bluuebunny/crossref_metadata_2025 huggingface dataset:
Referral of pain from dural stimulation in man
Authors: Wirth F. P. , Van Buren J. M.
Published: May 2009

✓ Electrical stimulation of the dura was carried out in 25 patients using chronically implanted electrodes to determine areas of referred pain. Referred pain occurred over areas supplied by all divisions of the trigeminal nerve and the upper three cervical spinal nerves. No pattern of pain referral could be established on the basis of electrode positions determined from bone landmarks on the skull. It is suggested that these findings may be explained either by a greater overlap of the dural nerves than had been previously recognized, or by an overlap of the connections of the cervical nerves and the trigeminal nerve in the dorsal horn of the cervical spinal cord. Both of these mechanisms seem to be operative to some degree. Bilateral and contralateral pain was also elicited; whether this was due to stimulation of the bilateral termination of the dural nerves near the midline or of the bilateral central projections of these dural nerves is not clear. Contralateral referral of pain from dural points widely separated from the midline, however, suggests that some contralateral central projections do exist. The authors conclude that head pain of dural origin has limited clinical usefulness because of the lack of consistent specificity in its referral pattern.
Familial frontonasal dermoid cysts
Authors: Plewes Jeremy L. , Jacobson Ivan
Published: May 2009

✓ A family group, comprised of father and all three children, had frontonasal dermoid cysts. Clinical features and x-ray findings are discussed, and the similarity to a slow-growing intracranial space-occupying lesion is emphasized. Plain x-ray films may show a widened nasal septum, and contrast radiology will help outline an avascular mass arising from the cribriform plate. Resection utilizing a synchronous nasal and frontal operation proved effective.
Leptomeningeal cyst of the posterior fossa
Authors: Dunkser Stewart B. , McCreary Howell S.
Published: May 2009

✓ A case of a posterior fossa extradural cyst is presented in which both the cyst and the arachnoiditis that accompanied it were thought to have been caused by trauma which had occurred 16 years earlier. The reasons why this was diagnosed as a leptomeningeal cyst are discussed.
Intramedullary sclerosing astrocytoma of the spinal cord
Authors: Gass Harvey , Goodman Paul A. , Miller John , Chason Jacob L.
Published: May 2009

✓ An intramedullary spinal cord tumor of unusual pathology is reported which has been called a “sclerosing astrocytoma” because of the predominance of a sclerotic collagenous nodule in its center. A successful removal was accomplished with virtually complete neurological recovery maintained now for 3 years.
Glioblastoma with extracranial metastasis through ventriculopleural shunt
Authors: Wakamatsu Tadaie , Matsuo Takeshi , Kawano Shohichi , Teramoto Shigeyoshi , Matsumura Hidekatsu
Published: May 2009

✓ Extracranial metastasis of an intracranial glioblastoma through a ventriculopleural shunt to the right thorax is reported in a 22-year-old man following a ventriculopleural shunt and telecobalt therapy. Autopsy 8 months after the shunt showed cerebral tumor involving the ventricular system, and irregularly thickened pleura in the right thorax. The primary intracranial tumor and the tumor located extracranially showed the same morphological appearance of glioblastoma.
New ventricular catheter for hydrocephalic shunts
Authors: Portnoy Harold D.
Published: May 2009

✓ A new ventricular catheter is described for ventriculoatrial (or peritoneal) shunts. Soft silicone rubber flanges fold back on insertion to protect the holes at the tip from debris. After entering the ventricle, the flanges expand to prevent the catheter from impinging on the ventricular wall. The number of revisions for occluded ventricular catheters has dramatically decreased with its use.
New neurosurgical operating glasses and fiberoptic headlight
Authors: Burton Charles
Published: May 2009

✓ A new type of neurosurgical operating glasses is described, which can be mounted on a regular pair of glasses and give high magnification (× 4.4). Good illumination is provided by means of a newly designed fiberoptic headlight.
Cyanoacrylate encasement of intracranial aneurysms
Authors: Yashon David , White Robert J. , Arias Belisario A. , Hegarty William E.
Published: May 2009

✓ Some intracranial aneurysms, because of their broad base or incorporation of essential nutritive vessels, must be treated by adhesive reinforcement. The authors report successful results with cyanoacrylate adhesives in five patients. The unique quality of this material permits maximum adhesion in a moist operative field. This adhesive is nonviscous and will coat the entire aneurysm, obviating problems related to incomplete coating. Excellent long-term results are apparently due to the biological effect of this adhesive in which a proliferative fibrous reaction occurs and counteracts recognized erosive properties.
Surgical experience with chromophobe adenomas of the pituitary gland
Authors: Ray Bronson S. , Patterson Russell H.
Published: May 2009

✓ Between 1950 and 1969, 165 operations were performed on 146 patients for the treatment of chromophobe adenoma of the pituitary gland unassociated with either acromegaly or Cushing's syndrome. The over-all operative mortality was 1.2%, and no deaths occurred in 138 cases operated on for the first time. In 106 of the patients who had not received prior treatment, vision was improved in 80% of cases and returned to normal in 50%. In the group of patients whose initial treatment was surgery, postoperative radiation therapy was administered in one-half of the cases. The rate of recurrence was 8% in those who received radiation and 22% in those who did not. Recurrence of symptoms within less than 1 year often was due to a hemorrhagic cyst which could be treated better by reoperation than by radiation therapy.
Histochemical investigation of nonspecific acid phosphatase in cerebral tumors
Authors: Lolova Ivanka , Ivanova Ana , Bojinov Sasho
Published: May 2009

✓ The activity of acid phosphatase in 144 cerebral tumor biopsies was investigated in an attempt to reveal correlations between enzymatic activity and biological states of the tumor cells. The distribution and intensity of the product of enzymatic reaction in different types of tumors, especially in some rare neoplasms (medulloepithelioma, gangliocytoma), showed evidence of the link between vascularization and the activity of the enzyme.
Results of nonoperative treatment in 15 cases of infantile subdural hematoma
Authors: McLaurin Robert L. , Isaacs Emily , Lewis H. Paul
Published: May 2009

✓ A group of 15 patients who had posttraumatic subdural effusion in infancy were treated by subdural tapping alone. Taps were performed only in response indicates intracranial hypertension. Subsequent psychometric testing indicates that the results compare favorably with those of previously reported series. The rationale for this method of management is discussed. The authors conclude that in most instances subdural hematomas can be successfully treated by tapping alone, and that complete evacuation of subdural fluid is not essential, although more extensive surgical procedures may occasionally be necessary when intracranial hypertension persists despite repeated tapping.
The effect of increased intracranial pressure on cerebrovascular hemodynamics
Authors: Lowell Harry M. , Bloor Byron M.
Published: May 2009

✓ Both brain edema (increased water content) and enlargement of the vascular compartment have been implicated as being responsible for intracranial hypertension following trauma. In this study pertinent cerebrovascular hemodynamic parameters have been investigated in states of increased intracranial pressure (ICP) and graded trauma to determine whether cerebral edema or vascular factors are of major importance. Utilizing the monkey-epidural balloon experimental model, continuous measurements of the mean arterial pressure (MABP) , jugular outflow pressure (MJVP), and sagittal sinus wedge pressure (SSWP) were obtained. Shulman's observations that the sagittal sinus wedge pressure accurately reflects the intracranial pressure have been confirmed. The total cerebral blood flow (CBF) and mean transit time (t̄) were determined and the total cerebral blood volume (CBV) computed. From these data the venous (Rv), arterial (Ra), and total resistances (Rt) were calculated. Analysis of these parameters during both the acute elevation of ICP and that following graded trauma has demonstrated: 1) a progressive decrease in the total cerebral blood flow and volume and a concomitant increase in the mean transit time; 2) a progressive increase in the total resistance with a shift from the arterial to the venous side; 3) a progressive decrease in the perfusion pressure (PP = MABP-SSWP); 4) impairment of CO2 reactivity pari passu with vasomotor activity and autoregulation of flow to pressure. The findings did not support the concept that increased intracranial pressure following trauma is the result of an increase in the size of the cerebrovascular compartment.
Clinical results of lyophilized human cadaver dura transplantation
Authors: Abbott William M. , Dupree Emmett L.
Published: May 2009

✓ The clinical results of lyophilized human cadaver dura transplantation in 170 neurosurgical patients show that it is a safe and effective material for dural closure. It is associated with low complication rates and minimal cortical scarring and adhesions. The successful results have been attributed to the minimal foreign body reaction stimulated by freeze-dried tissue. These factors plus its capacity for safe and convenient long-term storage at room temperature make lyophilization the method of choice for preserving dura mater.
Cerebral tissue lactate in experimental oligemic shock
Authors: Feldman Robert A. , Yashon David , Locke George E. , Hunt William E.
Published: May 2009

✓ Eleven anesthetized dogs underwent bilateral craniectomies. Four control dogs had serial resections of cerebral tissue in the normotensive state. After one control sample was removed from the remaining seven dogs, they were bled to a mean arterial pressure of 30 to 35 mm Hg and had cerebral tissue samples resected at 0, 30, and 60 min after the onset of hypotension. The tissue samples from the four normotensive dogs averaged 4.83 mM lactate/kg tissue with a range of 4.67 to 7.22 mM/kg. At 0 time post-shock the samples averaged 7.18 mM/kg, at 30 min post-shock 14.31 mM/kg, and at 60 min 18.76 mM/kg. It can be concluded that hemorrhagic shock causes a progressive elevation in cerebral tissue lactate, which correlates with the duration of shock. At low mean arterial pressures the brain is susceptible to the effects of poor tissue perfusion, which results in both inadequate oxygenation and lactate washout in spite of well-established mechanisms for preferential shunting of blood to the brain.
Surgical treatment of craniofacial dysostosis in monozygotic twins
Authors: Perrin Jane C. S. , Weiss Martin H. , Yashon David
Published: May 2009

✓ A family with craniofacial dysostosis affecting a father and his monozygotic twin sons is described. The father had no surgery until linear craniectomy when 3 years old; he is of normal intelligence but legally blind. Prophylactic coronal craniectomy and orbital decompression were done on the twins. One had an uncomplicated course and is developing normally. The other developed neonatal meningitis and ventriculitis with secondary hydrocephalus, plus poor vision and retarded development.
Evaluation and use of the ventriculoperitoneal shunt in hydrocephalus
Authors: Hammon William M.
Published: May 2009

✓ The high rate of complications associated with ventriculocardiac shunts at the Walter Reed General Hospital led to the evaluation of a new ventriculoperitoneal shunt procedure. Results with the ventriculoperitoneal shunt have shown a marked decrease in total complications and malfunctions and total absence of all cardiovascular-pulmonary complications, early and late. The Silastic peritoneal catheter has not become occluded, and is adaptable to other diagnostic procedures and injections. When lengthening of the peritoneal catheter is finally required due to the patient's growth, it should be easy to perform.
Bullet within the fourth ventricle
Authors: Charles W. , Sternbergh A. , Watts Clark , Clark Kemp
Published: May 2009

✓ A woman, shot in the left parietal area with a small caliber pistol, appeared moribund upon admission to the emergency room but rapidly stabilized and became more arousable. In the fifth week following injury, a pneumoencephalogram demonstrated the bullet lying free within the fourth ventricle; it was subsequently removed from the cisterna magna without difficulty. The patient has made progressive neurological improvement. Other reports concerning intraventricular foreign bodies are reviewed and discussed.
The subarachnoid space in congenital obstructive hydrocephalus
Authors: Milhorat Thomas H. , Hammock Mary K. , Di Chiro Giovanni
Published: May 2009

✓ In congenital obstructive (internal) hydrocephalus, a coexisting obstruction of the subarachnoid space is frequently present. In the current study, cisternographic evidence is provided that considerable re-expansion of the subarachnoid space may occur after temporary ventricular drainage. These findings suggest that in at least some cases of obstructive hydrocephalus, the subarachnoid space is potentially open but mechanically compressed. The therapeutic significance of re-expanding the subarachnoid space by temporary ventricular shunts is discussed.
The effect of proximal anterior cerebral occlusion on anterior communicating artery aneurysms
Authors: Durity Felix , Logue Valentine
Published: May 2009

✓ The arteriographic changes occurring in the anterior communicating aneurysmal sacs in 43 cases treated by ligation of the anterior cerebral artery have been presented and discussed.
Ruptured aneurysms of the middle cerebral artery
Authors: Robinson Richard G.
Published: May 2009

✓ Eighty-four consecutive patients with ruptured aneurysms of the middle cerebral artery were operated on between 1947 and 1969 at the Neurosurgical Unit, Dunedin Hospital, Dunedin, New Zealand. The lesions were commoner in women. Poor clinical condition, hypertension, retinal hemorrhage, age over 50 years, intracerebral hematoma, and very early operation each affected the surgical mortality adversely. The over-all mortality was 36.6%, and better patient selection reduced this to 7.8%. Clipping the aneurysm proved to be a better method of treatment than investment with muscle and gauze. Two-thirds of the surviving patients returned to full or partial working capacity.
Intracranial aneurysms in the neurosurgical clinics in Japan
Authors: Suzuki Jiro , Hori Shigeaki , Sakurai Yoshiaki
Published: May 2009

✓ To study the current state of intracranial aneurysms in the neurosurgical clinics in Japan, simple questionnaires were sent to 112 institutions in December, 1969, and answers were obtained from 111. The following questions were asked: The total number of cases and aneurysms; the age and sex; the site and side; and the anesthesia and treatment used. These statistical studies have been compared with those of the cooperative study on subarachnoid hemorrhage in the United States.
Operative hypotension for intracranial vascular surgery using pacemaker-induced ventricular tachycardia
Authors: Rovit Richard L.
Published: May 2009

✓ Temporary tachycardia of 130 to 160 beats/min was induced with a bipolar endocardial catheter pacemaker in 13 patients undergoing intracranial vascular surgery (nine for aneurysms, one for an arteriovenous anomaly, and three for brain tumors). It proved to be an effective method for achieving controlled hypotension of 25 to 40 mm Hg. Electrical pacing of the heart reduced diastolic filling time, lowered cardiac output, and produced systemic hypotension which was inversely proportional to the induced heart rate. Twelve patients made uneventful recoveries. One patient sustained intractable ventricular fibrillation while being paced at a rate of 180 to 190 beats/min and died. One patient developed transient ventricular fibrillation which was successfully converted. Cessation of pacing produced immediate return of systolic pressures to the prepacing levels. Although not without hazard, rapid ventricular pacing is recommended as an effective method for transiently lowering systemic blood flow during periods of potential or actual hemorrhage in intracranial vascular surgery.
Spinal arachnoid diverticula
Authors: Stewart Donald H. , Red Donald E.
Published: May 2009

✓ Four cases of symptomatic arachnoid diverticula are presented to illustrate the diagnosis, radiographic findings, and treatment of this condition. The myelographic demonstration of asymptomatic diverticula is not rare, and only when neurological symptoms are localized to the level of the myelographically demonstrated diverticula is surgical treatment considered. Supine and upright positions during myelography are important to demonstrate the lesions.
Intestinal volvulus secondary to a ventriculoperitoneal shunt
Authors: Sakoda Thomas H. , Maxwell John A. , Brackett Charles E.
Published: May 2009

✓ Volvulus with intestinal obstruction is an unusual complication of ventriculoperitoneal shunting. It was the most serious of the few complications experienced in 56 cases of intraperitoneal Silastic catheter implantation and probably represented reaction to the peritoneal incision rather than reaction of the tissue to Silastic.
A brief history of the development of the Mayfield clip
Authors: Mayfield Frank H. , Kees George
Published: May 2009

✓ The neurosurgeon and engineer most concerned with the creation and later modification of the Mayfield clip trace its development.
Technique for unilateral isolation of the subdural space in the intact primate
Authors: Boretos John W. , Bourke Robert S. , Nelson Kenneth M. , Naumann Robert A. , Ommaya Ayub K.
Published: May 2009

✓ Transparent polycarbonate domes, to cover craniectomies, now may be thermoformed by using readily available laboratory equipment. Special preparation of the bone and dura mater, in conjunction with the dome, can isolate the space over each cerebral hemisphere of the primate. Simultaneous perfusion of each side with solutions of alternatingly different concentrations indicates a lack of admixing. Brain edema of a single hemisphere may be induced and reduced by manipulating the potassium and chloride ion concentration of the perfusate.
Closure of cerebral incisions following intraventricular operations
Authors: Milhorat Thomas H.
Published: May 2009

✓ Ventricular collapse following intraventricular surgery is a formidable complication. In patients with significant dilation of the lateral ventricles, the operative mortality may exceed 40%. In the current report, a technique for closing cerebral incisions is described which has prevented this complication in 18 intraventricular operations in which it has been used. The essential steps include: 1) linear incision of a cerebral gyrus; 2) closure of the incision using bordering vessels for traction; 3) inflation of the ventricles with saline; and 4) attachment of the incision to the overlying dura.
Adrenergic innervation of the cerebral blood vessels in the rabbit
Authors: Peerless S. John , Yasargil M. Gazi
Published: May 2009

✓ The Hillarp technique of fluorescent staining of monoamines was used to examine the adrenergic fibers in the cerebral vessels of rabbit brains. These fibers were found to lie wholly within the deeper layers of the adventitia and not within muscle layers. Varicosities were interpreted as representing neural transmitter substance. The basilar artery had a sparse innervation; the anterior cerebral, carotid, and middle cerebral arteries were more richly supplied by adrenergic terminals, with the most dense innervation in the superficial vessels between 100 and 300 µ in diameter. Mild trauma to the basilar artery, as well as subarachnoid blood without trauma, caused the catecholamine reaction to disappear. A marked depletion of adrenergic fibers was also noted after administration of alpha methyl tyrosine and subjection of the animals to extremes of blood pressure.
Microregional blood flow changes in experimental cerebral ischemia
Authors: Yamamoto Y. Lucas , Phillips Kathryne M. , Hodge Charles P. , Feindel William
Published: May 2009

✓ A branch of the middle cerebral artery on the convexity of the dog brain was occluded to produce an area of focal cerebral ischemia which could then be defined by fluorescein angiography of the brain. Repeated fluorescein angiography and measurement of microregional cerebral blood flow by xenon133 injected into the carotid artery and monitored by miniature lithium-drifted silicon detectors for gamma activity demonstrated that the ischemic zone was reduced in size by better collateral flow when the animals were allowed to breathe 5% carbon dioxide and 95% oxygen. Conversely, hyperventilation reducing the pCO2 made the ischemic zone larger by reducing collateral flow. No evidence was found to indicate that hypercapnia preferentially deprived the ischemic zone of perfusion flow. Retrograde collateral flow in the surface arteries appeared effective in terms of microcirculatory perfusion.
The effects of subarachnoid blood on the electrocorticogram of the cat
Authors: Levitt Philip , Wilson William P. , Wilkins Robert H.
Published: May 2009

✓ Experiments were performed on 33 cats to determine the effects of subarachnoid blood on the electrical activity of the cerebral cortex. Electrocorticograms were obtained from both suprasylvian gyri by intracortical electrodes. Various preparations of autogenous whole blood were injected into the subarachnoid space overlying the suprasylvian gyrus of one side. These preparations included intact whole blood, hemolyzed whole blood, hemolyzed washed red blood cells with and without their membranes, and fresh serum. Lactated Ringer's solution and solutions high in potassium were also used. The preparations containing hemolyzed red blood cells produced much more pronounced effects than the other preparations, causing severe and prolonged suppression of activity in 11 of 15 cats, and spike activity in six. These phenomena did not appear in any other groups of cats in the study. Findings indicate that blood undergoing hemolysis in the subarachnoid space may have a direct effect on the electrical activity of the underlying cerebral cortex. This may in part explain the abnormalities seen in the electroencephalograms of patients with subarachnoid hemorrhage.
Preliminary observation on the hemodynamics of the internal carotid artery following bilateral external carotid ligation in the monkey
Authors: Abraham Jacob , Shetty Gita , Chandy Jacob
Published: May 2009

✓ Ligation of the external carotid artery induced an increased flow in the internal carotid artery in the monkey (Macaca radiata). Bilateral external carotid artery ligations were then done in patients with ischemia resulting from “stroke”; studies of internal carotid artery blood flow showed a consistent increase in flow.
Prediction of short-term verbal memory disturbance after ventrolateral thalamotomy
Authors: Ojemann George A. , Blick Hoyenga Katharine , Ward Arthur A.
Published: May 2009

✓ The acute change in short-term verbal memory following ventrolateral thalamotomy in patients with dyskinesia was measured by the technique of Peterson and Peterson. Performance on this test of short-term verbal memory deteriorated following left but not right ventrolateral thalamotomy. This deterioration could not be accounted for solely by disturbance in speech mechanisms after left thalamotomy (although these were present), but may be related to disturbance in retrieval mechanisms of short-term verbal memory. The relative magnitude of this deterioration in performance after left thalamotomy could be partially predicted at the time of operation by some of the effects of electrical stimulation of the ventrolateral thalamus on the same test. A large decrease in recall errors with stimulation during the presentation of material to be later recalled, and a small increase in recall errors with stimulation at the time of recall, correlated with little disturbance of short-term verbal memory following left thalamotomy.
Solitary posterior fossa plasmacytoma
Authors: Someren Ayten , Osgood Carrol P. , Brylski James
Published: May 2009

✓ The combined treatment of surgery and postoperative irradiation is described in a case of a solitary intracranial plasmacytoma involving the inner surface of the dura of the posterior fossa and the tentorium cerebelli. The tumor overlay the left cerebellar hemisphere and extended through the foramen magnum to approximately the C-1 level. Follow-up examination 16 months after treatment showed no recurrence or dissemination of the disease.
Benign astrocytoma associated with arteriovenous malformation
Authors: Heffner Reid R. , Porro Robert S. , Deck Michael D. F.
Published: May 2009

✓ An arteriovenous malformation associated with an underlying benign astrocytoma of the right frontal lobe is reported and the radiological and pathological features discussed. Previous reports of multiple primary tumors of the nervous system are reviewed and the few cases of vascular malformations associated with gliomas noted.
Intraluminal occlusion of a carotid-cavernous sinus fistula with a balloon catheter
Authors: Prolo Donald J. , Hanbery John W.
Published: May 2009

✓ A technique for intraluminal occlusion of a carotid-cavernous sinus fistula with a balloon catheter is described. Passage of a balloon catheter into the cavernous carotid artery from the cervical carotid usually is easily accomplished. Inflation of the balloon with contrast material allows it to be visualized as the fistula is occluded. The simplicity and effectiveness of this method offer advantages over preexisting ones. Appraisal of its usefulness awaits further clinical trial.
The microvasculature in transitory traumatic paraplegia
Authors: Dohrmann George J. , Wagner Franklin C. , Bucy Paul C.
Published: May 2009

✓ Fine structural alterations in the microvasculature, primarily of the gray matter, occur as one aspect of experimental spinal cord contusion. A force of 300 gm-cm, shown by the authors to produce a transitory paraplegia, was applied to the T-10 level of exposed primate spinal cord. At 5 min post-contusion, the muscular venules of the central gray matter were distended with erythrocytes. Erythrocytes were seen within the perivascular spaces of the post-capillary venules and muscular venules at 15 and 30 min post-contusion, and there was hemorrhage into the gray matter at 1 hour post-contusion. The appearance of erythrocytes within the perivenular spaces was apparently due to small ruptures in the walls of the muscular venules, which were first demonstrated by electron microscopy 15 min after contusion. Alterations in capillary and post-capillary venule endothelium of both gray and white matter were present at 4 hours post-contusion and consisted of vacuolation and endothelial swelling. In conclusion, following experimental contusion of the spinal cord sufficient to cause a transitory paraplegia, the principal changes were early perivascular and parenchymal hemorrhages followed by later evidence of ischemic endothelial injury in the microvasculature.
Histopathology of transistory traumatic paraplegia in the monkey
Authors: Wagner Franklin C. , Dohrmann George J. , Bucy Paul C.
Published: May 2009

✓ The microscopic appearance of the primate spinal cord within a 4-hour interval following the delivery of a direct force sufficient to produce a transitory paraplegia was investigated by light microscopy. The resulting hemorrhagic lesion involved primarily the central gray matter and was attributed to the direct effect of the trauma on the vessels in the gray matter with a consequent impairment of blood supply to the injured area. Chromatolysis, vacuolation, and alterations in cytoplasmic density and stainability were observed within the neurons. The edematous changes in the white matter, which were more marked in the internal layers relative to the external layers, appeared minimal and explain in part why the paraplegia was transient.
Denervation hyperpathia: a convulsive syndrome of the spinal cord responsive to carbamazepine therapy
Authors: Gibson John C. , White Lowell E.
Published: May 2009

✓ Two cases of denervation hyperpathia that responded well to treatment with carbamazepine are presented. A theoretical relation of this disorder to trigeminal neuralgia and focal seizures is emphasized in the light of experimental data and clinical characteristics.
Surgical treatment of multiple aneurysms and of incidentally-discovered unruptured aneurysms
Authors: Moyes Peter D.
Published: May 2009

✓ Review of a series of 460 patients with spontaneous intracranial hemorrhage showed that 241 had demonstrable aneurysms and 38 had multiple aneurysms. The importance of demonstrating the entire circulation following ligation of one aneurysm is emphasized. Treatment of the 38 patients with multiple aneurysms is described. Ligation of unruptured aneurysms that are incidentally discovered is advocated in patients who are Grade 1 on the Botterell scale and who are well informed as to the risks.
Ventriculoatrial shunt in tuberculous meningitis with hydrocephalus
Authors: Bhagwati S. N.
Published: May 2009

✓ Raised intracranial tension affects the course of tuberculous meningitis adversely. The development of hydrocephalus may account for the raised intracranial pressure. Insertion of a ventriculoatrial shunt significantly alters the course of the disease. The results in seven cases have been detailed and discussed. The levels of consciousness improved, hemiplegia and aphasia practically cleared up, and vision returned even in children who were blind for 4 to 6 weeks. Operation could be performed even in an active stage of the disease without much fear of miliary dissemination.
Simple cysts of the cerebellum
Authors: Silverberg Gerald D.
Published: May 2009

✓ Four cases of simple cyst of the cerebellum treated at Stanford University Medical Center are presented. Review of the literature and past experience at Stanford suggest that they are uncommon. They seem to occur most often in middle age, presenting the signs and symptoms of an expanding cerebellar mass, and appear to be adequately treated by unroofing and draining the cyst cavity. It is suggested that these cysts do not have a congenital origin but rather represent a degenerated form of cerebellar astrocytoma.
Transfemoral vertebral angiography as a cause of an anterior spinal artery syndrome
Authors: Lyon Lynn W.
Published: May 2009

✓ A case with signs of a lower cervical anterior spinal artery syndrome incident to vertebral angiography by the transfemoral approach is described. The literature is reviewed and a probable pathogenesis of angiography-related spinal cord injury is discussed.
Osteoid osteoma of the cervical spine
Authors: Heilbrun M. Peter , Lehman Ralph A. W.
Published: May 2009

✓ A case of osteoid osteoma involving the cervical vertebral pedicle is presented which reemphasizes the importance of complete removal of the nidus and the dramatic relief of symptoms following excision.
Lipoma of the spinal cord
Authors: Giuffrè Renato , Gambacorta Domenico
Published: May 2009

✓ A case of intradural spinal lipoma has been reported. Its pathological and clinical features are compared with those of 129 other cases collected from the literature.
Retrograde migration of the venous catheter as a complication of ventriculoatrial shunts in adults
Authors: Cowan Morgan A. , Allen Marshall B.
Published: May 2009

✓ The retrograde cephalad migration of the flexible venous catheter into a large internal jugular vein is described in two cases of adult “normal” pressure hydrocephalus treated with Holter ventriculoatrial shunts. The successful correction of this problem by replacement of the standard type “C” catheter with a slightly more rigid catheter and internal jugular vein ligation is described.
The repair of dural venous sinus wounds by autogenous venorrhaphy
Authors: Rish Berkley L.
Published: May 2009

✓ Military surgical experience with acute wounds of the dural venous sinuses is reviewed. A new technique, autogenous venorrhaphy, is described and reported as the method used in 10 Vietnam combat casualties.
Plasma globulin determinations in patients with microglioma
Authors: Gunderson Carl H. , Henry James , Malamud Nathan
Published: May 2009

✓ Five patients are described with cerebral microglioma or reticulum cell sarcoma. The tumors varied from local neoplasms to multicentric or miliary foci. One of these patients is the second case reported of a microglioma associated with Waldenström's macroglobulinemia. Serum electrophoresis on the other four patients did not reveal any consistent abnormality or pattern. Immunoglobulin studies performed on three of the five patients confirmed Waldenström's syndrome in one, revealed an elevated IgA globulin in a second, and was normal in a third. Cerebrospinal fluid findings included elevated spinal fluid protein in all five patients. The brain scan was abnormal in all four cases so tested. Arteriograms in four patients demonstrated tumor blushes indicative of increased numbers of enlarged vessels. The relationship between reticulum cell sarcomas originating in the central nervous system and those originating elsewhere is discussed.
Neuronal hyperactivity in experimental trigeminal deafferentation
Authors: Anderson Lloyd S. , Black Richard G. , Abraham Jacob , Ward Arthur A.
Published: May 2009

✓ Postoperative facial paresthesias frequently occur in patients following retrogasserian rhizotomy. To investigate the etiology of these paresthesias, microelectrode recordings of neuronal activity were made from the brain stem of the cat at variable times after trigeminal root section. Spontaneous neuronal hyperactivity was recorded from the deafferented spinal trigeminal nucleus in animals studied 8 to 10 days following rhizotomy. After this time the hyperactivity was found to progressively increase and was greatest in animals 1 month after rhizotomy, which was the longest time interval between rhizotomy and microelectrode recordings studied. The neuronal hyperactivity was similar to single cell recordings from cerebral epileptic foci both in monkey and man. This supports earlier experimental information that neuronal deafferentation is a factor in the development of epileptic activity. The authors postulate that brain-stem neuronal hyperactivity similar to epileptic activity is the physiological correlate of paresthesias that occur after sectioning the root of the trigeminal nerve. Further, if retrogasserian rhizotomy causes neuronal seizure activity in the spinal trigeminal nucleus, it may also be possible for trigeminal deafferentation produced by certain pathological processes involving the trigeminal nerve or ganglion to be the basis for other sensory disorders involving the face, i.e., trigeminal neuralgia.
Direct injury of the oculomotor nerve in craniocerebral trauma
Authors: Memon Muhammed Yacob , Paine K. W. E.
Published: May 2009

✓ Twelve cases with direct injury of the oculomotor nerve are presented. The clinical symptoms resemble those of an oculomotor nerve lesion associated with an expanding supratentorial mass lesion with uncal herniation. The clinical signs and mechanism of injury are discussed. The importance of early differentiation of the third nerve injury due to direct trauma from that of an expanding supratentorial mass lesion is emphasized, since conservative treatment of cases due to direct injury is preferable to operation.
Supratentorial intra-arachnoid cyst
Authors: Ghatak Nitya R. , Mushrush Grace J.
Published: May 2009

✓ The clinical and pathological features of a primary supratentorial arachnoid cyst are described. Expansion of the cyst led to progressive neurological deficits that terminated fatally. There was severe compression and marked distortion of the brain with secondary brain stem hemorrhage. It is suggested that intra-arachnoid cysts may represent a distinct pathological entity among the heterogeneous cysts overlying the cerebral hemisphere.
Intracranial dissecting aneurysm
Authors: Sato Osamu , Bascom James F. , Logothetis John
Published: May 2009

✓ The case of a 6-year-old boy who died 4 days after the acute onset of a left middle cerebral artery aneurysmal dissection is described. A review of the 30 reported cases with similar lesions reveals their relative rarity. The age distribution, sex incidence, intracranial vessels affected, and postulated causes of the dissection are discussed.
Extraosseous extradural tuberculous granuloma simulating a herniated lumbar disc
Authors: Balaparameswara Rao S. , Dinakar I. , Sreenivasa Rao K.
Published: May 2009

✓ A 25-year-old man with left-sided sciatica, in whom the cerebrospinal fluid and x-ray films of the spine were normal, was diagnosed as having a L5-S1 disc prolapse. At surgery extradural, extraosseous granulation tissue was removed, which histologically proved to be a tuberculous granuloma.
Discography and myelography in acute injuries of the cervical spine
Authors: Raynor Richard B.
Published: May 2009

✓ Nineteen patients who suffered trauma to the cervical spine that resulted in moderate to severe neurological deficit were studied by discography. In 15 cases, myelography was also performed. When both tests were done there was good correlation of results. In the four cases where only discography was performed, the lesion was accurately localized. The danger of myelography in acute cervical fracture dislocation is emphasized and the relative safety, ease, and value of discography stressed.
Longitudinal myelotomy in the treatment of spasticity of the legs
Authors: Laitinen Lauri , Singounas Evangelos
Published: May 2009

✓ Longitudinal myelotomy at the level of the conus medullaris relieved severe spasticity in eight of nine patients. There was some recurrence of spasticity attributed to inadequate myelotomy. Sensation was impaired by the myelotomy in some patients. Bladder function was temporarily worse in all patients, but in all but one was eventually equal to, or better than, that before surgery.
Experimental radiofrequency telethermohypophysectomy
Authors: Burton Charles , Black Richard C.
Published: May 2009

✓ A new means of producing well-delineated lesions of the pituitary gland by the heating of implanted electroseeds with electromagnetic radiation has been tested in a series of eight adult baboons (Papio anubis). The technique shows promise as a future simple and safe means of depressing anterior or posterior pituitary function in a controlled fashion over a period of time. In addition, possible fallacies relating to the rationale justifying total sellar hypophysectomy are considered. The authors believe that progressive depression of pituitary function may represent a more logical therapeutic approach to patients requiring hypophysectomy for the palliation of malignant disease, diabetic retinopathy, or eosinophilic pituitary adenomas.
Detailed anatomy of the intracranial portion of the trigeminal nerve
Authors: Gudmundsson Kristin , Rhoton Albert L. , Rushton Joseph G.
Published: May 2009

✓ Fifty trigeminal nerves were studied at autopsy under various magnifications. Two findings that could explain the preservation of sensation after rhizotomy of the main sensory root are: 1) anastomosis between the motor and sensory root in the majority of nerves, and 2) aberrant sensory rootlets that arose from the pons separately from the main sensory root in one half of the nerves. The motor root is composed of as many as 14 separately originating rootlets that usually join about 1 cm from the pons. At the pontine level, the first division fibers are usually dorsomedial and the third division fibers caudolateral within the main sensory root. However, the third division fibers may vary from being almost directly lateral to directly caudal to the first division fibers. This may explain the variability of sensory loss with partial section in the posterior fossa.
Intracerebral oligodendroglioma with metastatic involvement of the spinal cord
Authors: Reggiani Roberto , Solimé Franco , Eugenio del Vivo Romeo , Nizzoli Vitaliano
Published: May 2009

✓ A case of cerebral oligodendroglioma with a large metastasis in the spinal cord is reported. The patient had undergone two intracranial operations (1959 and 1961) before the successful removal (1966) of the spinal metastasis, and is still alive.
Large leptomeningeal cyst of the brain
Authors: Adeloye Adelola
Published: May 2009

✓ An unusually large leptomeningeal cyst of the brain is described in a 9-month-old girl who sustained a head injury at the age of 7 weeks. Although the impression was that the cyst was of the post-traumatic variety, it seemed possible that a congenital malformation of the brain antedated the head injury.
Experimental vasospasm, acute and chronic, due to blood in the subarachnoid space
Authors: Echlin Francis
Published: May 2009

✓ This investigation on monkeys provides arteriographic and other evidence that blood, in the absence of evident mechanical stimulation or injury to intradural arteries, will, when injected into the anterior cervical subarachnoid space through a catheter, consistently cause acute and chronic vasospasm of the intradural arteries, presumably where they are contacted by blood. Evidence indicates that vasoconstrictor agents or factors in fresh blood cause the vasospasm, since similar subarachnoid injection of saline or clear serum did not cause vasoconstriction. Other circumstances involving mechanical or other factors, such as vessel injury, may contribute to the length and severity of the vasospasm, but whether they have an etiological role needs further study.
Hydrocephalus due to membranous obstruction of the fourth ventricle
Authors: Amacher A. Loren , Page Larry K.
Published: May 2009

✓ Four patients with hydrocephalus due to membranous obstruction of the fourth ventricle are presented. This rare entity produced radiographic and clinical findings suggestive of posterior fossa tumor. Operative findings included normal cerebellar development and a translucent membrane just above the foramen of Magendie. Etiological possibilities are discussed.
Microangiographic observations of the experimentally traumatized spinal cord
Authors: Fried Larry C. , Goodkin Robert
Published: May 2009

✓ Monkey spinal cords were subjected to measured impacts sufficient to produce paraplegia in most instances, and the monkeys were perfused with 20% Micropaque suspension. Microangiograms of injured segments were compared with those of noninjured segments and controls. The most striking finding was diminished perfusion of the intrinsic arteries. This was proportional to the severity of the impact and the time interval from trauma until perfusion. Focal dilatations and constrictions of intrinsic arteries and other vascular changes were noted.
An angiographic study of meningiomas of the posterior fossa
Authors: Salamon Georges M. , Combalbert André , Raybaud Charles , Gonzalez Jorge
Published: May 2009

✓ The meningeal vasculature of the posterior cranial fossa was studied on injected normal anatomical specimens and in angiograms of patients with posterior fossa meningiomas. The correlated results indicate that the dura anterior to the foramen magnum is supplied by meningeal vessels from the carotid siphon, the ascending pharyngeal and middle meningeal arteries. The dura posterior to the foramen magnum is supplied primarily by the occipital artery and secondarily by the vertebral artery.
Spasm of the extracranial internal carotid artery resulting from blunt trauma demonstrated by angiography
Authors: Gurdjian Elisha S. , Audet Blaise , Sibayan Renato W. , Thomas Llywellyn M.
Published: May 2009

✓ Two cases of spasm of the extracranial portion of the internal carotid artery following trauma are described. In one case, the spasm did not cause lasting clinical symptoms, while in the other the spasm caused clinical symptoms with probable infarction.
Giant intracranial epidural meningioma
Authors: Rao S. Balaparameswara , Dinakar I. , Rao K. Sreenivasa
Published: May 2009

✓ A rare case of an epidural intracranial meningioma weighing 1890 gm is reported in a 5-year-old child.
Ependymal cyst of the Sylvian fissure
Authors: Patrick Bernard S.
Published: May 2009

✓ An ependymal cyst occurring in the Sylvian fissure is described. No ependymal cysts have been reported above the tentorium and external to the cerebrum. Concepts of the origin of ectopic ependymal tissue and other glial heterotopias are discussed.
Chiasmapexy for the correction of traction on the optic nerves and chiasm associated with their descent into an empty sella turcica
Authors: Welch Keasley , Stears John C.
Published: May 2009

✓ A patient recovered full vision after evacuation of a chromaphobe adenoma and subsequent irradiation, but experienced delayed visual loss in the left eye associated with descent of the diaphragm of the sella and the optic nerves and chiasm into the tumor bed. More normal anatomical relationships were restored by inserting silicone sponge beneath the diaphragm of the sella. Vision improved rapidly thereafter and has been maintained for more than 3½ years.
The permeability of capillaries of the sciatic nerve of the rabbit to several materials
Authors: Welch Keasley , Davson Hugh
Published: May 2009

✓ The course of penetration of radioactive sodium, chloride potassium, and thiourea from plasma into rabbits' sciatic nerves was observed after establishing and maintaining a level of radioactivity in plasma. The observations confirm the existence of a blood-nerve barrier since the exchange between blood and nerve is very much slower than the corresponding turnover for muscle. The vasa nervorum were 10 times more permeable to sodium and chloride than the cerebral vessels.
Subarachnoid hemorrhage in pregnancy
Authors: Robinson Julian L. , Hall Charles J. , Sedzimir Carol B.
Published: May 2009

✓ A series of women who had spontaneous subarachnoid hemorrhage during pregnancy is reviewed. These patients are more likely than the average to have an angiographically demonstrable lesion, with arteriovenous anomalies and aneurysms occurring equally. The clinical features are evaluated so that an idea of the causative lesion can be gained at the bedside in the absence of specific neurological tests. When the known cardiovascular changes of pregnancy are correlated with the clinical features in these patients, it is found that subarachnoid hemorrhage from an arteriovenous anomaly or aneurysm in pregnancy is not related to the increased cardiac output. From these data, the preferred neurosurgical and obstetrical management is defined.
Experimental effect of intracranial hypertension upon intraocular pressure
Authors: Lehman Ralph A. W. , Krupin Theodore , Podos Steven M.
Published: May 2009

✓ Intracranial pressure was elevated acutely by inflation of an epidural balloon inside one side of the skull of monkeys. In most of the animals, intraocular pressure rose, beginning only after intracranial pressure had been elevated well above normal and continuing until the pressure in the expanding epidural balloon approached the level of the blood pressure. Thereafter intraocular pressure stabilized until it fell as vasomotor collapse ensued. The role of systemic arterial pressure elevations in the rising phase of intraocular pressure is thought to be less important than increases of ophthalmic venous pressure.
Experience with calf bone in cervical interbody spinal fusion
Authors: Taheri Zia E. , Gueramy Monoucher
Published: May 2009

✓ In 200 cases following cervical diskectomy, cylindrical dowels of specially processed calf bone were placed in intervertebral holes, bored with a drill of the same size as the dowel. The anterior approach for cervical interbody fusion was used. With use of heterogenous bone, iliac osteotomy is unnecessary, and the hole is filled by a precisely formed, previously prepared, sterile dowel. The results are good, the operation time is shorter, and complications are diminished. The cases were evaluated separately from x-ray and clinical data.