bluuebunny/crossref_metadata_2025 huggingface dataset:
Sudden blindness with pituitary tumors
Authors: Robinson Julian L.
Published: May 2009

✓ Three patients in whom pituitary tumor led to sudden blindness are described; in two, there had been no other indication of a pituitary neoplasm. The authors believe that observation of these patients for 24 hours after the onset of blindness has prognostic value and is safe. If visual improvement occurs during this time, the chances of useful recovery of vision are good. Further delay is contraindicated since in spite of visual improvement, these patients may show a general deterioration which may terminate fatally unless operation is performed.
Ureteral injury incident to lumbar disc surgery
Authors: Gangai Mauro P.
Published: May 2009

✓ A case is reported in which combined vascular and ureteral injury occurred during lumbar disc surgery. The mechanism of injury is described and the importance of its early recognition emphasized.
Craniopharyngioma originating in the sphenoid bone
Authors: Cooper Paul R. , Ransohoff Joseph
Published: May 2009

✓ A case of craniopharyngioma originating in the sphenoid bone is presented. The tumor probably originated in the midline from epithelial cell rests along the path of the involuted craniopharyngeal duct. There was bone invasion and destruction of the floor of the middle fossa with intradural extension of tumor into the left temporal lobe. Survival from onset of symptoms was 37 years. Irradiation probably played a significant part in this patient's long survival. Modern techniques now in use might achieve cures with surgically unresectable intrasphenoidal craniopharyngiomas.
Delineation of the obex by contrast radiography during percutaneous trigeminal tractotomy
Authors: Fox John L.
Published: May 2009

✓ Accuracy of percutaneous implantation of an electrode into the descending trigeminal tract can be improved substantially by contrast radiography. A translateral x-ray film taken after 1 cc of Pantopaque emulsified with 1 cc of cerebrospinal fluid has been injected by midline puncture of the cisterna magna will outline the floor of the fourth ventricle, the obex, and the dorsum of the medulla oblongata. Injection is made under mild pressure and with the patient prone. This technique has been used successfully on 12 patients.
The empty sella and some related syndromes
Authors: Obrador Sixto
Published: May 2009

✓ A case of empty sella syndrome due to a benign intrasellar cyst leads the author to a review of variations in this syndrome. Association with intrasellar diverticuli of the subarachnoid space, deficiencies of the diaphragma sellae, and small pituitary glands are identified. Its relationship with certain headaches in women and to unexplained nontraumatic cerebrospinal fluid rhinorrhea are discussed.
Further definition of the subthalamic target for arrest of tremor
Authors: Velasco Francisco C. , Molina-Negro Pedro , Bertrand Claude , Hardy Jules
Published: May 2009

✓ During stereotaxic procedures for the treatment of tremor, the simple introduction of a 1-mm diameter electrode in the subthalamus may arrest the tremor on the contralateral side. Placement of the electrodes in relation to the ventricular system and intercommissural (AC-PC) line was studied radiologically in 88 cases operated on. The proximity of the medial lemniscus and pyramidal fibers was assessed by means of electrical monopolar stimulation. A proportional reduction of the AC-PC line was made in all cases by dividing it in 10 equal parts. The resultant 10ths were squared to divide the areas above and below the line. The place where the tremor was arrested corresponded to a small area that extended just in front of the area of sensory responses and medial to the area of motor responses. It seemed to have a topographical organization, as the tremor could be selectively arrested in the arm or the leg. Analysis of results on anatomical grounds showed the area in question corresponded to the prelemniscal radiations that extend caudally as far as the mesencephalic tegmentum and end at the level of the AC-PC line.
A morphological classification of sincipital encephalomeningoceles
Authors: Suwanwela Charas , Suwanwela Nitaya
Published: May 2009

✓ Cranial defects and cerebral abnormalities as revealed by postmortem dissection in 12 patients with sincipital encephalomeningocele are reported. The various methods of classifying this lesion are discussed. A classification based on the location of the defect in the cranium is outlined. The clinical application of such a classification and its usefulness in the surgical management are emphasized.
Dermoid cyst of the fourth ventricle demonstrated on brain scan
Authors: Bogdanowicz Wojciech M. , Wilson Donald H.
Published: May 2009

✓ A dermoid cyst of the fourth ventricle gave a positive brain scan. The presence of active glandular structures within the cyst may explain the uptake of radioisotope.
Hydrocephalus and congestive heart failure caused by intracranial arteriovenous malformations in infants
Authors: Cronqvist Sten , Granholm Lars , Lundström Nils-Rune
Published: May 2009

✓ Two infants with large intracranial arteriovenous (A–V) malformations associated with hydrocephalus and congestive heart failure responded favorably to operative treatment of the malformation. The fact that the hydrocephalus subsided suggests that raised venous pressure may be important in the production of hydrocephalus.
Infantile hydrocephalus: clinical, histological, and ultrastructural study of brain damage
Authors: Weller R. O. , Shulman Kenneth
Published: May 2009

✓ Cerebral biopsies were taken from five hydrocephalic infants at the time of primary ventricular shunt insertion. The histological appearance of the biopsies have been correlated with the children's subsequent intellectual and neurological development. In addition, the known sequence of histological events in puppies with experimental hydrocephalus has been correlated with an interpretation of the human material. One child showed periventricular white matter edema and sporadic axonal degeneration characteristic of the acute stage of experimental hydrocephalus in young dogs; this patient developed normally. Biopsies from the other children were not edematous but showed the extensive astrocytosis of white matter seen in long-standing hydrocephalus in young dogs. These children all showed mental retardation. The implications of these clinicopathological results for the treatment of hydrocephalic children are discussed.
Malfunction of ventriculoatrial shunts caused by the circulatory dynamics of coughing
Authors: Natelson Stephen E. , Molnar William
Published: May 2009

✓ Three adult patients are presented in whom the atrial catheter coiled on itself after a ventriculoatrial shunt. Pressures in the jugular and subclavian veins and right atrium were measured during respiration and coughing. It is suggested that the normal pressure changes during the act of coughing facilitate coiling if the atrial catheter material is not sufficiently rigid.
Impaired microvascular filling after focal cerebral ischemia in monkeys
Authors: Crowell Robert M. , Olsson Yngve
Published: May 2009

✓ Impairment of microvascular filling was demonstrated in relation to focal cerebral ischemia in the monkey. Temporary or sustained middle cerebral artery (MCA) clipping was achieved with a microsurgical technique. Animals were sacrificed by perfusion with a carbon black suspension. Brains were fixed in formalin, and the extent of microvascular carbon filling was estimated grossly and microscopically. In most animals, MCA occlusion of 2 hours to 7 days produced diminished filling in small vessels in the MCA territory of supply. The impairment of filling was most pronounced in the deep subcortical structures but also affected the cortex in some animals. Temporary and sustained occlusion of equal duration produced roughly equivalent areas of abnormal filling. The impairment of vascular filling tended to be more extensive with increasing duration of occlusion. Hypotension during MCA occlusion caused almost total non-filling of the microvasculature in the entire MCA territory. Impaired filling of vascular channels may play a role in the pathogenesis of some clinical cerebrovascular diseases.
Complications of 1000 brachial arteriograms
Authors: Feild James Rodney , Lee Ling , McBurney Robert F.
Published: May 2009

✓ Of 1000 patients who had 1202 brachial and 1099 carotid arteriograms between 1966–1970, 52 had mild and 15 severe complications. Cerebrovascular disease was most frequently encountered. There were 11 patients undergoing simultaneous carotid and brachial arteriography in whom complications could not be localized to an individual artery. Including this group the complication rate for brachial arteriograms was 3.99% and excluding this group the complication rate was 3.08%. There were 3.32% mild and 0.60% severe complications of brachial arteriography and a mortality rate of 0.21%. A serious complication occurred at a rate of one per 152 brachial arteriograms. The complication rate of brachial arteriography with carotid vascular disease was 2.70% and 6.41% with basilar artery disease. The total complication rate of brachial arteriography in cerebrovascular disease was 12.17%. The most common local complication was a transient loss of the radial pulse. The most common cerebral complication was a transient motor deficit.
Conversion of multilocular hydrocephalus to unilocular
Authors: Rhoton Albert L. , Gomez Manuel R.
Published: May 2009

✓ A patient with postinflammatory hydrocephalus had a multiloculated, lateral ventricular system that was treated by a routine shunting procedure after the multiloculated system had been converted into a uniloculated system by direct intraventricular surgery.
Mucocele of the sphenoid sinus with bilateral internal carotid artery occlusion
Authors: Doyle Colin S. , Simeone Frederick A.
Published: May 2009

✓ A young man with a large sphenoid sinus mucocele developed hypopituitarism, headaches, and visual difficulties. Subsequently the lesion caused complete occlusion of both internal carotid arteries in the parasellar region. The headaches and visual difficulty improved after simple transoral drainage of the cyst.
Kinking of the internal carotid artery clinically simulating an aneurysm in a child
Authors: Hoffman Edward P. , Garner John T. , Shelden C. Hunter , Johnson Paul E.
Published: May 2009

✓ A case is presented in which kinking of the right internal carotid artery simulated an aneurysm in the neck. The patient was 5 years old. The lack of associated tortuosity of the internal carotid artery and the lateral projection of the kinking were unusual findings. When there are no associated neurological symptoms, conservative treatment of the kinked artery is recommended.
Reversible spinal cord trauma: a model for electrical monitoring of spinal cord function
Authors: Croft Thomas J. , Brodkey Jerald S. , Nulsen Frank E.
Published: May 2009

✓ Cortical evoked potentials in anesthetized cats were recorded by a noninvasive averaging technique as a means of estimating spinal cord damage. Graded pressure on the spinal cord produced reversible blocking of these potentials. With this type of trauma, block of motor transmission through the cord paralleled the block of sensory transmission, and each seemed to be a sensitive indicator of spinal cord function. The possible use of such monitoring in anesthetized patients undergoing spinal operations is discussed.
Transitory traumatic paraplegia: electron microscopy of early alterations in myelinated nerve fibers
Authors: Dohrmann George J. , Wagner Franklin C. , Bucy Paul C.
Published: May 2009

✓ The white matter of the monkey spinal cord was examined by electron microscopy during the first 4 hours following a contusion sufficient to produce a transitory paraplegia. At 5 min after injury the myelinated nerve fibers resembled those of the control animals. By 15 and 30 min after contusion, selected fibers were noted to have moderately enlarged periaxonal spaces. Attenuated myelin sheaths, splaying of the myelin lamellae, and a marked increase in the periaxonal spaces were present in affected nerve fibers at 1 hr following trauma. By 4 hrs after contusion approximately one-fourth of the fibers showed breakage of the myelin sheaths and consequent denuding of axons or marked attenuation of the myelin sheaths, greatly enlarged periaxonal spaces, and degeneration of the associated axons.
The spinal cord central canal: response to experimental hydrocephalus and canal occlusion
Authors: Becker Donald P. , Wilson Jimmy A. , Watson G. William
Published: May 2009

✓ The central canal of the spinal cord was studied with canal occlusion alone, and in experimental (kaolin) hydrocephalus without and with central canal occlusion. Massive dilatation of the canal occurred with kaolin hydrocephalus. Syrinxes extending into the gray and white matter of the cord and communicating with the central canal developed in both the upper and lower spinal cord. The completely isolated central canal (occlusion at the obex and filum terminale) did not dilate, but remained patent. Canal occlusion at the obex and filum terminale completely protected the spinal cord from central canal dilatation or syrinxes in kaolin hydrocephalus. These findings suggest that the choroid plexus is responsible for producing neural tube dilatation in hydrocephalus. It also supports the concept that syringomyelia results from inadequate drainage of cerebrospinal fluid and increased pressure (or pulse pressure) in the spinal cord central canal.
Spinal cord stimulation and bladder function in normal and paraplegic animals
Authors: Friedman Harry , Nashold Blaine S. , Senechal Peter
Published: May 2009

✓ An experimental method is described for stimulation of the conus medullaris to produce micturition. The data collected and reported suggest the ultimate feasibility of such a method for treating the neurogenic bladder.
Ventriculo-direct atrial shunts
Authors: Fischer Edwin G. , Shillito John , Schuster Samuel
Published: May 2009

✓ Ventriculoatrial shunts were performed on 10 patients by placing the cardiac tube directly into the right atrium via the auricular appendage at thoracotomy, and the long-term results after 3 to 6 years were analyzed. Complications included distractions of the upper part of the shunt, pleural cyst formation, pleural effusion, and phrenic nerve injury. The procedure is not recommended for the primary treatment of hydrocephalus, but is useful when simpler shunts are no longer possible or desirable.
Direct measurement of mean and pulsatile blood pressure at operation in human intracranial saccular aneurysms
Authors: Ferguson Gary G.
Published: May 2009

✓ Mean and pulsatile intra-aneurysmal blood pressures were recorded from four cases of human intracranial saccular aneurysms at the time of operative exposure. In each case the mean intra-aneurysmal pressure equalled the mean systemic arterial pressure, and the intra-aneurysmal pressure was pulsatile. The results demonstrate that, contrary to the findings of another report, intracranial aneurysms are subjected to the full force of systemic blood pressure.
Tissue reactions to standard neurosurgical metallic implants
Authors: McFadden Joseph T.
Published: May 2009

✓ Metal devices currently used as permanent neurosurgical implants have been implanted in dogs for 6 months. The tissue responses corresponded to the known electrochemical characteristics of these metals. Tantalum caused the least reaction, and silver clips (sterling silver) uniformly provoked an inflammatory response. The various stainless steels caused reactions corresponding to the degree of ionization provoked by the tissues. Nonsurgical control materials used for comparison were gold, platinum, glass, and carbon steel.
Cerebellopontine angle myelography
Authors: Baker Hillier L.
Published: May 2009

✓ Review of more than 1400 positive-contrast myelograms of the posterior fossa performed at the Mayo Clinic indicates that this is an excellent method for depicting normal and pathological anatomy in the basal cisterns, if an adequate amount of medium and a precise technique are used. However, the technique is not without its sources of diagnostic error and these are discussed.
Effects of prostaglandin E1 on experimental cerebral vasospasm
Authors: Pelofsky Stanley , Jacobson Eugene D. , Fisher Robert G.
Published: May 2009

✓ This study reports the effects of intraarterial prostaglandin E1 (PGE1) upon intracerebral blood flow under control and vasospastic conditions. A new transorbital means of producing acute experimental subarachnoid hemorrhage with concomitant arterial spasm is presented. Two groups of animals were delineated in this investigation. Five animals (Group 1) were extremely sensitive to PGE1 and subarachnoid hemorrhage (SAH); carotid flow studies with simultaneous intracerebral angiography in this group demonstrated the ability of PGE1 to relieve vasospasm. Two other animals (Group 2) were relatively insensitive to SAH and PGE1. The study suggests an important role for PGE1 in the treatment of intracerebral vasospasm.
Angiographic demonstration of the bleeding point in a posterior fossa extradural hematoma
Authors: Jamieson Kenneth G.
Published: May 2009

✓ In a case of posterior fossa extradural hematoma, vertebral angiography demonstrated the bleeding point on the occipital branch of the vertebral artery.
Anomalous duplication of the posterior part of the internal cerebral vein and the great vein of Galen
Authors: Calabro Alberto , Palmieri A.
Published: May 2009

✓ The authors present a case of anomalous duplication of the posterior part of the internal cerebral vein and probably of the great vein of Galen, and hypothesize a relationship with subarachnoid hemorrhage.
Arteriovenous malformation of the cauda equina with arterial supply from branches of the internal iliac arteries
Authors: Stein Sherman C. , Ommaya Ayub K. , Doppman John L. , Di Chiro Giovanni
Published: May 2009

✓ A case is presented in which an arteriovenous malformation of the cauda equina received all of its arterial supply from branches of the internal iliac arteries. Surgical excision of the malformation was successfully accomplished. The need for thorough knowledge and arteriographic demonstration of all possible routes of arterial supply for such lesions is stressed.
A membrane filter technique for cerebrospinal fluid cytology
Authors: Rich J. Ronald
Published: May 2009

✓ A simple membrane filter technique is described for the collection and demonstration of exfoliated neoplastic cells in the cerebrospinal fluid (CSF). Abnormal cells were demonstrated in 30 cases: in four of these the diagnosis of a benign intracranial tumor was possible. Using this technique, it appears that cells from the majority of neoplasms in contact with the CSF will be demonstrable. This new technique is superior in many ways to the conventional concentration methods of centrifugation, flocculation, sedimentation, or filtration now used. The primary advantages are the simplicity, the bedside availability, the ability to reuse the filtered fluid for additional studies, the preservation of the cells for later analysis should a cytological laboratory not be immediately available, and, of primary importance, the excellent preservation of cellular morphology.
Linear skin incisions in trepanation of the skull
Authors: Zlotnik E. I.
Published: May 2009

✓ During the last 3 years the author has used only linear skin incisions in trepanation of the skull; this incision was applied in 725 operations. Linear incision procedures and their advantages over flap incisions are discussed.
Anterior approach to recurrent chordomas of the clivus
Authors: Guthkelch A. N. , Williams R. G.
Published: May 2009

✓ A modified transpalatal transclival approach was used for removal of two recurrent tumors of the clivus. New features of the exposure include placing the mucosal incision immediately behind the line of the upper teeth, removal of the posterior third of the hard palate, increased mobilization of the soft palate, and removing the posterior ends of the inferior turbinals.
Electrophoretic analysis of cerebrospinal fluid proteins in patients with central nervous system mass lesions
Authors: Weber Emil Lee
Published: May 2009

✓ The protein constituents of the cerebrospinal fluid (CSF) from 234 patients with central nervous system mass lesions and nine patients with pseudotumor syndrome were analyzed by cellulose acetate electrophoresis. The alpha 2 and gamma globulin fractions were most frequently elevated, and more so with metastatic and malignant glial tumors than with benign tumors. Elevation of either fraction frequently occurred independent of the total protein content of the CSF and appears to indicate a primary parenchymal involvement of the brain. Gamma globulin elevations in patients with benign glial tumors were often associated with intracerebral cyst formation. Pituitary adenomas were not associated with elevation of the gamma globulin fraction whereas this was a common finding with other parasellar lesions. All CSF specimens associated with masses of infectious origin had markedly elevated gamma globulin levels irrespective of normal total protein levels. Two metastatic tumors from the gastrointestinal tract, a solitary plasmacytoma, and a case of increased intracranial pressure secondary to nalidixic acid therapy showed dramatic and specific increases in certain CSF protein fractions. The origin of the various protein fractions is discussed as well as the overall clinical applicability of CSF protein electrophoresis in patients with intracranial mass lesions.
Evaluation of rhizotomy Review of 12 years' experience
Authors: Onofrio Burton M. , Campa Hernan K.
Published: May 2009

✓ This paper evaluates 286 Mayo Clinic patients who had dorsal rhizotomies for pain. For purposes of analysis the patients were divided according to the origin of the pain. The group with pain of unknown etiology had the highest success rate (25% to 50%), but the overall long-term results were discouraging. Many groups had no success. Diagnostic blocks were almost always unsuccessful and proved to be a very unreliable prognostic indication of the result to be expected from section of the same roots.
Hydrocephalus following removal of cerebellar astrocytomas in children
Authors: Stein Bennett M. , Tenner Michael S. , Fraser Richard A. R.
Published: May 2009

✓ Of 150 children undergoing surgery for cerebellar astrocytoma, 20% had evidence of postoperative hydrocephalus. This was manifested by either progressive symptomatic rise in intracranial pressure or abnormal mental and motor states accompanied by normal CSF pressure. This syndrome is presumed to be due to cisternal and subarachnoid adhesions formed after surgery. Prompt shunting in advanced cases resulted in reversal of neurological abnormalities.
Pituitary abscess in a craniopharyngioma
Authors: Obrador Sixto , Blazquez Martin G.
Published: May 2009

✓ A case is reported of a young man with hypopituitarism but no initial evidence of tumor who had several episodes of recurrent aseptic meningitis. At operation an abscess within a craniopharyngioma was drained and tumor tissue removed. After several postoperative episodes of meningitis the patient recovered. A review of four comparable reports is presented.
Intracranial chondrosarcoma with extracranial metastases
Authors: Waga Shiro , Matsushima Masayuki , Ando Kyozo , Morii Sotokichi
Published: May 2009

✓ This report describes a case of primary intracranial meningeal chondrosarcoma arising from the falx with extracranial metastases to the heart, liver, pancreas, kidneys, and adrenals.
Intracerebral schwannoma
Authors: New Paul F. J.
Published: May 2009

✓ A rare case of schwannoma occurring in the parietal lobe of an 8-year-old boy has been described. While the precise origin of such an unusually situated schwannoma remains uncertain, it appears most likely that the origin was from ectopic or perivascular nerve plexus Schwann cells within the parietal lobe.
Lack of correlation between clinical and angiographic findings in patients with brain tumors under BCNU chemotherapy
Authors: Koo Andrew H. , Fewer Derek , Wilson Charles B. , Newton Thomas H.
Published: May 2009

✓ Bis-chlorethyl-nitrosourea (BCNU) is one of the numerous experimental chemotherapeutic agents used to treat recurrent brain tumors. The clinical response and the angiographic changes in tumor vascularity were compared in 32 patients treated with BCNU for recurrent primary brain tumor. In five of 22 initially vascular lesions the tumor vasculature increased, in 11 it decreased, and in six it remained unchanged after treatment. There was no correlation between angiographic changes in the tumor and the clinical course following BCNU therapy.
Hyperoxia of cerebral venous blood and cisternal cerebrospinal fluid following arterial air embolism
Authors: Simms Norval M. , Long Don M. , Matthews James H. , Chou Shelley N.
Published: May 2009

✓ Oxygen tension and acid-base parameters of cerebral venous blood and cisternal cerebrospinal fluid, as well of femoral arterial blood, were studied in 14 dogs following injection of varying amounts of room air into the right vertebral artery. Acute elevations in oxygen tension were demonstrated in both cerebral venous blood and CSF, whereas hypoxemia occurred concomitantly in systemic arterial blood. Post-embolic increases in carbon dioxide tension with reciprocal diminutions in pH were evident in all sampling sites. The pathophysiological bases for these air-induced alterations are discussed.
The results of proximal anterior cerebral artery occlusion for anterior communicating aneurysms
Authors: Hugenholtz Herman , Morley Thomas P.
Published: May 2009

✓ A 3- to 10-year follow-up of a selected group of 23 patients treated for ruptured anterior communicating aneurysms by proximal clipping of one anterior cerebral artery has been evaluated. There was no instance of recurrent hemorrhage. The operation carried a relatively low morbidity and mortality (13%). Early and late results are compared. The importance of adequate preoperative angiography, the minimal complications, and the advantages of the procedure are discussed.
Lumbar disc syndrome
Authors: Paine Kenneth W. E. , Haung Peter W. H.
Published: May 2009

✓ In a series of 227 patients considered to have a sufficiently severe lumbar disc syndrome to warrant surgery, only 70 had a simple herniation of the nucleus pulposus; 65 had lumbar spondylosis and five spinal stenosis. The remainder had combinations of two or more of these three conditions, as determined by Pantopaque myelography in all cases and substantiated by operative findings in the majority. The possibility that any of these changes may cause a lumbar disc syndrome is emphasized in relation to appropriate surgical management.
Intermittent cauda equina compression due to narrow spinal canal
Authors: Yamada Hiroshi , Ohya Masaki , Okada Tsuguo , Shiozawa Zenji
Published: May 2009

✓ Five patients with intermittent claudication due to compression of the cauda equina in the presence of lumbar spinal canal stenosis or midline intervertebral disc protrusion are described. The characteristic myelographic evidence was complete obstruction during extension of the spine and release of the block with flexion. The cause of this syndrome is considered to be intermittent bulging of the ligamentum flavum into a narrow spinal canal so as to compress the cauda equina during extension of the back.
Head injury caused by underwater explosion of a firecracker
Authors: Hirsch Arthur E. , Ommaya Ayub K.
Published: May 2009

✓ A firecracker exploded in contact with the skin and within 6 inches of the base of the skull of a young man while he was swimming underwater. The resultant severe head injury and death appeared to be directly related to the underwater explosion. Reconstruction of the mechanics of this injury indicates that when the head is subjected to impact energies between 440 to 1800 in.-lb and impact impulses between 1.8 to 3.5 lb/sec, both skull fracture and brain injury can occur.
Diagnosis of basal meningeal gliomatosis by brain scan: significance of basal cistern sign
Authors: Lake Peter , Friedenberg Marvin J. , McCammon Charles J.
Published: May 2009

✓ The identification of gliomatosis of the basal cisterns by an intravascular mercury (203Hg) brain scan is described, and the prognostic value of this sign of impending hydrocephalus emphasized.
Combined posteroanterior approach to a tumor of the cervical spinal foramen
Authors: Habal Mutaz B. , McComb J. Gordon , Shillito John , Eisenberg Howard M. , Murray Joseph E.
Published: May 2009

✓ A case is presented to illustrate the technique of combined posteroanterior approach to tumors of the cervical spinal foramen. The anterior approach offers a direct, feasible complementary route when this type of tumor cannot be completely excised through the conventional posterior approach.
Evaluation of a subdural pressure transducer
Authors: Tindall George T. , McGraw Charles P. , Wendenburg Hans O. , Peel Herbert H.
Published: May 2009

✓ A simple practical method for monitoring intracranial pressure has been developed; it is based on a diaphragm-type, full-bridge, absolute-pressure gauge that is stable. The transducer is calibrated to absolute pressure at body temperature. It is placed in a trephine opening where it is in contact with the subdural space. The transducer is contained in a self-threading case that will fit in a 14 mm trephine opening. Its use in 30 patients with acute head injury is reported.
Regenerative phenomena in the central nervous system
Authors: Schneider Diana
Published: May 2009

✓ This report summarizes for neurosurgeons the basic science presentations at this symposium. Topics discussed include the roles of axoplasmic flow, non-neuronal support, hormones, monoamine neurons, and immunological factors in CNS regeneration. The subjects of neurotropism, remyelination, and muscle spindle afferents are evoked in discussion of the pathophysiology of paraplegia. Directions for future research in this field are suggested. (Editor)
Surgically treated traumatic subdural hematomas
Authors: Jamieson Kenneth G. , Yelland John D. N.
Published: May 2009

✓ The authors analyze 553 cases of surgically treated traumatic subdural hematomas. Simple subdural hematomas, subdural hematomas associated with cerebral lacerations, and subdural fluid collections are identified as three separate types. Age, sex, mechanism and cause of injury, rate of presentation, operative procedures, and outcome are discussed to illustrate differing pathogenesis, clinical course, and treatment.
The effect of intraventricular air on the rate of cerebrospinal fluid formation in dogs
Authors: Deck Michael D. F. , Deonarine V. , Potts D. Gordon
Published: May 2009

✓ Experiments were performed on dogs to estimate the effect of intraventricular air on the rate of cerebrospinal fluid formation. The rate of formation was measured satisfactorily in eight beagle dogs before and after the introduction of air using ventriculocisternal perfusion of artificial cerebrospinal fluid containing 14C-labelled inulin. Statistical analysis of rates of cerebrospinal fluid formation estimated half hourly indicated that there was little or no change after the introduction of air.
Use of antibiotics with external ventriculostomies
Authors: Wyler Allen R. , Kelly William A.
Published: May 2009

✓ A review of 102 external ventriculostomies in 70 patients is reported. Forty-four patients received prophylatic antibiotics and 26 did not. The infection rate was significantly lower in the treated group, and the shunts could be left in place longer. Prophylactic antibiotics are advocated for patients in whom an external ventriculostomy is to be left in place for 3 days or more.
Multiple extracranial vessel injuries following closed head and neck trauma
Authors: Heilbrun M. Peter , Ratcheson Robert A.
Published: May 2009

✓ A case with multiple extracranial vessel involvement following closed head and neck trauma is described. The use of selective cerebral angiography through the femoral route as a diagnostic aid is stressed. The etiology of the neurological deficit and the role of intensive supportive care is discussed.
Angiographic extravasation of contrast medium in acute traumatic subdural hematoma from arterial rupture
Authors: Ito Jusuke , Ueki Komei , Ishikawa Hisayuki
Published: May 2009

✓ Carotid angiography of a patient with suspected subdural hematoma showed extravasation of the contrast medium from an ascending branch of the middle cerebral artery. The leak was verified at operation. There was no visual evidence of an aneurysm, angioma, subarachnoid or subpial hemorrhage.
Acute massive infarction of pituitary adenomas
Authors: Dawson Benjamin H. , Kothandaram P.
Published: May 2009

✓ Five examples of acute massive infarction of a pituitary adenoma are described. In each case a severe head cold with nasal catarrh and persistent cough preceded the onset of the infarction. The clinical features varied from case to case and simulated bacterial meningitis, aneurysmal subarachnoid hemorrhage, brain abscess, and cavernous sinus thrombosis. Two patients required urgent surgical treatment for relief of acute visual failure; three did not require surgical treatment but were relieved with corticosteroid therapy.
Alteration of experimental cerebral vasospasm by adrenergic blockade
Authors: Flamm Eugene S. , Yasargil M. Gazi , Ransohoff Joseph
Published: May 2009

✓ Two alpha adrenergic blocking agents have been used to alleviate spasm induced in the basilar artery of the cat by the application of blood or by mechanical manipulation. Parenteral phenoxybenzamine is effective in preventing spasm from blood when given in doses of 6 mg/kg or more provided at least 1½ hours have elapsed between the completion of the infusion and the application of the blood; it also relieves and prevents spasm from blood when applied topically. Phenoxybenzamine does not prevent or alleviate spasm induced by mechanical manipulation of the basilar artery. Phentolamine alleviates both types of spasm, but its effect lasts no more than 15 minutes. The possible modes of action of these drugs are discussed.
Doppler ultrasound measurements of superior sagittal sinus blood velocity
Authors: Brisman Ronald , Hilal Sadek K. , Tenner Michael
Published: May 2009

✓ Transcutaneous Doppler recordings from the patent anterior fontanel were used to measure superior sagittal sinus blood velocity (SSSV). In 15 cases it ranged from 4.5 to 18.1 cm/sec. In five of these patients with no mass effect and normal intracranial pressure, the mean SSSV was 13.6 cm/sec. An independent arteriographic measurement of SSSV was 4.5 cm/sec in a hydrocephalic patient with elevated intracranial pressure whose Doppler measurement of SSSV was 6.6 cm/ sec. The Doppler technique may be used to diagnose sagittal sinus occlusion. SSSV tended to be low when CSF pressure was elevated, but the relationship was not constant.
Cerebral blood flow following induced subarachnoid hemorrhage in the monkey
Authors: Petruk K. C. , West G. R. , Marriott M. R. , McIntyre J. W. , Overtone T. R. , Weir Bryce K. A.
Published: May 2009

✓ The acute effects of experimental subarachnoid hemorrhage on cerebral blood flow were investigated in 14 adult rhesus monkeys injected with fresh autogenous blood through a needle positioned within the subfrontal subarachnoid space. Cerebral blood flow was measured by the xenon133 tissue clearance method before hemorrhage, and afterward at 30-minute intervals for a 3-hour period. Post-anesthetic neurological status was graded according to Botterell's classification. Twelve monkeys showed a significant decrease in cerebral perfusion, eight displayed focal neurological deficits, and four were moribund. There was a correlation between the degree of impaired circulation and the severity of neurological deficit. Four additional monkeys subjected to subarachnoid acidic saline injection showed no reduction in cerebral blood flow. In three animals cerebral perfusion was increased during the first hour after injection. It is suggested that measurement of cerebral blood flow may be a more valuable prognostic indication of cerebral function and survival than the angiographic demonstration of arterial vasospasm.
Radioisotopic cisternography contribution to the diagnosis of cerebellopontine angle tumors
Authors: Mamo Lysiane , Houdart Raymond
Published: May 2009

✓ A new use of radioisotopic cisternography in diagnosing cerebellopontine tumors is reported, and the value both in positive and topographic diagnoses stressed. Isotopic investigation seems to be a useful adjunct to the conventional method of detection.
Giant aneurysm of the middle cerebral artery containing an important blood channel
Authors: Terao Hideo , Muraoka Isao
Published: May 2009

✓ An enormous globoid aneurysm arising from the right middle cerebral artery is reported. A functioning blood channel ran through the laminated thrombus within the aneurysm, and operative injury to this blood channel caused serious cerebral infarction.
Spontaneous thrombosis in agiant middle cerebral artery aneurysm
Authors: Scott R. Michael , Ballantine H. Thomas
Published: May 2009

✓ Five-year follow-up angiography in a woman with an untreated giant aneurysm of the left middle cerebral artery revealed complete thrombosis of the aneurysm. Her case suggests that certain asymptomatic giant cerebral aneurysms may be treated without surgery.
Experimental vasoconstriction of cerebral arteries by prostaglandins
Authors: Yamamoto Y. Lucas , Feindel William , Wolfe Leonhard S. , Katoh Hiroko , Hodge Charles P.
Published: May 2009

✓ Effects of intracarotid infusion of prostaglandins (PG) E1 and F2a on the circulation to the dog brain were examined by fluorescein angiography, by measuring diameter changes in the epicerebral vessels, and by measuring microregional cerebral blood flow with 133xenon and lithium-drift silicon detectors. PGE1 at doses of 0.5 µg/min constricted the epicerebral arteries 700 µ or less in diameter, arrested fluorescein dye injected into the carotid system, and reduced rCBF by 42% with increase of collateral flow to the brain by the vertebrobasilar system. This effect was not obtained by PGE1 to which 0.08% ethanol had been added. PGF2a at doses of 25 µg/min constricted epicerebral arterial vessels less than 200 µ in diameter, reduced rCBF by 35%, and decreased fluorescein dye in the cortical microcirculation with lengthening of the cerebral circulation time. Selective clipping of external and internal carotid arteries indicated that PGE1 acts by constricting these vessels as well as the epicerebral arteries. Since prostaglandins are released from platelets as well as from stimulation of the cerebral cortex they should be considered as factors involved in the regulation of cerebral blood flow and in the mechanism of cerebral vasospasm. These properties of PGE1 and PGF2a also imply the need for caution when these substances are used for clinical investigation.
Teratoma occurring within a myelomeningocele
Authors: Mitgang Robert N.
Published: May 2009

✓ A teratoma lying within a myelomeningocele is described and comparable reported cases reviewed. Most such lesions occur in children and are solid as compared with the more cystic masses occurring in adults. It is postulated that expansion of the cyst with increasing age causes the compression responsible for the late onset of symptoms.
Excision of a congenital suboccipital vertebral arteriovenous fistula
Authors: Bartal Albert D. , Levy Morris J.
Published: May 2009

✓ This report describes the successful excision of a congenital vertebral arteriovenous malformation in an 8-year-old child. There was mild effort dyspnea and left ventricular cardiac enlargement; a left-to-right vertebral artery steal across the basilar trifurcation was a major consideration in planning the surgical approach.
Head bobbing associated with a cyst of the third ventricle
Authors: Obenchain Theodore G. , Becker Donald P.
Published: May 2009

✓ A woman with hydrocephalus and head bobbing presented with headaches and episodic loss of consciousness. Contrast studies revealed a cyst within the third ventricle. At craniotomy it occupied the entire third ventricle and its walls merged with the hypothalamus. This is considered to be a congenital suprasellar arachnoid cyst which expanded superiorly through the third ventricle. Similar cases are reviewed and therapy briefly discussed.
Ruptured mycotic pericallosal aneurysm with meningitis due to Neisseria meningitidis infection
Authors: Sypert George W. , Young Harold F.
Published: May 2009

✓ A case is reported in which a ruptured intracerebral aneurysm had been infected by Neisseria meningitidis. Evacuation of the resulting hematoma, clipping the aneurysm and antibiotic therapy resulted in a satisfactory recovery.
Granular cell myoblastoma of the pituitary
Authors: Satyamurti S. , Huntington Howard W.
Published: May 2009

✓ A rare case of granular cell myoblastoma of the pituitary is reported and discussed. It is not affected by radiation and should be surgically removed to preserve vision.
The effects of mass-induced intracranial pressures on arterial hypertension and survival in awake cats
Authors: Goodman Stanley J. , Becker Donald P. , Seelig John
Published: May 2009

✓ Intracranial pressures above and below the tentorium, arterial blood pressure, heart rate, and respiratory rate were recorded continuously before, during, and after expansion of a supratentorial mass in awake unsedated cats. In general, as the mass enlarged, the intracranial pressure rose; however, considerable variation was observed among animals with respect to specific mass size and associated intracranial pressures. There was considerable variation in the relationship of supratentorial pressure to infratentorial pressure. No animal survived that had sustained a mass-induced pressure exceeding 1100 mm H2O, and survival was shorter with greater pressures. Systemic hypertension occurred always and only when the infratentorial pressure exceeded 600 mm H2O, regardless of the magnitude of the associated supratentorial intracranial pressure. The methodological limitations of previous studies of mass-induced intracranial hypertension appear to have been substantially reduced by the technique described.
Traumatic intracerebral hematoma
Authors: Jamieson Kenneth G. , Yelland John D. N.
Published: May 2009

✓ A series of 63 cases of surgically treated traumatic intracerebral hematomas is reported. Age and sex incidence, cause and mechanism of injury, site of hematoma and its presentation and outcome are analyzed.
Production of clinical form of chronic subdural hematoma in experimental animals
Authors: Watanabe Satoru , Shimada Hironobu , Ishii Shozo
Published: May 2009

✓ A method for producing a clinical form of experimental chronic subdural hematoma is reported. When blood is mixed with cerebrospinal fluid and incubated, a peculiar clot is formed which, when inoculated into the subdural space of dogs or monkeys, grows gradually. Histologically the capsule of the hematoma is comparable to that seen in human chronic subdural hematoma. In some animals progressive hemiparesis develops.
Reversible spinal cord trauma in cats
Authors: Brodkey Jerald S. , Richards David E. , Blasingame James P. , Nulsen Frank E.
Published: May 2009

✓ In the barbiturate-anesthetized cat, spinal cord function was estimated using averaged cortical evoked potentials (CEP) elicited by stimulating the posterior tibial nerve. Although neither spinal cord compression nor an aortic blood pressure one-half the systemic pressure when applied individually blocked the CEP, these same factors when applied in combination produced reversible block of the CEP.
Early repair of myelomeningocele (spina bifida cystica)
Authors: Heimburger Robert F.
Published: May 2009

✓ Myelomeningocele was treated intensively in 104 children between 1950 and 1955, and a follow-up study made of 97 during 1968 and 1969. Surgical repair of the cystic mass was carried out in 71 of the 97, and was refused by parents in 26. Of the 71 surgical patients, 37 were alive in 1969, while all of the nonsurgical patients were dead. Seven of the 37 survivors are normal intellectually, in sphincter control, and in walking. Twenty-eight of the 37 are walking and competing with their peers in regular school. Four do not attend school because of paraplegia. The remaining five are mentally retarded and paraplegic. The quality as well as the quantity of survival has been related to the time after birth that surgery was performed.
Transorbital pituitary stalk section in primates
Authors: Shintani Akira , Zervas Nicholas T. , Kuwayama Akio , Pallotta Johanna , Spark Richard
Published: May 2009

✓ Pituitary stalk section through the orbit by microsurgical technique is described in eight monkeys. The use of the microscope and the approach through the optic foramen minimize incidental injury. Under these circumstances experiments designed to study neuroendocrine relationships may be carried out free of errors introduced by damage to the temporal lobe or hypothalamus. Plasma cortisol drops to very low levels, but still support life. Growth hormone output is negligible.
Neurological dysfunction in Paget's disease of the vertebral column
Authors: Sadar Edward S. , Walton Robert J. , Gossman Henry H.
Published: May 2009

✓ The authors report four cases of Paget's disease of the vertebral column causing neurological deficit, one with sarcomatous degeneration and one without compression of the spinal cord, and review 86 reported cases. Most cases responded well to decompressive laminectomy. The paradox of neurological deficit without myelographic block is discussed and the relatively common incidence of sarcomatous degeneration noted.
Physical factors in the initiation, growth, and rupture of human intracranial saccular aneurysms
Authors: Ferguson Gary G.
Published: May 2009

✓ An investigation using glass models disclosed that the apex of a bifurcation is subjected to hemodynamic forces which may initiate the aneurysmal process by producing focal destruction of the internal elastic membrane. A prediction from model studies that turbulence occurs within intracranial aneurysms was confirmed in a clinical study. Bruits, indicative of turbulent blood flow, were recorded from the sacs of 12 of 19 cases studied at the time of craniotomy. Turbulence causes degenerative changes that weaken the wall of an aneurysm and allow it to enlarge. Measurement in four cases revealed that intra-aneurysmal pressure is the same as systemic arterial pressure. An in vitro study of the static elastic properties of human intracranial aneurysms demonstrated that they are relatively nondistensible in comparison to major intracranial arteries. This altered elasticity reflects the destruction of the elastic tissue in the wall of an aneurysm. An analysis of the physical factors influencing whether an aneurysm ruptures showed that the probability of rupture increases with an increase in intra-aneurysmal pressure, an increase in aneurysmal size, a decrease in the minimum wall thickness of an aneurysm, or a decrease in the strength of its structural components.
Microsurgical treatment of intracranial saccular aneurysms
Authors: Krayenbühl Hugo A. , Yaşargil M. Gazi , Flamm Eugene S. , Tew John M.
Published: May 2009

✓ A consecutive series of 250 patients with cerebral aneurysms operated on with microsurgical techniques is presented. Good results were obtained in 83% of the entire series and in 94% of patients who were Grades 1, 2, and 3 preoperatively. The overall mortality rate was 5%; it was 1.6% for Grades 1, 2, and 3 patients, and there were no deaths in the 112 patients in Grades 1 and 2. The microsurgical techniques and the preoperative and operative factors that influenced the results are discussed.