bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcallosal, Interfornicial Approaches for Lesions Affecting the Third Ventricle
Authors: Apuzzo Michael L. J. , Chikovani Oleg K. , Gott Peggy S. , Teng Evelyn L. , Zee Chi-Shing , Giannotta Steven L. , Weiss Martin H. 
Published: May 2010

Abstract
A group of 11 patients with a variety of lesions affecting the 3rd ventricle have been treated using a direct transcallosal interfornicial approach to the region. In 3 patients, no attendant hydrocephalus was present. In an effort to minimize potential cortical injury related to the approach, we studied the venous anatomy in the region of the coronal suture. Based on this study, appropriate flap placement and interhemispheric entry points were defined. Although no lasting, clinically apparent morbidity was observed in any of the 11 cases, we performed more sophisticated studies of the interhemispheric transfer of somesthetic and perceptual motor tasks, as well as psychometric testing related to parameters of intelligence and memory, 3 to 8 months postoperatively in 6 cases. The results and clinical material indicate that this surgical technique is a safe, feasible alternative in the management of a wide spectrum of pathological lesions within this region. A transcallosal, interfornicial approach offers excellent visualization of the entire 3rd ventricle without the dependence on hydrocephalus or an extensive extra-axial mass to enhance the exposure. With proper planning and technique. it may be accomplished with a minimum of physiological consequence.
Retromastoid Approach for Biopsy of Brain Stem Tumors
Authors: Baghai Parviz , Vries John K. , Bechtel Phillip C. 
Published: May 2010

Abstract
Brain stem tumors constitute about 10 to 20% of all pediatric brain tumors. The clinical manifestations are protean and may be produced by malignant as well as benign lesions. Although the computed tomographic (CT) scan has contributed considerably in the diagnosis of these lesions, it is not possible to differentiate these tumors from viral encephalitis of the brain stem, vascular malformations, and other benign lesions. Over the years, biopsy of brain stem lesions has been considered a low yield and high risk procedure. In one of the recent series, the incidence of nondiagnostic biopsy approached 20% and major deterioration of cranial nerve function also occurred in 20% of the cases. Traditionally, suboccipital craniectomy and biopsy of the floor of the 4th ventricle has been used. This is usually associated with aggravation of cranial nerve deficits. Review of pathological specimens indicates that brain stem gliomas most often involve the pons, with predominantly unilateral involvement, and frequently fill in part of the cerebellopontine angle. On this basis, we have recently used a retromastoid approach on five patients with brain stem tumors to obtain biopsies from the ventrolateral pons and the cerebellopontine angle. A diagnosis was made in each case without complication. Minimal morbidity might be anticipated from this approach, as all cranial nerve nuclei are far away from the biopsy site. The biopsy of brain stem lesions is extremely important because aggressive therapeutic decisions may be made only after a histological diagnosis has been made. In one of our cases, a diagnosis of medulloblastoma was made in a patient with a clinical and CT scan diagnosis of brain stem glioma; this diagnosis changed the treatment plan. The retromastoid approach for the biopsy of brain stem tumors is a safe procedure with minimal morbidity and a high diagnostic yield.
Pediatric Cerebellar Infarction
Authors: Harbaugh Robert E. , Saunders Richard L. , Reeves Alexander G. 
Published: May 2010

Abstract
Infarction in the vertebrobasilar system is uncommon in children. Cerebellar infarction presenting as a posterior fossa mass lesion is distinctly rare. We recently treated a 13-year-old boy with such a lesion as a complication of basilar artery migraine. A review of the literature on vertebrobasilar infarction in children is presented and the therapeutic alternatives in cerebellar infarction are discussed.
Intractable Facial Pain Associated with a Ganglioglioma of the Cervicomedullary Junction
Authors: Epstein Nancy , Epstein Fred , Allen Jeffrey C. , Aleksic Slobodan 
Published: May 2010

Abstract
A 6-year-old child with a brain stem tumor presented with the unusual complaint of intractable facial pain resembling trigeminal neuralgia in the absence of other symptoms or signs referable to the 5th cranial nerve. The radiological evaluation included a computed tomographic scan with intravenous contrast administration, which demonstrated an enhancing intramedullary lesion extending from the obex to C-4. After radiation and chemotherapy had failed to achieve symptomatic relief, the tumor, later proven to be a ganglioglioma, was radically removed with the ultrasonic aspirator. Postoperatively the patient experienced full pain relief.
Transthoracic Approach to an Intramedullary Vascular Malformation of the Thoracic Spinal Cord
Authors: Raynor Richard B. , Weiner Richard 
Published: May 2010

Abstract
A transthoracic approach with resection of a vertebral body was used to obtain access to an intramedullary vascular malformation of the thoracic spinal cord. The malformation consisted of three discrete intramedullary tufts of vessels fed by an abnormal branch of the anterior spinal artery arising from the T-9 intercostal artery. Although the abnormal branch of the anterior spinal artery did not appear to supply normal cord, the patient developed transient weakness postoperatively after occlusion of this artery. Follow-up angiography showed that one part of the malformation was still present and was fed by the T-6 intercostal artery.
Decerebrate Rigidity in Humans
Authors: Davis Richard A. , Davis Loyal 
Published: May 2010

Abstract
Decerebrate rigidity (DR) in humans results from a midbrain lesion and is manifested by an exaggerated extensor posture of all extremities. It is characterized by shortening and lengthening reactions and can be modified by tonic neck, labyrinthine (Magnus-de Kleijn), and phasic spinal reflexes. These criteria, and not extensor posture alone, reflect the observations of Sherrington and should form the basis of the clinical examination; however, the experimental-anatomical lesion and physiological findings can never be reproduced exactly in humans. “Tonic and cerebellar fits” are not the equivalent of DR, but are forms of muscle spasm that result in an extensor attitude. They are caused by irritation and excitation of the brain stem. The most common cause of DR in humans is trauma. The incidence of DR in head-injured patients may be as high as 40%, resulting in an average mortality rate of 80%; the presence of an extensor posture increases the mortality from 20 to 70%. The surgical removal of an intracranial lesion does not improve the high mortality rate in patients with craniocerebral trauma who are decerebrate. Although the Glasgow coma scale (GCS) does not consider the specific type of central nervous system abnormality caused by trauma, it is an accurate and accepted assessment of outcome after coma lasting longer than 6 hours. DR is a factor in the best motor response of the GCS and should be assigned major importance in the prognosis of comatose head-injured patients.
Preservation of Cochlear Nerve Function with the Aid of Brain Stem Auditory Evoked Potentials
Authors: Hardy Russell W. , Kinney Sam E. , Lueders Hans , Lesser Ronald P. 
Published: May 2010

Abstract
Somatosensory, visual, and auditory evoked potentials have been used to monitor neurological function in patients under general anesthesia. This paper describes the preservation of useful hearing in three patients with cerebellopontine angle tumors. In each case, cochlear function was monitored during the procedure, and confirmation of intact conduction intraoperatively was associated with preserved hearing postoperatively.
Carotid Angioplasty in the Management of External Carotid Artery Stenosis Associated with an Occluded Internal Carotid Artery
Authors: Rogers Larry A. 
Published: May 2010

Abstract
The author describes the surgical treatment of 14 patients in whom angiography demonstrated total occlusion of the internal carotid artery (ICA) associated with stenosis at the origin of the ipsilateral external carotid artery (ECA). Each patient underwent ECA endarterectomy followed by an angioplasty to enlarge the ECA outflow tract by incorporating the ICA stump into the proximal ECA. Nine patients subsequently underwent superficial temporal-middle cerebral artery anastomosis. There was no mortality or permanent neurological morbidity. This method of treating ECA stenosis is recommended because it is simple and effective and because it simultaneously eliminates the ICA stump as a potential source of cerebral emboli.
Melanotic Schwannoma of the Spinal Cord
Authors: Gregorios Jocelyn Bruce , Chou Samuel M. , Bay Janet 
Published: May 2010

Abstract
The eighth case of axial melanotic nerve sheath tumor involving the thoracic spinal cord is reported. The literature is reviewed, and proposed theories on the origin of these tumors are discussed. The present study further supports the melanogenic capacity of neoplastic Schwann cells.
Symptomatic Congenital Spinal Stenosis in a Child
Authors: Dauser Robert C. , Chandler William F. 
Published: May 2010

Abstract
A case of congenital lumbar stenosis producing lower extremity spasticity and bladder dysfunction in a young child is presented. Myelography demonstrated a marked stenosis of the spinal canal at L-2, L-3, and decompressive laminectomy resulted in a marked improvement in symptoms. A discussion of lumbar stenosis in general illustrates that it is extremely rare for this condition to become symptomatic during childhood. The literature on congenital lumbar stenosis is reviewed.
Recurrent Intracranial Hypertension and a Midbrain Glioma
Authors: Zant Julius D. , Collins George H. , King Robert B. , Kim Ronald C. 
Published: May 2010

Abstract
At the age of 36, this patient's clinical picture satisfied the criteria for the diagnosis of benign intracranial hypertension. After an essentially symptom-free interval, she developed new symptoms 17 years later that proved to be the result of a neoplasm in the midbrain and in the splenium of the corpus callosum. Postmortem examination revealed a mixed glioma associated with glial-lined cavities in the midbrain and malignant glioma in the splenium. Ths possibility of a relationship between these disparate events is considered.
Shunting for Hydrocephalus: An Oral History
Authors: Wallman Lester J. 
Published: May 2010

Abstract
Twelve neurosurgeons and an inventor-manufacturer, all veterans of the early days (1950s) of shunting for hydrocephalus, were interviewed and recorded on tape. Others were interviewed, but not recorded. Reminiscences that might illuminate the social context of this development in surgical practice were sought.
Moderate Head Injury: Completing the Clinical Spectrum of Brain Trauma
Authors: Rimel Rebecca W. , Giordani Bruno , Barth Jeffrey T. , Jane John A. 
Published: May 2010

Abstract
We have divided head injury into three categories based on the Glasgow Coma Scale (GCS) (severe, 3–8; moderate, 9–12; and minor, 13–15). In a previous report, we described significant disability after minor head injury. The present report describes 199 patients with moderate head injury, 159 of whom underwent follow–up examinations at 3 months. In contrast to patients with minor head injury, half as many were students (17%) and twice as many were intoxicated (53%). Seventy–five patients were studied with computed tomographic (CT) scanning; 30% of the scans were negative and 31% showed a space–occupying mass. As reported by Gennarelli et al. in patients with severe head injuries, those with moderate head injury and subdural hematoma had a very poor outcome: 65% died or were severely disabled and none made a good recovery as measured by the Glasgow Outcome Scale. At 3 months, 38% of the moderate head injury patients had made a good recovery compared with 75% of the minor head injury patients. Within the good recovery category, however, there was much disability (headache, 93%; memory difficulties, 90% difficulties with activities of daily living, 87%), and only 7% of the patients were asymptomatic. The Halstead–Reitan Neuropsychological Battery in an unselected subset (n = 32) showed significant deficits on all test measures. Sixty–six per cent of the patients previously employed had not returned to work, compared to 33% of the minor head injury patients. The major predictors of unemployment after minor head injury were premorbid characteristics (age, education, and socio–economic status). In contrast, all predictors in moderate head injury were measures of the severity of injury (length of coma, CT diagnosis. GCS on discharge). We conclude that: (a) moderate head injury, not described previously in the literature, results in mortality and substantial morbidity intermediate between those of severe and minor head injury; (b) unlike minor head injury, the principal predictors of outcome after moderate head injury are measures of the severity of injury; and (c) more attention should be directed to patients with moderate head injury than to those with the most severe injuries, in whom brain damage is probably irreversible and all forms of management have demonstrated little success.
Craniopharyngiomas in Children
Authors: Carmel Peter W. , Antunes Joao L. , Chang Chu H. 
Published: May 2010

Abstract
Forty-three children with craniopharyngiomas were operated upon at The Neurological Institute of New York between 1952 and 1977. The removal was thought to be total in 14 children and subtotal in 20, and cyst aspiration/biopsy was performed in 9 cases. Radiation was given as part of the initial therapy in 6 children after subtotal removal and to 8 others after aspiration/biopsy. There was 1 postoperative death. All children with tumors thought to have been removed totally are alive. The 10-year actuarial survival rates are 52% for subtotal removal alone and 87% for subtotal removal plus radiation. Tumors have recurred by 10 years in half of those thought to be totally removed, in more than 90% of those subtotally removed, and in less than 25% of those at risk after subtotal removal and radiation therapy. Tumors recurred in 22 children, and 17 underwent reoperation. Total removal was obtained in 4 cases, and 5 had radiation after subtotal removal. Radiotherapy alone was used in 2 cases. Recurrences usually occurred within 2 years. However, after “total” removal recurrences were quite delayed. Our data indicate that total removal allows excellent survival rates and that some of these children are potentially cured. The attempt at total removal did not inflict a severe hypothalamic or visual burden on these children. Where total removal is not possible, further therapy, either radiation or reoperation, will be required. Radiation dramatically decreased recurrence and improved survival after subtotal removal.
Cerebrospinal Fluid Rhinorrhea: A Complication of Therapy for Invasive Prolactinomas
Authors: Landolt Alex M. 
Published: May 2010

Abstract
The majority of invasive prolactinomas can be predicted with a high probability if the preoperative prolactin level is above 2000 ng/ml. As these tumors cannot be extirpated radically, adjunctive radiation therapy is used to improve the results of treatment. On the basis of reports that bromocriptine induces tumor shrinkage and has an antimitotic effect, we combined adjunctive irradiation with bromocriptine therapy in 14 patients who had particularly extensive invasion. Two of these patients developed cerebrospinal fluid rhinorrhea 3 and 5 months, respectively, after the completion of radiation therapy. In both patients, the fistula was localized in the sellar region and was closed successfully. Rapid tumor shrinkage caused by irradiation combined with bromocriptine therapy may be a factor causing this complication; postoperative rhinorrhea is otherwise extremely rare in our surgical series. We also observed a third patient who did not have an operation, but who developed rhinorrhea after a course of irradiation and bromocriptine treatment. The periods of rhinorrhea coincided with periods of bromocriptine treatment.
Functional Improvement after Spinal Surgery for the Dysraphic Malformations
Authors: Linder Martin , Rosenstein Jacob , Sklar Frederick H. 
Published: May 2010

Abstract
Spinal surgery for the various dysraphic malformations is generally indicated to arrest disease progression. The results of the present study suggest that certain clinical conditions and presentations are associated with an exceptionally good surgical prognosis. Sixty-nine procedures were done in 55 patients. The diagnoses included hydromyelia and tethered cord related to diastematomyelia, lipoma, lipomeningocele, previous operation, and thickened filum terminale. The operative results were evaluated for significant functional neurological and urological improvement, as well as for the relief of pain. Pain relief was achieved in 92% of patients with preoperative pain. Significant functional return was seen in 67% of hydromyelia patients. On the other hand, surgical treatment of tethered cord caused improvement in 24% (lipoma) to 46% (thickened filum and diastematomyelia). These results suggest that patients with hydromyelia and patients with a dysraphic malformation and pain have an excelient prognosis after operation. A re-evaluation of the indications for surgery for these patients may be necessary.
Spinal Extrathecal Hemangiolipomas: Report of Two Cases and Review of the Literature
Authors: Padovani Roberto , Tognetti Francesco , Speranza Stefano , Pozzati Eugenio 
Published: May 2010

Abstract
Two cases of a rare entity, spinal extrathecal hemangiolipoma, are presented. The clinical and histological features of the tumor are discussed, with particular attention to the uncommonly sudden onset of symptoms in one patient. Complete neurological recovery was exhibited by one patient after excision of the lesion, whereas only a partial recovery was achieved in the other case. The pathogenetic aspects of hemangiolipomas and the literature dealing with the previously reported 12 cases are reviewed.
Treatment of Bilateral Spontaneous Carotid-Cavernous Fistula by Hamby's Method Combined with an Extracranial-Intracranial Bypass Procedure
Authors: Eguchi Tsuneyoshi , Mayanagi Yoshiaki , Hanamura Tetsu , Tanaka Hideki , Ohmori Kitaroh , Takakura Kintomo 
Published: May 2010

Abstract
A case of bilateral spontaneous carotid-cavernous fistula is presented. Hamby's operation combined with extracranial-intracranial (EC/IC) bypass with a long vein graft was performed on both sides. The feasibility and precautions of using a long vein graft for the EC/IC bypass are discussed.
The So-Called Cavernous Sinus: A Review of the Controversy and Its Implications for Neurosurgeons
Authors: Taptas John N. 
Published: May 2010

Abstract
The so-called cavernous sinus is a venous pathway, an irregular network of veins that is part of the extradural venous network of the base of the skull, not a trabeculated venous channel. This venous pathway, the internal carotid artery, and the oculomotor cranial nerves cross the medial portion of the middle cranial fossa in an extradural space formed on each side of the sella turcica by the diverging aspects of a dural fold. In this space the venous pathway has only neighborhood relations with the internal carotid artery and the cranial nerves. The space itself must be distinguished from the vascular and nervous elements that it contains. The revision of the anatomy of this region has not only theoretical interest but also important clinical implications.
Photocoagulation of Cerebral Arteriovenous Malformations and Arterial Aneurysms with the Neodymium: Yttrium-Aluminum-Garnet or Argon Laser: Preliminary Results in Twelve Patients
Authors: Fasano Victor Aldo , Urciuoli Rosa , Ponzio Roberto Maria 
Published: May 2010

Abstract
Six arteriovenous malformations (AVMs) and five arterial aneurysms (AAs) were treated with either argon or neodymium:yttrium-aluminum-garnet laser irradiation; one AVM was treated with both. All AVMs were occluded completely, leaving adjacent tissue untouched and preserving the regional vascularization. Photocoagulation produced varying effects on AAs: in one case an intraoperative rupture was sealed, in two cases the volume of an ectasia was reduced when the bleeding and thinner areas were coagulated, and in one case a saccular aneurysm was progressively and completely obliterated while the patency of the parent artery was preserved. These preliminary results are satisfactory; more experience will indicate how and when these new techniques can replace traditional ones or be used in combination with them.
Cerebrospinal Fluid Hydromechanics in Adult Patients with Benign Noncommunicating Hydrocephalus: One-Hour Test Shunting and Balanced Cerebrospinal Fluid Infusion test to Select Patients for Intracranial Bypass Operation
Authors: Magnæs Bjørn 
Published: May 2010

Abstract
Cerebrospinal fluid (CSF) pressure and absorption were determined in 12 patients with benign noncommunicating hydrocephalus. An extracorporeal communication of plastic tubing between the ventricular system and the lumbar subarachnoid space was established to imitate the hydromechanical condition after an intracranial bypass operation. This extracorporeal shunt, which in effect was an externalized Torkildsen shunt, served first as a test shunt for 1 hour and then as a route for the constant rate CSF infusion test. The total CSF absorptive capacity was thus determined under a condition of balanced CSF pressure between the proximal and distal compartment. Four patients, whose tests showed normal CSF pressure and absorption, were selected for intracranial bypass operation. Follow-up examination showed a normal clinical condition, reduction of the ventricular system, normal CSF pressure, and normal CSF absorption in all 4 patients. The other 8 patients, whose tests indicated impaired CSF absorption, were treated by ventriculoatrial shunting. The tests were valid in selecting patients for intracranial bypass operation.
Neurocutaneous Masson's Vegetant Intravascular Hemangioendothelioma
Authors: Nagib Mahmoud G. , Sung Joo Ho , Seljeskog Edward L. 
Published: May 2010

Abstract
Since first described, Masson's vegetant intravascular hemangioendothelioma (VIH) has been recognized in various locations. The neurocutaneous dissemination of the lesions in our case represent a unique characteristic. The histopathological and radiological similarities between VIH and malignant lesions are stressed.