectly smooth and uniform in its surface, but just in the centre of the area uncovered was a slightly discolored pulsating spot. Here a small opening was made with the point of a scalpel, and a Buy Cheap Lotrisone pair of artery forceps was plunged into the brain Lotrisone Ointment through this opening, and when the blades were separated there was a tremendous gush of pus from an ab- scess in the brain. Introduction of the finger showed this cavity to be about Lotrisone Creme the size of a hen's tgg. A drainage tube was introduced into this cavity and brought out through a puncture through the centre of the flap, and the flap sutured in place. This tube was shortened from day to day, and finally the abscess closed entirely in about six weeks. The interesting feature about this case is that the patient now has a large pul- sating area, that was original!}^ covered over by the plate, and it is so uncomfortable, as compared with his former condition, that even though he has alread}' undergone three operations, he asks that a plate be reinserted for the purpose of com- fort and protection. Case VI. — Insanity Following Depressed Frac- ture and Brain Cyst. B. S., white, male, Lotrisone Online aged 36 years. When 18 years of age, in an altercation he received a blow over the right temple result- ing in a depressed fracture. Within a few months his mind became disturbed, and it was Generic Lotrisone necessary to commit him to the Alabama Insane Asylum. The form of his mania was of the nature of a harmless dementia. He continued in this condi- tion until five years later, when he was oper- ated upon by Dr. A. S. Talley, of Birmingham, Ala. Following the operation there was such de- cided improvement that he was taken home. His mother says that as soon as the opening began to " sink in and Lotrisone Cost get hard," his mind again grew worse, and he was recommitted to the asylum. Another operation was discouraged by the officer of the asj'lum, but he came to me in December

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