bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pain Management after Lower Extremity Amputation
Authors: Iacono Robert P. , Linford Jennifer , Sandyk Reuven 
Published: May 2010

Abstract
Phantom pain may occur in up to 85% of patients after limb amputation. Although the pathophysiology of postamputation phantom pain is not well understood, it seems to be produced by a complex multifactorial interaction between the peripheral, sympathetic, and central nervous systems. The theoretical aspects of this are reviewed. Management of phantom limb pain may be both medical and surgical. Among the pharmacological agents proved effective against phantom pain are B-blockers, tricyclic antidepressants, and anticonvulsants. Surgical management includes peripheral nerve stimulation, thermocontrolled coagulation of the spinal cord, spinal cord stimulation, transcutaneous nerve stimulation, and stereotactic deep brain stimulation.
Neurolysis Combined with the Application of a Silastic Envelope for Ulnar Nerve Entrapment at the Elbow
Authors: Benoit Brien G. , Preston David N. , Atack David M. , Da Silva Vasco F. 
Published: May 2010

Abstract
Sixty-six patients with ulnar nerve entrapment at the elbow underwent neurolysis and the application of a Silastic envelope in an attempt to prevent postoperative scarring and recurrence of symptoms. All patients were evaluated pre- and postoperatively using a numerical scoring system that included clinical, motor, and sensory evaluation as well as nerve conduction studies. The Silastic material was well tolerated in the 70 cases. The overall 66% score improvement was more closely related to clinical relief (64%) than to improvement in motor conduction velocities (45%). Our 10-year experience indicates that ulnar neurolysis with Silastic envelope interposition is a safe surgical method of treatment for ulnar nerve entrapment at the elbow.
Craniometaphyseal Dysplasia Associated with Hydrocephalus: Case Report
Authors: Hudgins Roger J. , Edwards Michael S. B. 
Published: May 2010

Abstract
Craniometaphyseal dysplasia is a rare bone disorder that may cause a variety of neurological abnormalities; hydrocephalus has not been observed with this disorder, however. A case of craniometaphyseal dysplasia associated with hydrocephalus is reported, and possible causes are discussed.
Chronic Posttraumatic Lumbar Intradural Arachnoid Cyst with Cauda Equina Compression: Case Report
Authors: Zuccarello Mario , Powers Gerald , Tobler William D. , Sawaya Raymond , Hakim Simon Z. 
Published: May 2010

Abstract
An unusual case of a chronic posttraumatic lumbar intradural arachnoid cyst causing compression of the cauda equina is reported. The etiological, pathological, and clinical features are discussed. Emphasis is placed on the importance of a correct interpretation of radiological findings.
Prevention of Deep Venous Thrombosis in Patients with Acute Spinal Cord Injuries: Use of Rotating Treatment Tables
Authors: Becker Daniel M. , Gonzalez Marco , Gentili Amilcare , Eismont Frank , Green Barth A. 
Published: May 2010

Abstract
A randomized clinical trial of 15 patients with acute spinal cord injuries was performed to test the hypothesis that rotating treatment tables prevent deep venous thrombosis in this population. Four of 5 control (nonrotated) patients developed distal and proximal thrombi, assessed by 125I fibrinogen leg scans and impedance plethysmography. In comparison, only 1 of 10 treated (rotated) patients developed both distal and proximal thrombosis (P = 0.007). These results suggest but do not prove that rotating treatment tables prevent the development of proximal deep venous thrombosis in spinal cord-injured patients. Larger clinical trials are needed to confirm this heretofore undocumented benefit of rotating treatment tables.
Evoked Potential Monitoring during Aneurysm Operation: Observations after Fifty Cases
Authors: Friedman William A. , Kaplan Barry L. , Day Arthur L. , Sypert George W. , Curran Michael T. 
Published: May 2010

Abstract
Somatosensory or brain stem auditory evoked potentials (EPs) were monitored during 50 aneurysm procedures. Base line EPs were obtained shortly after the induction of general anesthesia and were recorded continuously during operation. Absolute latency, interpeak latency, and cortical EP amplitude were subsequently determined. Statistical analysis confirmed that significant changes in these parameters are routine during aneurysm operation. Arbitrary definitions of abnormal latency and amplitude changes led to an excessive false-positive/false-negative rate. From the time of dural opening to the time of closure, prolongation of central conduction time, decrease in cortical amplitude, or disappearance of the EP was predictive of postoperative sensory or motor deficit in all patients monitored, except those undergoing operation on basilar artery aneurysms. In basilar aneurysm cases, outcome could not be reliably predicted with either EP technique.
Malignant and Atypical Meningiomas: A Reappraisal of Clinical, Histological, and Computed Tomographic Features
Authors: Alvarez Fernando , Roda José M. , Romero Mercedes Pérez , Morales Carmen , Sarmiento Maria A. , Blázquez Martin G. 
Published: May 2010

Abstract
A series of 21 patients with atypical and malignant meningiomas is presented. Histological criteria such as high cellularity, typical and atypical mitosis, necrosis, infiltration of the underlying brain, poor differentiation, and distant metastasis define nonbenign meningiomas. Male predominance in this nonbenign group is significant when compared to a group of 205 benign meningiomas, which were also operated on. The malignant and atypical meningiomas are compared with the benign meningiomas, and special emphasis is placed on their computed tomographic features. The presence of tumor fringes (suggesting invasion of the brain substance) and intratumoral hypodense areas were both significant signs of malignancy of atypia. Radical surgical excision is still considered the treatment of choice.
Effect on Management Mortality of a Deliberate Policy of Early Operation on Supratentorial Aneurysms
Authors: Disney Lew , Weir Bryce , Petruk Kenneth 
Published: May 2010

Abstract
Of 736 patients with intracranial aneurysms seen at the University of Alberta from 1968 to 1985, 437 were admitted on the day of or the day after subarachnoid hemorrhage (SAH) from a supratentorial aneurysm. Of these, 205 were managed from 1968 through 1977 and 232 were managed from 1978 through early 1985 after a policy of early aneurysm operation had been implemented. Postoperative and management mortality and morbidity rates were related to the grade of the patient at the time of admission and the time interval before operation. Overall management mortality (and postoperative mortality) rates for patients treated before 1978 were 47% (19%) for all grades, 17% (12%) for Grades 1 and 2, 51% (25%) for Grades 3 and 4, and 100% (100%) for Grade 5. Since 1978, mortality has been reduced to 38% (11%) for all grades, 10% (5%) for Grades 1 and 2, 39% (17%) for Grades 3 and 4, and 96% (60%) for Grade 5. Management mortality for patients operated on Day 0 to 3 was lower than for those operated later after SAH both before and after 1978. Postoperative mortality was lowered in all patients operated from 1978 to 1985 regardless of the interval from SAH to operation, and management mortality was reduced overall, as well as for patients operated on day 0 to 3, in those treated from 1978 to 1985. The authors conclude that a policy of early aneurysm operation has contributed to a reduction of both postoperative and management mortality.
Solitary Histoplasmoma of the Thalamus: Case Report and Literature Review
Authors: Venger Benjamin H. , Landon Gene , Rose James E. 
Published: May 2010

Abstract
Only nine cases of solitary thalamic abscess have been reported. All were of bacterial origin, and three were successfully treated by surgical drainage and antibiotic therapy. The authors present the history of a patient with a histoplasmoma of the thalamus. As is often the case with solitary thalamic lesions, this lesion was initially assumed to be a tumor and was first treated with radiotherapy. Despite the sensitive location of the lesion, tissue diagnosis and decompression was safely accomplished with the aid of ultrasonic localization. Appropriate antifungal treatment was given, and the patient made a good recovery.
Surgical Results in Obese Patients with Sciatica
Authors: Hanigan William C. , Elwood Patrick W. , Henderson John P. , Lister Richard J. 
Published: May 2010

Abstract
A prospective study was done to determine the effect of obesity on the surgical results in patients with intractable sciatica. One hundred ten patients entered the study over an 8-month period. Five patients (1 obese) were excluded. Seventeen patients were included in the obese group. The two populations did not differ in age, sex, occupation, level of disc herniation, involvement of compensation, length of hospitalization, duration of disability, or incidence of surgical complications. At the 6-month follow-up assessment, 14 obese patients vs. 80 nonobese patients rated their surgical results good or excellent. Patients with postoperative weight loss were equally distributed between the groups. The data demonstrate that obesity should not be considered a prognostic factor when patients are eligible for surgical therapy.
Toleration of Head Injury by the Elderly
Authors: Amacher Loren A. , Bybee David E. 
Published: May 2010

Abstract
Fifty-six patients 80 or more years of age, admitted because of head injury, provide a clinical profile of the effects of head injury upon an aging population. The mortality rate is high, even in those with good admission Glasgow coma scores. The incidence of intracranial mass hematoma is striking. Falls in the residence constitute the principal mechanism of injury, and preexisting medical conditions are important contributing factors. A significant proportion (60%) of old people may make a full recovery from head injury.
Transoral Transclival Removal of Anteriorly Placed Meningiomas at the Foramen Magnum
Authors: Miller Elizabeth , Crockard Alan H. 
Published: May 2010

Abstract
Anteriorly placed meningiomas at the level of the foramen magnum are rare, are difficult to diagnose, and present technical problems for a conventional posterior fossa removal. The authors describe the successful transoral transclival excision of two such tumors. Cerebrospinal fluid (CSF) fistula can be avoided by dural repair using a thrombin glue and long term CSF diversion. This modification enables the transoral route to be considered for anteriorly placed intradural lesions.
Phenylpropanolamine: An Over-the-Counter Drug Causing Central Nervous System Vasculitis and Intracerebral Hemorrhage
Authors: Glick Roberta , Hoying John , Cerullo Leonard , Perlman Susan 
Published: May 2010

Abstract
Phenylpropanolamine (PPA) is the major ingredient in more than 70 over-the-counter preparations including diet pills, nasal decongestants, and the legal “look-alike” stimulants. Structurally and functionally similar to amphetamine and ephedrine, PPA has recently been associated with several neurological manifestations including psychosis, stroke, severe headache, seizures, and intracerebral hematoma. We report a case of intracerebral hematoma and subarachnoid hemorrhage in a young woman with angiographic and biopsy-proven vasculitis of the central nervous system (CNS) induced by PPA in her diet pills. From review of the literature, we distinguish drug-induced vasculitis as a separate entity from primary CNS vasculitis, both clinically and pathologically. This report should alert physicians, in general, to this potentially fatal side effect of PPA, a commonly used over-the-counter drug. Also, neurosurgeons in particular should consider the possibility of drug-induced vasculitis when faced with cases of intracerebral or subarachnoid hemorrhage without apparent cause.
Radiation Therapy in the Treatment of Cerebral Astrocytoma
Authors: Morantz Robert A. 
Published: May 2010

Abstract
With the advent of more sensitive diagnostic techniques, we are encountering an increasing number of young patients harboring cerebral astrocytoma. The great danger in such patients is that the astrocytoma cells will undergo dedifferentiation to a higher state of malignancy. An essential question is whether the use of postoperative adjuvant radiation therapy can decrease the incidence of this event. Because a prospective, randomized study has never been carried out, it is extremely difficult to ascertain whether radiation therapy should be given to these patients. This article reviews the main retrospective clinical studies in an attempt to determine whether the addition of radiation therapy increases the length or quality of survival in patients with astrocytoma. Based on this literature review, the following tentative conclusions have been reached: (a) All reported studies are inconclusive; therefore, dogmatic statements as to whether radiation therapy should be used are not warranted. (b) One should try to obtain pathological confirmation of the precise nature of all tumor-like cerebral lesions that have been detected on neuroradiological studies. (c) Consistent with sound neurosurgical judgment, every attempt should be made to carry out a gross total removal of the hemispheric astrocytoma. (d) In the case of such a gross total surgical removal and even in its absence in the case of a juvenile pilocytic astrocytoma, radiation therapy may be withheld and the patient carefully followed for tumor recurrence. (e) In those cases where total removal cannot be accomplished, postoperative radiation therapy seems warranted. (f) Such radiation therapy should be given in a conventional fractionated schedule to a maximum of 5500 rads. The radiation therapy should not be given to the whole brain, but rather to the tumor plus a limited surrounding margin as determined by computed tomography/magnetic resonance imaging. Such a treatment regimen may reasonably be expected to lead to a 5-year survival rate of approximately 40%.
Whatever Happened to Stereotactic Surgery?
Authors: Gildenberg Philip L. 
Published: May 2010

Abstract
The field of human stereotactic surgery began when Spiegel and Wycis introduced their stereoencephalotome in 1947, reached its epitome in the early 1960s, and declined sharply after the introduction of l-dopa in 1968. When the development of implantable stimulators provided an abrupt expansion of techniques in nonstereotactic functional neurosurgery, the field became “stereotactic and functional neurosurgery.” The marriage of stereotactic surgery with computed tomography has reawakened the use of stereotactic surgery and brought it closer to general neurosurgery than ever before. Stereotactic and functional neurosurgery as a subspecialty has expanded rapidly and will continue to expand at an unprecedented rate, with significant changes reflecting the continuing advances in technology begun 15 years ago. It is becoming an increasingly important part of the field of neurosurgery and has extended its influence in many new clinical areas previously outside the realm of stereotaxis.
Sylvian Fissure Arteriovenous Malformations
Authors: Sugita Kenichiro , Takemae Toshiki , Kobayashi Shigeaki 
Published: May 2010

Abstract
We have operated on 16 cases of arteriovenous malformation (AVM) in and around the sylvian fissure. We call these lesions “sylvian fissure AVMs” and classify them into four subdivisions, namely, pure, lateral, medial, and deep AVMs. By others, they have been variously called AVMs of the basal ganglia, insula, anterior choroidal artery, frontal lobe, or temporal lobe. These sylvian fissure AVMs showed similar angiographic findings: the feeders in all cases were branches of the middle cerebral artery; in some cases, additional feeders from the anterior and posterior choroidal and posterior communicating arteries were present also. We describe the characteristic features of these AVMs from the anatomical and surgical points of view. The surgical results were satisfactory in 15 cases (no additional neurological deficits), and 1 patient died. (Neurosurgery 21: 7-14, 1987)
Magnetic Resonance Imaging of Cerebral Arteriovenous Malformations
Authors: Leblanc Richard , Levesque Michel , Comair Youssef , Ethier Romeo 
Published: May 2010

Abstract
Magnetic resonance imaging (MRI) was performed in 15 patients with small to very large supratentorial arteriovenous malformations (AVMs). Unlike non-contrast infused computed tomographic (CT) scanning, MRI demonstrated the AVM in all cases. The nidus had a characteristic honeycomb appearance, and in all cases feeding arteries and deep or superficial draining veins were demonstrated without intervening bone artifact. The relationship of the AVM to surrounding cortical areas, deep nuclei, important white matter tracts, and the ventricular system was well appreciated. These characteristics make MRI useful for the diagnosis of cerebral AVMs and add to the accuracy of systems that grade operability on the basis of the angiographic demonstration of size, location, depth, arterial supply, and venous drainage. In many cases, based on the MRI appearance of the AVM and its relationship to important brain structures, the lesion can be deemed inoperable or unsuitable for other forms of treatment, making angiography unnecessary. Thus, the superior anatomical and morphological resolution of MRI, the lower false-negative rate, and the independence from x-ray and contrast material make MRI more useful than CT scanning for the diagnosis of AVMs and as an aid in the management of specific cases. (Neurosurgery 21: 15-20, 1987)
Primary Oligodendroglioma of the Septum Pellucidum
Authors: Garza-Mercado Román , Campa Hernán , Grajeda Jorge 
Published: May 2010

Abstract
The oligodendroglioma is an infrequent cerebral tumor of glial ancestry. It is even rarer when primarily arising within the confines of the ventricles and particularly if originating from the septum pellucidum. A 22-year-old man harboring a primary oligodendroglioma of the septum pellucidum was successfully treated by intraventricular tumor removal through a left transcortical-transventricular approach, using microsurgical technique. A brief review of relevant data about both intraventricular oligodendrogliomas and tumors of the septum pellucidum is presented. (Neurosurgery 21: 78-80, 1987)
Cerebellar Medulloblastoma in a 73-Year-Old Woman
Authors: Kepes John J. , Morantz Robert A. , Dorzab William E. 
Published: May 2010

Abstract
A case of a 73-year-old woman with cerebellar medulloblastoma is described. The patient presented with the classical symptoms and signs of a medulloblastoma, and radiological findings were also consistent with this entity. Nevertheless, because of the patient's advanced age, the possibilities of metastatic tumor involving the cerebellum or a primary cerebellar lymphoma were considered before operation. Pathological examination of the operative specimen showed a classical medulloblastoma with occasional areas of early neuroblastic differentiation. Immunoperoxidase stains for neurofilaments were of help in confirming the neurogenic origin of the neoplastic cells. Although medulloblastomas in adults are not rare, onset after the age of 50 is exceptional, with only two cases on record in patients 65 or older. The present patient seems to be the oldest individual with a cerebellar medulloblastoma thus far reported. (Neurosurgery 21: 81-83, 1987)
Traumatic Bilateral Ophthalmic Artery Aneurysms: A Case Report
Authors: Hahn Yoon S. , McLone David G. 
Published: May 2010

Abstract
A case of bilateral ophthalmic artery aneurysm of traumatic origin is discussed. The patient presented with progressive loss of vision, memory deficit, and expressive aphasia. A computed tomographic scan revealed enhancing lesions near the region of the optic chiasm. The diagnosis of cerebral aneurysm was confirmed by cerebral angiography. At operation, bilateral ophthalmic artery aneurysms were successfully clipped. (Neurosurgery 21: 86-89, 1987)
Diastematomyelia of the Cervical Spinal Cord with Tethering in an Adult
Authors: Wolf Aizik L. , Tubman David E. , Seljeskog Edward L. 
Published: May 2010

Abstract
A case of cervical diastematomyelia associated with spinal cord tethering in an adult is presented. The differences between cervicodorsal and lumbar region spinal dysraphic states are emphasized with a review of the embryological factors involved. Possible causes and subsequent treatment are outlined. (Neurosurgery 21: 94-98, 1987)
Three-Dimensional Computed Tomography in the Diagnosis of Vertebral Column Pathological Conditions
Authors: Hadley Mark N. , Sonntag Volker K. H. , Amos Rob M. , Hodak John A. , Lopez Lynda J. 
Published: May 2010

Abstract
Three-dimensional computed tomographic scanning is a valuable adjunct in the diagnosis and treatment of disease processes involving the spine. We present our experience with this noninvasive radiological diagnostic technique in 32 patients with vertebral column abnormalities ranging from craniovertebral junction disorders to fractures of lumbar vertebrae. The three-dimensional CT images often demonstrate pathological conditions and occult lesions that are not adequately defined by conventional radiographic means.
Hearing Preservation after Acoustic Neurinoma Operation
Authors: Frerebeau Ph. , Benezech J. , Uziel A. , Coubes P. , Segnarbieux F. , Malonga M. 
Published: May 2010

Abstract
Between 1981 and 1984, 44 patients underwent acoustic neurinoma removal by a posterior cranial fossa approach with an attempt to preserve hearing. Seven tumors were small (&lt;20 mm), 28 were medium (20 to 40 mm), and 9 were large (&gt;40 mm). Preoperatively, 4 patients had normal hearing, 15 had serviceable hearing, 10 had poor hearing, and 15 had no hearing. Postoperative hearing was preserved in 11 cases. Of the 19 patients with normal or serviceable hearing, 8 (42%) had serviceable hearing preserved postoperatively. Hearing preservation was achieved in 43% of the patients with small tumors, 25% of those with medium tumors, and 11% of those with large tumors. This study confirms the value of the suboccipital approach, which can be used in an attempt to preserve hearing whenever the patient has serviceable hearing preoperatively and whenever the tumor size makes it feasible.