bluuebunny/crossref_metadata_2025_split huggingface dataset:
Idiopathic Hypertrophic Cranial Pachymeningitis
Authors: Roncallo F. , Turtulici I. , Bonaldo A. , Bisio N. , Bartolini A. 
Published: April 2015

Hypertrophic cranial pachymeningitis is a rare, idiopathic form of granulomatous pachymeningitis. To understand the modes and mechanism of meningeal involvement in various disease processes that affect the different layers of the meninges, one needs to be familiar with the anatomy of the meninges and the pathophysiology of the blood-brain barrier. The anatomy of the meninges and the pathophysiology of bood-brain barrier justify two distinct patterns of meningeal enhancement: leptomeningeal and pachymeningeal; dural meningeal enhancement is categorised as diffuse, linear only or linear and nodular, and focal. Diffuse dural enhancement was defined in our patient as an intense and continuous dural enhancement as seen on MR imaging, encompassing at least 75% of the dural surface. Other causes of dural thickening include epidural abscess, rheumatoid arthritis, lymphoma, neurosyphilis, sarcoidosis, tuberculosis, Wegener's granulomatosis and intracranial fibromatosis. HTLV-1 infection and chronic dialysis have also been reported to cause granulomatous thickening of the pachymeninges. Intense enhancement of the normal dura mater following gadolinium injection has been seen in cases of intracranial hypotension and the marked dural enhancement resolves with treatment of the intracranial hypotension. Pachymeningeal thickening has been reported with orbital pseudotumour and in a case of multifocal fibrosclerosis. Idiopathic hypertrophic pachymeningitis is thus a diagnosis of exclusion. The most common symptoms are headache and cranial nerve palsies. Cerebellar ataxia has been reported in some patients. The treatment of hypertrophic cranial pachymeningitis is not well defined, owing to the rarity of the disease and uncertainty regarding its aetiology. At present, high-dose corticosteroid therapy is the treatment of choice, followed by immunosuppressive agents, such as azathioprine and cyclophosphamide, if necessary.
Evaluation of Empty Sella in Patients with Cerebral Arteriovenous Malformations
Authors: Yüksel C. , Chen J.J. , Kollias S. , Christoforidis G. , Valavanis A. 
Published: April 2015

To evaluate the incidence of empty sella in patients with cerebral arteriovenous malformations we retrospectively evaluated the pituitary gland height (PGH) on midsagittal T1 -weighted images in 216 patients with cerebral AVM (37.5% female, 62.5% male, mean age 33.4). Complete empty sella was defined as PGH<2 mm and partial empty sella as PGH<3 mm. Empty sella in patients with cerebral AVMs was analysed on the basis of nidal size, nidal location and age. We compared our results with those found in a normal population. Mean PGH in our patient population was 3.96 mm (range 1–9 mm). 3.4 mm in males and 4.8 mm in females. The overall incidence of empty sella was 41.2% (89/216). Empty sella occurred in 32% (48/150) of patients less than 40 years old and 62% (41/66) of patients over 40. The distribution of mean PGH values in AVM patients grouped by age was lower than but parallel to the distribution in normal PGH values. A statistically significant increased incidence of empty sella was found with cortical AVM location (48%; 69/144, p<0.0001), and nidal size> 3 cm (60%; 75/125, p<0.0001). Our results indicate that empty sella occurs more frequently in patients with cerebral AVM especially with a cortical location or a nidus greater than 3 cm. We conjecture that this may be related to altered CSF flow dynamics in these patients. Further studies may explain the higher incidence of empty sella in patients with cerebral AVM.
CT Fluoroscopy-Guided Interventions in Intracranial Disease
Authors: Katada K. , Kato R. , Anno H. , Ogura Y. , Koga S. , Nonomura K. , Hayakawa M. , Kanno T. 
Published: April 2015

Real-time CT fluoroscopy (CTF), which permits real-time monitoring of CT images at a rate of 8 images per second with a 0.5 s delay time, has recently entered clinical use. The purpose of this paper is to evaluate the usefulness of CTF as a tool for guiding intracranial interventions. Twenty-six interventional procedures were undertaken in 16 patients under CTF guidance. These included puncture of intracranial hematoma (n=8), hematoma drainage (n=9), cerebrospinal fluid (CSF) drainage (n=3), biopsy of intracranial tumors (n=4), and marking of intracerebral tumors (n?2). Needle puncture and placement were clearly monitored by CTF in all the cases. Hematoma puncture and drainage, CSF drainage, and tumor marking were performed successfully under CTF guidance. Biopsy failed in one patient with suspected brain tumor. Intra- and extra-tumor bleeding was observed in two patients who underwent tumor biopsy and was detected by CTF immediately after the occurrence. Our preliminary study indicates that real-time CTF is a potentially valuable tool for guiding neurosurgical interventions.
Endovascular Therapy and Gamma Radiosurgery in Brain AVMs
Authors: Lemme-Plaghos L. , Ceciliano A. , Garbugino S. , Antico J. , Chinela A. , Bunge H. 
Published: April 2015

Superselective embolization (SE) and Stereotactic Radiosurgery (RS) are established therapeutics for cerebral arteriovenous malformations (AVMs). Their sequential use has been proposed by several authors. 92 cases with complete follow-up after treatment with SE (using IBCA or NBCA) and RS were analysed.
Magnetic Resonance Imaging following Treatment of Aneurysmal SAH by Neurosurgical Clipping or Endovascular Coiling: Comparison of Parenchymal Damage with Cognitive Outcome
Authors: Hadjivassiliou M. , Tooth C.L. , Romanowski C.A.J. , Powell T. , Byrne J. , Battersby R.D.E. , Oxbury S. , Mayes A.R. , Sagar H.J. 
Published: April 2015

The relative contribution to cognitive outcome of haemorrhage and surgery following aneurysmal subarachnoid haemorrhage has been assessed using a battery of cognitive tests and magnetic resonance imaging one year after the procedure. To tease out the effect of surgery we have used 40 case-matched patients treated with endovascular coiling as controls. Surgery resulted in greater areas of structural damage than endovascular coiling. Both the surgical and the coiled groups were cognitively impaired on a broad range of cognitive tasks. When comparing the coiled and clipped groups there is a trend towards a poorer cognitive outcome amongst the surgically treated patients. Cognitive outcome following aneurysmal subarachnoid haemorrhage is primarily dictated by the haemorrhage. This first comparison of the two techniques, however, suggests that endovascular coiling may be more advantageous than surgery in the treatment of aneurysmal subarachnoid haemorrhage.
MRI Patterns of Leigh Syndrome
Authors: Sintini M. , Giustina E. Della , Mavilla L. 
Published: April 2015

To emphasize the varied clinical, neuroradiological and biochemical/genetic features of Leigh syndrome (LS). 3 cases with different metabolic anomalies and a family with 5 members affected by the same biochemical/genetic abnormality had 2 to 4 years follow-up with a 1.5 unit. Cases 1 and 2 had respectively pyruvate dehydrogenase (PDH) and activated Complex I defect; both presented at birth with seizures and brainstem involvement and developed microcephaly and quadriparesis. MRI showed rapid, progressive cortical atrophy with transient subdural fluid collections (case 1), and haemorrhagic necrosis of both thalami and central mesencephalon (case 2). Case 3 started at the 5th month of life with seizures, hypotonia, brainstem signs, and was found to have a defect of Complex II of the mitochondrial respiratory chain; MRI disclosed transient subdural fluid collections, necrosis of the basal ganglia at first, and of brainstem and subcortical white matter soon afterwards. Of the five members of a family with the so called NARP mutation only two had symptoms of brain involvement: an infant who developed at four months of age hypotonia, epilepsy, mental/motor regression and retinitis pigmentosa, had MRI pictures of putaminal, cerebellar, brainstem necrosis along with hypomyelination of the cerebral hemispheric white matter. His aunt of 28 who, after presenting when 1 year old with a Lennox- Gastaut syndrome, suffered from mental delay, ataxia, pigmentary retinopathy, displayed a severe brain atrophy, mostly cerebellar, at MRI. The peculiar variability of Leigh syndrome is stressed and confirmed, with emphasis on case 2.
Facial Capillary Malformation, Ocular Anomalies and Cerebral Developmental Venous Anomalies
Authors: Boukobza M. , Enjolras O. , Beylot C. , Merland J.-J. 
Published: April 2015

To describe an uncommon vascular syndrome combining a facial Port-Wine-Stain (PWS) in the ophthalmic V1 trigeminal area, without evidencing the pial vascular malformation and subsequent cerebral lesions. Six patients with facial PWS, comprising the ophthalmic V1 location, underwent clinical studies, plain radiographs and CT. Cerebral angiography was carried out in 4 patients, MR in 3, and MR, enhanced-MR and MR angiogram in 2 other cases. All 6 patients had a facial PWS with V1 involvement, ocular anomalies (glaucoma or choroid angioma), ipsilateral to the facial port-wine-stain in 3 cases and bilateral in 3 cases, and extensive supratentorial DVAs. In all cases clinical examination was normal and no stigmates of leptomeningeal angioma, no brain anomalies were detected on radiological studies. We focus on this particular vascular syndrome, a variant of classic SWS, with excellent brain tolerance, in contrast to what happens to patients with a leptomeningeal vascular malformation.
The Role of Intravascular EEG
Authors: Asensio S. García , Guelbenzu S. , Uclés P. , Barrena M.R. , Valero P. 
Published: April 2015

In presurgical evaluation of temporal lobe epilepsy, invasive methods of recording are necesary if noninvasive electroencephalography is not conclusive. We describe a technique for recording electroencephalographic activity via an endovascular approach. Recordings were performed with a Seeker-10 microguide. All recordings were compared with simultaneous scalp recording. This semi-invasive method of identifying epileptogenic areas can detect the epileptiform discharges without interferences; it is useful as a complement to invasive techniques such as foramen ovale or depth recording.
Localization of a Myelin Layer within the Hippocampal Formation: MRI and Histologic Correlation
Authors: Kido D.K. , Vogler R.C. , McKeel D. , Venkatesan R. , Havlioglu N. , Gokden M. , Lin W. 
Published: April 2015

A white matter layer within the hippocampal formation can be reliably identified in fixed brain specimens with high resolution MR imaging. Correlation with histologic specimens indicates that the myelin layer is located within the stratum moleculare and lacunosum. This myelin layer might be called either the internal medullarly lamina or the internal myelin layer. Identification of this internal layer of white matter is the initial step in radiologically evaluating the internal architecture of the hippocampal formation since it has different signal characteristics from the surrounding gray matter in the hippocampus and dentate gyrus. The ability of MRI to detect subtle atrophic abnormalities in the internal myelin layer has been limited by its ability to resolve small structures. Recent evolution in MRI technology has resulted in improved gradient coils (25mT/m) and imaging sequences (T2 weighted fast spin echo). Further improvements have also been made through the use of either surface or phase array coils. These developments have made it possible to improve resolution from a 5 mm thick 256 × 256 matrix to a 3 mm thick 512 × 512 matrix.
Pre-Mammillary Endoscopy: Evaluation with Phase Contrast Cine-MR Imaging
Authors: Zuccoli G. , Bargallo N. , Mercader J.M. , Ibañez J. , Rossi M. , Ferrozzi F. , Bassi P. 
Published: April 2015

Cerebrospinal fluid (CSF) waveform evaluation through the use of Phase Contrast Cine-Magnetic Resonance (MR) imaging after pre-mammillary endoscopic ventriculostomy. A descriptive study of 21 patients, 13 men and 8 women (average age 36), submitted to pre-mammillary endoscopic ventriculostomy for treatment of non-communicating hydrocephalus. Evaluation of CSF was accomplished using a Siemens System (1.5 Siemens Magnetom 63SP) with continuous data recording and retrospective cardiac gating. The quantitative study was performed with in-plane and through-plane spatial resolution: sagittal and transverse 2D FISP (70,100 TR/13,16 TE, flip angle 15°), recording the mean velocity at the level of aqueduct, pontine cistern and CSF space in front of C1 as well as mean and maximum velocities and stroke volume at the ventriculostomy site. A Pearson correlation (P<0.001) is present between diastolic and systolic stroke volumes not only at the site the ventriculostomy but also among stroke volumes and velocities in the pontine cistern and aqueduct. The only level where no statistical correlation was found between stroke volumes and velocities was the CSF space before the first cervical vertebral body (C1). Analysis with Phase Contrast Cine-MR imaging shows that pre-mammillary endoscopic ventriculostomy is efficient for restoring cerebrospinal fluid pulsatile waveform.
Torsional Instability of the Lumbar Spine
Authors: Johansen J.G. , Nork M. , Grand F. 
Published: April 2015

This study was to test the hypothesis that in disc degeneration there is increased intervertebral rotation when the spine is subjected to a torsional stress. Twenty-five patients with chronic low back pain without sciatica were examined in all five lumbar disc levels by both a diagnostic and a functional CT scan, the latter performed with maximal rotation of the lumbar spine. The results showed that the normally small rotation between the lumbar vertebrae was increased in the presence of disc bulges, and particularly in disc herniations.
MR Angiography Detection of Occult Vertebral Artery Injuries following Cervical Spine Trauma
Authors: Mayat A.M. , Corr P. , Govender T. 
Published: April 2015

To determine the prevalence of vertebral artery injury following cervical spine trauma using magnetic resonance angiography (MRA). Patients with cervical spine trauma referred for MR were prospectively imaged using 3D time-of-flight angiography to visualise the extracranial vertebral arteries. Patients were assessed clinically for vertebral basilar ischaemia prior to imaging. MR angiograms were assessed by two neuroradiologists blinded to the clinical status. Vertebral arteries were assessed as: normal, abnormal, absent. If clinically indicated, follow-up digital angiography was performed. 25 patients were evaluated. Age range 20–64 years, mean 25 years old. 15 patients (60%) were quadraparetic or paraparetic. There was no clinical evidence of vertebral basilar ischaemia. Commonest injuries were flexion subluxation/dislocations or rotational injuries, followed by hyperextension injuries and burst fractures. MRA abnormalities were detected in 10 patients (40%). In 8 patients there was absence of 1 artery confirmed in 6 as occlusions on angiography, in 2 there were contour abnormalities which were confirmed to be dissections on angiography. Commonest site of injury was: C5/6, C1/2. Cord contusions were detected in 15 patients. There was no correlation between the severity of cord and bony injury and vertebral artery injury. Clinically occult vertebral artery injury is common in patients following cervical spine trauma. Arterial occlusions are more common than dissections. Routine MRA during MR spine imaging is recommended to identify these patients who may require anticoagulation and careful follow-up.
Periprosthetic Fractures About the Hip
Authors: Cassidy J. Tristan , Baker Joseph F. , Keogh Peter , Kenny Paddy 
Published: April 2015

Introduction: Little research has examined postrehabilitation functional outcomes of periprosthetic hip fractures. Predicted functional deficits and acceptable rehabilitation outcomes for these patients are not established. This study aimed to compare functional outcomes of periprosthetic fractures to matched patients with total hip arthroplasty (THA). Materials and Methods: Cases with periprosthetic fracture (PPF) were matched for age, gender, and surgeon to primary THA cases. Only patients who had completed at least 1 year of rehabilitation were included. Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were calculated for all surviving cases with PPF and primary THA. Secondary outcomes included length of stay and mortality. Statistical analysis was performed using Microsoft Excel and the 2-tailed Wilcoxon signed rank test. A P value of <.05 was accepted as indicative of statistical significance. Results: We identified 25 patients with PPF. Three patients were unsuitable for functional assessment. Of the cases with PPF suitable for functional assessment, 14 (14/22) were male. The median age of the PPF and the THA groups was 71 years and 68 years respectively. The median WOMAC score for the PPF group was 26 (interquartile range [IQR] 5.5-49.5) compared to that of the primary THA group, 3 (IQR 2.0-24.5; P < .05). In the PPF group, there were 7 deaths and 3 of the surviving patients had significant complications. The median length of stay in the PPF group was 13 days (IQR 10.5-35) compared to the matched group of 5 days (IQR 5-8.5; P < .05). Conclusion: Patients with PPF have markedly poorer functional outcomes than age-, gender-, and surgeon-matched patients with THA as well as prolonged length of stay. Future research should target the identification of factors that may improve functional outcomes in this growing cohort.
Excessive antigen reactivity may underlie the clinical aggressiveness of chronic lymphocytic leukemia stereotyped subset #8
Authors: Gounari Maria , Ntoufa Stavroula , Apollonio Benedetta , Papakonstantinou Nikos , Ponzoni Maurilio , Chu Charles C. , Rossi Davide , Gaidano Gianluca , Chiorazzi Nicholas , Stamatopoulos Kostas , Ghia Paolo 
Published: April 2015

Key PointsmAbs from aggressive CLL subset #8 display extreme antigen polyreactivity, in clear contrast with the mAbs from other aggressive CLL subsets. Subset #8 CLL clones respond avidly to stimulation by multiple antigens and this may underlie their noted propensity to transform.
Immune cells subpopulations in cerebrospinal fluid and peripheral blood of patients with Aneurysmal Subarachnoid Hemorrhage
Authors: Moraes Leandro , Grille Sofía , Morelli Paula , Mila Rafael , Trias Natalia , Brugnini Andreína , LLuberas Natalia , Biestro Alberto , Lens Daniela 
Published: April 2015

AbstractBackgroundThere is growing evidence supporting the role of inflammation in aneurysmal subarachnoid hemorrhage (aSAH) pathophysiology and it is of great interest to elucidate which immune mechanisms are involved.Methods12 aSAH patients and 28 healthy controls were enrolled prospectively. We assessed leukocytes subpopulations and their activation status by flow cytometry in cerebrospinal fluid (CSF) and peripheral blood (PB) of SAH patients at the same time and in PB of controls.ResultsMonocytes and neutrophils were activated in CSF of aSAH patients. The percentage of CD14++CD16+monocytes were higher in CSF than in PB of aSAH patients, and were also increased in PB of aSAH patients compared with controls. An enhanced expression of CD69 was shown in CSF neutrophils compared with PB in aSAH patients. PB of aSAH patients showed lower percentage of total lymphocytes compared with controls PB. Additionally, lymphocytes were activated in CSF and PB of aSAH patients. CD4+and CD8+T cells had a decreased expression on CD3 and higher levels of CD69 in CSF compared with PB in aSAH patients. Moreover, PB CD4+and CD8+T cells of aSAH patients were activated compared with controls. Additionally, CD28 expression was decreased on CSF T lymphocytes.ConclusionsOur data suggest an important recruitment of leukocytes to the site of injury in aSAH as well as an increased activation at this level. Overall, these results indicate that aSAH probably stimulates both the innate and adaptive immune responses.
Regional 3D geophysical investigation of the Sudbury Structure
Authors: Olaniyan Oladele , Smith Richard S. , Lafrance Bruno 
Published: April 2015

The 3D geologic and structural setting of the Sudbury Structure was predicted by an integration of surface and subsurface geologic data with 2.5D modeling of high-resolution airborne magnetic and gravity data using 3D GeoModeller software. Unlike other CAD-based 3D software, GeoModeller uses the field interpolator method, whereby contacts of rock units are assumed to be equipotential surfaces, whereas orientation data determine the gradient and direction of the surfaces. Contacts and orientation variables are cokriged to generate 3D continuous surfaces for each geologic unit. Our 3D geologic model was qualitatively evaluated by forward computing the predicted gravity response at 1 m above topography and by comparing this response to the measured gravity field. Large-scale structures within the Onaping Formation and Archean basement, which overlie and underlie the Sudbury Igneous Complex (SIC), respectively, were not the cause of the linear gravity high in the center of the Sudbury Structure. We suggested that the deformation of the initial circular SIC may have commenced under the Sudbury Basin due to the reversal of the normal faults related to the Huronian rift system during the Penokean orogeny, therefore resulting into a north verging fold at the base of the SIC in the south range. This new interpretation was consistent with the magnetic and gravity data and honoured most of the significant seismic reflectors in the Lithoprobe seismic sections.
Last offices: nurses' experiences of the process and their views about involving significant others
Authors: Martin Susan , Bristowe Katherine 
Published: April 2015

Background: Last offices are the procedures carried out shortly after a person dies. The National End of Life Care Programme UK guidelines recognise the potential impact of last offices on nurses and advocate the involvement of significant others, but offer no guidance on how to facilitate this. Aim: To explore nurses' experiences of carrying out last offices, in hospice inpatient and community settings, and their views on involving the person's significant others in the process. Methods: Semi-structured interviews with 10 nurses/health-care assistants (held in June to August 2012). Interviews were analysed using interpretative, thematic analysis. Results: Four main themes emerged from the data. Last offices were described as: a range of care activities, a learning and coping challenge, a time of transition, and a demonstration of respect and support. Conclusion: Last offices are a range of care activities, shaped by the environment, time and help available. Further research into the potential benefits and harms of involving significant others is required.
p-adic L-functions and the coniveau filtration on Chow groups
Authors: Bertolini Massimo , Darmon Henri , Prasanna Kartik , Conrad Brian 
Published: April 2015

Abstract
We give evidence for the refined version of the Beilinson–Bloch conjecture involving coniveau filtrations, by
studying several infinite families of CM motives (indexed by the integers

r
≥
1

{r\geq 1}

) that are irreducible of Hodge type

(

2
⁢
r

+
1

,
0
)

+

(
0
,

2
⁢
r

+
1

)

{(2r+1,0)+(0,2r+1)}

and whose
L-functions vanish at the center.
In each case, we construct a corresponding algebraic cycle that is homologically trivial but nontrivial in the top graded
piece for the coniveau filtration. Consequently, we obtain new explicit examples of
cycles on varieties over number fields that are nontorsion in the Griffiths group. The proof of the main result relies crucially on
p-adic Hodge theoretic methods, and in particular on the relation between images of
homologically trivial cycles under the p-adic Abel–Jacobi map and the values of p-adic L-functions.