bluuebunny/crossref_metadata_2025 huggingface dataset:
Atlanto-axial dislocation due to agenesis of the os odontoideum or odontoid
Authors: Nagashima Chikao
Published: May 2009

✓ Five patients having atlanto-axial dislocation due to an os odontoideum or odontoid agenesis are presented. Two were operated on successfully with preliminary realignment of the dislocation by skeletal traction and subsequent occipitocervical fixation with wiring and acrylic plastic. In one case, the usual two-step procedure of anterior fixation and suboccipital decompression was satisfactorily combined into one procedure.
The effect of hyperbaric oxygen on experimentally increased intracranial pressure
Authors: Miller J. Douglas , Fitch William , Ledingham Iain M. , Jennett W. Bryan
Published: May 2009

✓ The effect of breathing high partial pressures of oxygen on intracranial pressure (ICP) was assessed in 10 anesthetized, ventilated dogs in which ICP had been increased by slow inflation of extradural balloons. Cerebrovascular responsiveness was tested by the addition of carbon dioxide (CO2) to the inspired gases. Inhalation of 100% oxygen reduced ICP by 23% when delivered at normal atmospheric pressure (arterial pO2, 585 mm Hg) and by 37% when delivered at 2 atmospheres absolute (ATA) in a hyperbaric chamber (arterial pO2, 1076 mm Hg). This reduction in ICP, which was present only during oxygen administration, was not associated with any change in arterial blood pressure or pCO2. Hyperbaric oxygen (OHP) reduced ICP only at the stage when the cerebral circulation was still responsive to CO2, as manifested by a rise in ICP; at high levels of ICP, responsiveness to both CO2 and OHP was lost. When the ipsilateral pupil became dilated following balloon inflation, a reduction in size was observed during administration of OHP in 11 out of 13 instances. During the responsive phase, when OHP reduced ICP, cerebral venous PO2 which was 41.7 ± 2.3 mm Hg (S.E.M.) on air breathing was modestly increased by OHP to 58.3 ± 2.5 mm Hg; when ICP no longer responded to OHP, cerebral venous PO2 was higher, on both air breathing (52.0 ± 4.1 mm Hg) and OHP (161.4 ± 14.7 mm Hg).
Electrical impedance of the pituitary gland
Authors: Zervas Nicholas T. , Shintani Akira , Pickren Kenneth S.
Published: May 2009

✓ Experimental and clinical measurements of electrical impedance revealed a significant well-delineated difference between the pars distalis and the pars nervosa, providing an accurate and easy means of identifying the tissue interface between these two elements of the pituitary gland.
The occipital sinus
Authors: Das A. C. , Hasan Mahdi
Published: May 2009

✓ Fresh dural preparations and dried occipital bones from 200 adult cadavers were examined to define the characteristics of the occipital sinus. The occipital sinus was found to be present in 64.5% cases. Different morphological types are classified into the following: median occipital sinus (35%), double occipital sinus (22.5%), left occipital sinus (4%), and right occipital sinus (3%). Communications with the confluence, superior sagittal, straight, transverse, and sigmoid sinuses are described. The normal findings and some notable anomalies are discussed in the light of the available literature.
Meningitis following acute traumatic cerebrospinal fluid fistula
Authors: MacGee Edwin E. , Cauthen Joseph C. , Brackett Charles E.
Published: May 2009

✓ The effect of prophylactic antibiotics in preventing meningitis are reviewed in 58 cases of acute traumatic cerebrospinal fluid (CSF) fistula. A summary of the literature plus data from the present series show a total of 402 cases of acute traumatic CSF fistula; there were 46 cases (14%) of meningitis in 325 patients receiving expectant antibiotics, and four cases (5%) in 77 patients treated without antibiotics. No statistically significant conclusion can be drawn from these data regarding the usefulness of expectant antibiotics in acute traumatic CSF rhinorrhea or otorrhea.
Relation of the accessory rootlets of the trigeminal nerve to its motor root
Authors: Saunders Richard L. , Sachs Ernest
Published: May 2009

✓ Microsurgical dissection of trigeminal nerves in autopsy specimens demonstrates that the so-called “accessory rootlets” are really a component of the motor root. This confirms Meckel's description of 1748.
Direction of blood flow in the primate cervical spinal cord
Authors: Fried Larry C. , Doppman John L. , Chiro Giovanni Di
Published: May 2009

✓ The direction of blood flow in the cervical spinal cord of monkeys was studied by direct cinematic observation of the results of dye injections, plus separate angiographic studies. The studies indicated that in monkeys blood enters the cervical spinal cord mainly from radicular arteries that are usually derived from branches of the costo-cervical trunk. Although some blood entering at the low cervical level flows toward the thoracic cord, the major component flows up to the C-2 level. The findings cast doubt on the established assumption that the vertebral arteries provide the main blood supply of the cervical cord.
Ventricular size and chronic increased intracranial venous pressure in the dog
Authors: Guthrie Thomas C. , Dunbar Howard S. , Karpell Barbara
Published: May 2009

✓ Intracranial venous pressure was increased by blocking the torcular Herophili in 10 dogs. At intervals of 1 to 29 weeks, pressure in the superior sagittal sinus and cerebrospinal fluid (CSF) were recorded and the size of the ventricles determined at autopsy. Changes in venous pathways were documented by sinograms. Significant increase in both sagittal sinus and CSF pressures occurred after torcular block. CSF pressures remained elevated for as long as 29 weeks at an average of 100 mm above preblock levels. Neurological deficits after torcular block were minimal. Autopsies showed normal-sized ventricles without any stigmata of hydrocephalus.
Acute hemorrhagic leucoencephalitis
Authors: Litel Gerald , Ehni George
Published: May 2009

✓ In a case of acute hemorrhagic leucoencephalitis, proven by biopsy, a steroid preparation and dehydrating agents used in unusual amounts resulted in almost complete recovery. The characteristic features and related studies of this disease are reviewed and the policy of conservative therapy emphasized.
Turbulence in human intracranial saccular aneurysms
Authors: Ferguson Gary G.
Published: May 2009

✓ Preliminary experiments with glass model bifurcation aneurysms demonstrated that turbulent flow pattern occurs in the sac of an aneurysm at a low flow rate (critical Reynolds number, 400 ± 10 S.E.M.). A prediction that flow is turbulent in the sac of human intracranial saccular aneurysms was confirmed in a clinical study. Bruits, indicative of turbulence, were recorded with a phonocatheter from the sacs of 10 out of 17 intracranial aneurysms exposed at surgery where the mean arterial pressures were above 50 mm Hg. The amplitude of the bruits varied with the pressure. All of the patients in whom no bruit was found had profound Arfonad hypotension at the time of recording.

Turbulence causes vibration in the wall of a vessel. This vibration produces and accelerates degenerative changes in vascular tissue by a process similar to the structural fatigue of metals by vibration. The author proposes that the turbulent blood flow within an aneurysm contributes to the degeneration of the elastica, and the production of the atheromatous changes, characteristically seen in its wall. This weakens the wall causing continuing enlargement and eventual rupture.
Occult infections of ventriculoatrial shunts
Authors: Fokes Ernest C.
Published: May 2009

✓ Organisms usually considered nonpathogens have been implicated with increasing frequency as the cause of infected ventriculoatrial shunts. Often the signs of infection are minimal, with no evidence of inflammation; but there may be low-grade fever, anemia, leukocystosis, and variably present hepatosplenomegaly. By routinely culturing all shunts electively revised, a form of infection completely unapparent clinically has been recognized. Coagulasenegative staphylococcus or diphthenoids were grown from the cardiac or ventricular catheters of each patient. Pre- and postoperative spinal fluid and blood cultures were sterile, and there was no other clinical or laboratory evidence of infection. Six such cases are discussed in detail. It is suggested that prophylactic use of appropriate antibiotics at the time of surgery may have a place in the control of the problem.
Regional vascular reactivity in the middle cerebral arterial distribution
Authors: Symon Lindsay
Published: May 2009

✓ Regional vascular reactivity has been assessed in anesthetized baboons by comparing the arterial and venous pulse heights in the pial circulation within the middle cerebral arterial field. The ratio of venous to arterial pulse height (the “pulse index”) provided some indication of the state of the regional cerebral vascular resistance within the field of the middle cerebral artery. The pulse index increased in response to increased arterial pCO2 and to the effects of vascular occlusion, indicating vasodilatation in response to biochemical or autoregulatory stimuli. The pulse rose sharply for a short time following release of temporary vascular occlusion; this rise was used to assess the phenomenon of reactive hyperemia following occlusion. Occlusion of the same artery produced hyperemia of approximately the same extent irrespective of the length of occlusion, but longer occlusions produced longer lasting hyperemia. Vascular resistance steadily decreased to very low levels of input arterial pressure in progressive exsanguination experiments, indicating that the failure of cerebral blood flow autoregulation at low levels of arterial pressure is probably not due to exhaustion of myogenic mechanisms within the small resistance vessels themselves.
Effects of local hypothermia and tissue oxygen studies in experimental paraplegia
Authors: Kelly David L. , Lassiter Kenneth R. L. , Calogero John A. , Alexander Eben
Published: May 2009

✓ A controlled series of adult mongrel dogs were rendered paraplegic by traumatizing the thoracic spinal cord. Those animals treated with local hypothermia, whether immediately or after a delay, recovered to a significantly greater degree than the untreated group. Spinal cord pO2 studies revealed a marked fall in the pO2 at the area of maximal injury over a 30-min period. The severe hypoxia lasted at least 7 hours. Pathological studies showed the varying degrees of injury produced. It is postulated that local hypothermia may be effective in altering the clinical recovery by decreasing the tissue metabolism at the site of injury.
Brain tissue reaction to some chronically implanted metals
Authors: Dymond Anthony M. , Kaechele Lloyd E. , Jurist John M. , Crandall Paul H.
Published: May 2009

✓ The toxicity of certain metals, namely, platinum, platinum-8% tungsten, platinum-10% rhodium, platinum-10% iridium, platinum-10% nickel, platinized platinum, a gold-nickel-chromium alloy, a gold-palladium-rhodium alloy, a chromium-nickel-molybdenum alloy (Vitallium), stainless steel, silver, rhenium, and gold, was evaluated histologically following chronic implantation for 2 months in the brains of cats. Of the above metals, all but silver were found to be nontoxic. Boron was also evaluated and found to be nontoxic.
Bilateral carotid vertebrobasilar rete mirabile
Authors: Jones Ronald R. , Wetzel Nicholas
Published: May 2009

✓ A case of bilateral internal carotid artery hypoplasia with bilateral carotid rete mirabile is described in which the intracranial circulation was fed predominantly by external carotid anastomosis, the vertebrobasilar system, and the internal carotid system.
Acinar choroid plexus adenoma
Authors: Davis Richard L. , Fox Gerald E.
Published: May 2009

✓ Mucin-producing cystic tumors of the choroid plexus are rare and most are papillomas or carcinomas. An acinar choroid plexus adenoma of the right lateral ventricle is described. Symptoms and signs included headache, vomiting, papilledema, and a gait disturbance. The neoplasm was located with ventriculography and totally removed, but the patient died of complications of surgery. The relationship of this tumor to others arising in the choroid plexus is discussed.
Radiographic and histologic demonstration of an aneurysm developing on the infundibulum of the posterior communicating artery
Authors: Stuntz J. Timothy , Ojemann George A. , Alvord Ellsworth C.
Published: May 2009

✓ In this case an aneurysm of the posterior communicating artery developed 9 years after an infundibular dilatation of this posterior communicating artery, without aneurysm formation, had been radiographically demonstrated. Histological examination, after a fatal subarachnoid hemorrhage from the aneurysm, demonstrated that it arose exactly at the site of narrowing of the funnel-shaped infundibulum.
Trigeminal neuralgia secondary to asymmetry of the petrous bone
Authors: Obrador Sixto , Queimadelos Victor G. , Soto Manuel
Published: May 2009

✓ This patient with a 12-year history of right trigeminal neuralgia had a marked asymmetry of the skull and petrous bone due to unilateral basilar impression of the right side. Partial section of the trigeminal root through a right subtemporal extradural approach was performed, with a good therapeutic result. Stretching and angulation of the root over the ridge of the elevated petrous bone was the probable cause of the trigeminal pain.
Ultrasound placement of cardiac tube in ventriculoatrial shunt
Authors: Nishimoto Akira , Shimada Hikozo , Ueda Shin , Yagyu Yasunori
Published: May 2009

✓ A new technique using an ultrasonic probe for accurate placement of the cardiac tube in a ventriculoatrial shunt is described. This method provides correct measurement of the distance between the tube tip and the pulsating tricuspid valve.
The unresting specialty
Authors: Walker A. Earl
Published: May 2009

✓ The president of the American Association of Neurological Surgeons reviews many of the problems considered by the Board of Directors during 1969–70. To their thoughts the president adds his views of such varied neurosurgical areas as: changing scope of neurosurgical practice, malpractice, future undergraduate and graduate training, continuing education, and governmental influence on medical practice.
Extradural and subdural hematomas
Authors: Jamieson Kenneth G.
Published: May 2009

✓ The pattern of head injuries due to traffic accidents has changed markedly in Australia in the period since 1935. A review of autopsy cases of extradural and acute subdural hematomas shows a startling shift toward inoperable lesions. The author points out that accident prevention must now be considered the chief means of reversing man's trend toward self-destruction on the highway.
The syndrome of carotid occlusion following minor craniocerebral trauma
Authors: Olafson Richard A. , Christoferson Lee A.
Published: May 2009

✓ A new syndrome of carotid occlusion following a minor head injury not obviously involving the neck is reported in two patients. The characteristic delayed onset of unilateral motor, sensory, and visual defects in the relatively young patient is discussed. The authors have also hypothesized a mechanism for carotid occlusion produced by minor head injuries.
Cervical spinal cord hemorrhages in experimental head injuries
Authors: Gosch Hank H. , Gooding Elwyn , Schneider Richard C.
Published: May 2009

✓ Petechial hemorrhages at the cervicomedullary junction have been noted in football players who sustained direct “head-on” or vertex impacts when they struck an opponent. Head and cervical spinal cord injuries were produced in experimental animals on an impact track simulating this mechanism. Severe cervical spinal cord destruction was obtained in the absence of cervical flexion and extension. Cord movement was enhanced by sectioning the dentate ligaments, which prevented these lesions. It is postulated that the transmission of shear strains along the axis of acceleration is responsible for the hemorrhages when the elastic deformation of the cervical spinal cord is exceeded.
The fate of retained intracerebral shotgun pellets
Authors: Sights Warren P. , Bye Robert J.
Published: May 2009

✓ An experimental study is presented of the histopathological reaction of the brain to shotgun pellets surgically implanted in cats. Hardened lead shot produced the least reaction, copper-coated pellets the most, and nickel-coated shot an intermediate reaction. Seven histological changes and neurological deficits were apparent in cats with implanted copper-coated pellets; a marked migration of copper-coated shot was revealed by x-ray and autopsy examination. Three clinical cases are presented to illustrate the clinical significance of the laboratory data.
Spinal cord participation in the Cushing reflex in the dog
Authors: Meyer Glenn A. , Winter David L.
Published: May 2009

✓ The vasopressor response to increased intradural pressure (Cushing reflex) is caused by decreased arterial perfusion (hypoxia) and the mechanical effects of pressure acting in concert. Increased pressure in the range 50–200 mm Hg alters ongoing activity in all neurons concerned with the autonomic nervous system at multiple levels of the neuroaxis. Therefore, the response of an intact organism is highly variable and unpredictable. Conversely, the response to increased pressure exerted upon the spinal cord of a spinal animal is relatively uniform and predictable. Spinal neurons of both the somatic and autonomic nervous systems show facilitation followed by inhibition, but the time course and magnitude of these events are much different for the two systems. Autonomic neurons retain the ability to fire under very adverse conditions, thus enhancing the organism's chance for survival.
Creation and operation of a bone bank
Authors: Cloward Ralph B.
Published: May 2009

✓ The author states that sterile frozen cadaver bone has proven to be a superior bone graft for anterior (interbody) fusion operations on the spine. An adequate supply of good quality bone is necessary, and a bone bank can be an important and reliable source. The author reviews his 22-year experience with bone banks and gives details for their creation, operation, and maintenance.
Results of stimulation and destruction of the posterior hypothalamus in man
Authors: Sano Keiji , Mayanagi Yoshiaki , Sekino Hiroaki , Ogashiwa Motohide , Ishijima Buichi
Published: May 2009

✓ Autonomic and somatomotor responses to electrical stimulation of the posterior hypothalamus are reported in 51 patients with pathologically aggressive behavior. The stimulated area causing rise in blood pressure, tachycardia, and maximal pupillary dilatation lies in the posteromedial hypothalamus, more than 1 mm and less than 5 mm lateral to the lateral wall of the third ventricle, occupying a triangle formed by the midpoint of the intercommissural line, the rostral end of the aqueduct, and the anterior border of the mammillary body. Electrical stimulation of this (ergotropic) triangle resulted in desynchronization of the electroencephalogram (EEG) with hippocampal theta waves, or diffuse irregular delta waves of high voltage.

Cases with violent behavior showed higher plasma levels of non-esterified fatty acids (NEFA) in the fasting stage; these were markedly elevated by electrical stimulation of the ergotropic triangle.

Points in the ergotropic triangle where signs of sympathetic discharge were most marked were electrocauterized bilaterally. This procedure produced marked calming effects (95% of the cases) during the follow-up period of more than 2 years. Postoperatively there was a tendency to a decrease in sympathicotonia or an increase in parasympathicotonia. The follow-up plasma level of NEFA was found to have decreased to approximately the normal value.
Radiographic identification and surgical excision of an epidermoid tumor of the pineal gland
Authors: Kirsch Wolff M. , Stears John C.
Published: May 2009

✓ An epidermoid tumor of the pineal gland for 5 years was incorrectly assumed to be a surgically inaccessible lesion. The patient showed progressive neurological deterioration despite two courses of irradiation therapy and numerous attempts at cerebrospinal fluid shunting. A ventriculogram ultimately demonstrated the epidermoid tumor. Significant improvement resulted from resection of the tumor and the use of a shunting system capable of passing particulately contaminated ventricular fluid.
Sagittal sinus thrombosis related to oral contraceptives
Authors: Shende Michael C. , Lourie Herbert
Published: May 2009

✓ A case of thrombosis of the cortical veins and superior sagittal sinus occurred in a young woman with no obvious predisposing factors other than the possible implication of contraceptive pills. Angiographic, surgical, and pathological findings are presented. Survival in this case resulted from a large cranial decompression, and later a ventriculojugular shunt to control extraventricular obstructive hydrocephalus.
External carotid-transverse sinus fistula
Authors: Robinson Julian L. , Sedzimir Carol B.
Published: May 2009

✓ A case of congenital fistula between the posterior auricular artery and the transverse sinus is described. A comment is added on the possible embryological mechanism producing these lesions, and the usual symptomatology and treatment are discussed.
A technique for repeated access to the subarachnoid space in the dog
Authors: Redmond D. Eugene , Rinderknecht H. Robin , Hudgins Phillip T.
Published: May 2009

✓ A simple and reliable technique for repeated access to the CSF in dogs is reported. A permanent vinyl catheter was inserted caudally through the atlanto-occipital membrane using a Tuohy spinal needle. Three alternative systems of access to the catheter were compared for use in obtaining CSF samples, making intrathecal injections, and measuring pressure. Problems with bacterial infection, tissue reactions or damage, and leakage were evaluated experimentally. Of 42 dogs, 37 tolerated the catheters well for periods up to 62 days, two died with signs of spinal cord injury, and three died with meningeal signs and positive bacterial cultures. The mean CSF pressure of 175 readings in 30 normal dogs was 130.6 mm H2O, using an open manometric method. The adequacy of the tubing and its placement to monitor subtle pressure changes and to allow effective caudad and cephalad diffusion of intrathecally injected substances were illustrated.
Central nervous system tuberculosis: a persistent disease
Authors: Wilkinson Harold A. , Ferris Ernest J. , Muggia Albert L. , Cantu Robert C.
Published: May 2009

✓ The authors report their experience with four recent cases of tuberculosis affecting the central nervous system (CNS), including tuberculous meningitis and tuberculomas of both the cerebrum and the cerebellum. They emphasize that antituberculous drugs have given the neurosurgeon a role of increased importance and effectiveness in the management of CNS tuberculosis. Shunts, radical excisions, and fusion have new significance. Angiography and brain scans may reveal operable lesions. The authors believe that CNS tuberculosis should always include triple therapy with INH, PAS, and streptomycin plus corticosteroids to control cerebral edema and help to minimize basilar adhesions and hydrocephalus in tuberculous meningitis.
The arteries of the thalamus: an anatomical and radiological study
Authors: Lazorthes Guy , Salamon G.
Published: May 2009

✓ Based on a previous anatomical study and description of the arteries of the thalamus, the authors have attempted to identify these arteries by lateral vertebral angiography. They describe modifications of these vessels in cases of primary tumors of the thalamus and adjacent areas.
Experimental approach for monitoring surface brain pressure
Authors: Schettini Alfonso , McKay Lachlan , Majors Raymond , Mahig Joseph , Nevis Arnold H.
Published: May 2009

✓ A method for monitoring brain surface pressure through the intact dura has been designed based upon the concept of a coplanar, non-sensitive ring transducer. The transducer detects the underlying brain pressure while the stretching forces of the dural membrane are dissipated at the outer ring. The strain gauge consists of a piezo-resistive silicon-chip sensing element and a dummy element that provides temperature compensation. Cisternal cerebrospinal fluid (CSF) and brain surface pressures were monitored simultaneously in dogs under general anesthesia, both before and after increased intracranial pressure was produced experimentally. A difference was found between CSF and brain surface pressures. Possible explanations for this observation are discussed.
Percutaneous embolization of spinal cord arteriovenous malformations
Authors: Doppman John L. , Chiro Giovanni Di , Ommaya Ayub K.
Published: May 2009

✓ A technique is described for embolically occluding the feeding arteries of spinal cord arteriovenous malformations by non-operative means. Following the identification of each feeder by selective arteriography, a system of coaxial catheters is introduced percutaneously and each feeding artery is occluded within the spinal canal using metallic pellets, gelfoam, and muscle fragments. Technical details of the procedure are described and the choice of embolic material discussed. Embolization has been successfully accomplished in five patients. None were made worse, and three have shown progressive neurological improvement. The simplicity of the procedure and the absence of morbidity are stressed. Percutaneous embolization should be considered as an alternative to operative ligation of feeding arteries.
The choroid plexus in experimental hydrocephalus
Authors: Dohrmann George J.
Published: May 2009

✓ Experimental hydrocephalus was created in dogs by injection of kaolin into the cisterna magna. One month after the kaolin injection, ventriculojugular shunts were performed on certain of the hydrocephalic dogs. Shunted hydrocephalic dogs were killed 1 day or 1 week after placement of the shunt. Cerebrospinal fluid (CSF) pressures were measured prior to the kaolin administration and/or 1 month post-kaolin injection and/or after the shunting procedure. Choroid plexuses from control, hydrocephalic, and shunted hydrocephalic dogs were examined by light and electron microscopy. The hydrocephalic dogs had choroid plexuses with a flattened epithelium, compacted cytoplasm, and multiple large vacuoles usually containing small, rounded membrane-bound structures; it was postulated that these vacuolar structures were dilated multivesicular bodies possibly related to CSF resorption. Choroid plexuses from hydrocephalic dogs examined 1 day post-shunt closely resembled choroid plexuses from the control dogs. Intracytoplasmic, apical lipoid inclusions, 1.0 to 6.0 µ in diameter, were noted within many choroidal epithelial cells of dogs shunted for 1 week. This change was probably related to the trauma of shunt insertion. It was concluded that the morphology of the canine choroid plexus returned to normal 1 day after the ventriculojugular shunt.
Hemicraniectomy in the management of acute subdural hematoma
Authors: Ransohoff Joseph , Benjamin M. Vallo , Gage E. Lyle , Epstein Fred
Published: May 2009

✓ Acute subdural hematomas requiring surgical drainage as a life-saving procedure shortly after injury have been associated with mortality rates as high as 90%. Important factors include early diagnosis, complete clot removal, control of active bleeding, and provision for control of subsequent cerebral edema. In a series of 35 patients who had large, unilateral acute subdural hematomas and were unconscious and decerebrate, the mortality rate was reduced to 60%, and 28% returned to normal activity, through the use of a radical procedure. Following establishment of airway and intravenous Mannitol, emergency angiography was carried out to demonstrate the exact intracranial pathology. A hemicranial bone flap was utilized to aid in clot removal and control of hemorrhage from bridging veins and/or cerebral lacerations. The bone flaps were discarded and the dura not closed to afford postoperative decompression. Plating of the skull defects was carried out at a later date when indicated.
Intraventricular craniopharyngioma Report of two cases
Authors: Cashion Ernest L. , Young Joseph M.
Published: May 2009

✓ Craniopharyngiomas are usually considered to arise along the pituitary stalk and upper aspect of the pituitary gland. Two cases of craniopharyngioma confined to the third ventricle are reported.
Medulloblastoma of the neonatal period and early infancy
Authors: Papadakis Nikolas , Millan Jose , Grady Donald F. , Segerberg Ludwig H.
Published: May 2009

✓ Two infants with medulloblastoma are reported, both of whom underwent surgery for their tumors. The characteristic presenting symptoms were vomiting, head enlargement, opisthotonic attacks, and downward deviation of the eyes. The diagnosis was established by ventriculography and millipore study of the ventricular fluid. Both children were operated on and subsequently received radiation therapy. One child also received chemotherapy.
Successful removal of a large meningioma in a three-year-old boy
Authors: Klump Thomas E. , McDonald Joseph V.
Published: May 2009

✓ A 300 gm fibroblastic meningioma was successfully removed from the right frontal lobe of a 3-year-old boy. It extended into and distorted the right ventricle but had no obvious meningeal attachment. One month after surgery, the patient developed a spastic paraparesis probably due to vascular insufficiency of the regions supplied by the anterior cerebral arteries. This neurological deficit cleared within 6 months, and the neurological examination 3 years postoperatively was normal.
Spondylolisthesis of the cervical spine
Authors: Dawley John A.
Published: May 2009

✓ A case of spondylolisthseis involving the cervical spine in an 11-year-old girl is reported. The age, x-ray appearance, and absence of history of trauma suggest a congenital origin.
Analysis of 2187 consecutive penetrating wounds of the brain from Vietnam
Authors: Hammon William M.
Published: May 2009

✓ A series of 2187 cases of penetrating wounds of the brain, treated in a U.S. Army Hospital in Vietnam, is analyzed according to operability, wounding agents, sites of cranial penetration, associated organ system injuries, operative and postoperative complications, and mortalities. A detailed description of the operative technique of thorough intracranial debridement and dural repair is presented and stressed. The previously established principles of combat neurosurgery are confirmed and their continued use recommended.
A syndrome characteristic of tangential bullet wounds of the vertex of the skull
Authors: Adeloye Adelola , Odeku E. Latunde
Published: May 2009

✓ Six patients with tangential missile wounds of the vertex of the skull presented symptoms of limb paresis which were more marked proximally in the arms and distally in the legs where there was also sensory loss of a cortical type. Carotid cerebral angiography and operative treatment showed patency of the longitudinal sinus and injury to the medial aspects of the frontoparietal cortex. The term “longitudinal sinus syndrome” formerly applied to these cases is therefore a misnomer since the main underlying cause is cortical injury and not thrombotic occlusion of the superior longitudinal sinus, as previously suspected.
Induced seizures as therapy of experimental strokes in dogs
Authors: Reed Ronald R. , Ciesel Conrad , Owens Guy
Published: May 2009

✓ Intracerebral pO2, as measured in normal dog brains by a modified mass spectrometer, was found to increase following seizure activity and remain elevated at least 2 hours. These results were found with both drug- and electrically-induced seizures. The pO2 increased to a greater degree in brain tissue rendered ischemic by middle cerebral artery occlusion. A transient reflex hypertension was observed with seizure activity, but hypertension alone failed to produce significant pO2 changes. Since oxidative metabolism has been shown by other investigators to proceed at an elevated rate during seizure activity, the increased pO2 must reflect improved collateral circulation following seizure activity.
The effect of passive hyperventilation on intraventricular pressure in the dog
Authors: Kitahata Luke M. , Galicich Joseph H. , Sato Isao
Published: May 2009

✓ The effectiveness of passive hyperventilation in reducing intracranial pressure was studied in mongrel dogs by varying the levels of end-tidal pCO2 and airway pressure, and comparing the positive-negative and positive-atmospheric pressure. It has been shown that there is a point beyond which reduction of pCO2 does not affect cerebral blood flow. The present study demonstrates that another limiting factor is the degree of positive or negative airway pressure. Positive airway pressure impedes venous drainage, thereby increasing intracranial pressure. This increase could only partly be offset by applying negative expiratory airway pressure, since it was found that excessive negative airway pressure (greater than static recoil pressure of the lung) may trap air in alveoli. An optimal range of positive and negative airway pressures is defined.
Brain tumors in hereditary multiple system hamartomatosis (tuberous sclerosis)
Authors: Cooper Jack R.
Published: May 2009

✓ In this study brain tumors developing with tuberous sclerosis were biologically benign; total transcortical tumor removal permanently relieved the attending cerebral hypertension and achieved prolonged survival without notable functional impairment. In tuberous sclerosis, hamartomas characteristically develop from a random focal defect in organogenesis that affects many organ systems, sometimes seriously altering their function. Thus, genetic penetrance primarily determines the over-all prognosis, and “hereditary multiple system hamartomatosis” accurately describes the disease.
Diuretic synergy in the treatment of acute experimental cerebral edema
Authors: Wilkinson Harold A. , Wepsic James G. , Austin George
Published: May 2009

✓ Acute cerebral edema was created in dogs by the intracarotid injection of sodium lauryl sulfate, a method that produces no structural or vascular disruption in the brain. Cerebrospinal fluid (CSF) pressure elevations were measured through subdural balloons, and ranged from 300 to 1500 mm H2O. The nature of the cerebral edema produced was studied with intravital Trypan blue, electrocorticography, and visual observation of cerebral circulation, and by postmortem histological sections and determinations of brain water content. Two dissimilar diuretic agents were studied: the osmotic diuretic, mannitol; and the renal diuretic, ethacrynic acid. As expected, mannitol reduced CSF pressure effectively, with no significant rebound overshoot. Ethacrynic acid, despite favorable reports, proved to have only a slight effect on CSF pressure but did prove to be a potent diuretic. Unexpectedly, the two agents were found to act synergistically. When both agents were administered, significantly greater reductions in pressure were obtained and pressure reductions were maintained for longer periods.
Brain injury from a spent bullet descending vertically
Authors: Hanieh Ahmad
Published: May 2009

✓ This is a report of five cases in which a bullet penetrated the vertex of the skull and brain, apparently during its vertical descent after having been fired into the air.
Unilateral amaurosis in a hydrocephalic child with an obstructed shunt
Authors: Calogero John A. , Alexander Eben
Published: May 2009

✓ A 7-year-old child with treated hydrocephalus became blind in the left eye as a consequence of malfunction of the ventriculoatrial shunt. This complication probably could have been avoided by elective revision of the shunt with growth.
Morphological and immunochemical studies of rat glial tumors and clonal strains propagated in culture
Authors: Benda Philippe , Someda Kuniyuki , Messer Janette , Sweet William H.
Published: May 2009

✓ Rat glial tumors, induced by weekly injections of N-nitrosomethylurea for 8 months, were plated and propagated in culture. Cells grew as a glial tumor when injected back into various sites in newborn rats, and were then carried for many generations by transplantations from rat to rat or by alternate culture and animal passage. Light, phase, and electron microscopy of the cultured cells showed great variability among the glial types in all the primary tumors, in the cultures grown from them, and in the secondary in vivo tumors grown from the cultures. Many unmistakable stigmata of glia were conserved. Cloned cultures (derived from a single cell) were frozen and stored, and upon thawing resumed growth with their original histological appearance. Tumor lines from these cultured cloned strains showed much more constant growth rates and cell types; two stable lines were carried for many generations: a slow-growing astrocytoma and a faster growing glioblastoma.

The distinctive neural protein called “S-100” was detected in soluble extracts of cultured cells from all five different primary tumors studied and the secondary tumors grown from them. It represented 0.2% to 0.4% of the soluble proteins extracted from the cultures, and was also present in some clonal strains and their derived tumors. One clonal strain after a few hundred generations continues to synthesize S-100. It is concluded that clonally derived cultures of gliomas histologically similar to those in man provide a stable and suitable model in rats for the study of human glia and gliomas.
The clinical significance of the optic strut
Authors: Cares Herbert L. , Bakay Louis
Published: May 2009

✓ The anatomy, radiological appearance, and diagnostic importance of the optic strut are described and five cases presented to illustrate its value in the diagnosis of infraclinoid aneurysms, optic gliomas, and orbital deformities associated with neurofibromatosis. A distinction is made between erosion and deformity of the optic strut.
The effect of epsilon aminocaproic acid and tranexamic acid on thrombus size and strength in a simulated arterial aneurysm
Authors: Patterson Russel H. , Harpel Peter
Published: May 2009

✓ An arterial sac was created in rats by ligating the abdominal aorta, and the size and strength of the thrombus that formed in the sac were studied in the rats whose drinking water contained one of two antifibrolytic agents, 5% epsilon aminocaproic acid (EACA), or 1%, 2.5%, or 5% tranexamic acid (trans-AMCHA). The thrombus in the rats treated with 5% EACA, although no larger, was able to resist an intra-aortic pressure of 80 mm Hg, which was 2.5 times as much as in untreated animals. The weight of the thrombus was the same in rats that received 1% trans-AMCHA as in controls, slightly more in those receiving 2.5% trans-AMCHA, and 2.5 times greater with 5% trans-AMCHA. In the latter group the thrombus could resist an intra-aortic pressure eight times greater than that withstood by the thrombus in control animals. This evidence suggests that treatment with antifibrinolytic drugs may preserve the size and strength of the thrombus in a saccular aneurysm which has recently hemorrhaged.
Acute meningeal reaction following Pantopaque myelography
Authors: Mayher William E. , Daniel Ernest F. , Allen Marshall B.
Published: May 2009

✓ Severe neurological complications including one death followed Pantopaque myelography in three cases in a series of 6000 myelograms over a 10-year period. In each of the three cases there was incomplete removal of the contrast material at the end of the procedure. The literature is reviewed and similar cases cited. The possibility that the acute meningeal reaction may be due to a hypersensitivity reaction is discussed.
Conray ventriculography in the diagnosis of intraventricular and posterior fossa lesions
Authors: Gonzalez-Cornejo Salvador
Published: May 2009

✓ The author reports the safe and satisfactory use of Conray ventriculography in 26 patients with increased intracranial pressure and discusses his technique for this procedure.
Spontaneous rupture of a metastatic brain tumor into the ventricular system
Authors: Wilkins Robert H. , Wu Wang-Kuen
Published: May 2009

✓ Two cases are reported in which spontaneous rupture of a metastatic brain tumor occurred into the ventricular system, leading to the dissemination of the tumor contents in the cerebrospinal fluid. The site of rupture was demonstrated by ventriculography in the first case and by surgical exposure in the second. These cases support the assumption that metastatic neoplasms within the brain may rupture into the ventricular system and spread via the cerebrospinal fluid pathways.
Posterior fossa subdural hematoma of the newborn
Authors: Carter L. Philip , Pittman Hal W.
Published: May 2009

✓ A newborn infant with a posterior fossa subdural hematoma is described, and nine similar cases from the literature summarized. A postnatal asymptomatic period was followed by signs of increased intracranial pressure. The diagnosis was established on the basis of negative subdural taps, bloody or xanthochromic ventricular fluid under increased pressure, and demonstration of a posterior fossa mass on the ventriculogram. Surgical evacuation with careful observation for an associated intracerebellar hematoma is the treatment of choice. Five of the 10 cases developed postoperative communicating hydrocephalus.
Cylindroma in the region of the Gasserian ganglion
Authors: Fortuna Aldo , Gambacorta Domenico
Published: May 2009

✓ A rare case of cylindroma of the region of the Gasserian ganglion is reported. Signs and symptoms simulated a trigeminal neurinoma. Total removal was attempted; however, even when it seems to have been feasible as in this case, it may not be so since what appears to be erosion of the base of the skull may in fact be infiltration.
Neurosurgical hyponatremia: the role of inappropriate antidiuresis
Authors: Fox John L. , Falik Joel L. , Shalhoub Robert J.
Published: May 2009

✓ Of 80 consecutive neurosurgical patients, 23 exhibited inappropriate secretion of the antidiuretic hormone (ISADH); 11 of these patients required marked fluid restriction. Sodium concentration in the urine characteristically increased as serum values decreased. Only by following the urine sodium concentrations could the differential diagnosis of nutritional hyponatremia and ISADH be made. The role of ISADH in cerebral edema is stressed. The treatment recommended for ISADH is marked fluid restriction, whereas in nutritional hyponatremia, saline replacement is indicated.
Double lucid interval in patients with extradural hematoma of the posterior fossa
Authors: Parkinson Dwight , Hunt Brian , Shields Christopher
Published: May 2009

✓ The classic clinical sequence in posterior fossa extradural hematoma is head injury, lucid interval, deterioration; the deterioration is usually terminated by death or surgical intervention. This report emphasizes a syndrome characterized by a double lucid interval in which the phase of deterioration terminates spontaneously with improvement. This is actually only a second lucid interval and can lead surgeons into a false sense of security since it is followed by deterioration, as the clot continues to enlarge. Four such cases are described in detail. The characteristics of the initial phase of deterioration are described and contrasted with those of the deterioration following the lucid interval in the classic supratentorial extradural hematoma.
Relief of facial pain after combined removal of precentral and postcentral cortex
Authors: Lende Richard A. , Kirsch Wolff M. , Druckman Ralph
Published: May 2009

✓ Cortical removals which included precentral and postcentral facial representations resulted in relief of facial pain in two patients. Because of known failures following only postcentral (SmI) ablations, these operations were designed to eliminate also the cutaneous afferent projection to the precentral gyrus (MsI) and the second somatic sensory area (SmII). In one case burning pain developed after a stroke involving the brain stem and was not improved by total fifth nerve section; prompt relief followed corticectomy and lasted until death from heart disease 20 months later. In the other case persistent steady pain that developed after fifth rhizotomy for trigeminal neuralgia proved refractory to frontal lobotomy; relief after corticectomy was immediate and has lasted 14 months. Cortical localization was established by stimulation under local anesthesia. Each removal extended up to the border of the arm representation and down to the upper border of the insula. Such a resection necessarily included SmII, and in one case responses presumably from SmII were obtained before removal. The suggestions of Biemond (1956) and Poggio and Mountcastle (1960) that SmII might be concerned with pain sensibility may be pertinent in these cases.
Meningeal invasion by gliomas
Authors: Silverberg Gerald D. , Hanbery John W.
Published: May 2009

✓ Three cases in which gliomas invaded the meninges are presented. In each instance, one or several aspects of the case suggested the diagnosis of benign or malignant meningioma to the neurosurgeon. The points of confusion included clinical history, location of the tumor, gross appearance of the lesion, radiographic and isotope studies, and, in some cases, the microscopic appearance of the tumor as well.
Unusual intradural spinal metastasis of a cranial chordoma
Authors: Stough Daniel R. , Hartzog Joe T. , Fisher Robert G.
Published: May 2009

✓ In this unusual case, multiple intradural spinal cord implants of chordoma were removed 5 years after partial resection of an intracranial chordoma. The “seeding” had occurred in spite of combined surgical and irradiation therapy.
Spondylolisthesis following lumbar disc surgery in a child
Authors: Kobrine Arthur , Bucy Paul C.
Published: May 2009

✓ The case of a 13-year-old boy with a gelatinous, herniated lumbar intervertebral disc is reported. Roentgenographic examination 8 years following laminectomy demonstrated spondylolysis and spondylolisthesis of L-5 on S-1. Related case reports and theories are tabulated and discussed.
Trigeminal neuralgia due to cholesteatoma of Meckel's cave
Authors: Mehta Dhirendra S. , Malik Gauri Bazaz , Dar Jawahar
Published: May 2009

✓ A young man with typical symptoms of third division trigeminal neuralgia, without sensory impairment, was found to have a small localized cholesteatoma in Meckel's cave. Removal of the tumor resulted in immediate cure.
The concurrence of hydrocephalus and craniosynostosis
Authors: Fishman Marvin A. , Hogan Gwendolyn R. , Dodge Philip R.
Published: May 2009

✓ The clinical course and pneumoencephalographic findings of 14 patients with the associated anomalies of craniosynostosis and hydrocephalus are reviewed. Postmortem examination in two cases, one of which had aqueductal stenosis, confirmed the presence of hydrocephalus. Eight of the 14 had associated anomalies of the extremities consistent with the diagnosis of Apert's syndrome and six patients had dull to normal intelligence. Various types of sutural involvement were present including isolated closure of the sagittal suture. The hydrocephalus, which appears to be an associated anomaly rather than a direct consequence of the craniosynostosis, is most often communicating, but stenosis and atresia of the aqueduct may be present. No single pathogenetic mechanism seems responsible for the abnormal ventricular enlargement, but when the dilation becomes progressive, surgical intervention may be indicated.