bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computed Tomographic, Myelographic, and Operative Findings in Patients with Suspected Herniated Lumbar Discs
Authors: Moufarrij Nazih A. , Hardy Russell W. , Weinstein Meredith A. 
Published: May 2010

Abstract
Fifty patients presenting with a suspected herniated lumbar intervertebral disc were evaluated with sector computed tomography (CT). Excluded from this series were patients with prior lumbar laminectomy or a clinical diagnosis of lumbar canal stenosis. Forty-six of the patients also underwent preoperative lumbar myelography. All patients subsequently underwent laminectomy. In 40 patients (80%), CT was positive. In the remaining 10 patients (20%), it was negative; in this group the myelogram correctly predicted the lesion in 8 (80%), Sector CT correctly predicted the nature of the lesion in 24 patients (48%), was incorrect in 14 (28%), and gave incomplete findings in 12 (24%). CT was most accurate when it demonstrated a disc protrusion as the only finding. In this group, sector CT correctly predicted the operative findings in 24 of 25 patients (96%). CT was less accurate when spondylitic compression was diagnosed. This study suggests that sector CT is a useful test in the evaluation of patients with sciatica and that, when a soft herniated disc is demonstrated on CT, myelography may be omitted.
Intraoperative Localization of Subcortical Brain Tumors: Further Experience with B-Mode Real-Time Sector Scanning
Authors: Voorhies Rand M. , Engel Ivy , Gamache Francis W. , Patterson Russel H. 
Published: May 2010

Abstract
Intraoperative ultrasonography is a potentially useful tool for the neurosurgeon faced with the task of finding and removing small subcortical brain tumors. With the B-mode real-time sector scan equipment now available, satisfactory images of the intracranial contents can be obtained. Others have reported obtaining images by applying the transducer directly to the dura mater or cortex. This carries the risk of pressure damage to the brain. Furthermore, the presence of acoustical noise in the region close to the transducer results in poor image resolution in the superficial region of the cortex. To circumvent these two problems, we have used a saline-filled cylinder placed over the craniotomy site to achieve acoustical coupling. This technique also increases the area of cortex visualized by the pie-shaped beam of the sector scan by separating the transducer from the brain surface.
Familial Intracranial Aneurysms, with Two Occurring at the Distal Anterior Cerebral Artery
Authors: Verdura Javier , Resnikoff Samuel , Rosenthal Jaime , Cardenas Juan 
Published: May 2010

Abstract
Familial aneurysms of the distal anterior cerebral artery are a neurosurgical rarity. We report a family with four of its members (a mother and three sons) suffering from subarachnoid hemorrhage secondary to ruptured aneurysms, two of them being of the distal anterior cerebral artery. There was no evidence of endocarditis, septic emboli, coarctation of the aorta, or trauma. There was no family history of Marfan's syndrome, polycystic kidney, or hereditary connective tissue disorder. We believe that there has been no report in the neurosurgical literature of familial cases of distal anterior cerebral artery aneurysms.
Proposed Operation for Occipital Neuralgia: C-2 and C-3 Root Decompression
Authors: Poletti Charles E. 
Published: May 2010

Abstract
The common association of occipital neuralgia with post-traumatic cervical arthritis raises the question of whether some cases of occipital neuralgia are due to delayed C-2 or C-3 root entrapment. This hypothesis led to surgical exploration of the C-3 and C-2 roots in a young patient with post-traumatic arthritic occipital neuralgia. The abnormal operative findings and resolution of the neuralgia after C-3 foraminal and C-2 fascial root decompression lead to the tentative proposal that some cases of occipital neuralgia represent a root entrapment syndrome amenable to neurosurgical decompression.
Size of Intracranial Aneurysms
Authors: Kassell Neal F. , Torner James C. 
Published: May 2010

Abstract
Intracranial aneurysms are common lesions, occurring in as many as 2% of the age-corrected population of North America. Most aneurysms are small and innocuous, but some will enlarge and rupture. The clinical frequency of intact aneurysms has been increasing as a result of computed tomographic scanning and digital subtraction angiography, and this trend can be expected to accelerate in the future. Intact aneurysms are an important neurosurgical problem. Once an aneurysm ruptures, there is an associated 50 to 60% overall mortality and morbidity. In contrast, surgical correction of an unruptured aneurysm in skilled hands carries a mortality and morbidity of approximately 3%. Obviously, the optimal time for correction of aneurysm is before it ruptures. For effective management of patients with intact aneurysms, prognostic criteria for rupture are clearly needed. Aneurysm size is both theoretically and empirically a key prognostic factor for rupture. However, the critical size at which an aneurysm becomes hazardous is not known. The purpose of this investigation was to study the size of ruptured aneurysms in an attempt to infer the behavior of unruptured aneurysms. The angiographic size of aneurysms in the 1092 patients admitted to the Cooperative Aneurysm Study between 1970 and 1977 was measured. The average maximal diameter was 8.2 + 3.9 (SD) mm, and the median diameter was 7.0 mm. Seventy-one per cent of the sacs were smaller than 10 mm and 13% were less than 5 mm in diameter. Middle cerebral artery aneurysms were the largest and anterior communicating artery aneurysms were the smallest. These data suggest that aneurysms less than 1 cm in diameter are hazardous and that operation should be considered for lesions more than approximately 5 mm in diameter. Additional prognostic factors for rupture are clearly needed.
Improved Outcome in the Treatment of Trigeminal Neuralgia by Percutaneous Stereotactic Rhizotomy with a New, Curved Tip Electrode
Authors: Tobler William D. , Tew John M. , Cosman Eric , Keller Jeffrey T. , Quallen Barbara 
Published: May 2010

Abstract
Percutaneous stereotactic rhizotomy (PSR) as a method of treatment of trigeminal neuralgia has gained popularity in recent years as techniques of electrode placement and lesion production have improved. However, undesirable side effects including major and minor paresthesias, trigeminal motor root weakness, diplopia, and keratitis continue to occur even in cases where the neuralgia is treated successfully. In an attempt to improve treatment further, we have developed an electrode with a flexible curved tip for PSR of the trigeminal nerve. Once the electrode and the cannula are positioned in the retrogasserian portion of the trigeminal nerve with a standardized technique, manipulation of the electrode about its 360° axis readily enables an infinite variety of position adjustments of the electrode tip. This capability enables easier and more precise electrode placement and lesion production. Undesirable lesions of the motor root may be avoided. A curved electrode has been used in 150 patients. The incidence of masseter weakness is 7.3% in this series, compared to 24% in our series of 700 patients treated with a straight electrode. The incidence of undesirable paresthesias has decreased from 27% to 10.6%. The immediate results obtained in patients with the curved electrode have improved. Excellent results (no pain, no side effects) have been achieved in 88% of patients, in contrast to 76% treated with the straight electrode. Application of stereotactic principles and the use of the curved electrode have enhanced the appeal of PSR for the treatment of trigeminal neuralgia.
Epidural Myxoma Causing Compression of the Cauda Equina: A Case Report
Authors: Bell William O. , Gill Amarjit , Babiak Taras , Patterson Russell H. 
Published: May 2010

Abstract
A unique case of a patient with an epidural myxoma arising at L-3, L-4 presented with a history mimicking lumbar spinal stenosis. Tumor removal with decompression of the cauda equina was curative.
Primary Choroid Plexus Papilloma of the Cerebellopontine Angle
Authors: Chan Richard C. , Thompson Gordon B. , Durity Felix A. 
Published: May 2010

Abstract
A case of choroid plexus papilloma of the cerebellopontine angle, extending from the upper cervical region to the level of the tentorial notch, in a 50-year-old woman is presented. The differential diagnosis of tumors in the cerebellopontine angle and the role of surgical treatment vs. radiation therapy are discussed.
Barbiturate Therapy in Uncontrolled Intracranial Hypertension
Authors: Rea Gary L. , Rockswold Gaylan L. 
Published: May 2010

Abstract
From July 1978 to September 1981, 27 patients from a group of 210 patients with severe head injuries developed uncontrolled intracranial hypertension despite intensive medical and surgical management. These 27 patients were considered appropriate candidates for barbiturate therapy. Abnormal posturing or flaccidity was present in 70%; of the patients, and 41%; had bilaterally fixed pupils. Twenty-five of 27 patients had mass lesions requiring operation. Of the 15 patients who responded to barbiturate therapy with normalization of intracranial pressure for 24 hours, 5 died (33%; mortality). Nine of the 12 patients who did not respond to the barbiturate therapy died (75%; mortality). The total mortality in this group of 27 patients was 52%;. Of the survivors, 69%; had a recovery classified as good recovery/moderate disability, and 31%; were in a severe disability/vegetative state. The morbidity and mortality in these patients is high, but comparisons with previous studies show that this is a selected group of severe head injuries with a high percentage of poor prognostic indicators. Our experience suggests that barbiturates can be effective in lowering intracranial pressure in patients with otherwise unresponsive intracranial hypertension and, by doing so, may decrease the mortality in a group of patients considered untreatable by the usual therapeutic modalities.
Evaluation of Cervical Spine Surgery by Postoperative Myelography
Authors: Fager Charles A. 
Published: May 2010

Abstract
After spontaneous remission of nerve root compression, a myelographic defect may persist. Similarly, myelopathy may remain nonprogressive for long periods despite appreciable myelographic deformity. Although operation may arrest or improve the symptoms of cervical disc lesions and spondylosis, the ultimate confirmation that entrapped neural elements have been relieved permanently can only be provided by postoperative myelography. Preoperative and postoperative myelography documents the significant improvement that can be achieved by using posterolateral and posterior approaches to the cervical spine in patients with nerve root or spinal cord compression. The results in this group of patients were achieved with none of the disadvantages or complications of cervical spine fusion or of the interbody removal of cervical disc tissue, also leading to cervical fusion.
Traumatic Paraplegia in Children without Contiguous Spinal Fracture or Dislocation
Authors: Walsh John W. , Stevens David B. , Young Byron A. 
Published: May 2010

Abstract
Traumatic paraplegia in children is uncommon and, in almost half of these injuries, no contiguous fracture or dislocation of the spine is found. This report presents eight such cases, three in detail. Most of the children were injured in motor vehicle accidents and sustained thoracic level injuries with a permanent loss of neurological function caudal to the injury. The clinical presentation and radiological diagnosis are reviewed. Four mechanisms of injury have been proposed: transient vertebral subluxation, transient disc herniation, traction and stretching of the spinal cord, and vascular compromise with infarction. Unless extramedullary spinal cord compression is present, laminectomy is not useful.
Surgical Treatment of Incidental Intracranial Aneurysms
Authors: Wirth F. P. , Laws E. R. , Piepgras D. , Scott R. M. 
Published: May 2010

Abstract
A 6-year retrospective analysis of incidental intracranial aneurysm surgery was conducted at 12 medical centers (1975-1981). The surgical facilities and techniques were comparable at the institutions surveyed. From a total of 1671 aneurysms operated upon, 119 in 107 patients were unruptured and were discovered incidentally. Among these 107 patients, there was no operative mortality. Operative morbidity occurred in 7 cases (6.5%). Surgical treatment of large aneurysms in less accessible locations incurred the greatest operative morbidity. Presenting symptoms of cerebral ischemia seemed to be associated with increased operative morbidity, whereas repair of aneurysms incidental to other ruptured aneurysms had a uniformly low morbidity. These surgical results compare favorably with the risks of hemorrhage from unruptured intracranial aneurysms as defined by recent reports. The low morbidity without mortality supports a recommendation for surgical management of incidental aneurysms in the anterior circulation at centers equipped for modern aneurysm surgery.
Temporary Clipping during Early Operation for Ruptured Aneurysm: Preliminary Report
Authors: Ljunggren Bengt , Säveland Hans , Brandt Lennart , Kågström Erik , Rehncrona Stig , Nilsson Per-Erik 
Published: May 2010

Abstract
Temporary arterial occlusion was performed in 16 patients undergoing early aneurysm operation. Ten patients had a ruptured middle cerebral artery (MCA) aneurysm, and 6 had a ruptured anterior communicating artery aneurysm. Premature aneurysm rupture during operation necessitated temporary arterial occlusion in 10 patients. In 5 patients, temporary arterial occlusion was performed to facilitate dissection of the aneurysm. In 1 patient with a large MCA aneurysm, temporary occlusion was performed to provoke collapse of the completely exposed aneurysm sac, thus making clipping of the base possible. The results do not indicate that temporary occlusion by the standard aneurysm clips now in general use leads to angiographically detectable arterial wall changes or increased thromboembolic complications. Temporary clipping of the MCA proximal to the perforating arteries may be well tolerated for up to 20 minutes during early aneurysm operation. Temporary occlusion of one or both anterior cerebral arteries or temporary pericallosal clipping need not unconditionally lead to disastrous consequences if rendered necessary during aneurysm operations performed in the acute stage.
Ipsilateral Symptoms Caused by an Arteriovenous Malformation of the Second or Supplementary Sensory Area of the Island of Reil
Authors: Schneider Richard C. , Crosby Elizabeth 
Published: May 2010

Abstract
A report of a patient with an arteriovenous anomaly stresses the correlation of clinical findings with a neuroanatomical basis for ipsilateral sensory symptoms. The significance of the second or supplementary motor and sensory patterns existing in the island of Reil, as demonstrated by the experimental work of Crosby and Augustine, is presented. At present, the evidence is that the discharges from the island of Reil are through the extrapyramidal system, a part of the ansa lenticularis system. The actual anatomical basis for such ipsilateral symptoms should be sought in more patients who are perhaps often designated as “hysterical” because they do not fit the much more commonly known pattern of contralateral symptoms.
Acute Operation in Cases of Middle Cerebral Artery Occlusion
Authors: Gagliardi Rolando , Benvenuti Lucia , Guizzardi Giancarlo 
Published: May 2010

Abstract
The authors describe their personal experience with middle cerebral artery embolectomy performed in four patients within 6 hours after the start of clinical symptoms. The work is of a preliminary nature. No conclusion can be drawn as to the ultimate value of this treatment, and further clinical trials seem justified.
Internal Metal Plate Fixation Combined with Anterior Interbody Fusion in Cases of Cervical Spine Injury
Authors: Bremer Alfonso M. , Nguyen Tai Q. 
Published: May 2010

Abstract
The authors report their experience with the use of a modified method of internal metal plate fixation combined with anterior interbody fusion in six patients with an unstable lower cervical spine. All of the patients had sustained severe cervical spine injuries in accidents. In most of the cases, the operation was carried out at 1 to 4 weeks after injury. The insertion of the metal plate was very simple and maintained the block bone graft in satisfactory position. This alternative method of internal fixation of the cervical spine was not associated with morbidity, allowed very early mobilization, and shortened the hospital stay.
Spontaneous Regression of a Dural Arteriovenous Malformation
Authors: Olutola Segun P. , Eliam Miguel , Molot Michael , Talalla Andrew 
Published: May 2010

Abstract
The case of a 50-year-old man with a supratentorial dural arteriovenous malformation (AVM) associated with intracerebral hemorrhage is reported. Angiographically confirmed spontaneous regression of the AVM occurred without any form of surgical intervention. A possible mechanism of spontaneous closure of the AVM is offered.
Intracranial Subdural Hematoma after Lumbar Myelography
Authors: Dohrmann Peter A. , Elrick William L. , Siu Kevin H. 
Published: May 2010

Abstract
Two cases of intracranial subdural hematoma after lumbar myelography are reported. This complication should be considered in patients who complain of prolonged headache or who develop neurological signs after lumbar puncture.
Cerebellopontine Angle Lipoma: A Review
Authors: Leibrock Lyal G. , Deans William R. , Bloch Soloman , Shuman Robert , Skultety Miles F. 
Published: May 2010

Abstract
Lipomas located in the cerebellopontine angle(CPA) have rarely been reported. With the advent of computed tomographic scanning and more sophisticated physiological diagnostic techniques, CPA lipomas are being reported more frequently. This paper reviews the world's literature on this lesion and summarizes the symptoms and signs, diagnostic studies, pathology, and surgical results. Recommendations regarding the therapy of this lesion are presented.
Femoral Neuropathy and Retroperitoneal Hemorrhage
Authors: Mastroianni Patrick P. , Roberts Melville P. 
Published: May 2010

Abstract
A case of femoral neuropathy secondary to psoas muscle hematoma in a patient on warfarin sodium anticoagulation therapy is presented. Computed tomography was used to establish the diagnosis. The literature is reviewed with regard to the pathophysiology, clinical presentation, and therapy of this case. Surgical decompression is suggested to shorten the recovery period and minimize residual neurological deficit.
Large Intramedullary Neurofibroma of the Conus Medullaris: Case Report
Authors: Young Henry A. , Robb Peter , Hardy David G. 
Published: May 2010

Abstract
A case of a very large intramedullary neurofibroma of the conus medullaris extending over 31/2 segments is reported. The tumor was successfully treated by midline myelotomy and radical excision with no exacerbation of the preoperative neurological deficit. Intramedullary neurofibroma is extremely rare, accounting for less than 1% of spinal neurofibromas. Myelotomy and radical excision under the operating microscope are recommended in such cases.
An Intramedullary Ependymal Cyst in a 71-Year-Old Woman
Authors: Rousseau Marc , Lesoin Francis , Combelles Guy , Krivosic Yvan , Warot Pierre 
Published: May 2010

Abstract
An intraspinal ependymal cyst of the thoracolumbar spinal cord was found in a 71-year-old woman with a history of right side abdominal pain since the age of 18. The late discovery of the cyst is related to the extremely slow evolution of this type of cyst in the absence of spinal trauma. Etiopathogenic problems are discussed after a review of the literature.
Epidural Hematoma Communicating with Cephalhematoma in a Neonate
Authors: Aoki Nobuhiko 
Published: May 2010

Abstract
The author reports a unique case of a neonate with a depressed skull fracture detected immediately below a cephalhematoma complicated with an epidural hematoma. The epidural hematoma communicating with the cephalhematoma through a depressed skull fracture disappeared after the cephalhematoma was punctured for aspiration, and the depressed fracture reduced spontaneously 6 months thereafter.
Hemangiopericytoma of the Pituitary Fossa: Case Report
Authors: Mangiardi John R. , Flamm Eugene S. , Cravioto Humberto , Fisher Boguslav 
Published: May 2010

Abstract
A case of hemangiopericytoma presenting as a sellar and suprasellar mass is reported. Although this is the first report of this tumor in such a location, it appears similar to hemangiopericytomas found in other locations.
Acute Bilateral Extradural Hematomas in a Case of Osteogenesis Imperfecta Congenita
Authors: Pozzati Eugenio , Poppi Massimo , Gaist Giulio 
Published: May 2010

Abstract
Acute bilateral extradural hematomas occurred after apparently trivial trauma in a patient suffering from osteogenesis imperfecta congenita. Factors influencing the development of this dramatic complication are peculiar to this rare disorder of bone and connective tissue development and include bony weakness, increased vascular fragility, and possible coagulopathies
Mechanisms of Hydrocephalus in Cerebral Cysticercosis: Implications for Therapy
Authors: Estañol Bruno , Kleriga Enrique , Loyo Mauro , Mateos Humberto , Lombardo Luis , Gordon Felipe , Saguchi Andrés Félix 
Published: May 2010

Abstract
Patients with hydrocephalus secondary to cerebral cysticercosis are a highly heterogeneous group. The mechanisms of hydrocephalus in these patients are multiple. Intraventricular cysts may be found in the 3rd and 4th ventricles, the sylvian aqueduct, and the foramen of Monro. Intraventricular cysts can be suspected when the 3rd and 4th ventricles or aqueduct remain enlarged despite shunting. Intraventricular contrast medium demonstrates the presence of the parasites. The intraventricular cysts should be removed surgically. Hydrocephalus due to cisternal cysticercosis can be diagnosed by isotope cisternography. These patients should receive shunts, but the long term prognosis is probably poor. Guidelines for the management of hydrocephalus due to cysticercosis are suggested.
Hemifacial Spasm: Treatment by Microsurgical Facial Nerve Decompression
Authors: Loeser John D. , Chen James 
Published: May 2010

Abstract
The literature on hemifacial spasm and its surgical therapy is reviewed, and the authors' experiences with 20 patients are described. Vascular cross compression of the facial nerve adjacent to the brain stem is seen in 90% of the surgical patients. Mobilizing the offending vessel will cure or significantly improve approximately 80% of the patients. Complications occur in 25% of the patients and usually involve decreased hearing or facial weakness. Mortality is virtually zero, and this operation is vastly superior to any other medical or surgical therapy for hemifacial spasm. The pathophysiology is not yet understood.