bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preliminary experience with self-expanding closed-cell stent placement in small arteries less than 2 mm in diameter for the treatment of intracranial aneurysms
Authors: Chung Joonho , Suh Sang Hyun , Hong Chang-Ki , Joo Jin-Yang , Lim Yong Cheol , Shin Yong Sam , Kim Yong Bae 
Published: January 2015

OBJECT
The purpose of this study was to report the authors' preliminary experience using self-expanding closed-cell stents deployed in small arteries (< 2 mm in diameter) to treat intracranial aneurysms.

METHODS
A total of 31 patients were studied. All subjects met the following criteria: 1) they received an Enterprise stent for treatment of a wide-necked aneurysm or a dissecting aneurysm or as part of a stent-salvage procedure; and 2) they had an Enterprise stent deployed in a small parent artery (< 2 mm in diameter) that had no atherosclerotic stenosis. Procedure-related complications and follow-up sizes of the parent arteries were evaluated for safety and patency.

RESULTS
There were 16 ruptured aneurysms and 15 unruptured aneurysms. Three (9.7%) of the 31 patients experienced procedure-related complications, and they all were asymptomatic. Follow-up angiography was performed in 27 patients (87.1%) (at a mean 15.5 months after surgery). Parent arteries with 2 acute angles (n = 4) were occluded in 3 cases (75.0%), and those with no acute angles (n = 13) or 1 acute angle (n = 6) showed 100% patency on follow-up angiography. There was a significant difference between the follow-up sizes (mean 1.72 ± 0.30 mm) of parent arteries and their sizes (mean 1.59 ± 0.26 mm) before treatment (95% CI − 0.254 to − 0.009 mm; p = 0.037, paired-samples t-test).

CONCLUSIONS
In the current series the deployment of self-expanding closed-cell stents in small arteries was safe and resulted in good patency, especially when the stents were deployed in segments of the parent artery with no acute angles or only 1 acute angle.
Odontoid balloon kyphoplasty associated with screw fixation for Type II fracture in 2 elderly patients
Authors: Terreaux Luc , Loubersac Thomas , Hamel Olivier , Bord Eric , Robert Roger , Buffenoir Kevin 
Published: January 2015

Anterior screw fixation is a well-recognized technique that is used to stabilize Type IIB fractures of the odontoid process in the elderly. However, advanced age and osteoporosis are 2 risk factors for pseudarthrosis. Kyphoplasty has been described in the treatment of lytic lesions in C-2. The authors decided to combine these 2 techniques in the treatment of unstable fractures of the odontoid.
Two approximately 90-year-old patients were treated for this type of fracture. Instability was demonstrated on dynamic radiography in one patient, and the fracture was seen on static radiography in the other. Clinical parameters, pain, range of motion, 36-Item Short Form Health Survey (SF-36) score (for the first patient), and radiological examinations (CT scans and dynamic radiographs) were studied both before and after surgery.
After inflating the balloon both above and below the fracture line, the authors applied a high-viscosity polymethylmethacrylate cement. Some minor leakage of cement was noted in both cases but proved to be harmless. The screws were correctly positioned. The clinical result was excellent, both in terms of pain relief and in the fact that there was no reduction in the SF-36 score. The range of motion remained the same. A follow-up CT scan obtained 1 year later in one of the patients showed no evidence of change in the materials used, and the dynamic radiographs showed no instability.
This combination of kyphoplasty and anterior screw fixation of the odontoid seems to be an interesting technique in osteoporotic Type IIB fractures of the odontoid process in the elderly, with good results both clinically and radiologically.
Vincenzo Quercioli (1876–1939), researcher and pioneer of the atlas fracture
Authors: Domenicucci Maurizio , Dugoni Demo Eugenio , Mancarella Cristina , D'Elia Alessandro , Missori Paolo 
Published: January 2015

A review of early 20th century literature regarding fractures of the atlas led the authors to discover a paper written in Italian by Professor Vincenzo Quercioli in 1908, at that time an assistant surgeon at the University of Siena. The work was published in the journal Il Policlinico, which at that time was directed by Professor Francesco Durante. The paper described the first case of a quadripartite fracture of the atlas, and it accurately reported the mechanism of injury, symptoms, neurological examination, treatment, complications, and cause of death of the patient.
Quercioli performed an autopsy on the patient and gave a detailed description of anatomopathological features. In particular, he identified the 4 symmetrical fracture lines related to the arches of the atlas and the substantial integrity of the atlantoaxial ligaments, particularly the transverse ligament. Based on those findings, Quercioli concluded that the mechanism of trauma was an axial force. This force passed through the center of the vertebral ring and caused symmetrical displacement and compression of the articular masses.
These concepts of dynamic physics led Quercioli to conclude that, because the atlas is wedge shaped, the masses of the atlas reacted to stress by moving away from the center. This reaction resulted in stretching the front and rear arches, which then fractured at their 4 points of weakness. The integrity of the spinal cord was intact, based on a negative neurological examination for CNS lesions. Thus, he concluded that these injuries were not fatal and could be cured by appropriate treatment with a Minerva cast and, in the presence of swallowing disorders, with a nasogastric tube.
The case described by Quercioli was later mentioned in two classic works on atlas fractures by Sir Geoffrey Jefferson, published in 1920 and 1927. In those works, Jefferson proposed his classification of 5 different anatomopathological classes; this work is widely cited in the literature and should be considered a classic. The patterns and deductions that Jefferson reported on these fractures appeared to draw upon the scientific experience of Quercioli and his description of the quadripartite atlas fracture, which appeared to be unique, even in Jefferson's review. Therefore, the authors believe that they have identified another scientist and pioneer of the atlas fracture in Professor Vincenzo Quercioli. With his brilliant insights, which remain useful and valid, Quercioli led the way to further research on the subject.
Flow diversion for complex intracranial aneurysms in young children
Authors: Navarro Ramon , Brown Benjamin L. , Beier Alexandra , Ranalli Nathan , Aldana Philipp , Hanel Ricardo A. 
Published: January 2015

Pediatric intracranial aneurysms are exceedingly rare and account for less than 5% of all intracranial aneurysms. Open surgery to treat such aneurysms has been shown to be more durable than endovascular techniques, and durability of treatment is particularly important in the pediatric population. Over the past 2 decades, however, a marked shift in aneurysm treatment from open surgery toward endovascular procedures has occurred for adults.
The authors describe their early experience in treating 3 unruptured pediatric brain aneurysms using the Pipeline embolization device (PED). The first patient, a girl with Majewski osteodysplastic primordial dwarfism Type II who was harboring multiple intracranial aneurysms, underwent two flow diversion procedures for a vertebrobasilar aneurysm and a supraclinoid internal carotid artery aneurysm. The second patient underwent PED placement on a previously coiled but enlarging posterior communicating artery aneurysm. All procedures were uneventful, with no postsurgical complications, and led to complete angiographic obliteration of the aneurysms. To the authors' knowledge, this is the first series of flow diversion procedures in children reported in the medical literature.
While flow diversion is a new and relatively untested technology in children, outcomes in adults have been promising. For challenging lesions in the pediatric population, flow diversion may have a valuable role as a well-tolerated, safe treatment with durable results. Many issues remain to be addressed, such as the durability of flow diverters over a very long follow-up and vessel response to growth in the presence of an endoluminal device.
Subdural to subgaleal shunts: alternative treatment in infants with nonaccidental traumatic brain injury?
Authors: Blauwblomme Thomas , Di Rocco Federico , Bourgeois Marie , Beccaria Kevin , Paternoster Giovanna , Verchere-Montmayeur Juliette , Sainte-Rose Christian , Zerah Michel , Puget Stéphanie 
Published: January 2015

OBJECT
The ideal treatment for subdural hematomas (SDHs) in infants remains debated. The aim of this study was to analyze the safety and efficiency of subduro-subgaleal drainage in SDH.

METHODS
The authors conducted a single-center open-label study between August 2011 and May 2012. Data were prospectively collected in a database and retrospectively analyzed.

RESULTS
Eighteen patients (male/female ratio 1.25) with a median age of 5 months were surgically treated. All had preoperative symptoms of intracranial hypertension or seizures. The SDH was bilateral in 16 cases, with a median width of 12 mm. Success of the procedure was noted in 14 of the 18 patients. There was no intraoperative complication or postoperative infection. Drainage failure was attributable to suboptimal positioning of the subdural drain in 2 cases and to migration in 1 case.

CONCLUSIONS
Subduro-subgaleal drainage is an efficient treatment that could be proposed as an alternative to external subdural drainage or subduroperitoneal drainage.
Combined microsurgical PICA-PICA bypass and endovascular parent artery occlusion for a ruptured dissecting vertebral artery aneurysm
Authors: Starke Robert M. , Ding Dale , Durst Christopher R. , Crowley R. Webster , Liu Kenneth C. 
Published: January 2015

Dissecting vertebral artery (VA) aneurysms are difficult to obliterate when the parent artery cannot be safely occluded. In this video, we demonstrate a combined microsurgical and endovascular treatment technique for a ruptured, dissecting VA aneurysm incorporating the origin of the posterior inferior cerebellar artery (PICA). We first performed a PICA-PICA side-to-side bypass to preserve flow through the right PICA. An endovascular approach was then utilized to embolize the proximal portion of the aneurysm from the right VA and the distal portion of the aneurysm from the left VA.The video can be found here: http://youtu.be/dkkKsX2BiJI.
Subtemporal approach for distal basilar occlusion for giant aneurysm. Nuances and advantages of the subtemporal approach
Authors: Lanzino Giuseppe , Cannizzaro Delia , Villa Stefano Lorenzo 
Published: January 2015

We described the subtemporal approach, which was used for distal basilar artery occlusion in a patient with a symptomatic giant unclippable aneurysm. We discuss issues related to positioning and lumbar drainage. We illustrate the basic steps: identification of the tentorial notch; sharp opening of the arachnoid behind the third nerve; placement of a fixed mechanical retractor to “hold” the brain; identification of the third nerve and mobilization from arachnoid attachments; identification of the course and insertion of the fourth nerve; division and retraction of the tentorial edge to enhance exposure; preparation of the “perforator-free zone”; and final clip application followed by ICG fluorescein angiography. We show some of the areas exposed with this approach.The video can be found here: http://youtu.be/S_NLIjKQL_o.
Anterior communicating artery aneurysm clipping using standard small fronto-pterional approach, clipping with 3 Lazic clips
Authors: Reinert Michael , Valci Luca , Dalolio Martina , Reyes Vladimir , D'Auria Justine 
Published: January 2015

An 80-year-old female presented 5 months previous for nonspecific gait disturbance, during which an MRI was performed. A large based anterior communicating artery aneurym was found independent of neurology. An interdisciplinary discussion favored surgical treatment, on which the patient insisted.Surgery was performed using standard anesthesia techniques with intraoperative burst supression during surgery, neuromonitoring with MEP and SEP, as well as ICG angiography, microdoppler and neuronavigation. Successful clipping was performed with 2 fenestrated straight and one bayoneted straight Lazic clip. Temporary clipping was 6.1 minutes. Postoperative angiography showed exclusion of the aneurysm, and there was no neurological deficit.The video can be found here: http://youtu.be/WKjOHG8irFo.
Surgical clipping of a ruptured posterior inferior cerebellar artery aneurysm
Authors: Kalani M. Yashar S. , Nakaji Peter , Zabramski Joseph M. , Spetzler Robert F. 
Published: January 2015

Posterior circulation aneurysms are commonly treated with endovascular techniques. In select cases, microsurgery remains an essential tool for treating these lesions. We present a case of a ruptured posterior inferior cerebellar artery (PICA) aneurysm approached via a craniotomy. Given the labyrinth of neurovascular bundles present in the posterior fossa, surgical exposure of PICA aneurysms can be challenging. This video demonstrates the steps of the craniotomy, subarachnoid dissection, mobilization of the vertebral artery and lower cranial nerves, and clipping of the aneurysm.The video can be found here: http://youtu.be/fQSxQj7oL0U.
Repair of intraoperative aneurysm neck tear utilizing the cotton-clipping technique
Authors: Safavi-Abbasi Sam , Sun Hai , Oppenlander Mark E. , Nakaji Peter , Kalani M. Yashar S. , Zabramski Joseph M. , Spetzler Robert F. 
Published: January 2015

Intraoperative rupture of an intracranial aneurysm is a potentially devastating but controllable complication. The authors have successfully used the previously described cotton-clip technique to repair tears at the necks of aneurysms.1–4 A tear on the neck of the aneurysm is covered with a piece of cotton and held in place with a suction device. The cotton is then clipped onto the tear with an aneurysm clip, using the cotton as a bolster. This simple, effective method has been useful in repairing a partial avulsion of the neck of an aneurysm.1,3The video can be found here: http://youtu.be/nT86RYVQWpc.
Direct clipping of large basilar trunk aneurysm
Authors: Kimura Toshikazu , Nakagawa Daichi , Kawai Kensuke 
Published: January 2015

A large basilar trunk aneurysm was incidentally found in a 77-year-old woman in examination for headache. Though it was asymptomatic, high signal intensity was noticed in the brainstem around the aneurysm on FLAIR image of MRI. As she was otherwise healthy, surgical clipping was performed through anterior temporal approach.The video can be found here: http://youtu.be/0soWM8meCW8.
Comparative Efficacy of the Combination of Topical Betamethasone Dipropionate and Calcipotriene with Betamethasone Dipropionate and Calcipotriene Alone in the Treatment of Localized Vitiligo
Authors: Alam Mohd Nurul , Wahab Md Abdul , Husain Md Anwar , Khondker Lubna , Ahmad Gulam Kazem Ali , Chakraborty Anjana 
Published: December 2014

Vitiligo is an acquired skin disorder characterized by welldefined white patches that are often symmetrically distributed. The study was conducted to compare the efficacy of the combination of topical betamethasone dipropionate and calcipotriene with betamethasone dipropionate and calcipotriene alone in the treatment of localized vitiligo. A clinical trial was carried out with the patients of vitiligo from January 2012 to August 2012. In group A, 20 patients were applied betamethasone dipropionate cream 0.05% and topical calcipotriene ointment (0.005%), in group B, 20 patients were applied betamethasone dipropionate cream 0.05% only; In group C, 20 patients were applied calcipotriene ointment 0.005% alone. From base line percentage reduction of total lesion in 1st follow up in group A, group B and group C were 20%, 15% and 10% respectively. At 3rd follow up in group A, group B and group C it was 50%, 37% and 30% and at 5th follow up, it was 80%, 75% and 65% respectively. ANOVA test was done and found significant difference of reduction of total lesion of vitiligo among the groups (p< 0.05). At the completion of the study, each patient was separately graded the treated sides on a 6-point ordinal scale based on a global estimate of the change in vitiligo and found that, the very much improvement were 70%, 55% and 45%, much improvement were 20%, 30% and 35% and improvement were 10%, 15% and 20% in group A, group B and group C respectively. ANOVA test was found significant difference of success rate of patients of localized vitiligo among the groups (p value 0.005). Both the drugs, calcipotriene and betamethasone dipropionate when used individually, were found to be equally effective in the treatment of vitiligo, but the combination of the two was found to be superior in efficacy. DOI: http://dx.doi.org/10.3329/medtoday.v26i1.21310 Medicine Today 2014 Vol.26(1): 31-35
Association of Serum 25-Hydroxyvitamin D with Life Style and Dietary Factors in Egyptian Prepubescent Children
Authors: Abu Shady Mones M. , Youssef Mai M. , Shehata Manal A. , Salah El-Din Ebtissam M. , ElMalt Heba A. 
Published: January 2015

BACKGROUND:Â There had been a growing evidence of high prevalence ofÂ vitamin DÂ deficiency especially among children which may increase the risk of many chronic diseases in adulthood. AIM:Â Â Assessment of different lifestyles and dietary behaviour influencing the level of serum 25-OHD in a group of Egyptian prepubescent children.SUBJECTS AND METHODS:Â Two hundred boys andÂ girls aged from 9 to 11 years were recruited from two primary public schools situated in Giza governorate in Egypt. A questionnaire was developed to obtain relevant information related to age, dietary habits, and physical activity. Thorough clinical examination and measurement of weight and height were performed. Body mass index was calculated. Serum samples were assayed for 25-hydroxy vitamin D (25-OHD).RESULTS:Â Low serum 25-OHD (< 20Â ng/ml) was found in 11.5% of the whole sample. Mean serum 25-OHD was significantly lower in obese subjects and in those with low physical activity (p < 0.05). Multiple stepwise linear regression analysis showed that BMI and physical activity were the main predictors of serum 25-OHD (P < 0.05).CONCLUSIONS:Â Lifestyle factors in terms of physical activity and BMI may contribute significantly to the optimal vitamin D status of apparently healthy children.
Compromis et renoncement
Authors: Lichtenberger Yves 
Published: December 2014

Entre la guerre et l’arrangement implicite, le compromis instaure une nature particulière de relations sociales. Il dessine un espace et un temps où l’acteur qui s’y engage s’accepte comme appartenant à un monde pluriel, partie prenante d’une histoire qui le dépasse, ni seul ni tout puissant, ni soumis ni impuissant. Aussi est-il important, au-delà de la description des processus d’échange et de négociation, de mettre l’accent sur ce qui caractérise plus profondément le compromis : un travail de reconfiguration identitaire et un dispositif d’orientation conjointe d’un futur commun entre partenaires opposés.
Do transfusion requirements increase after the diagnosis of vasospasm in patients with aneurysmal subarachnoid haemorrhage?
Authors: Venkatraghavan Lashmikumar , Tymianski Sarah , Singh Jeffrey 
Published: January 2015

Abstract
Background: Many patients experience impaired cerebral oxygen delivery secondary to vasospasm and delayed cerebral ischemia following aneurysmal subarachnoid haemorrhage (SAH). Anaemia is common after SAH affecting up to 50% patients, which may decrease cerebral oxygen delivery and is associated with worse clinical outcomes. Transfusion of allogeneic red cells increases the oxygen content of the blood but it not consistently associated with improved physiologic markers of clinical outcomes. The threshold for transfusion is not clear in patients with SAH. A recent survey found that most physicians would alter their transfusion threshold in SAH patients who develop delayed ischemia. The objective of our study is to identify the predictors of transfusion and to determine if the diagnosis of delayed ischemia increases the transfusion rates in patients with aneurysmal subarachnoid haemorrhage. Materials and Methods: We retrospectively reviewed the charts of 100 consecutive patients with SAH who were admitted to ICU for mechanical ventilation, and collected demographic and clinical data. Data were analyzed for the association between clinical factors and transfusion the differences in transfusion between the patients with and without vasospasm. Statistical methods included the t-test, univariate analysis and multivariate analysis. Results: Data from 96 patients were included in the analysis. Incidence of anaemia haemoglobin (Hb) < 100 gm/l and vasospasm were 67% (64/96) and 39% (38/96) respectively. Of 64 patients with anaemia, 27 patients received transfusion, while 38 patients did not receive a transfusion. The transfusion rates were similar between those who had vasospasm and who did not. However, out of the 14 patients with vasospasm who received a transfusion, 11 patients had been transfused after experiencing vasospasm, while only 3 were transfused before. On multivariate analysis only female sex, starting Hb levels and lowest Hb levels were found to be predictors of transfusion. Presence or absence of vasospasm was not found to be a predictor. Conclusions: From our retrospective review, we conclude that the incidence of anaemia is higher in patients with vasospasm. Sex and starting and lowest Hb levels were the only predictors of transfusion likelihood in aneurysmal subarachnoid haemorrhage while presence of vasospasm was not.
Use of gelatin-thrombin matrix haemostatic sealant in neurosurgery: Anaesthetic implications and review of literature
Authors: Khanna Puneet , Mahajan Charu , Gupta Priyanka , Banik Sujoy , Ray Bikash , Rath Girija 
Published: January 2015

AbstractThe topical haemostatic agents have been developed to be used as adjunctive measures to promote haemostasis. These include bone wax, absorbable gel sponges, microfibrillar collagen, oxidised regenerated cellulose, gelatin sponges with thrombin, gelatin-thrombin matrix sealant or fibrin sealants. Gelatin-thrombin matrix sealant is a mixture of a bovine-derived gelatin matrix and human-derived thrombin component that are mixed together at the time of use. This agent has been found to be more effective haemostat than thrombin-soaked gelatine sponges. The possible adverse effects of this can be transmission of diseases from human or bovine sources, allergic reactions, thromboembolism, disseminated intravascular coagulopathy (DIC), perilesional oedema, and compression of neural tissue. Although it is used routinely in the operating room, there is little literature available on the perioperative implications with use of intraoperative gelatin-thrombin matrix sealant. Here, we present clinical report of 20 neurosurgical patients where the sealant was used and literature in view of current evidence has been reviewed.