bluuebunny/crossref_metadata_2025 huggingface dataset:
Central cholinergic control of cerebral blood flow in the baboon
Authors: Aoyagi Minoru , Meyer John Stirling , Deshmukh Vinod D. , Ott Erwin O. , Tagashira Yukio , Kawamura Yasuo , Matsuda Masayuki , Achari Amrit N. , Chee Anthony N. C.
Published: May 2009

✓ Cerebral autoregulation and vasomotor responsiveness to carbon dioxide (CO2) were measured quantitatively by the use of the autoregulation index and chemical index, respectively, in normal baboons before and after intravertebral and intracarotid infusion of the anticholinesterase agent, neostigmine methylsulfate (Prostigmin). Continuous measurements were made of cerebral blood flow (measured as bilateral internal jugular venous outflow), arterial and cerebral venous pO2 and pCO2, cerebral arteriovenous oxygen differences, and endotracheal CO2.

The effect of intravertebral infusion of neostigmine (12.5 µg/kg body weight) was compared to intracarotid infusion of neostigmine (25 µg/kg body weight) for assessment of any specific action of the drug on a hypothetical cholinergic vasomotor center, presumed to be located in the territory of the vertebrobasilar supply. No significant or persistent changes in cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRO2) followed either intravertebral or intracarotid infusion of neostigmine. Cerebral vascular resistance (CVR) and cerebral perfusion pressure (CPP), however, decreased significantly after intravertebral infusion. Cerebral autoregulatory vasoconstriction during increases of CPP was significantly reduced following both intravertebral and intracarotid infusion. Cerebral autoregulatory vasodilatation was not altered as CPP was lowered. Cerebral vasodilatory reactivity to CO2 inhalation was significantly enhanced following intravertebral neostigmine but not following intracarotid neostigmine. Cerebral vasoconstrictive response to hyperventilation was not influenced by neostigmine. These results support the view that central cholinergic cerebrovascular influences exist, and are vasodilatory in nature.
Prophylactic antibiotics and wound infections following laminectomy for lumber disc herniation
Authors: Horwitz Norman H. , Curtin James A.
Published: May 2009

✓ The authors review 531 consecutive operations for lumbar disc herniation performed on 496 patients by one neurosurgeon to determine the effect of prophylactic antibiotics upon postoperative wound infections. In this retrospective analysis 16 instances of sepsis were found, 11 considered to be major and five minor. In the 128 cases in which no antibacterial agents were given, 11 major and 1 minor infection occurred. Four minor infections developed in the 402 occasions when antibiotics were given in the perioperative period. Men had a significantly greater risk of developing infection than women. These data suggest that pre- and postoperative antibiotic therapy directed at a narrow spectrum of microorganisms reduced the incidence of significant wound infections in patients undergoing laminectomy for lumbar disc herniation.
Management of cervical spinal cord trauma in Southern California
Authors: Heiden James S. , Weiss Martin H. , Rosenberg Alan W. , Apuzzo Michael L. J. , Kurze Theodore
Published: May 2009

✓ Acute cervical spinal cord injuries were reviewed in 356 patients treated by the neurosurgical community in Southern California. Neurological recovery was compared in operated and nonoperated patients with complete and incomplete cervical myelopathies. The complications of nonsurgical and surgical therapy are identified. No neurological improvement was noted in any patient with a complete lesion who underwent early surgical decompression. In those with incomplete sensorimotor paralysis, it was difficult to document any effect of surgical decompression on neurological recovery. Patients with some degree of sensory preservation had a similar incidence of motor recovery in both surgical and nonsurgical groups. With complete sensorimotor paralysis, anterior cervical fusion within the first week of injury was associated with increased pulmonary morbidity.
Electrospinogram and spinal and cortical evoked potentials in experimental spinal cord trauma
Authors: Morrison Glenn , Lorig Ronald J. , Brodkey Jerald S. , Nulsen Frank E.
Published: May 2009

✓ Studies in 28 traumatized cats showed the following acute changes after spinal cord compression in the cord segment below the trauma: 1) increase in size of the spinal cord evoked potential; 2) increase in size of the electrospinogram; and 3) increase in frequency of the electrospinogram.
Ventriculo-orbital fistula in closed head injury
Authors: Terao Hideo , Sato Seitaro
Published: May 2009

✓ A ventriculo-orbital fistula developing as a result of closed head injury produced intraorbital compression symptoms including downward deviation of the globe and inability of upward gaze. Percutaneous injection of Conray clearly demonstrated the fistula, which was successfully closed by frontal craniotomy.
Malignant teratoma arising within a lipomeningocele
Authors: Mickle J. Parker , McLennan James E.
Published: May 2009

✓ The authors report the case of an 11-year-old, neurologically normal girl, followed since birth for lipomeningocele, who developed a malignant teratoma within the lumbosacral lesion and presented with metastases to the lungs and groin. This rare occurrence is discussed from an embryological and management viewpoint.
Percutaneous lumboperitoneal shunt
Authors: Spetzler Robert F. , Wilson Charles B. , Grollmus John M.
Published: May 2009

✓ The authors describe a new catheter for use in percutaneous lumboperitoneal shunting, designed to overcome the problem of kinking. They present their experience with the catheter in 14 patients.
Monkey brain damage from radiation in the therapeutic range
Authors: Nakagaki Hiroyuki , Brunhart Gunter , Kemper Thomas L. , Caveness William F.
Published: May 2009

✓ Twelve Macaca mulatta monkeys received 200 rads of supervoltage radiation to the whole brain per day, 5 days a week. The course in four monkeys was 4 weeks for a total dose of 4000 rads; in four monkeys, 6 weeks for 6000 rads; and in four monkeys, 8 weeks for 8000 rads. Four unirradiated monkeys served as controls. One from each group, sacrificed at 6 and 12 months from start of irradiation, are reported here. The results from 4000 rads were negligible; those from 8000 rads, profound, with gross brain destruction. The results from 6000 rads, within the therapeutic range, included at 6 months punctate necrotic lesions, 1 mm or less, widely scattered but with a predilection for the forebrain white matter. The reaction to these lesions ranged from an early macrophage response to calcification. Some were accompanied by focal edema. There were occasional examples of vascular endothelial proliferation. In addition, there were patches of dilated capillaries or telangiectasia. Twelve months after 6000 rads there were a few mineralized lesions and innumerable minute deposits of calcium and iron. A more active process was suggested by widely disseminated areas of telangiectasia, 6 to 12 mm in extent. The clinical course from this exposure included papilledema from the third to the sixth month and depressed visual evoked response accompanied by delta activity in the electroencephalogram from the sixth to the twelfth month.
Spinal cord blood flow as affected by changes in systemic arterial blood pressure
Authors: Kobrine Arthur I. , Doyle Thomas F. , Rizzoli Hugo V.
Published: May 2009

✓ The authors used the hydrogen clearance method to measure focal spinal cord blood flow (SCBF) in the rhesus monkey over a wide range of mean arterial blood pressures (MAP) in an attempt to test the hypothesis of autoregulation. The MAP was either lowered by bleeding or raised by the intravenous infusion of norepinephrine or angiotensin. The SCBF remained constant and in the normal range with an MAP of 50 to 135 mm Hg, indicating the presence of autoregulation. Below 50 mm Hg, SCBF fell passively with further decreases in MAP. At MAP values above 135 mm Hg, vasodilatation occurred which resulted in a breakthrough of autoregulation and marked increases in SCBF with further increases in the MAP.
Medical modification of sensation
Authors: Hodge Charles J. , King Robert B.
Published: May 2009

✓ The authors describe the sensory examinations of three patients who had undergone cervical rhizotomy alone and in combination with trigeminal tractotomy and section of the nervus intermedius, the glossopharyngeal nerve, and the upper portion of the vagus nerve. Following administration of L-dopa there was an increase in their pain and a decrease in the area of clinically anesthetic or analgesic skin. When methyldopa was given, the subjective and objective changes were the opposite of those elicited by L-dopa. These observations support the existence of a wider dorsal root cutaneous distribution than is usually accepted as well as significant control of cutaneous sensation by suprasegmental areas of the central nervous system. Part of the suprasegmental bias supplied to the area in the spinal cord that processes sensory information apparently occurs by way of an aminergic descending reticulospinal tract. These findings are discussed in terms of attempts totally to denervate restricted cutaneous areas of the body for treatment of pain-producing states.
Monitoring optic nerve function during craniotomy
Authors: Feinsod Moshe , Selhorst John B. , Hoyt William F. , Wilson Charles B.
Published: May 2009

✓ During surgical removal of a pituitary adenoma, conduction in the anterior visual pathways was monitored by continuous recording of visual evoked responses (VER). The method employed a scleral contact lens with an embedded flashing diode for delivery of visual stimuli. Evoked potentials of nearly normal latency, amplitude, and form were recorded from occipital scalp electrodes immediately after the optic nerves were decompressed. Restoration of the VER was correlated with restoration of normal vision.
Effects of collagenase upon the intervertebral disc in monkeys
Authors: Stern W. Eugene , Coulson Walter F.
Published: May 2009

✓ The authors studied five rhesus monkeys for the effects of annulotomy, with or without the addition of a bacterially-derived collagenase into the nuclear-evacuated centrum of lumbar intervertebral discs. The animals were sacrificed from 3 weeks to 21 months after the single or staged double procedures. The earliest radiographic changes were loss of height of the interspace at 7 days, erosion of the vertebral body margins at 3 weeks, malalignment at 6 weeks, osteophytic formation at 3½ months, sclerosis of vertebral body surfaces at 9½ months, and fusion of adjacent vertebral bodies at 13½ months. Pathological changes included early loss of disc convexity, focal new bone formation, osteophytic new growth, through-and-through bone formation, irregular cystification, and disc replacement by hyaline fibrous tissue. Changes were reminiscent of those seen in humans with naturally acquired disc disease or aging of the disc. Injuries were produced in a tissue that probably has a limited scope of variation in reaction to insult.
Experimental evaluation of the spasmogenicity of dopamine on the basilar artery
Authors: White Richard P. , Hagen Ainsworth , Robertson James T.
Published: May 2009

✓ Arteriograms of the basilar artery reveal that dopamine given intracisternally to dogs can generate cerebral vasospasm. This finding supports a recent hypothesis of others that dopamine may play a role in the pathogenesis of vasospasm, especially since many substances are known which fail to produce such spasm. Compared to blood or prostaglandin E2, however, the spasm induced by dopamine was delayed in onset, less in incidence, and usually less intense. Possible explanations for such experimental differences are discussed.
Anatomical features of the straight sinus and its tributaries
Authors: Browder Jefferson , Kaplan Harry A. , Krieger Abbott J.
Published: May 2009

✓ The authors report a variety of arrangements of the venous channels comprising the straight sinus (sinus rectus) and its connections during a continuing study of the cerebral sinuses and their tributaries. In approximately 85% of 131 specimens of dura mater with enclosed venous sinuses derived from fresh cadavers, the straight sinus was represented by a single midline tentorial channel whereas in the remaining 15%, segments of it were doubled and in a few, tripled. In addition to these aberrations in the development of the main trunk of this sinus, the venous patterns at the junctions of the inferior sagittal sinus, vein of Galen and straight sinus showed comparable developmental inconstancies. Also in no specimens were the patterns of venous channels in the leaves of the tentorium cerebelli alike. The course, size, and connections of all the tributaries of the straight sinus have been studied and consideration given to their potentials as collateral pathways in the event either the vein of Galen or the straight sinus itself were occluded.
Management of depressed skull fracture in the newborn
Authors: Loeser John D. , Kilburn H. Lee , Jolley Tim
Published: May 2009

✓ The authors describe three cases of neonatal depressed skull fracture subsequent to difficult delivery, treated without surgical elevation. None of the patients developed neurological deficits, cosmetic deformity or electroencephalographic signs of epileptiform activity. Neonatal depressed skull fractures not associated with focal neurological signs may not require surgical therapy; we are not certain what the absolute criteria for operation should be.
Management of diabetes insipidus in neurosurgical patients
Authors: Shucart William A. , Jackson Ivor
Published: May 2009

✓ The authors present a brief review of the problem of diabetes insipidus in neurosurgical patients, with particular emphasis on the differential diagnosis of postoperative and posttraumatic polyuria and the management of diabetes insipidus in these periods. A listing of drugs currently used in its treatment is given.
Vertebral hydatid disease
Authors: Apt Werner L. , Fierro Juan L. , Calderón Ciro , Pérez Carlos , Mujica Patricio
Published: May 2009

✓ The authors present 27 cases of vertebral hydatidosis with clinical and laboratory findings. The most frequent location of the lesion was the lumbar spine. Principal neurological symptoms were paraparesis, sphincter disturbances, paresthesia and paraplegia. The average number of surgical interventions per patient was 2.6; the most common procedure was laminectomy with extirpation of the cyst and surgical toilet. The results of surgical treatment were generally good in the immediate postoperative period, but long-term results were poor.
Mycotic aneurysms of the internal carotid artery
Authors: Shibuya Satoshi , Igarashi Seishi , Amo Tadashi , Sato Hideo , Fukumitsu Taro
Published: May 2009

✓ The authors report a case with two mycotic aneurysms in the cavernous portion of the internal carotid artery, presumably secondary to a transient bacteremia from pneumonia. The strikingly rapid development of the aneurysms was demonstrated by angiography. Painful total ophthalmoplegia and exophthalmos were the main clinical features.
Intracranial epithelial cysts
Authors: MacGregor Beth J. L. , Gawler Jeffrey , South John R.
Published: May 2009

✓ The authors report two cases with large unilocular intracerebral epithelial cysts. Diagnosis was facilitated in both patients by computerized tomography (EMI scanner). The clinical and diagnostic aspects of previously reported cases are reviewed, and the etiology and pathogenesis of these cysts discussed.
Perforation of the skull by a Gardner-Wells tong
Authors: Feldman Robert A. , Khayyat Ghassan F.
Published: May 2009

✓ The authors report a case in which skeletal traction was applied with Gardner-Wells tongs and one of the pins perforated the inner table of the skull.
Muslin gauze in intracranial vascular surgery
Authors: Pool J. Lawrence
Published: May 2009

✓ The author comments on three ways in which he has found muslin gauze an aid to clotting in intracranial vascular surgery.
A new approach to the surgical treatment of lumbar spondylosis
Authors: Shenkin Henry A. , Hash Cecil J.
Published: May 2009

✓ The authors discuss routine removal of inferior articular processes and their facets during laminectomy, with wide visualization of the lumbar nerve roots, which has proven to be most successful in relief of the symptoms of lumbar spondylosis. No instance of postoperative vertebral instability has been found. In a consecutive series of 70 patients averaging 58.3 years of age, 91% of patients adequately followed did well. Of six patients who did poorly, three had apparent explanations and, presumably, such errors are avoidable. Despite the generally advanced age of this series (12 patients aged over 70 years) there was no mortality or undue morbidity. Patients previously operated on for disc herniation, as a group, were somewhat younger and the spondylosis tended to be more localized (to the area of previous surgery) than in patients operated on for the first time.
Effect of dopamine-beta-hydroxylase inhibition on cerebral vasospasm in the cat
Authors: Battista Arthur F. , Flamm Eugene S. , Goldstein Menek , Freedman Lewis S.
Published: May 2009

✓ Inhibitors of dopamine beta hydroxylase (DBH) administered intraperitoneally were shown to prevent spasm of the basilar artery caused by blood application in cats. A low or nondetectable blood DBH activity level may be related to the absence of spasm. In several instances, however, moderate spasm did occur with a low blood DBH activity level. Possible mechanisms for these findings are discussed.
Spasmogenic qualities of prostaglandin F2α in the cat
Authors: Kapp John P. , Robertson James T. , White Richard P.
Published: May 2009

✓ Available data indicate that the concentration of prostaglandin F2α required to produce arterial spasm in an experimental model is approximately a thousand-fold higher than the concentration that occurs under physiological conditions. The spasmogenic platelet factor which has been previously described is shown to be a substance other than prostaglandin F2α because of differences in susceptibility of the two substances to enzymatic digestion.
Diagnosis and treatment of abscess of the central ganglia
Authors: Law Jay D. , Lehman Ralph A. W. , Kirsch Wolff M. , Ehni George
Published: May 2009

✓ The authors present four cases of abscess of the thalamus and basal ganglia and review an additional 10 cases from the literature. These abscesses appear to be metastatic and are usually associated with a cardiac septal defect or a preceding intrathoracic infection. Fever, elevated white blood count, and/or meningismus, in combination with angiography demonstrating an avascular mass, help distinguish abscess from tumor in this location. The authors advocate aspiration rather than excision.
Surgical removal of orbital osteoma
Authors: Rawe Stephen E. , VanGilder John C.
Published: May 2009

✓ The authors report a patient with a large orbital osteoma causing marked physical deformity and diplopia but with preservation of visual acuity. A combined transorbital and transcranial operative approach was used for total tumor removal and cosmetic repair.
Fibromatosis presenting as a cranial mass lesion
Authors: Quest Donald O. , Salcman Michael
Published: May 2009

✓ The authors report a case of fibromatosis presenting as a mass lesion following previous craniotomy and radiation therapy. The clinical and pathological characteristics of this rare condition are discussed.
Trochlear nerve sheath tumor
Authors: King J. Stovall
Published: May 2009

✓ The author describes the presenting symptoms and treatment of a patient with a trochlear nerve sheath tumor.
Cardiovascular complications on upper vagal rootlet section for glossopharyngeal neuralgia
Authors: Nagashima Chikao , Sakaguchi Arata , Kamisasa Akira , Kawanuma Seiichi
Published: May 2009

✓ Acute hypotension and right bundle-branch block occurred when the authors sectioned the uppermost rootlet of the vagus nerve in a case of glossopharyngeal neuralgia. Hypotension lasted for 20 minutes and arrhythmia for 4 days. A possible mechanism is discussed and cardiovascular disorders are reviewed in similar cases.
Functional representation on the medial aspect of the frontal lobes in man
Authors: Van Buren John M. , Fedio Paul
Published: May 2009

✓ Sensorimotor responses to stimulation of the medial frontal and cingulate area were studied in seven unrestrained, unsedated patients who suffered from intractable seizures. Complex postural synergies involving the trunk and proximal extremities appeared contralaterally or occasionally bilaterally. Contraversive turning of head and eyes was not observed. Sensory responses from the supplementary motor area were referred contralaterally and focally; those from the cingulate gyrus were widely referred. Speech impairment from stimulation of the supplementary motor area showed striking similarities with that obtained from stimulation in the frontostriatal region or lateral aspect of the frontal lobe. The observations support the hypothesis that interference with striatal function may be the basis of speech inhibition produced by stimulation of the frontal lobe.
Aneurysm of a superior cerebral vein
Authors: Kaplan Harry A. , Browder Jefferson
Published: May 2009

✓ Among 880 specimens of cerebral dura mater with enclosed sinuses, one had a sharply delineated bulbous conformation of the distal segment of a superior cerebral vein. There was no evidence of an arteriovenous malformation. Early plaque formation was present in the inner aspect of the thick wall of the dilated segment of vein.
Experimental bypass for sagittal sinus repair
Authors: Sindou Marc , Mazoyer Jean-François , Fischer Georges , Pialat Jean , Fourcade Claude
Published: May 2009

✓ Bypasses of the sagittal sinus, 2.5 mm in diameter, were carried out in 25 dogs with venous (13 cases) and arterial (12 cases) autogenous grafts, by classical microtechniques. Animals were sacrificed 10 to 75 days after the operation, average 40 days. The patency rate was 54% in the venous autograft group; in all cases, thrombosis occurred early and was due to technical factors. The immediate postoperative patency rate was 100% in the arterial graft group, but this type of graft showed a tendency to progressive occlusion because of extensive fibrosis of the arterial wall; thus the patency rate was 75% at the time of autopsy. This preliminary work demonstrates the technical feasibility of bypass procedure which could be used for sagittal sinus repair.
Surgical anatomy of the proximal anterior cerebral artery
Authors: Dunker Ralph O. , Harris A. Basil
Published: May 2009

✓ The authors present this study of proximal anterior cerebral arteries in the normal human to provide a clearer basis for strategy in aneurysm surgery. They describe patterns of origin of branches, their subarachnoid course, and parenchymal distribution. Branches that originate from the anterior cerebral artery at the internal carotid bifurcation perfuse the genu and contiguous posterior limb of the internal capsule and the rostral thalamus. Proximal 4-mm branches supply the anterior limb of the internal capsule, the neighboring hypothalamus, anteroventral putamen, and pallidum. The remaining anterior cerebral artery proximal to the communicating artery sends branches to the optic chiasm, the adjacent hypothalamus, and the anterior commissure. Heubner's artery arises directly opposite the anterior communicating artery to supply much of the striatum and internal capsule rostral to the anterior commissure. The anterior communicating artery branches supply the fornix, corpus callosum, septal region, and anterior cingulum. The parenchymal distribution of these end arteries may be surmised from the site of origin of named vessels. With this anatomical information one can avoid interruption of blood supply to vital structures when dealing with the anterior cerebral artery and its branches.
Treatment of Jefferson fracture with a halo apparatus
Authors: Zimmerman Eric , Grant John , Vise W. Michael , Yashon David , Hunt William E.
Published: May 2009

✓ Two patients with bursting fractures of the atlas vertebra are presented. The use of a halo apparatus as an effective alternative to bedrest and cervical traction in these patients is discussed. Polytomography was helpful in establishing an accurate diagnosis.
Cerebrovascular accident after percutaneous rf thermocoagulation of the trigeminal ganglion
Authors: Rish Berkley L.
Published: May 2009

✓ A case of a cerebrovascular accident associated with percutaneous radiofrequency thermocoagulation of the trigeminal ganglion is presented in the hope of alerting other surgeons to this possible complication.
Carotid-anterior cerebral artery anastomosis
Authors: Nutik Stephen , Dilenge Domenico
Published: May 2009

✓ The angiographic and anatomical features of an anomalous communication between the intradural internal carotid artery and the anterior cerebral artery are described. Essential features of the anastomosis include an origin at, or close to, the origin of the ophthalmic artery, a course ventral to the ipsilateral optic nerve and anterior to the optic chiasm, and a termination near the anterior communicating artery. Although rare, the condition should be considered as an entity. The incidence of associated berry aneurysm and other congenital vascular anomalies is high.
Tension pneumocephalus after insertion of ventriculoperitoneal shunt for aqueductal stenosis
Authors: Little John R. , MacCarty Collin S.
Published: May 2009

✓ A case of tension pneumocephalus after the insertion of a ventriculoperitoneal shunt for aqueductal stenosis is reported. The possible mechanisms producing this complication are discussed.
Myxochondrosarcoma of the fourth ventricle
Authors: Scott R. Michael , Dickersin G. Richard , Wolpert Samuel M. , Twitchell Thomas
Published: May 2009

✓ The authors report a case of myxochondrosarcoma of the fourth ventricle. The tumor was heavily calcified and proved impossible to remove at surgery. Histological examination revealed areas of loose fibroblastic tissue, hyaline cartilage, osteoid, and bone. It is postulated that the tumor arose from the stroma of the choroid plexus.
Sagittal synostectomy
Authors: Venes Joan L. , Sayers Martin P.
Published: May 2009

✓ A procedure for correction of scaphocephaly is described. It differs from strip craniectomy in that it provides early correction of the deformity by removing the protuberances at the bregma and at the occiput. The morbidity and mortality of this procedure is no greater than with the more standard linear craniectomy.
Isotope sinograms
Authors: Kapp John P. , Alfred Harry C. , Jones Terri
Published: May 2009

✓ A technique is described for examination of the dural venous sinuses using isotope angiography.
Preserved autoregulation in the rhesus spinal cord after high cervical cord section
Authors: Kobrine Arthur I. , Doyle Thomas F. , Newby Norwyn , Rizzoli Hugo V.
Published: May 2009

✓ The authors studied the effect of high cervical cord section on the phenomenon of autoregulation in the rhesus monkey with the hydrogen clearance method to measure focal spinal cord blood flow (SCBF). Laminectomies were performed at T7–11 and C1–2. The spinal cord was completely severed at C1–2. Under normocapnic conditions, SCBF was then measured in the thoracic spinal cord over a wide range of blood pressures (MAP). The MAP was either lowered by bleeding or raised by the intravenous infusion of angiotensin. Autoregulation was found to be intact between 50 and 125 mm Hg, following a pattern similar to the one observed in the intact animal.
Possible mechanisms for observed pathophysiological variability in experimental spinal cord injury by the method of Allen
Authors: Koozekanani Said H. , Vise W. Michael , Hashemi Reza M. , McGhee Robert B.
Published: May 2009

✓ Experimental spinal cord injuries were induced in dogs by dropping calibrated weights through a vented tube onto a small impounder resting on the surgically exposed cord. The motion of the impounder and the drop-mass were recorded by high-speed photography and the resulting data were compared to those obtained from a computer simulation of the dynamics of the injury mechanism. It is concluded that this method of inducing spinal cord injuries may yield markedly different degrees of cord compression depending upon the parameters of the animal material and apparatus even when the gm-cm of impact energy is maintained at a constant value. Some approaches to standardization of this injury model are suggested.
Classification of cervical spondylosis or disc protrusion by preoperative evoked spinal electrogram
Authors: Matsukado Yasuhiko , Yoshida Mamoru , Goya Tomokazu , Shimoji Koki
Published: May 2009

✓ The evoked spinal electrogram (SEG) was studied in 11 patients with cervical spondylotic myelopathy or disc protrusion. All the patients were severely handicapped before surgery. The evoked SEG was classified in three grades before and during surgery. Periodic follow-up studies were done at 18 to 35 months, with an average of 24 months. Four of six patients with normal or slightly abnormal SEG recordings showed satisfactory improvement of the disability; however, only one patient showed any improvement when the recording was moderately or severely abnormal. Location of the cord lesion and type of surgery were similar in all patients examined, and the difference was likely ascribed to the physiological change of the intramedullary structures. The evoked SEG provides some information relative to the surgical treatment of spondylotic myelopathy or disc protrusion with cord lesion.
Computer mapping of brain-stem sensory centers in man
Authors: Tasker Ronald R. , Rowe Ian H. , Hawrylyshyn Peter , Organ Leslie W.
Published: May 2009

✓ A computer program is described for use on-line with a two-stage stereotaxic technique in man. It has four capabilities. It transposes coordinates between a brain atlas and a stereotaxic frame, simultaneously adjusting for variations in individual brain dimensions. Corrections for electrode trajectories, and for any irregularities of placement of the stereotaxic frame in the head are also made. It plots an operative template that shows electrode trajectories and the sites from which physiological data are collected appropriately oriented upon a sagittal diagram of the brain. It graphically displays physiological data in the form of a Woolsey-type figurine chart that indicates threshold in milliamperes and, through the use of coded symbols, the quality of response and certain other data. It stores all this data in a tape library together with the locations of any lesions made. This makes it possible to replot any individual patient's operative data at any time. It also permits scanning of the stored protocols from all patients for any particular type of data either by itself or in combination with other data. This retrieved information is plotted on appropriate sagittal brain diagrams corrected for individual variations in brain size. Illustrations of the capabilities of the program are presented particularly with reference to the primary afferent pathways of the upper brain stem.
Use of epsilon aminocaproic acid (EACA) in the preoperative management of ruptured intracranial aneurysms
Authors: Sengupta Ram P. , So Sing C. , Villarejo-Ortega Francisco J.
Published: May 2009

✓ The authors report their experience with the use of epsilon aminocaproic acid (EACA) in the preoperative management of a series of patients with ruptured intracranial aneurysms. A similar series of patients was taken as control. They found that EACA is of definite value in preventing recurrent hemorrhage in the preoperative period. The significance of antifibrinolytic therapy in ruptured intracranial aneurysms is discussed.
Jugular venography for evaluation of abnormalities of the skull base
Authors: Quencer Robert M. , Tenner Michael S. , Rothman Lewis M. , Laster D. Wayne
Published: May 2009

✓ Jugular venography done to evaluate abnormalities at the base of the skull demonstrated three distinctly different patterns depending on whether there is occlusion, invasion, or growth within the internal jugular vein. Improper technique results in a lack of intracranial dural sinus filling which may masquerade as venous occlusion. This problem is avoided by adequate neck compression along with proper volume and rate of delivery of contrast. Radiographically, an abnormal jugular vein at the base of the skull will show a concave defect in true occlusion, constriction or invasion of the vein by tumor, or tumor growth within the vein.
Radionuclide cisternographic evaluation and follow-up of posttraumatic subconjunctival CSF loculation
Authors: McLennan James E. , Mickle J. Parker , Treves Salvadore
Published: May 2009

✓ The case of a patient with massive, posttraumatic, subconjunctival cerebrospinal fluid collections is described in which diagnosis and postoperative management was simplified by serial radionuclide cisternography.
Chondrosarcoma of the cervical spine
Authors: Blaylock Russell L. , Kempe Ludwig G.
Published: May 2009

✓ The authors present a case of chondrosarcoma involving the lateral mass of the C-2 vertebra, treated by an apparent total removal of the tumor. A review of the literature revealed that these patients can be cured in a significant number of cases if a radical removal is accomplished.
Fatal paradoxical muscle embolization in traumatic carotid-cavernous fistula repair
Authors: McCormick William F. , Kelly Patrick J. , Sarwar Mohammed
Published: May 2009

✓ A unique case of fatal paradoxical muscle embolism in a patient with a traumatic carotid-cavernous fistula is described. The muscle plug intended to occlude a left-sided fistula passed through the large fistula, bypassed the lungs by way of a patent foramen ovale, and embolized through the right carotid artery to lodge in the internal carotid and middle cerebral arteries producing fatal brain infarction.
Middle cerebral artery embolectomy
Authors: Garrido Eddy , Stein Bennett M.
Published: May 2009

✓ A patient who developed an embolic occlusion of the right middle cerebral artery while undergoing a cerebral arteriogram was successfully operated on by removal of the embolus under the surgical microscope. Early postoperative cerebrovascular spasm was a factor in the transient deterioration of the patient's neurological condition. When the patient was last seen 2 ½ months after surgery she was almost intact neurologically with only a mild right parietal dysfunction but with total resolution of the left hemiplegia. The literature is reviewed.
Damage to a Hakim valve
Authors: Haase Jens
Published: May 2009

✓ A case is reported where a Hakim valve was displaced by daily checking of the valve function.
Surgical treatment for aneurysms of the upper basilar artery
Authors: Wilson Charles B. , U Hoi Sang
Published: May 2009

✓ Fifteen patients with basilar bifurcation arterial aneurysms were treated surgically and their results presented. The importance of preoperative angiographic study to delineate regional anatomy is emphasized. Developments in neuroanesthesia and microsurgical techniques have made possible the successful attack of these formidable lesions.
Tolosa-Hunt syndrome: one cause of painful ophthalmoplegia
Authors: Hunt William E.
Published: May 2009

✓ The author reports 12 cases of Tolosa-Hunt syndrome, a benign steroid-resistant cryptogenic granuloma that presents as painful ophthalmoplegia. This syndrome is differentiated from other causes of painful ophthalmoplegia including tumors, aneurysms, collagen disease, specific infections, mucoceles, and benign granulomas of unknown etiology. These other conditions should be excluded by appropriate tests. Surgical exploration is not necessary if there is a prompt remission on steroid therapy.
Orbicularis oculi reflex and facial muscle electromyography
Authors: Raman P. T. , Reddy P. Krishna , Rao Sarasvani V.
Published: May 2009

✓ The electrically evoked orbicularis oculi reflex was analyzed in 26 patients with proven posterior fossa space-occupying lesions (11 cerebellopontine angle and 15 cerebellar hemispheric masses). In the former group, although only six had clinical evidence of trigeminal or facial involvement, the reflex analysis showed both nerves to be involved in all. Electromyography (EMG) of the orbicularis oculi showed profound denervation of this muscle while only minimal abnormalities of the masseter were seen. The sensory component of the trigeminal nerve was always more involved than its motor component and this was a reliable guide as to the upward and medial extension of the tumor, especially in the absence of clinical localizing signs. In the 15 patients with cerebellar masses, six with masses located posteriorly and entirely within the confines of the cerebellum had normal studies. In eight, the mass was located anteriorly, and fifth nerve involvement could be detected in all by EMG, although only two patients had clinical evidence of such involvement. One patient with dysfunction of the central reflex arc had EMG evidence of an intraventricular dermoid tumor abutting the pons, later confirmed at surgery. Thus, an invaluable body of diagnostic and prognostic data can be obtained by this nontraumatic and simple electrodiagnostic procedure.
Cerebrospinal fluid shunt infections with anaerobic diphtheroids (Propionibacterium species)
Authors: Everett E. Dale , Eickhoff Theodore C. , Simon Richard H.
Published: May 2009

✓ The clinical and laboratory findings in six cases of anaerobic diphtheroid infection of cerebrospinal fluid shunts are described. These organisms have been infrequently reported as a cause of shunt infections but our data indicate that such infections may be more common than currently appreciated. Propionibacterium species are common contaminants of cerebrospinal fluid specimens, but when isolated from the spinal fluid of a patient with a shunt who has symptoms and signs compatible with infection, the organism should not be dismissed as a contaminant. Fever was a constant finding frequently accompanied by signs of central nervous system dysfunction. Spinal fluid pleocytosis was usually limited to 1 to 200 cells and protein and sugar values were variable. The organisms grow slowly, therefore spinal fluid cultures should be held for at least 14 days before they are reported as negative.
Cerebral arterial spasm
Authors: Allen George S. , Gross Carol J. , French Lyle A. , Chou Shelley N.
Published: May 2009

✓ In vitro experiments were performed with a small volume chamber to determine the contractile activity of various vasoactive agents on human basilar and anterior cerebral arteries. Cumulative log-dose response curves were obtained for most of the agents tested including serotonin and three different prostaglandins; many of these curves were found to be similar to curves previously obtained with canine cerebral arteries. It was concluded from these similarities that canine cerebral arteries are a good in vitro model for studying human cerebral arterial spasm. It was also demonstrated that human cerebrospinal fluid, collected up to 17 days after a subarachnoid hemorrhage from patients with clinical and angiographic evidence of cerebral arterial spasm, would cause large, dose-dependent contractions in human anterior cerebral arteries.
Unoperated subdural hematomas
Authors: Lusins John , Jaffe Robert , Bender Morris B.
Published: May 2009

✓ The authors report nine patients selected from over 100 patients with subdural hematomas successfully treated without surgery. These patients were followed for as long as 5 years. All had angiographically demonstrated subdural hematomas. Electroencephalograms (EEG) documented well the clinical improvement of the patient, but were poor guides to the true size of the hematoma, since EEG returns to normal early in the patient's course. Static scans are a better guide to the presence of a subdural hematoma, but they lag behind clinical improvement and usually remain abnormal for considerable periods of time after a major portion of the hematoma has been reabsorbed, and the patient is asymptomatic.
Brain and bone scans in primary Ewing's sarcoma of the petrous bone
Authors: Fitzer Pete M. , Steffey William R.
Published: May 2009

✓ The authors present a case in which primary Ewing's sarcoma of the right petrous pyramid in a 9-year-old girl showed no uptake on a 99mTc-pertechnetate nuclide angiogram. Intense uptake was present on a 99mTc-polyphosphate bone scan, but a static brain scan was only minimally abnormal. The diagnosis and treatment of Ewing's sarcoma are reviewed.
Spinal arterial malformation in a child with hereditary hemorrhagic telangiectasia
Authors: Merry Glen S. , Appleton D. Barry
Published: May 2009

✓ A case is reported of spinal aneurysm in a child with a family history of hereditary hemorrhagic telangiectasia causing spinal cord and cauda equina compression. The operative approach is discussed.
Parietal intradiploic encephalocele
Authors: Kosnik Edward J. , Meagher John N. , Quenemoen Lowell R.
Published: May 2009

✓ An unusual case is presented of an intradiploic encephalocele surrounding a cerebrospinal fluid cyst. The relationship of this developmental anomaly to the more commonly encountered midline encephalocele and isolated reports of temporal bone encephaloceles are discussed.
Mouth guide for operating microscope
Authors: Holly Eugene H.
Published: May 2009

✓ An inexpensive mouth guide is described, which increases the mobility of the operating microscope and effectively shortens operating time.
Evaluation of mithramycin in the treatment of anaplastic gliomas
Authors: Walker Michael D. , Alexander Eben , Hunt William E. , Leventhal Carl M. , Mahaley M. Stephen , Mealey John , Norrell Horace A. , Owens Guy , Ransohoff Joseph , Wilson Charles B. , Gehan Edmund A.
Published: May 2009

✓ A controlled, prospective, randomized study evaluated the use of mithramycin in the treatment of anaplastic glioma compared to a similar group of patients receiving best conventional care. From a total of 116 patients in the study, 96 were within the valid study group. All patients were operated on, had histological confirmation of anaplastic glioma, and received radiotherapy at the discretion of the principal investigator. Fifty-two patients received mithramycin at a dose of 25 µg/kg/day for 21 days, while 44 patients were in the control group. There was no significant difference in the median survival from time of randomization in those receiving mithramycin (21 weeks) as compared to those not receiving mithramycin (26 weeks). There was no significant difference between the two groups in relation to age distribution, sex, location, diagnosis, tumor characteristics, signs or symptoms, or radiotherapy received. Duration of symptoms correlates positively with survival and was also significantly longer in the control group than in the treated group. This, however, did not account for the failure of mithramycin to be found an effective agent. Although the study was not designed to evaluate the efficacy of radiotherapy, patients who were so treated had a significant improvement in survival. The toxic complications of mithramycin included gastrointestinal symptoms, dermatological involvement, anemia, and liver dysfunction, indicating the need for close supervision.
Carbohydrates as potential diagnostic tracers for brain tumors
Authors: Wassenaar Willem , Tator Charles H.
Published: May 2009

✓ Currently available diagnostic tracers for brain tumors are not specific. Tumor-specific tracers would improve the detection of brain tumors by gamma encephalography. Glucose is an important substrate for tumor metabolism and is known to be taken up in large amounts. The authors have studied five labeled carbohydrates in an attempt to find a tumor-specific tracer: three were tritiated (L-galactose-1-3H, L-fucose-3H, and 4,6-dideoxy-xylo-hexose-3H) and two were radioiodinated (methyl-6-125I-6-deoxy-D-glucoside and 6-125I-6-deoxy-D-glucose). The uptake of these tracers by a transplantable mouse ependymoblastoma after intravenous injection was determined by liquid and well scintillation counting. The highest tumor-to-brain ratio was 7.1 to 1 for the tritiated tracers and 6.2 to 1 for the radioiodinated tracers. Although these ratios are not high enough for gamma encephalography, one of the iodinated tracers may be useful for enhancement of contrast in computerized axial tomography.
Body position and cerebrospinal fluid pressure
Authors: Magnæs Bjørn
Published: May 2009

✓ Cerebrospinal fluid (CSF) pressure was recorded in 149 patients and arterial blood pressure (BP) in 11 patients while moving between lateral and sitting positions. Rapid tilting initiated waves in BP and CSF filling pressure. The postural CSF pressure wave manifested itself either as a transient or as a stationary wave similar to a plateau wave. When patients sat up, transient waves had amplitudes up to 550 and stationary waves up to 1000 mm H2O. When they lay down, transient waves had amplitudes up to 800 mm H2O. Stationary waves were found only among patients with elevated intracranial pressure and a diseased brain. The waves were mainly caused by changes in cerebral blood volume probably reflecting the postural BP wave and brain autoregulation. Most patients with stationary and large transient waves also manifested clinical symptoms. These symptoms were aggravated when a craniospinal block developed in the sitting position, and were reduced or avoided when the tilting was performed slowly over 2 to 3 minutes.
Sensory Jacksonian seizures
Authors: Lende Richard A. , Popp A. John
Published: May 2009

✓ Sensory Jacksonian seizures were analyzed in 42 patients with regard to anatomical and temporal sequences. The origin of sensory Jacksonian seizures, in contrast to motor Jacksonian seizures, often began at peripheral sites with little cortical representation. The progression of seizure activity across the cerebral cortex followed a course that was neither rectilinear, radiate, nor random; it appeared to proceed in an organized manner to involve functionally coherent units. The patterns analyzed conformed more closely to cortical somatosensory maps reported for the chimpanzee than the sensory sequences presently available for the cortex of man. Complete diagnostic studies are indicated in patients presenting with sensory Jacksonian seizures because of the frequency of related focal pathology.
Microvascular bypass surgery
Authors: Chater Norman , Spetzler Robert , Tonnemacher Kent , Wilson Charles B.
Published: May 2009

✓ Microvascular anatomical studies were performed to ascertain the most suitable cortical vessel for extracranial-intracranial arterial bypass (EIAB). The three most commonly used cortical areas (the tip of the frontal lobe, the tip of the temporal lobe, and the area at the angular gyrus) were examined in detail. Because of their accessibility and size, the cortical arteries in the area of the angular gyrus offer the most suitable location for creating an EIAB.
Cerebrospinal fluid lactate and electrolyte levels following experimental spinal cord injury
Authors: Anderson Douglas K. , Prockop Leon D. , Means Eugene D. , Hartley Lawrence E.
Published: May 2009

✓ Cerebrospinal fluid (CSF) lactate, sodium (Na+), potassium (K+), calcium (Ca++), magnesium (Mg++), and chloride (Cl−) levels were determined for 17 to 21 days following experimental spinal cord compression in cats. Laminectomies were performed at L-2 under general anesthesia with aseptic techniques. Paraplegia was produced by applying a 170-gm weight transdurally for 5 minutes. Significant increases in CSF lactate levels were observed on the first through ninth days post injury with peak levels (50% above normal) occurring at Day 5. The only significant postinjury CSF electrolyte changes were elevation in Ca++ concentration on Days 3, 9, 11, 13, and 15, elevation in K+ concentration on Days 9 and 11 and decline in Cl− levels on the first day. The CSF K+ increase probably reflected cellular loss of K+ from damaged tissue whereas the Ca++ rise may have resulted from increased CSF protein levels. The prolonged elevation of CSF lactate indicates that tissue hypoxia plays a role in spinal cord compression paralysis, and that there is a continuing hypoxia of metabolically active spinal cord tissue for several days post injury.