bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supratentorial Intracerebral Hemorrhage after Posterior Fossa Operation
Authors: Seiler Rolf W. , Zurbrügg Heinz R. 
Published: May 2010

Abstract

OBJECTIVE
Three cases of supratentorial intracerebral hemorrhage after posterior fossa operation are described, and nine other cases reported in the literature are reviewed. The possible causes are discussed, but in eight cases no definite cause could be found. All eight patients were operated on in the sitting position, and all had hematomas in the subcortical white matter. A possible cause might be changes in intracranial dynamics in the sitting position with disruption of subcortical veins. Other authors mention the possibility of occlusion of carotid or vertebral vessels in the neck by improper positioning of the head leading to intraoperative infarction and to hemorrhage within the infarcted brain after repositioning of the patient. With the patient in a lateral or semilateral position, this complication should be preventable.
Reformatted Sagittal Images in the Differential Diagnosis of Meningiomas and Pituitary Adenomas with Suprasellar Extension
Authors: Clark Craig W. , Acker James D. , Robertson Jon H. , Eggers Frank , Muhlbauer Michael S. 
Published: May 2010

Abstract
Approximately 3 to 4 times a year, a tumor with suprasellar extension escapes classification on high resolution coronal and transaxial computed tomography. When arteriography failed to determine the diagnosis, the differential choices were usually meningioma or pituitary adenoma. The authors report the use of sagittal reformatted images in this differential diagnosis and conclude that these images may aid in the distinction between pituitary tumors with suprasellar extension and meningiomas located in this area.
Selective Posterior Rhizotomy in the Dorsal Root Entry Zone for Treatment of Hyperspasticity and Pain in the Hemiplegic Upper Limb
Authors: Sindou Marc , Mifsud Jean Jacques , Boisson Dominique , Goutelle Alain 
Published: May 2010

Abstract
The authors report a series of 16 hemiplegic patients suffering from harmful spasticity in the upper limb and treated with selective posterior rhizotomy (SPR) in the dorsal root entry zone (DREZ). This severe spasticity was associated with irreducible abnormal postures in flexion in 11 cases and painful manifestations in 12. The method was introduced in 1972 on the basis of anatomical studies of the DREZ in humans, in which a topographical segregation of the root afferents, according to their anatomicofunctional destinations, has been shown. It consists of a DREZ microsurgical lesion 1 to 2 mm in depth and directed at a 45° angle, performed ventrolaterally in the posterolateral sulcus of the spinal cord and into the internal part of the Lissauer's tract. The procedure is carried out in each rootlet of the posterior roots considered to be responsible for the harmful spasticity. SPR interrupts selectively the (lateral) nociceptive and (central) myotactic afferent fibers connecting the motor neurons, while sparing most of the (medial) lemniscal fibers and the inhibitory circuitry of Lissauer's tract and the dorsal horn. The results were evaluated after a 1- to 12-year follow-up. There were no deaths and no general complications; in 1 case a loss of motility in the leg ipsilateral to the procedure occurred. The excess of spasticity was slightly diminished (2 cases), markedly reduced (9 cases), or totally abolished (5 cases), making possible an improvement in voluntary movements in 8 patients and at least a good passive mobilization in 7 further case. In 1 case only, a marked tendency for spasticity to return was observed. Of the 12 patients with painful manifestations, 9 were completely relieved and 3 improved. These beneficial effects on both spasticity and pain led to a gain in functional status in 93% of cases. This was achieved without impairing sensation in the upper limb in 8 cases and with its diminution only in the 8 others.
Mycobacterium tuberculosis Meningitis: A Report of Twelve Cases and a Literature Review
Authors: Clark Craig W. , Metcalf James C. , Muhlbauer Michael S. , Dohan Curtis F. , Robertson Jon H. 
Published: May 2010

Abstract
Twelve recent cases of Mycobacterium tuberculosis meningitis are presented, and the literature is reviewed. Indications for neurosurgical intervention are outlined, and principles of therapy are reviewed.
Intervertebral Disc Infection after Lumbar Chemonucleolysis: Report of a Case
Authors: Zeiger Evan H. , Zampella Edward J. 
Published: May 2010

Abstract
Intervertebral disc space infection can be a serious and disabling complication of any procedure that affords entry for bacteria into the susceptible disc space. Most disc space infections occur after cervical or lumbar laminectomies. Discitis has been reported after myelography, lumbar puncture, paravertebral injection, and obstetrical epidural anesthesia. A case of septic discitis occurring after intradiscal therapy with chymopapain is presented. Patients who return for evaluation of recurrent spinal pain after chemonucleolysis, especially those with paravertebral muscle spasm, should be evaluated for the possibility of disc space infection by obtaining an erythrocyte sedimentation rate, peripheral white count, differential cell count, and plain roentgenograms. Radionuclide bone scans, although not specific, may provide further objective evidence leading to the diagnosis of an intervertebral disc space infection.
Magnetic Resonance Imaging in the Evaluation of Low Attenuation Lesions on Computed Tomography
Authors: Bucci Michael N. , Black Keith L. , Venes Joan L. , Latack Joseph T. 
Published: May 2010

Abstract
Computed tomography has proven invaluable in the assessment of intracranial mass lesions. Low attenuation lesions can, however, present diagnostic difficulties. We report three cases where magnetic resonance imaging was beneficial in clarifying solid versus cystic intracranial lesions.
Bilateral Upper Extremity Paralysis (Bell's Cruciate Paralysis) from a Gunshot Wound to the Cervicomedullary Junction
Authors: Marano Stephen R. , Calica Arnold B. , Sonntag Volker K. H. 
Published: May 2010

Abstract
Cruciate paralysis is characterized by midline involvement of the rostral portion of the pyramidal decussation, resulting in paralysis of the upper extremity without lower extremity involvement. The neuroanatomical basis is the more rostral and medial decussation of the upper extremity motor fibers in the medulla compared with the more caudal and lateral decussating fibers of the lower extremity at the lower boundary of the cervicomedullary junction. We believe this to be the first reported case of Bell's cruciate paralysis caused by a gunshot wound to this region. The neuroanatomical basis and the mechanisms that produce this unique clinical entity are discussed.
Transoral Unilateral Facetectomy in the Management of Unilateral Anterior Rotatory Atlantoaxial Fracture/Dislocation: A Case Report
Authors: Schmidek Henry H. , Smith Donald A. , Sofferman Robert A. , Gomes Francisco B. 
Published: May 2010

Abstract
An unusual case of unilateral anterior rotatory atlantoaxial fracture/dislocation with neurological deficit is presented. The injury could not be reduced by skeletal traction, but was successfully reduced by partial facetectomy at C-1, C-2 accomplished through a transoral exposure of the atlantoaxial region combined with labiomandibularglossotomy. To the best of our knowledge, this is the first instance of an injury of this type to be so managed. The details of the operative procedure are described, and the subject of rotatory atlantoaxial dislocation is reviewed.
Postradiation Sarcoma Involving the Spine
Authors: Sundaresan Narayan , Huvos Andrew G. , Krol George , Hughes James E. O. , Cahan William G. 
Published: May 2010

Abstract
Postradiation sarcomas arising many years after treatment of cancer are long term sequelae of therapy. We describe the clinical features, radiographic findings, and results of treatment in 13 patients with such sarcomas encountered over a 6-year period. Of these patients, 9 had bone sarcomas and the remaining 4 had paraspinal tumors arising from adjacent soft tissue and nerve. The primary cancer for which radiation was given included Hodgkin's disease (4 patients), breast cancer (2 patients), cervix cancer (2 patients), and a variety of others (5 patients). The latent interval to the occurrence of the second neoplasm varied from 6 to 30 years (median, 10 years) after treatment of the original tumor. Despite aggressive treatment, the overall prognosis was poor. The median survival was 8 months, with only 3 surviving more than 2 years. Although rare, postradiation sarcoma should be considered in the differential diagnosis of patients presenting with late onset of spinal pain or neurological symptoms after clinical remission of an original cancer.
Administration of Intraspinal Morphine Sulfate for the Treatment of Intractable Cancer Pain
Authors: Shetter Andrew G. , Hadley Mark N. , Wilkinson Elizabeth 
Published: May 2010

Abstract
A total of 24 patients with intractable cancer pain were evaluated as candidates for spinal morphine therapy. Temporary trials were carried out with bolus injections of preservative-free morphine sulfate via percutaneously inserted epidural catheters. Fourteen patients felt that pain relief was sufficient to warrant long term morphine application, and permanent drug delivery systems were implanted. These consisted of an Ommaya reservoir and an epidural spinal catheter in 6 patients and an Infusaid pump with either an epidural or subarachnoid spinal catheter in 8 patients. Pain relief with these systems was felt to be excellent in 7 patients, good in 4 patients, and fair in 3 patients. There was a statistically significant reduction in supplemental narcotic use between the pre- and postoperative periods (P &lt; 0.001). Median survival after operation was 3.0 months (mean, 5.0 months), with a range of 1 to 23 months. Tolerance was seen in all patients regardless of the mode of drug delivery, but it occurred more quickly with bolus injections than with continuous infusion (statistically significant difference, P &lt; 0.05). A persistent cerebrospinal fluid fistula developed in 1 patient; this required wound revision. No other serious complications or episodes of respiratory depression occurred. We conclude that intraspinal morphine sulfate is a beneficial treatment option for cancer patients in whom pain has become debilitating and unresponsive to oral or parenteral narcotic regimes.
Hyperglycemia-induced Hemichoreoathetosis: The Presenting Manifestation of a Vascular Malformation of the Lenticular Nucleus
Authors: Vincent Frederick M. 
Published: May 2010

Abstract
A 72-year-old diabetic woman developed paroxysmal hemichoreoathetosis during an episode of nonketotic hyperglycemia. The movement disorder abated as the blood glucose normalized. A computed tomographic scan revealed a vascular malformation involving the lenticular nucleus on the side contralateral to the dyskinesia. Hyperglycemia has rarely been reported to cause episodic dyskinesias, but there have been no prior reports of patients with striatal vascular abnormalities in whom hyperglycemia seemingly caused a transient movement disorder.
Successful Combination Chemotherapy (Cisplatinum, Vinblastine, and Bleomycin) against Peritoneal Dissemination of Intracranial Germ Cell Tumor
Authors: Kumura Eiji , Arita Norio , Hayakawa Toru , Ushio Yukitaka , Nakata Hiroyuki , Murasawa Akira , Mogami Heitaro , Ikezoe Junpei , Minami Yuzo 
Published: May 2010

Abstract
We found combination chemotherapy with cisplatinum, vinblastine, and bleomycin (PVB therapy) effective in the treatment of a patient with a pineal germ cell tumor with peritoneal dissemination. The metastatic complication may have been attributable to the ventriculoperitoneal shunt tube. After the first course of PVB therapy, the disseminated tumors were decreased in size; no residual tumors were detected after the third course by laparoscopic examination, computed tomographic scanning, or echogram. Our results suggest that combined PVB therapy is effective in the treatment of extraneural metastasis from intracranial germ cell tumors. (18:802-804, 1986)
Delayed Epidural Hemorrhage in Hypotensive Multiple Trauma Patients
Authors: Bucci Michael N. , Phillips Timothy W. , McGillicuddy John E. 
Published: May 2010

Abstract
Despite the availability of high resolution computed tomography, severely head-injured patients often present diagnostic dilemmas. An initially negative computed tomographic scan in the presence of severe multiple trauma does not predict an uncomplicated course. Early repeat scanning should be considered. We present three cases of delayed epidural hemorrhage in multiple trauma patients who initially were hypotensive secondary to hypovolemia. Possible etiologies for the hemorrhage as well as a list of indications for repeat scanning in the posttraumatic period are discussed.
Subdural Electrodes for Seizure Focus Localization
Authors: Rosenbaum Thomas J. , Laxer Kenneth D. , Vessely Michael , Smith W. Brewster 
Published: May 2010

Abstract
Fifty patients with medically refractory partial seizure disorders have undergone subdural electrode placement for seizure focus localization. Standard scalp telemetry recordings of ictal events had failed to demonstrate accurately the site of seizure onset, and these patients were considered candidates for telemetry with intracerebral depth electrodes. Excellent recordings of interictal and ictal events were obtained, and localization of the epileptogenic focus was derived from recordings made during spontaneously occurring seizures. Electrocorticograms were monitored for up to 21 days. The recordings enabled a surgical decision to be made in 43 of 50 cases (86%). Thirty patients have subsequently undergone cortical excision of their foci with good results. Subdural electrode recordings are a significant addition to the armamentarium of the neurosurgeon attempting to localize surgical seizure foci, offering a low morbidity procedure as an alternative to depth electrode implantation.
Charcot's Spine with Neurological Deficit: Computed Tomography as an Aid to Treatment
Authors: Raynor Richard B. 
Published: May 2010

Abstract
A patient with Charcot's disease of the lumbar spine presented with weakness of one extremity. Myelographic and x-ray film studies indicated stenosis and compression due to degenerative changes. Although decompression and fusion were considered, computed tomographic scans indicated the wide extent and location of the destructive changes. Nonoperative treatment was elected because of the high risk of fusion failure and instability.
Glioblastoma Occurring after Radiation Therapy for Meningioma: Case Report and Review of Literature
Authors: Zuccarello Mario , Sawaya Raymond , deCourten-Myers Gabrielle 
Published: May 2010

Abstract
A 32-year-old man developed an intracranial glioblastoma multiforme 10 years after irradiation for an incompletely resected convexity meningioma. The association of these two tumors is exceedingly rare. Therefore, we propose that this is a case of radiation-induced glioma and review the evidence supporting this view.
Brain Abscess Due to Haemophilus aphrophilus: Possible Canine Transmission
Authors: Abla Adnan A. , Maroon Joseph C. , Slifkin Malcolm 
Published: May 2010

Abstract
A 58-year-old patient developed progressive right hemiparesis and a hemisensory loss. Computed tomography demonstrated a lesion in the left frontoparietal region with ring enhancement. A craniotomy was performed and an abscess was removed, which on culture grew Haemophilus aphrophilus. The same organism was isolated from the patient's poodle dog but not from three other poodles of family members. This, along with previous reports, suggests that the poodle may be a vector in the transmission of this organism, which rarely may cause a brain abscess.
Subarachnoid Hemorrhage in the Presence of a Cerebral Arteriovenous Malformation and an Intraventricular Oligodendroglioma: Case Report
Authors: Martinez-Lage Juan F. , Poza Máximo , Esteban Juan A. , Sola Joaquin 
Published: May 2010

Abstract
The authors report a case of a ventricular oligodendroglioma associated with a cortical arteriovenous malformation. The patient presented with subarachnoid hemorrhage. Computed tomographic scan showed an intraventricular hyperdense lesion, mimicking a hematoma. Angiography revealed a superficial arteriovenous malformation in the right parietal lobe, unrelated to ventricular cavities. Both lesions were treated during the same operation. The diagnostic difficulties and the significance of this uncommon association are discussed.
Posterolateral Approach and Anterior Spinal Canal Recalibration in Severe Spinal Injury Affecting T-12, L-1: A Study of Seven Cases
Authors: Richaud Jacques , Boetto Sergio , Lazorthes Yves 
Published: May 2010

Abstract
The authors present seven cases of spinal trauma at the T-12-L-1 level with severe spinal canal stenosis secondary to compressive, anterior discocorporeal lesions. Associated neurological disorders were of varying severity. Six cases were investigated by computed tomography, which enabled the degree of thoracolumbar spinal canal stenosis to be determined. In all cases, the surgical procedure involved rectification of spinal deformity, with an initial unilateral posterolateral approach permitting anterior spinal canal recalibration, either by impaction of protrusive fragments or ablation of ejected disc fragments. The stabilization was in all cases achieved by complimentary bilateral plates using Roy-Camille material, associated with posterolateral arthrodesis by grafting with reconstruction of the articulopedicular structure. The functional spinal result was excellent in all cases, and recalibration was verified by tomography. In those cases showing neurological deficiency, good and early recovery was attributable to the suppression of spinal canal stenosis. The application of this posterolateral approach for severe lesions of the thoracolumbar junction seems to represent, in all cases of recent lesions, an alternative to the anterior or combined methods, which present widely recognized difficulties at the thoracoabdominal junction.
Coincidental Pituitary Adenoma and Parasellar Meningioma: Case Report
Authors: Yamada Kenji , Hatayama Takashi , Ohta Masahiro , Sakoda Katsuaki , Uozumi Tohru 
Published: May 2010

Abstract
We report a patient who had pituitary adenoma and parasellar meningioma coincidentally, with neither irradiation nor a history of head injury. Preoperative computed tomographic (CT) scan had shown a large intrasellar mass with ringlike enhancement; in contact with this mass, another well-enhanced mass had been shown. Histopathologically, the intrasellar mass was diagnosed as chromophobic pituitary adenoma and the other mass as meningotheliomatous meningioma. We present clinical, radiological, and histopathological findings and discuss previously reported cases of coincidental pituitary adenoma and meningioma without irradiation. This is the first case report since the advent of CT that pituitary adenoma and parasellar meningioma in contact with each other could be clearly demonstrated by CT.
Postoperative Oculomotor Palsy Due to Vasospasm in a Patient with a Ruptured Internal Carotid Artery Aneurysm: A Case Report
Authors: Kudo Tadashi 
Published: May 2010

Abstract
Postoperative oculomotor palsy is not uncommon in patients with aneurysm, but delayed postoperative peripheral oculomotor palsy due to vasospasm has not been reported. This paper presents such a patient. Oculomotor palsy was successfully treated with volume therapy. The importance of recognizing this entity and initiating appropriate treatment for vasospasm as soon as possible in order to prevent permanent deficit is emphasized.
Neurogenic Pulmonary Edema Associated with Ruptured Intracranial Aneurysm: Case Report
Authors: Yabumoto Michio , Kuriyama Tsuyoshi , Iwamoto Munehisa , Kinoshita Tatsuyuki 
Published: May 2010

Abstract
A case of ruptured distal anterior cerebral artery aneurysm associated with neurogenic pulmonary edema is presented. It is suggested that this association should not be accepted as a “taboo” for radical intervention followed by a proper management of ventilation with positive end-expiratory pressure to maintain the anesthetic condition. Cardiorespiratory control is essential in cases of pulmonary edema with ruptured aneurysm. Decompression and evacuation of blood clot surrounding the hypothalamus could subdue the hyperadrenosympathetic discharge that may cause neurogenic pulmonary edema.
Anterior Approach and Osteosynthesis for Recent Fractures of the Pedicles of the Axis
Authors: Lesoin F. , Pellerin P. , Villette L. , Jomin M. 
Published: May 2010

Abstract
The authors report their experiences using the anterior approach and osteosynthesis for recent fractures of the pedicles of the axis in eight patients. They describe the transcervical transclival approach and osteosynthesis and discuss the advantages of and indications for this approach. (Neurosurgery 19:374-377, 1986)
Further Experience Utilizing the Gildenberg Technique for Computed Tomography-guided Stereotactic Biopsies
Authors: Bullard Dennis E. , Osborne Dennis , Burger Peter C. , Nashold Blaine S. 
Published: May 2010

Abstract
Initial experience using the Gildenberg technique for computed tomography-guided stereotactic biopsies is reviewed. Of 50 patients, adequate tissue was obtained in 49. In one patient, the stereotactic frame was unable to reach the selected biopsy site. In 32 of 49 patients, the diagnosis was obtained with one biopsy: in the remainder, two to five samples were required. In 4 cases, a subsequent craniotomy was performed: these provided similar histopathological tissue and in no case was the diagnosis altered. The lesions were categorized by CT as ring-enhancing lesions (REL), enhancing lesions with surrounding low density (ELLD), and low density lesions with and without peripheral areas of enhancement. Of the REL, 21 of 23 were primary tumors. Of the ELLD, 5 of 13 were primary tumors: the remainder had a wide spectrum of disease. Of the low density lesions without enhancement, 6 were primary tumors and 1 was an inflammatory process. Three patients had low density lesions with peripheral areas of enhancement and proved to have malignant primary tumors. The remaining patients had multiple lesions with both primary and metastatic disease. Twelve RELs were biopsied in multiple sites. An accurate diagnosis was best obtained by performing the first biopsy in the enhancing rim with additional biopsies as needed in the low density center. Homogeneous lesions could be biospied with target selection based upon a primary regard for safety rather than imaging characteristics. Three patients had transiently increased hemiparesis and one had a transient decrease in level of consciousness after biopsy. There were no patients with long-term morbidity in this series. From our experience, we believe this technique offers a safe, accurate, and relatively inexpensive alternative for performing-CT-guided intracranial biopsies.