Franklin Westhout

• MD
• Carrington Neurosciences Institute

This report provides a rare documentation of spontaneous thrombosis of a ruptured aneurysm followed by delayed recanalization and subsequent rerupture. A 47-year-old female presented with spontaneous subarachnoid hemorrhage (SAH). Four aneurysms were identified on CT angiogram including a basilar apex aneurysm, considered source of bleeding. Cerebr...

Introduction: Langerhans cell histiocytosis (LCH) is a group of idiopathic disorders characterized by the proliferation of specialized bone marrow-derived Langerhans cells (LCs) and mature eosinophils, resulting in solitary or few, indolent and chronic, lesions of bone or other organs called eosinophilic granulomas. Calvarial LCH is quite rare and...

Objective and Importance: The authors report the first known case of a giant multiloculated grape-like enterogenous cyst extending from the upper cervical canal to the ambient cistern. Clinical Presentation/Methods: We report the case of a 40-year-old male who had a prior transmastoid craniotomy at an outside facility 14 months prior with an indete...

Uterine leiomyosarcomas do not frequently metastasize to the bone, and spinal column metastases are even less common. Surgery is the treatment of choice. Adjuvant radiation with or without chemotherapy depending on the extent of disease can be beneficial. We present the case of leiomyosarcoma metastasis to the spine with a previous history of known...

Background: The authors report the first retrospective analysis of all reported cases of death from aneurysmal subarachnoid hemorrhage in the state of New Mexico from 1 January 2001 to 31 December 2007. Methods: Data were obtained from the New Mexico Vital Records and Health Statistics Department in Santa Fe, New Mexico. Results: The incidence...

Chemical prophylaxis using unfractionated heparin (UH) and low-molecular weight heparin is used in surgical patients to prevent venous thromboembolism. There is some evidence that prophylactic doses of heparin may increase the rate of surgical site infection (SSI) after elective orthopedic procedures. Little is known regarding the effect of heparin...

The measurement and treatment of ICP within the management of TBI generally focuses on keeping the mean ICP to less than 20 mm Hg. More sophisticated analysis of the intracranial pressure waveform has yielded important relationships, but those methods have not gained widespread use. Prior analysis of the slope of the ICP waveform during inspiration...

Hematopoiesis outside the bone marrow is known to occur in patients with severe anemia, leukemia, polycythemia, or myelofibrosis, and in patients affected by chronic poisoning by marrow-toxic substances. A 66-year-old right-handed man complained of 4 days of terrible right-sided, sharp, and shooting headache for which he saw his primary care provid...

Neurosarcoidosis presents with meningitis, cranial nerve involvement, and parenchymal masses. Usually, abnormal MR enhancement and/or structural lesion(s) are present. Communicating hydrocephalus arises from meningeal arachnoid granulation involvement. Reported cases of obstructive hydrocephalus have all involved obstructing ventricular lesions. A...

Prolonged cerebrospinal fluid bathing of cranioplasty cement frequently results in breakdown of the cement implants. A 5-year-old boy with a history of severe head trauma at 2 weeks of age presented with marked protrusion of the entire superior temporal bone and inferior parietal bone. The defect was elevated by more than 1 cm and was associated wi...

Schwannomatosis has become a newly recognized classification of neurofibromatosis. Although the genetic loci are on chromosome 22, it lacks the classic bilateral vestibular schwannomas as seen in NF-2. We present the surgical treatment of 4 patients with schwannomatosis, including a brother and sister. Case 1 presented with multiple progressively e...

Intra-arterial verapamil infusion with or without balloon angioplasty is a common therapy for patients with hypertensive, hypervolemic, and nimodipine-refractory vasospasm following aSAH. Seizures occurring from IA infusion of verapamil are rare. A 24-year-old Korean-American woman presented with aSAH from the rupture of a 5-mm ICA bifurcation aneu...

The authors report a case of short-term high-dose propofol-related metabolic acidosis in a 3-year-old girl. The patient initially presented at another institution with left fourth cranial nerve palsy, and examination revealed a large, wide-necked 19 x 22 x 17-mm aneurysm in the left internal carotid artery. She had undergone three previous unsucces...

We describe a case of intraprandial vertebro-basilar insufficiency secondary to posterior cerebral circulation ischemia. Secondary collateralization was seen from facial and external carotid artery branches to the posterior circulation causing facial arterial steal during mastication. This condition was treated endovascularly. Occluded common and e...

Peripheral causes of foot drop are well recognized. However, causes stemming from the central nervous system represent rare, important, and underappreciated differential etiologies. Two cases of foot drop stemming from central causes are described. The first patient, a 46-year-old man with a remote history of lumbar spine fracture and L4-L5 instrum...

Lemierre syndrome is an extremely rare complication of mild-to-moderate pharyngeal infections. The authors present an unusual case of Lemierre syndrome in a 16-year-old boy with cavernous sinus thrombosis and right internal carotid artery narrowing without neurological sequelae, right subdural empyema, and cerebritis in the right temporal and occip...

This report shows that CT fluoroscopy guided anterior approach injections can be effectively utilized for inflammatory conditions affecting the atlanto-odontoid joint, and that steroid injections thus injected can provide pain relief lasting six months in properly selected patients. Patients with underlying rheumatoid arthritis demonstrating signif...

This report shows that CT fluoroscopy guided anterior approach injections can be effectively utilized for inflammatory conditions affecting the atlanto-odontoid joint, and that steroid injections thus injected can provide pain relief lasting six months in properly selected patients. Patients with underlying rheumatoid arthritis demonstrating signif...

The LifePoint™ instrumented assay system is a Continuous Flow Fluorescence Immunoassay (CFFI) Instrument for the detection of drugs of abuse in saliva. The CFFI is a patented method* which utilizes an antibody-fluorescent labeled tracer complex with the antibody covalently bound to the solid phase (cellulose beads). The reagent is packed in micro c...