bluuebunny/crossref_metadata_2025 huggingface dataset:
Radiotherapy of glioblastoma multiforme
Authors: Ramsey Ruth G. , Brand William N.
Published: May 2009

✓ A comparison is made between limited field and whole brain irradiation in the treatment of 60 patients with intracranial glioblastomas, 34 of whom were picked at random for either treatment and 26 who were selected for specific treatment. A significant increase in overall survival time and tumor-free period was found in the limited field treatment groups and this was especially significant in those patients selected for limited field treatment. The improved results are felt to be due to the higher dose permissible because of avoidance of more sensitive brain-stem structures. Tumor location in the frontal lobe also appears significant in the longer survival of those patients selected for limited field treatment. More exact localization of the lesion by brain scan, surgery, and angiography also contribute to more efficient treatment and consequently better survival.
Treatment of protruded lumbar intervertebral discs with chymopapain (Discase)
Authors: Parkinson Dwight , Shields Christopher
Published: May 2009

✓ Thirty-three intervertebral disc patients who otherwise would have been subjected to surgery were treated by injection with chymopapain. The pharmacology, toxicology, physiology, immunology, and chemical action of this enzyme, which specifically reacts with chondromucoproteins, are discussed. Results indicate that this method, although still experimental and unapproved by the U. S. Food and Drug Administration, may become a useful addition to the surgeon's armamentarium in the treatment of intervertebral disc disease.
The H-reflex in experimental spinal cord trauma
Authors: D'Angelo Charles M.
Published: May 2009

✓ The H-reflex, the electrical correlate of the monosynaptic stretch reflex, recorded from the median nerve was monitored in cats sustaining controlled impact injuries to the eighth cervical segment of the spinal cord. The H-wave was unchanged in cats that showed only scattered gray matter petechial hemorrhages, whereas the H-wave could not be recorded in cats with central hematoma formation and central cavitation. With intermediate impact injuries that produced a coalescence of gray matter hemorrhages, the H-wave, although initially present, gradually diminished in amplitude and disappeared completely in approximately 2 hours.
Intradural spinal bronchiogenic cyst
Authors: Yamashita Junkoh , Maloney Anthony F. J. , Harris Phillip
Published: May 2009

✓ The successful treatment of an intradural cervical cyst of apparent bronchial origin in a 14-year-old girl is recorded. Its possible relationship to enterogenous cysts and the split notochord syndrome is discussed.
Unusual hematomas outside the spinal cord
Authors: Schwartz Frederic T. , Sartawi Mohammed A. , Fox John L.
Published: May 2009

✓ Two unusual hematomas outside the spinal cord are reported. One lay on both sides of a synthetic dural graft and was enclosed by regenerating dura. The other occurred within the leaves of the dura in a patient who had recently been under anticoagulation therapy.
Successful treatment of long-standing hystericalpain and visceral disturbances by unilateral anterior thalamotomy
Authors: Andy Orlando J.
Published: May 2009

✓ The author reports a case in which a unilateral anterior thalamotomy successfully relieved chronic recurrent pain and visceral disturbances.
An intracranial cartilage-containing meningeal tumor
Authors: Lynch P. G. , Uriburu E.
Published: May 2009

✓ A case is recorded in which a solitary cartilage containing mesenchymal tumor arising from the dura mater over the convexity of the right cerebral hemisphere was successfully removed. The tumor was composed of mesenchymal tissue in which there were several large islands of typical cartilage, sometimes calcified. Suggestions are made as to the possible classifications of this unusual tumor.
Lumbar disc surgery: technique of radical removal and early mobilization
Authors: Scoville William Beecher , Corkill Guy
Published: May 2009

✓ The operative technique and results of radical removal and early mobilization in lumbar disc surgery are presented. The operation involves decompression of the nerve root ventrally and dorsally and radical removal of disc material. The importance of immediate mobilization and an exercise regime without braces is stressed. Spondylolisthesis with sciatica is treated as a simple disc. The results were good to excellent in 96% of the patients, with a return to work in 2 to 4 weeks. The recurrence rate in 779 cases over 10 years has averaged 2.7%.
The development of an intracerebral glioma model for brain tumor chemotherapy
Authors: Wassenaar Willem , Tator Charles H. , So Wei Sum
Published: May 2009

✓ The authors describe a brain tumor model for chemotherapy studies. The tumor is an intracerebral ependymoblastoma that kills the host in a short time (median survival, 27.5 days) and yields consistent, uniform survival curves. A suspension of tumor cells is injected into the right frontal lobe of the mouse by means of a stereotaxic frame, and produces a highly invasive, almost entirely intracranial brain tumor. The use of mice permits extensive chemotherapeutic trials for brain tumors at low cost. It is felt that this model will prove to be very useful for studies of brain tumor chemotherapy.
Reflex hypotension following carotid endarterectomy: mechanism and management
Authors: Tarlov Edward , Schmidek Henry , Scott R. Michael , Wepsic James G. , Ojemann Robert G.
Published: May 2009

✓ Postoperative changes in blood pressure regulation were studied retrospectively in 56 patients and prospectively in 46 patients after carotid endarterectomy. Hypotension, of a degree sufficient to require pressors and/or volume-expanding agents to maintain systolic blood pressure above 100 mm Hg, associated with bradycardia and low central venous pressure occurred in 41% of the retrospectively studied group. In the prospectively studied group, controllable variables were excluded by standardizing fluid management and anesthetic technique. It was found that infusion of colloid preoperatively, intraoperatively, and postoperatively to maintain central venous pressure above zero markedly reduced the incidence of postoperative hypotension. Denervation of the carotid sinus prevented postoperative hypotension. We hypothesize that the atheromatous plaque damps the pressure wave reaching the carotid sinus baroreceptors. Removal of the plaque results in increased stimulation of these baroreceptors, with a resulting bradycardia and hypotension of neurogenic origin. The data indicate that blood pressure usually returns to its previous level within a few hours. Closely monitored infusion of colloid before, during, and after operation is the recommended form of management.
Local cerebral blood flow in experimental middle cerebral artery vasospasm
Authors: Fein Jack M. , Boulos Roushdy
Published: May 2009

✓ The authors report a study of the effect of middle cerebral artery spasm on cerebral blood flow, its autoregulation, and the subsequent development of ischemic infarction in the rhesus monkey. Spasm induced by puncturing the middle cerebral artery was followed by serial angiography and the determination of “local” cerebral blood flow (1CBF). Xenon133 washout was measured by a collimator whose isoresponse characteristics allowed exclusive sampling from the middle cerebral territory. Before the development of ischemic necrosis, 1CBF varied indirectly with the severity of spasm. The onset of infarction was marked by permanent depression of 1CBF despite recovery of arterial caliber. Despite wide changes in blood pressure, autoregulation of 1CBF was maintained in the normal rhesus monkey. However, soon after the onset of spasm, the 1CBF was constant only during hypotensive periods, and flow values increased significantly during hypertensive periods. When prolonged spasm (22 hrs) caused ischemic infarction, a reversal of the autoregulatory pattern occurred; the 1CBF was constant in the hypertensive period and decreased during the hypotensive period. Although the constancy of the relationship of 1CBF to hypotension in the absence of infarction might indicate a degree of reflex vasodilatation, this could not be substantiated on serial angiography. The therapeutic implications of these findings are discussed.
The prognosis of hydrocephalus overt at birth
Authors: Mealey John , Gilmor Richard L. , Bubb Michael P.
Published: May 2009

✓ The clinical records of 79 infants with congenital hydrocephalus and excessive head size at birth were reviewed to determine the prognosis and results of surgical treatment. In 55 infants hydrocephalus was the principal malformation, and in 24 this condition occurred in association with a myelomeningocele. Follow-up was complete in 69 cases. Of 27 unoperated cases only two are living, and one of these, an achondroplastic dwarf, has normal intelligence. Only one of eight patients treated surgically before Holter valve shunts were introduced has survived, and he is moderately retarded. Of 34 infants treated by ventriculoatrial shunting, 15 have lived up to 15 years and an average of nearly 7 years; five of these survivors have normal intelligence, five are trainable, and six are grossly retarded. Ventricular shunting was accompanied by a significant persisting morbidity, and operative complications, especially sepsis, accounted for 42% of the deaths in this group. Relative head size determined at birth and the type of hydrocephalus demonstrated had no conclusive association with life or death among the uniformly megalocephalic cases. The results showed a positive correlation between early operation for hydrocephalus and survival in the group treated by ventriculoatrial shunting, and this treatment is recommended.
Ventriculoatrial shunt blockage by previous positive contrast ventriculography
Authors: Mendez S. Jorge
Published: May 2009

✓ Obstruction of both Torkildsen and ventriculoatrial shunts by positive contrast medium injected at a previous ventriculography is reported. This complication was surgically confirmed and alleviated. Two similar cases with ventriculoatrial shunts obstructed by Pantopaque are briefly described. All cases presented symptoms of increased intracranial pressure until the contrast medium was eliminated. In cases requiring Pantopaque ventriculography, central ventriculography often permits removal of the opaque medium at the end of the examination, avoiding this complication if shunting is performed later.
Lumbar nerve root compression at the intervertebral foramina caused by arthritis of the posterior facets
Authors: Epstein Joseph A. , Epstein Bernard S. , Lavine Leroy S. , Carras Robert , Rosenthal Alan D. , Sumner Philip
Published: May 2009

✓ The authors report their experience with 12 cases in which the roots of the sciatic nerve were compressed at the intervertebral foramina by degenerative arthritis (arthrosis) of the posterior facets, and in which foraminotomy and facetectomy brought relief of pain. Patients with disc narrowing, spondylolisthesis, and transitional vertebrae place unusual stress on the posterior facets. This may lead to hypertrophy and the development of marginal osteophytes that project downward with eventual constriction of the intervertebral foramen and entrapment of the nerve root. Such alterations are common in patients over 40, and when found in the presence of unremitting sciatic pain without evidence of a herniated disc or other etiology, a causal relationship must be considered.
The normal position of the cerebellar tonsils as demonstrated by myelography
Authors: O'Connor Sheilah , du Boulay George , Logue Valentine
Published: May 2009

✓ The authors describe a reference line from basion to opisthion above which the lower border of the normally positioned cerebellar tonsil can be delineated by Myodil myelography. The study is based on data obtained from 100 cases with normal tonsils.
Extrasellar extension of a pituitary adenoma in a patient with a normal-sized sella turcica and impaired vision from an atheromatous carotid artery
Authors: Clifford John R. , Echols Dean H.
Published: May 2009

✓ Chromophobe adenomas rarely invade the brain without causing enlargement of the sella turcica and without compressing the optic nerves or chiasm. Such a case is reported, in which the patient made a complete recovery after surgical removal of the tumor. Five years later impaired vision in the other eye suggested recurrence of the adenoma. This time surgical intervention disclosed compression of the optic nerve by an atheromatous carotid artery.
Epidural spinal lymphoma in an infant
Authors: Bharati R. Sarasa , Kalyanaraman S.
Published: May 2009

✓ A malignant lymphoma involving the spinal epidural space is reported in a 1½-year-old-boy. This is probably the youngest patient reported with a spinal epidural lymphoma.
Experimental study of irreversible shock and the brain
Authors: Golden Patrick F. , Jane John A.
Published: May 2009

✓ The roles of various organ systems in preventing the phenomenon of irreversible hemorrhagic shock were studied in dogs by artificially maintaining or depriving these systems of circulation. It was found that depriving the abdominal viscera of circulation did not necessarily result in death if the heart and brain were perfused. If the heart was maintained at normal pressures while the rest of the body was subjected to what would have otherwise been a lethal period of shock, the animal nevertheless survived. Thus, in the standard “35 mm Hg shock model” the heart seemed to be crucial. However, in the “30 mm Hg shock model” death occurred even if the heart was adequately perfused, indicating that failure of neural mechanisms accounts for irreversibility at these levels of hypotension.
Hyperoxia of internal jugular venous blood in brain death
Authors: Minami Takao , Ogawa Michio , Sugimoto Tsuyoshi , Katsurada Kikushi
Published: May 2009

✓ The oxygen tension and acid-base values of internal jugular venous blood were compared to those of arterial and systemic mixed venous blood in 40 patients suffering from severe head injury. The results were divided into “brain death” and “coma groups” according to the clinical status when the sample was obtained. Hyperoxia of the jugular venous blood was a common finding in both groups, especially in the brain death group. The mean value of the arteriojugular venous oxygen content difference was 1.86 vol % in the brain death group, and 4.41 vol % in the coma group. Although most of the oxygen content differences in the brain death group were below 3 vol %, there was an overlap with the coma group at the low level of arteriojugular O2 difference. For definitive assessment of brain death, the fact that jugular pO2 was higher than that in systemic mixed venous pO2 was more valuable than the decrease of arteriojugular oxygen difference. The extreme hyperoxia of the jugular venous blood is possibly a sign of brain death, but should not be interpreted as the result of decreased oxygen consumption in the brain, because most of the jugular venous blood is returned from the extracerebral tissues. The causes of jugular hyperoxia in the state of brain death are discussed.
Veins draining the pineal body
Authors: Tamaki Norihiko , Fujiwara Kiyoshi , Matsumoto Satoshi , Takeda Hajime
Published: May 2009

✓ The authors present a detailed anatomical and neuroradiological study of the veins draining the pineal body proper, which they designate “pineal veins.” They describe three variations of the pineal veins. Since each has a characteristic angiographic relationship to the pineal body, the results of the study may permit early diagnosis of a pinealoma and distinguish the nature of the tumors of the posterior third ventricle.
Posttraumatic syringomyelia
Authors: McLean Donald R. , Miller Jack D. R. , Allen Peter B. R. , Ezzeddin S. Ali
Published: May 2009

✓ A detailed study of posttraumatic syringomyelia is reported. The interior of the syrinx was outlined by positive contrast and gas myelography. The contrast material entered the syrinx via a communication between the cavity and the subarachnoid space at the site of spinal cord injury. The syrinx also communicated with the fourth ventricle. It is postulated that posttraumatic syringomyelia results from the dissection of cystic remnants of hematomyelia known to be present at the site of serious spinal cord injury. Dissection occurs when pressure within the cyst is increased by elongation of the spinal cord during neck movements, principally flexion. Posttraumatic syringomyelia should be treated by a surgical procedure, which allows permanent drainage of the syrinx into the subarachnoid space.
Surgical management of diastatic linear skull fractures in infants
Authors: Thompson John B. , Mason Thomas H. , Haines Gerald L. , Cassidy Robert J.
Published: May 2009

✓ In seven infants, nondepressed diastatic linear skull fractures occurred with extrusion of brain tissue into the subgaleal space. These patients exhibited a triad of clinical findings that should encourage early surgery. Craniotomy and duroplasty seem to offer the most satisfactory long-term results.
Herniation of the spinal cord into an iatrogenic meningocele
Authors: Cobb Cully , Ehni George
Published: May 2009

✓ The authors describe a case in which the cervical spinal cord became incarcerated in the mouth of an iatrogenic meningocele or “pseudocyst.”
Venous aneurysm of the inferior sagittal sinus
Authors: Kaplan Harry A. , Browder Jefferson
Published: May 2009

✓ Among 449 specimens of dura mater and enclosed sinuses obtained at autopsy, there was one with a venous sac in the midpart of the falx cerebri. The vascular connections of this cavity indicated that it was an aneurysm of the inferior sagittal sinus without arterial components.
Double straight sinus
Authors: Saxena R. C. , Beg M. A. Q. , Das A. C.
Published: May 2009

✓ The straight sinus was examined in 43 human cadavers. In 13.95% of the cadavers the straight sinus was double, being either median in position, that is, one was superior and the other inferior (9.3%), or paramedian, that is, both lay side by side on either side of the midline at the junction of the falx cerebri with the tentorium cerebelli (4.65%).
The principle of spring-loaded points for cervical traction
Authors: Gardner W. James
Published: May 2009

✓ The author describes a skull traction tong devised for bedside application. The instrument eliminates the need for shaving, incising, or drilling.
Vascular pathology of the brain stem due to experimentally increased intracranial pressure: changes noted in the micro- and macrocirculation
Authors: Goodman Stanley J. , Becker Donald P.
Published: May 2009

✓ The neurological status and supra- and infratentorial intracranial pressures were studied in awake unsedated cats during expansion of a supratentorial mass. The pontomesencephalic portion of the brain stem was removed, serially sectioned, stained with sodium nitroprusside benzidine, and microscopically examined. Three types of vascular abnormality were seen: macrocirculation hemorrhages, microcirculation hemorrhages, and vascular stasis. As the supratentorial mass expanded and the intracranial pressure rose, there was a progression of vascular lesions from stasis to microcirculation hemorrhages, and finally to macrocirculation hemorrhages. The microcirculation hemorrhages occurred in stuporous animals, and the macrocirculation hemorrhages in comatose animals. Microcirculation hemorrhages were distributed primarily in the tectum, and macrocirculation hemorrhages were mainly in the tegmentum. Microcirculation hemorrhages first appeared in association with moderate to severe intracranial hypertension; macrocirculation hemorrhages were seen mainly with extreme intracranial hypertension. The clinical implications of these brain-stem vascular lesions are discussed.
Transverse fracture of the clivus
Authors: Sanders Bob B. , Vanderark Gary D.
Published: May 2009

✓ Three young patients with transverse fracture of the clivus exhibited clinical findings of progressive cranial nerve palsies associated with a Horner's syndrome. Clinical and radiological findings of this syndrome are described.
Dandy-Walker syndrome: an evaluation of surgical treatment
Authors: Fischer Edwin G.
Published: May 2009

✓ Twenty-seven patients with Dandy-Walker syndrome surgically treated between 1947 and 1972 are reviewed. The results of treatment and the ultimate functional status of the patients are evaluated. The initial treatment in 17 cases was excision of cyst membranes; 15 of these patients required further surgery to control hydrocephalus, while the other two, one of whom had normal pressure preoperatively, still have large heads. Ten patients were treated by ventricular shunting alone. Thus far 11 patients have died; the commonest causes of death have been CSF infection, uncontrolled hydrocephalus, and acute shunt obstruction. In a 1½- to 20-year follow-up, eight patients have normal or near-normal mental function; these results seem to correlate with the absence or control of increased intracranial pressure. Six patients who are alive are clinically retarded; two of these had severe, diffuse neurological deficits before treatment, two had multiple shunt problems and revisions, and two were either retarded or had severe behavior problems before treatment.
Acute paraplegia as the initial symptom of acute leukemia
Authors: Stefansson Thorstein A. , Bask Birgitte Elisabeth
Published: May 2009

✓ A case in which acute paraplegia occurred as the initial symptom of acute leukemia in an 11-year-old girl is reported.
Papilloma and venous angioma of the choroid plexus causing primary intraventricular hemorrhage
Authors: Matsushima Masayuki , Yamamoto Toyoshiro , Motomochi Masao , Ando Kyozo
Published: May 2009

✓ Papilloma and venous angioma of the choroid plexus manifested by massive intraventricular hemorrhage are described. Although these lesions were too small to be visualized on the cerebral angiograms, they were recognized at operation, and the patients survived with good recovery.
Postoperative angiography and the “slipped” clip
Authors: Drake Charles G. , Allcock John M.
Published: May 2009

✓ After intracranial surgery for an aneurysm, postoperative angiography should be routine. This may demonstrate lesions such as arterial spasm and hematoma, and may also show, sometimes quite unexpectedly, that the sac has not been completely obliterated. A clip or ligature may be merely misplaced, not be closed tightly enough, slip, or include the parent artery. In our series of 329 patients who underwent postoperative angiography, contrast filling of a significant part of the sac still occurred in 43 (13%); at least 12 of these rebled. Further intracranial surgery was carried out in 18, with satisfactory obliteration of the sac in 16. An incompletely obliterated aneurysm should be reoperated on as soon as possible. The risk involved at this time is minimal and far less than the possibility of another catastrophic hemorrhage.
Isosorbide in the medical treatment of infantile hydrocephalus
Authors: Lorber John
Published: May 2009

✓ The author reports the methods, results and complications of isosorbide therapy in 60 patients with various types of infantile hydrocephalus. Treatment was monitored by serial measurements of head circumference, assessment of fontanel tension, air ventriculography, and echoencephalography. Frequent estimation of plasma electrolytes, urea, and Astrup figures were found essential to guard against serious hypernatremia and acidosis, especially if higher doses were used. Infants with moderate hydrocephalus and those whose shunt was removed temporarily because of infection did particularly well under isosorbide. Cases of severe hydrocephalus rarely responded to therapy and in these, at best, only a delay before surgical therapy was achieved.
Evidence of preservation of aerobic cerebral metabolism during halothane-induced hypotension
Authors: Yashon David , Stone William , Magness Alfred , Hunt William E. , Hamelberg William
Published: May 2009

✓ The effect of halothane-induced profound systemic arterial hypotension on brain ischemia was evaluated by comparison with hypotension caused by oligemia and trimethaphan as well as nonhypotensive controls. Mean cerebral tissue lactate concentrations after halothane-induced hypotension at 5, 30, and 60 minutes were 4.34, 5.92, and 7.48 mM/kg. There was no significant difference between halothane and control animals during the experimental period. At 30 and 60 minutes, both oligemic and trimethaphan groups were higher than the control and halothane series. Definite protection from cerebral ischemia is provided by halothane during induced hypotension. Exact mechanisms of protection conveyed by halothane are unclear, but are probably not related to relative increased blood flow since cerebral vasodilation is maximal in these low blood-pressure ranges irrespective of etiology.
Use of radioactive bleomycin to detect malignant intracranial tumors
Authors: Mamo Lysiane , Nouel Jean-Paul , Robert Jacques , Chai Nicitha , Houdart Raymond
Published: May 2009

✓ A new isotopic method for the detection of cerebral tumors using labeled bleomycin is described. In a series of 104 patients, bleomycin was found superior to technetium-99m for the diagnosis of intracranial metastatic lesions; in 50% of the cases, bleomycin revealed metastases undetected by the Tc-99m, particularly in the posterior fossa. This method also provides valuable data for the differentiation of gliomas from metastases.
Temperature of the spinal cord during local hypothermia in dogs
Authors: Yashon David , Vise W. Michael , Dewey Richard C. , Hunt William E.
Published: May 2009

✓ The temperature of the spinal cord parenchyma during local hypothermia was recorded in 18 dogs with and without a 300 to 500 gm-cm spinal cord injury. Other variables included opening the dura, location of the inflow stream, and the use of alcohol bath cooling. In nontraumatized cord, the temperature varied between 5.4° and 23.5°C depending on the location of the inflow stream; the variable range of 10–15 minutes of perfusion to reach these levels was unexpected. Temperatures of the injured cord fell to those of the reservoir (1.0° to 3.8°C) within 2½ minutes. The fact that the temperature of nontraumatized areas two segments cephalad to the injury was also reduced showed the capacity of the cord for thermal conduction. Opening the dura or use of an alcohol bath had little effect on cord temperature. Lack of heat transport due to ischemia is postulated as the primary cause of the rapid reduction of temperature in the injured cord to that of the surrounding environment.
Stereotaxic pontine spinothalamic tractotomy
Authors: Hitchcock Edward R.
Published: May 2009

✓ A stereotaxic method of radiocoagulation of the spinothalamic tract at the pontine level is described. A system of coordinates is presented for the spinothalamic tract in relation to the floor of the fourth ventricle. The advantages of tractotomy at this level are discussed, and the results presented in a small series of patients suffering intractable pain. In two cases the lesion has been verified histologically.
Two unusual complications of a ventriculoperitoneal shunt
Authors: Portnoy Harold D. , Croissant Paul D.
Published: May 2009

✓ A case is presented in which puncture of the gallbladder and pneumothorax occurred during placement of a ventriculoperitoneal shunt. Treatment of these complications is outlined.
Cerebellar astrocytoma: malignant recurrence after prolonged postoperative survival
Authors: Scott R. Michael , Ballantine H. Thomas
Published: May 2009

✓ A patient who underwent subtotal resection of a cerebellar astrocytoma had a recurrence of his original symptoms 39 years later. Surgery disclosed a malignant glioma arising in the original operative site in the right cerebellar hemisphere.
Monoamine neurotransmitters and the pathophysiology of stroke and central nervous system trauma
Authors: Wurtman Richard J. , Zervas Nicholas T.
Published: May 2009

✓ The authors, at the invitation of the Editorial Board, have outlined their general interpretation of the role of monoamine neurotransmitters following injury to the central nervous system. Their work on experimental stroke is discussed, and its relevance to spinal cord injuries accompanied by comparable hemorrhage and ischemia involving neurons is implied.
Studies in experimental spinal cord trauma
Authors: Hedeman Lynn S. , Shellenberger M. Kent , Gordon J. H.
Published: May 2009

✓ The authors report a study of levels of norepinephrine (NE), dopamine (DA), and 5-hydroxytryptamine (5-HT) in the traumatized spinal cords of dogs, and with alpha-mehtyltyrosine before and after injury. There was a significant elevation of DA 15 to 45 minutes after injury. NE was significantly reduced. Twenty-four hours of pretreatment with alpha-methyltyrosine depleted cord catecholamines and prevented trauma-induced DA elevation. Alpha-methyltyrosine given 15 minutes after the trauma did not prevent this trauma-related DA elevation. In a small pilot study in cats, DA was elevated and NE remained essentially normal.
Biogenic amine concentrations in traumatized spinal cords of cats
Authors: Naftchi N. Eric , Demeny Margaret , DeCrescito Vincent , Tomasula John J. , Flamm Eugene S. , Campbell James B.
Published: May 2009

✓ Concentrations of norepinephrine (NE), dopamine (DA), serotonin (5-HT), and histamine (HIST) were determined in spinal cords of five groups of cats. One group underwent laminectomy only; a second untreated group received a 400 gm-cm impact at the T-9 level. These were compared with three groups treated with epsilon aminocaproic acid (EACA), methyl prednisolone sodium succinate (MP), and a combination of EACA and MP after similar trauma. The biogenic amines were measured in three 1-cm segments of the cord, rostral, middle, and caudal, 1 hour after trauma. There was no change in NE concentration in any of the three segments after impact compared with laminectomized controls, nor was the NE concentration in the impacted (middle) area higher than that in the rostral or caudal sites. Although the NE content of the cord in treated animals decreased compared to that of laminectomized controls, the decrease was not significant. The concentration of DA, however, significantly increased after impact and significantly decreased after treatment with EACA and EACA plus MP. There was no significant change in 5-HT levels, but the level of HIST increased significantly after impact and was lowered by treatment with EACA and EACA with MP. The implications of these changes in biogenic amines in spinal cord trauma are discussed.
Chemical characteristics of traumatic spinal cord edema in cats
Authors: Lewin Marcial G. , Hansebout Robert R. , Pappius Hanna M.
Published: May 2009

✓ Edema of the spinal cord, secondary to an impact injury produced in cats, was measured chemically. One day after injury a decrease in percentage dry weight and potassium concentration and an increase in sodium concentration were seen in the injured cord. By the second day these changes had spread to adjacent tissue. Edema was maximal between the third and sixth day and had begun to recede by the ninth day. A net loss of potassium, not directly related to the edematous changes, was observed throughout the analyzed cord starting on the third day and persisting on the ninth day after injury, when edema was regressing. Dexamethasone, started 48 hours before or 5 or 24 hours after injury had only minimal effect on edema but prevented loss of potassium from the injured cord. Six days after injury this effect was statistically significant in all three groups of dexamethasone-treated animals. All treated animals showed significantly better functional recovery than the untreated cats. On the sixth post-injury day the functional state of all animals was highly correlated with the potassium content of the spinal cord. Thus, the beneficial effect of dexamethasone may be related to the postulated role of steroid treatment in the maintenance of structural integrity of cellular elements in traumatized tissues. This could result in a better functional state of the injured cord, as well as in the maintenance of the normal content of potassium, the principal intracellular ion.
Effect of sacral nerve blocks on the function of the urinary bladder in humans
Authors: Rockswold Gaylan L. , Bradley William E. , Chou Shelley N.
Published: May 2009

✓ The authors report over 100 sacral root blocks performed in 50 patients with detrusor activation by air cystometry. The detrusor reflex was abolished with unilateral sacral blocks in over 50% of the patients. The nerve roots most frequently innervating the bladder were S-3 and S-4. Most of these patients suffered from multiple sclerosis and had spinal cord involvement. The possible pathophysiology and its significance regarding urinary bladder innervation is discussed.
Variations of intraventricular pressure during pneumoencephalography
Authors: Philippon Jacques , George Bernard , Metzger Jean
Published: May 2009

✓ Intraventricular pressure was studied in eight patients during and after diagnostic pneumoencephalography. In cases with normal initial pressure and normal cerebrospinal fluid (CSF) dynamics, variations in pressure were moderate, immediate, and disappeared at the end of the examination. In cases of normal-pressure hydrocephalus, there was a slow but relatively important elevation that continued for at least 24 hours. In cases with intracranial hypertension, there was a rapid significant increase; return to normal depended principally upon the flow from a large CSF compartment.
Chondromyxoid fibroma: a rare cause of spinal cord compression
Authors: Ramani P. S.
Published: May 2009

✓ A rare case is reported in which a primary chondromyxoid fibroma of the 12th rib spread into the epidural space of the spinal canal to cause spinal cord compression. The benign nature of the tumor is stressed and the only other reported case reviewed.
External carotid-cavernous fistula treated by arterial embolization
Authors: Mahalley M. Stephen , Boone Stephan C.
Published: May 2009

✓ The unusual occurrence of a carotid-cavernous fistula supplied entirely by branches of the external carotid artery is presented, and its successful treatment by arterial embolization described.
Ganglion of the posterior tibial nerve
Authors: Mahaley Moses Stephen
Published: May 2009

✓ A unique instance of ganglion of a posterior tibial nerve is described, and the histology and nature of this lesion evaluated.
Solitary sclerosing plasma-cell myeloma of the spine
Authors: Roberts Melville , Rinaudo Peter A. , Vilinskas Juliet , Owens Guy
Published: May 2009

✓ A case is reported in which spinal cord compression was caused by a solitary sclerosing plasma-cell myeloma involving the T-9 vertebra.
The treatment of penetrating wounds of the brain sustained in warfare
Authors: Gurdjian E. Stephen
Published: May 2009

✓ The author reviews the history of the management of head injuries with particular emphasis on penetrating wounds from antiquity to modern times. He traces the influence of gunpowder weaponry and early instrumentation on the development of treatments.
Sleep-induced apnea
Authors: Krieger Abbott J. , Rosomoff Hubert L.
Published: May 2009

✓ Data are reported on 10 patients who developed a syndrome of sleepinduced apnea preceded by lethargy and asthenia following bilateral percutaneous cervical cordotomy. Respiratory dysfunction occurred within 24 to 48 hours in most cases but appeared as early as 1 hour and as late as 6 days. One type of respiratory dysfunction was characterized by an attenuated CO2 response with a normal vital capacity; in a second type an attenuated CO2 response and a decreased vital capacity were both present. A variety of other autonomic dysfunctions were present in some of the patients; these included hypotension, hyponatremia, inappropriate antidiuretic hormone secretion, and difficulties in micturition. The syndrome lasted from 3 to 32 days in surviving patients. Five patients required endotracheal intubation. Three deaths were attributable to this syndrome; two occurred in patients who were not intubated and died in their sleep. The incidence of apnea during sleep, its reversal by arousal, and the absence of significant motor changes strongly suggest that the ascending reticular fibers in the ventrolateral segment of the spinal cord have been damaged.
Sleep-induced apnea
Authors: Krieger Abbott J. , Rosomoff Hubert L.
Published: May 2009

✓ The syndrome of sleep-induced apnea is described in two patients who had anterior spinal surgery at the C3–4 interspace. Postoperatively both had high levels of analgesia, periods of confusion, and signs of respiratory failure at night. The management of occult respiratory failure by endotracheal intubation and assisted ventilation is described, and the associated variations in pulmonary function are discussed.
Effects of profound hypothermia and circulatory arrest on cerebral oxygen metabolism and cerebrospinal fluid electrolyte composition in dogs
Authors: Bering Edgar A.
Published: May 2009

✓ Cerebral oxygen metabolism was studied in the dog at brain temperatures ranging from 37° to 8°C. As brain temperature decreased, the cerebral oxygen metabolism (CMRO2) decreased following the Arrhenius equation. The natural logarithm of the CMRO2 was a linear function of the reciprocal of the absolute (K) brain temperature. Oxygen metabolism, although much decreased, continued at very low brain temperatures. The CSF composition was unchanged after 1 hour at brain temperatures down to 10°C. Circulatory arrest for tolerable periods and longer caused changes only in the CSF potassium concentration. The interval between the onset of circulatory arrest and the beginning of the CSF K concentration increased with decreasing temperature and the rate of CSF K increase was increasingly slower at lower temperatures. At all temperatures the rate of CSF K changed gradually increased with time.

The interval before the CSF K started to increase was dependent upon the amount of O2 available in the brain and the length of this interval was inversely proportional to the CMRO2. The amount of CSF K concentration was not clearly related to the tolerable periods of circulatory arrest, but at normal temperatures an obviously increased CSF K following a period of acute cerebral anoxia without CSF hemorrhage may indicate brain damage.
Detection of 247 midline and posterior fossa tumors by combined scintigraphic and digital gammaencephalography
Authors: Ostertag Christoph , Mundinger Fritz , McDonnell Dennis , Hoefer Thorwald
Published: May 2009

✓ The authors report their experience using digital and scintigraphic techniques simultaneously, with the application of two isotopes (mercury 197/203 and technetium-99m) of different tissue uptake. Basal supratentorial midline cerebral tumors (88 cases) and posterior fossa tumors (159 cases) could be diagnosed in over 90% of cases. This safe isotope investigation of the intracranial structures offers diagnostic help as a screening method before angiography and pneumoencephalography.
Intracranial sympathetic pathways associated with the sixth cranial nerve
Authors: Johnston J. A. , Parkinson Dwight
Published: May 2009

✓ During a continuing study of the anatomy of the parasellar region, a macroscopically identifiable nerve has been observed to leave the foramen lacerum and join the abducens nerve within the cavernous sinus. A description and photographic documentation of this sympathetic branch to the fifth cranial nerve by way of the sixth cranial nerve are presented.
Direct surgical obliteration of a persistent trigeminal artery aneurysm
Authors: Morrison Glenn , Hegarty William M. , Brausch Charles C. , Castele Theodore J. , White Rorert J.
Published: May 2009

✓ A woman with a fusiform aneurysm of a persistent trigeminal artery sustained a subarachnoid hemorrhage and presented with hypalgesia in the distribution of the maxillary and mandibular nerves. The first successful direct operative treatment of this rare aneurysm is reported.
Ectopic intrasellar chordoma
Authors: Mathews William , Wilson Charles B.
Published: May 2009

✓ The authors report a case in which a chordoma ballooned an otherwise intact sella. Following almost total removal of the lesion, the patient recovered normal vision and returned to work. Neoplastic transformation of ectopic notochordal tissue is suggested as an explanation for the unique intrasellar origin of this tumor.
Multiple false localizing signs in intracranial tumor
Authors: Turnbull Andrew R.
Published: May 2009

✓ A case of cerebellar hemangioblastoma is presented in which multiple false localizing signs caused difficulty in the clinical localization of the lesion. The mode of presentation and pathogenesis of these signs are briefly discussed, and the observation made that the ninth and tenth cranial nerve palsies recorded in this case rarely lead to false localization.
Experience with an intracranial pressure transducer readjustable in vivo
Authors: Gobiet Wolfgang , Bock Wolfgang Joachim , Liesegang Jürgen , Grote Wilhelm
Published: May 2009

✓ A new implantable miniature intracranial pressure transducer is described whose main advantage is the possibility of zero point calibration in vivo. Comparative studies verify that epidural pressure corresponds well with ventricular fluid pressure. During long-term monitoring of 30 patients the transducer proved both safe and reliable.
Embolization and reduction of the “steal” syndrome in cerebral arteriovenous malformations
Authors: Kusske John A. , Kelly William A.
Published: May 2009

✓ The authors report their experience with embolization of unresectable cerebral arteriovenous malformations in 10 patients; seven showed clinical improvement, two no change, and one became worse. Follow-up studies for up to 9 years suggest that partial obliteration of a lesion that shunts blood away from normal brain alleviates the clinical syndrome by enhancing cerebral perfusion. Thus, satisfactory results may be obtained without occlusion of malformations causing symptomatology on the basis of a cerebral steal.
Dural arteriovenous malformations
Authors: Kosnik Edward J. , Hunt William E. , Miller Carole A.
Published: May 2009

✓ The history, physical findings, and treatment of dural arteriovenous malformations are reviewed. The importance of completely identifying and obliterating the fistula, even at the expense of obliterating major venous sinuses, is emphasized. Failure of surgical treatment usually is the result of mistaking the more obvious dilated feeding vessels for the lesion itself.
Cavernous nodules in the dural sinuses
Authors: Bergquist Eric , Willén Roger
Published: May 2009

✓ In x-ray examination of the confluence of the great vein of Galen and the straight sinus in 94 autopsy cases, a polypoid or lip-like contrast defect was observed at the lower border of this confluence in 10 cases. The contrast defect was caused by a structure containing collagen fibers forming a trabecular system, a plexus of sinusoidal channels, and nerve fibers. The defect has also been observed clinically in the venous phase of cerebral angiograms. The possible effect of the structure on the blood flow in the great vein of Galen and the straight sinus is discussed.
Brain scans and echoencephalography in the diagnosis of chronic subdural hematoma
Authors: Hurwitz Sheldon R. , Halpern Samuel E. , Leopold George
Published: May 2009

✓ Eighteen patients with chronic subdural hematomas were studied by both brain scans and echoencephalography. All cases were verified by cerebral angiography. Brain scanning was accurate in predicting hematomas in 93% of the cases, and echoencephalography in 44%. When hematomas were bilateral or when frontal clots caused no shift in the diencephalic midline, the routine echoencephalogram often was negative. The two procedures are complementary, and serial studies may be helpful in the study of changing clinical situations.
Procarbazine hydrochloride in the treatment of brain tumors
Authors: Kumar A. R. Vasantha , Renaudin Justin , Wilson Charles B. , Boldrey Edwin B. , Enot K. Jean , Levin Victor A.
Published: May 2009

✓ A series of 43 patients, all of whom were deteriorating due to progression of primary or metastatic brain tumors, were treated daily with n-isopropyl-α-(2-methylhydrazine)-p-toluamide hydrochloride (matulane, Procarbazine hydrochloride: NSC-77213, 150 mg./m2) for 30 consecutive days, with a 30-day rest interval between treatments. Of 29 patients evaluated, 12 showed a definite clinical response to therapy and two a probable response, for a response rate of 48%. Reversible myelosuppression was the major toxic effect encountered. Combination with other chemotherapeutic agents may enhance the drug's effectiveness against brain tumors.
Negative intracranial pressure hydrocephalus in adults with shunts and its relationship to the production of subdural hematoma
Authors: McCullough David C. , Fox John L.
Published: May 2009

✓ Subdural hematomas and effusions have been noted in at least 20% of adult patients treated with CSF shunts for normal pressure hydrocephalus. In a series of 39 cases the incidence of this complication is correlated with the low 41% improvement rate. The very low intracranial pressure achieved with conventional shunt systems is probably the most important factor causing subdural collections of blood or fluid. In a study of pre- and post-shunt CSF pressures in 25 patients it was found that in the erect position ventriculoatrial and ventriculoperitoneal shunt systems produced pressures averaging —238 and —251 mm H2O respectively. Although the new antisiphon valves produced much smaller decrements of CSF pressure with significant clinical improvement in some cases, these units did not always prevent subdural hematomas.
Cerebrospinal fluid overproduction and hydrocephalus associated with choroid plexus papilloma
Authors: Eisenberg Howard M. , McComb J. Gordon , Lorenzo Antonio V.
Published: May 2009

✓ With the use of a ventricular perfusion technique, a cerebrospinal fluid formation rate of 1.4 ml/min was determined in a 5-month-old child with a choroid plexus papilloma and hydrocephalus. This rate was slightly greater than four times the rate observed in normal children. The clinical course, as well as a measured absorption rate, indicated that the patient's capacity for absorption was normal.
Brain-stem abscess in childhood
Authors: Danziger J. , Allen K. Lewer , Bloch S.
Published: May 2009

✓ A rare case is reported of a solitary abscess of the brain-stem which was suspected clinically, confirmed surgically, and successfully removed. The few reports of similar cases in the literature are reviewed.
Atlantoaxial dislocation with quadriparesis in achondroplasia
Authors: Gulati Des Raj , Rout Damodar
Published: May 2009

✓ The authors report a rare instance of progressive quadriparesis resulting from atlantoaxial dislocation in a patient with achondroplasia. The problem was successfully treated by skeletal traction and fusion.
Persistent hypoglossal artery associated with superior cerebellar artery aneurysm
Authors: Springer Thomas D. , Fishbone Gerald , Shapiro Robert
Published: May 2009

✓ An aneurysm at the origin of the superior cerebellar artery in a patient with a primitive hypoglossal artery is reported. Selective catheterization of the primitive artery is described with a brief discussion of the embryogenesis of carotid-basilar anastomoses. Associated findings in previously reported cases of persistent hypoglossal artery are briefly reviewed.
Egas Moniz and cerebral angiography
Authors: Antunes J. Lobo
Published: May 2009

✓ The author recalls many manifestations of Moniz's fertile mind, and in particular the story of his development of cerebral angiography. The Journal publishes this article in tribute to a great neuroscientist in this 100th year since his birth.