bluuebunny/crossref_metadata_2025_split huggingface dataset:
Degenerative changes in adolescent spines: a comparison of motocross racers and age-matched controls
Authors: Daniels David J. , Luo T. David , Puffer Ross , McIntosh Amy L. , Larson A. Noelle , Wetjen Nicholas M. , Clarke Michelle J. 
Published: January 2015

OBJECT
Motocross racing is a popular sport; however, its impact on the growing/developing pediatric spine is unknown. Using a retrospective cohort model, the authors compared the degree of advanced degenerative findings in young motocross racers with findings in age-matched controls.

METHODS
Patients who had been treated for motocross-related injury at the authors' institution between 2000 and 2007 and had been under 18 years of age at the time of injury and had undergone plain radiographic or CT examination of any spinal region were eligible for inclusion. Imaging was reviewed in a blinded fashion by 3 physicians for degenerative findings, including endplate abnormalities, loss of vertebral body height, wedging, and malalignment. Acute pathological segments were excluded. Spine radiographs from age-matched controls were similarly reviewed and the findings were compared.

RESULTS
The motocross cohort consisted of 29 riders (mean age 14.7 years; 82% male); the control cohort consisted of 45 adolescents (mean age 14.3 years; 71% male). In the cervical spine, the motocross cohort had 55 abnormalities in 203 segments (average 1.90 abnormalities/patient) compared with 20 abnormalities in 213 segments in the controls (average 0.65/patient) (p = 0.006, Student t-test). In the thoracic spine, the motocross riders had 51 abnormalities in 292 segments (average 2.04 abnormalities/patient) compared with 25 abnormalities in 299 segments in the controls (average 1.00/patient) (p = 0.045). In the lumbar spine, the motocross cohort had 11 abnormalities in 123 segments (average 0.44 abnormalities/patient) compared with 15 abnormalities in 150 segments in the controls (average 0.50/patient) (p = 0.197).

CONCLUSIONS
Increased degenerative changes in the cervical and thoracic spine were identified in adolescent motocross racers compared with age-matched controls. The long-term consequences of these changes are unknown; however, athletes and parents should be counseled accordingly about participation in motocross activities.
Primitive neuroectodermal tumors of the brainstem in children treated according to the HIT trials: clinical findings of a rare disease
Authors: Friedrich Carsten , Warmuth-Metz Monika , von Bueren André O. , Nowak Johannes , Bison Brigitte , von Hoff Katja , Pietsch Torsten , Kortmann Rolf D. , Rutkowski Stefan 
Published: January 2015

OBJECT
Primitive neuroectodermal tumors of the central nervous system (CNS-PNET) arising in the brainstem are extremely rare, and knowledge about them is limited. The few existing case series report fatal outcomes. The purpose of this study was to analyze clinical characteristics of and outcome for brainstem CNS-PNET patients treated according to the consecutive, population-based HIT studies covering a 19-year time period.

METHODS
Between September 1992 and November 2011, 6 eligible children with histologically proven brainstem CNS-PNET not otherwise specified and 2 children with brainstem ependymoblastomas (3, partial resection; 3, subtotal resection; 2, biopsy), median age 3.3 years (range 1.2–10.6 years), were treated according to consecutive multimodal HIT protocols for CNS-PNET/medulloblastoma. Postoperative treatment was according to maintenance chemotherapy protocols (3, craniospinal irradiation [CSI] followed by maintenance chemotherapy), sandwich chemotherapy protocols (2, neoadjuvant chemotherapy, CSI, maintenance chemotherapy), or a therapy protocol for children younger than 4 years (3, postoperative chemotherapy followed by CSI).

RESULTS
The median duration of prediagnostic symptoms, predominantly cranial nerve deficits (n = 7), pyramidal tract signs (n = 5), or ataxia (n = 5), was 5 weeks (range 1–13 weeks). The tumors were all located in the pons. Most involved more than half of the pontine axial diameter and were sharply marginated. All patients had postoperative residual disease, including metastasis in 1 case. With 1 exception all tumors progressed early during treatment within 3.9 months (range 2.5–10.4 months), leading to a 1-year event-free survival rate (± standard error) of 13% ± 12%. After progression, patients succumbed early to their disease resulting in a 1-year overall survival rate of 25% ± 15%. The only surviving patient had a partially resected CNS-PNET, received a sandwich chemotherapy protocol, and is without disease progression 14 months after diagnosis.

CONCLUSIONS
CNS-PNET is a rare but important differential diagnosis in childhood brainstem tumors. So far, efficient therapies are lacking. The sampling of tumor material for improved biological understanding and identification of new therapeutic targets is important.
Extent of collateralization predicting symptomatic cerebral vasospasm among pediatric patients: correlations among angiography, transcranial Doppler ultrasonography, and clinical findings
Authors: Moftakhar Parham , Cooke Daniel L. , Fullerton Heather J. , Ko Nerissa U. , Amans Matthew R. , Narvid Jared A. , Dowd Christopher F. , Higashida Randall T. , Halbach Van V. , Hetts Steven W. 
Published: January 2015

OBJECT
Although the development and prevalence of cerebral vasospasm (CV) has been extensively investigated in adults, little data exist on the development of CV in children. The authors hypothesized that even though children have highly vasoreactive arteries, because of a robust cerebral collateral blood flow, they rarely develop symptomatic CV.

METHODS
The authors retrospectively reviewed their university hospital's neurointerventional database for children (that is, patients ≤ 18 years) who were examined or treated for aneurysmal or traumatic subarachnoid hemorrhage (SAH) during the period 1990–2013. Images from digital subtraction angiography (DSA) were analyzed for the extent of CV and collateralization of the cerebral circulation. Results from transcranial Doppler (TCD) ultrasonography were correlated with those from DSA. Cerebral vasospasm on TCD ultrasonography was defined according to criteria developed for adults. Clinical outcomes of CV were assessed with the pediatric modified Rankin Scale (mRS).

RESULTS
Among 37 children (21 boys and 16 girls ranging in age from 8 months to 18 years) showing symptoms of an aneurysmal SAH (comprising 32 aneurysms and 5 traumatic pseudoaneurysms), 17 (46%) had CV confirmed by DSA; CV was mild in 21% of these children, moderate in 50%, and severe in 29%. Only 3 children exhibited symptomatic CV, all of whom had poor collateralization of cerebral vessels. Among the 14 asymptomatic children, 10 (71%) showed some degree of vessel collateralization. Among 16 children for whom TCD data were available that could be correlated with the DSA findings, 13 (81%) had CV according to TCD criteria. The sensitivity and specificity of TCD ultrasonography for diagnosing CV were 95% and 59%, respectively. The time to CV onset detected by TCD ultrasonography was 5 ± 3 days (range 2–10 days). Twenty-five (68%) of the children had good long-term outcomes (that is, had mRS scores of 0–2).

CONCLUSIONS
Children have a relatively high incidence of angiographically detectable, moderate-to-severe CV. Children rarely develop symptomatic CV and have good long-term outcomes, perhaps due to robust cerebral collateral blood flow. Criteria developed for detecting CV with TCD ultrasonography in adults overestimate the prevalence of CV in children. Larger studies are needed to define TCD ultrasonography–based CV criteria for children.
Spinal cord compression secondary to metastasis of malignant chondroid syringoma: case report
Authors: Menéndez Ricardo H. , Erice Santiago G. , Bas Carlos A. , Casas Gabriel , Dillon Horacio S. 
Published: January 2015

The authors describe a case of spinal cord compression due to an epidural metastasis of malignant chondroid syringoma. Chondroid syringoma is a rare mixed tumor of the skin composed of both epithelial and mesenchymal elements. Although most are benign, malignant forms have been reported. Malignant chondroid syringoma may progress very slowly and the metastatic spread occurs late, appearing years after the original diagnosis. There is only one other report of spinal cord compression secondary to metastasis of malignant chondroid syringoma, which was finally diagnosed by microscopic examination of an autopsy specimen.
This 63-year-old woman presented with a 4-week history of progressive paraparesis. Admission MRI of the thoracic spine showed an extradural mass arising from the posterior elements and left pedicle of T-9, which caused posterior compression of the spinal cord. Surgical decompression resulted in resolution of the neurological impairments. The histological results were consistent with metastasis of malignant chondroid syringoma. The patient underwent adjuvant radiotherapy and a favorable outcome was noted at the 2-year follow-up visit. This represents the first reported case of spinal cord compression from a metastasis of a malignant chondroid syringoma histologically confirmed in vivo. The authors' experience in this case suggests that resection followed by radiotherapy might be an acceptable means for achieving short-term, progression-free survival.
Trapping and V3-radial artery graft-V4 bypass for ruptured dissecting aneurysm of the vertebral artery
Authors: Inoue Tomohiro , Tamura Akira , Saito Isamu 
Published: January 2015

The authors show a surgical technique of trapping/resection of ruptured dominant vertebral artery aneurysm in conjunction with reconstruction of vertebral artery by V3–radial artery (RA) graft–V4 bypass through suboccipital craniotomy and far lateral approach. Step by step muscle dissection in posterior fossa enable fine exposure of occipital artery for possible OA-PICA bypass and V3 portion of vertebral artery. Extradural drilling of posterior one-third condyle and condylar fossa facilitate exposure of triangular surgical corridor made by medulla, spinal root of 11th nerve and lower cranial nerves, and thus enabling aneurismal resection and RA–V4 anastomosis.The video can be found here: http://youtu.be/LxsARGdHSVw.
Clipping and STA-MCA bypass for unruptured AcomA aneurysm associated with unilateral MCA occlusion
Authors: Inoue Tomohiro , Yoshida Hiroki , Tamura Akira , Saito Isamu 
Published: January 2015

The authors show a surgical technique of clipping in conjunction with superficial temporal artery (STA)–middle cerebral artery (MCA) bypass to treat unruptured anterior communicating artery (AcomA) aneurysm associated with unilateral MCA occlusion. First, through MCA occlusion side, fronto-temporal craniotomy, extra-dural drilling of lesser sphenoid wing, and followed by wide exposure of Sylvian fissure, STA–MCA bypass was performed. Then, through trans-Sylvian, fronto-basal, and lateral trajectory, interhemispheric fissure was dissected from the base, which enabled good exposure and clipping of high positioned AcomA aneurysm.The video can be found here: http://youtu.be/GWItnRSs3m4.
Clipping of ipsilateral posterior communicating and superior cerebellar artery aneurysms
Authors: Welch Babu G. 
Published: January 2015

The case is a 55-year-old female who presented with dizziness as the chief complaint. She has a family history of two relatives with subarachnoid hemorrhage. Digital subtraction angiography revealed the presence of a left-sided posterior communicating artery aneurysm and an ipsilateral superior cerebellar artery (SCA) aneurysm. Due to the smaller nature of the SCA, a decision was made to proceed with surgical clipping of both lesions through a pterional approach. A narrated video with illustrations depicts the intraoperative management of these lesions with postoperative angiography results.The video can be found here: http://youtu.be/HCHToSsXv-4.
Surgical treatment of a large ruptured internal carotid artery bifurcation aneurysm
Authors: Dehdashti Amir R. 
Published: January 2015

Ruptured aneurysms with intraparenchymal hematoma and mass effect are primarily treated by surgical clipping. In this video presentation, a 68 year old male with a large ruptured right ICA bifurcation aneurysm is presented. Patient's neurological exam was rapidly deteriorating, therefore the patient was transferred to the operating theater after initial evaluation by CT and CT angiogram. A pterional craniotomy was performed, the frontal hematoma was partially removed and the aneurysm was clipped. Residual hematoma was removed after securing the aneurysm and the aneurysm dome was punctured(detail of surgical clipping in the video). Patient made a good recovery at 2 weeks post-op with complete recovery of left sided weakness, and some remaining cognitive deficit.The video can be found here: http://youtu.be/dKFWptdgC4M.
Clip ligation of contralateral P1 aneurysm: extending the working depth of microsurgery along the skull base
Authors: Rupani Karishma Vijay , Cohen-Gadol Aaron A. 
Published: January 2015

Clip ligation of posterior circulation aneurysms can be challenging because of limited operative working space and angles. Certain proximal posterior cerebral (P1) aneurysms are especially challenging because of their locations within the lateral anterior interpeduncular fossa.We present a 52-year-old woman who had previously undergone coil embolization of a ruptured right-sided posterior communicating artery aneurysm. She also had two other small aneurysms (left posterior communicating artery and right P1 aneurysms). She underwent clip ligation of the latter two unruptured aneurysms through a left-sided pterional craniotomy. The microsurgical techniques to clip ligate a contralateral P1 aneurysm are discussed in the video.The video can be found here: http://youtu.be/YBE7FcFGlpQ.
High flow EC–IC bypass for a giant left MCA aneurysm
Authors: Arias Eric J. , Zipfel Gregory J. 
Published: January 2015

Giant cerebral aneurysms may be treated through a variety of options, including aneurysm trapping with concurrent bypass. This video describes the case of a large, recurrent, left middle cerebral artery aneurysm that was treated using a high flow, radial artery bypass graft, from the external carotid artery to the left temporal M2 branch. A step-by-step operative description, with emphasis on proper microsurgical technique, is included.The video can be found here: http://youtu.be/9xTMC6InivQ.
Far-lateral approach for surgical treatment of fusiform PICA aneurysm
Authors: Couldwell William T. , Neil Jayson A. 
Published: January 2015

Ruptured fusiform posterior inferior cerebellar artery (PICA) aneurysms can be technically challenging lesions. Surgeons must be ready to employ a variety of strategies in the successful treatment of these aneurysms. Strategies include complex clip techniques including clip-wrapping or trapping and revascularization. The case presented here is of a man with subarachnoid hemorrhage from a fusiform ruptured PICA aneurysm. The technique demonstrated is a far-lateral approach and a clip-wrap technique using muslin gauze. The patient was given aspirin preoperatively in preparation for possible occipital–PICA bypass if direct repair was not feasible. It is the authors' preference to perform direct vessel repair as a primary goal and use bypass techniques when this is not possible. Vessel patency was evaluated after clip-wrapping using intraoperative Doppler. Intraoperative somatosensory and motor evoked potential monitoring is used in such cases. The patient recovered well.The video can be found here: http://youtu.be/iwLqufH47Ds.
Microsurgical clipping of an unruptured basilar apex aneurysm
Authors: Kalani M. Yashar S. , Oppenlander Mark E. , Levitt Michael , Safavi-Abbasi Sam , Spetzler Robert F. , Zabramski Joseph M. 
Published: January 2015

Unruptured posterior circulation aneurysms pose a treatment challenge. Although data supports the use of endovascular technique for select ruptured cases, in unruptured cases, there may be clinical equipoise. Furthermore, wide-necked basilar apex aneurysms commonly require the use of stents and placement of patients on dual therapy. We present a case of a healthy 50-year-old woman with an incidental basilar tip aneurysm treated via an orbitozygomatic craniotomy. This video highlights the steps of dynamic retraction, which is retraction without placement of permanent rigid retraction system, and the added maneuverability afforded by the use of the mouthpiece on the microscope.The video can be found here: http://youtu.be/jVfC6CCXdZY.
Surgical clipping of a large left middle cerebral artery aneurysm
Authors: Kalani M. Yashar S. , Nakaji Peter , Zabramski Joseph M. , Spetzler Robert F. 
Published: January 2015

Middle cerebral artery aneurysms, especially those with complex morphology, are considered excellent aneurysms for surgical clipping, given the challenges that exist with current endovascular techniques. We present a case of a large, complex, left middle cerebral artery aneurysm treated with microsurgical clipping. This video highlights critical steps in obtaining proximal and distal control as well as subarachnoid dissection necessary to prepare the aneurysm for final clipping.The video can be found here: http://youtu.be/RlKH2Km9z5Y.
Combined interhemispheric and pterional approach for ACOM and left MCA aneurysms
Authors: Kiyofuji Satoshi , Inoue Tomohiro , Tamura Akira , Saito Isamu 
Published: January 2015

This video demonstrates combined two separate craniotomies for two difficult unruptured cerebral aneurysms. The anterior communicating artery (ACOM) aneurysm existed at a high position, projected posteriorly, and thus necessitated an interhemispheric approach. Left middle cerebral artery (MCA) aneurysm with complex figure was treated through a separate pterional approach. Meticulous micro-cisternal opening under high magnification enabled safe and effective exposure of both aneurysms with minimal brain retraction, which alleviated brain damage as shown in postoperative images.The video can be found here: http://youtu.be/mBYsaAVekCA.
Microsurgical clipping following failed coiling of a giant ophthalmic aneurysm
Authors: Kalakoti Piyush , Murray Richard D. , Bir Shyamal C. , Ahmed Osama , Nanda Anil 
Published: January 2015

With the advent of endovascular modalities, endovascular coiling has become a progressively more common method of addressing intracranial aneurysms. When despite coiling, an aneurysm continues to enlarge, open microsurgical clipping is a viable, though technically demanding option. We present a unique case of failed coiling of a giant ophthalmic region aneurysm, in which the aneurysm was successfully managed via open microsurgical approach. We highlight the unique challenges faced and demonstrate the surgical process in an operative video presentation.The video can be found here: http://youtu.be/k2P4c4Lvq7g.
Clipping of a partially thrombosed giant VA aneurysm
Authors: von Schilling Andrej , Spetzger Uwe 
Published: January 2015

Microsurgical aspects of clipping of a giant partially thrombosed VA aneurysm in a 57-year-old female are presented and explained in the form of a short video. The presentation includes preparation of the VA, PICA and perforating arteries, the clipping of the aneurysm itself as well as the reduction of the aneurysm mass using ultrasonic tissue ablation. In addition pre- and post-operative imaging and superimposed text is used to illustrate the presented anatomy.The video can be found here: http://youtu.be/7so8qPMQ1Jk.
Clipping of bilateral MCA aneurysms and a coiled ACOM aneurysm through a modified lateral supraorbital craniotomy
Authors: Hage Ziad A. , Charbel Fady T. 
Published: January 2015

We showcase the microsurgical clipping of a left middle cerebral artery (MCA) aneurysm-(B) done through a modified right lateral supraorbital craniotomy, as well as clipping of a previously coiled anterior communicating (ACOM) artery aneurysm-(C) and a bilobed right MCA aneurysm-(A). Splitting of the right sylvian fissure is initially performed following which a subfrontal approach is used to expose and dissect the contralateral sylvian fissure. The left MCA aneurysm is identified and clipped. The ACOM aneurysm is then clipped following multiple clip repositioning based on flow measurements. The right MCA aneurysm is then identified and each lobe is clipped separately.The first picture showcased in this video is a side to side right and left ICA injection in AP projection. In this picture, (A) points to the bilobed right MCA aneurysm, (B) to the left middle cerebral artery (MCA) aneurysm, and (C) to the previously coiled anterior communicating (ACOM) artery aneurysm. The red dotted line shows that both MCA aneurysms lie within the same plane which makes it easier to clip both of them, through one small craniotomy.The video can be found here: http://youtu.be/4cQC7nHsL5I.
Clip reconstruction of an 8 cm giant internal carotid artery bifurcation aneurysm: microsurgical technique
Authors: Cikla Ulas , Uluc Kutluay , Baskaya Mustafa K. 
Published: January 2015

Thrombosed giant intracranial aneurysms usually present with symptoms and signs from their mass effect. Although multiple treatment options are available, direct clip reconstruction with thromboendarterectomy remains the gold standard. Here we present a 66-year-old man with seizure, aphasia and hemiparesis. Work-up revealed a giant partially thrombosed aneurysm of the internal carotid artery bifurcation with surrounding vasogenic edema. He underwent clip reconstruction of the aneurysm via a cranio-orbital approach. Although we prepared for bypass with the radial artery and/or the superficial temporal artery, we were able to clip-reconstruct the aneurysm without bypass. The patient improved upon his pre-morbid state after surgery and made an excellent recovery.The video can be found here: http://youtu.be/P_10hRQFuPo.
Tumour cell–derived extracellular vesicles interact with mesenchymal stem cells to modulate the microenvironment and enhance cholangiocarcinoma growth
Authors: Haga Hiroaki , Yan Irene K. , Takahashi Kenji , Wood Joseph , Zubair Abba , Patel Tushar 
Published: January 2015

The contributions of mesenchymal stem cells (MSCs) to tumour growth and stroma formation are poorly understood. Tumour cells can transfer genetic information and modulate cell signalling in other cells through the release of extracellular vesicles (EVs). We examined the contribution of EV‐mediated inter‐cellular signalling between bone marrow MSCs and tumour cells in human cholangiocarcinoma, highly desmoplastic cancers that are characterized by tumour cells closely intertwined within a dense fibrous stroma. Exposure of MSCs to tumour cell–derived EVs enhanced MSC migratory capability and expression of alpha‐smooth muscle actin mRNA, in addition to mRNA expression and release of CXCL‐1, CCL2 and IL‐6. Conditioned media from MSCs exposed to tumour cell–derived EVs increased STAT‐3 phosphorylation and proliferation in tumour cells. These effects were completely blocked by anti‐IL‐6R antibody. In conclusion, tumour cell–derived EVs can contribute to the generation of tumour stroma through fibroblastic differentiation of MSCs, and can also selectively modulate the cellular release of soluble factors such as IL‐6 by MSCs that can, in turn, alter tumour cell proliferation. Thus, malignant cells can “educate” MSCs to induce local microenvironmental changes that enhance tumour cell growth.