bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcranial Stab Wounds: A Report of Three Cases and Suggestions for Management
Authors: Herring Carl J. , Lumsden Alan B. , Tindall Suzie C. 
Published: May 2010

Abstract
Transcranial stab wounds are uncommon. Three such cases are presented. The severity of the wounds may vary from innocuous to devastating. Skull films are useful in delineating the depth of penetration. The presence of the knife blade in situ may make the computed tomographic scan impossible to perform or difficult to interpret. Cerebral angiography may be indicated if injury to a major cerebral vessel is suspected or if the patient suffers a delayed subarachnoid or intracerebral hemorrhage. Provided that the patient's clinical status indicates a positive prognosis, transcranial stab wounds should be explored surgically. The weapon should be removed in the operating room immediately before or at the time of operation.
Trigeminal Depressor Response during Percutaneous Microcompression of the Trigeminal Ganglion for Trigeminal Neuralgia
Authors: Brown Jeffrey A. , Preul Mark C. 
Published: May 2010

Abstract
Percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia was performed 23 times on 21 patients. Significant abrupt drops in heart rate and blood pressure (P &lt; 0.0002) occurred when the needle entered the foramen ovale or upon balloon advancement or inflation. In 16 of 23 (70%) procedures, the heart rate fell abruptly to 60 or less, by a mean of 38%. Mean arterial blood pressure decreased transiently by 31% during 12 of 23 (55%) procedures. Our findings of transient bradycardia and hypotension upon mechanical stimulation or compression of the mandibular nerve or trigeminal ganglion show for the first time the presence of a trigeminal depressor response in humans. We recommend that heart rate and arterial blood pressure be monitored continuously during percutaneous microcompression of the trigeminal ganglion. Intravenous atropine should be available for immediate use, and an external pacemaker should be fitted preoperatively.
Spontaneous Remission of Paralysis Due to Spinal Extradural Hematoma: Case Report
Authors: Emery D. J. , Cochrane D. D. 
Published: May 2010

Abstract
Spontaneous spinal extradural hematoma is an uncommon cause of cord compression and paraplegia. The clinical presentation of this entity is uniform, with sudden pain followed by sensory and motor dysfunction. Unlike other considerations in the differential diagnosis of cord compression, here the pain and clinical deficit may remit suddenly and spontaneously. This feature may obscure the diagnosis of an organic cause for cord dysfunction. This report describes a patient whose extradural hematoma was caused by hemorrhage from an arteriovenous malformation. Dramatic reduction of his pain and paralysis followed myelography.
Surgery of Petroclival Meningiomas: Report of 24 Cases
Authors: Samii Madjid , Ammirati Mario , Mahran Ahmed , Bini Walter , Sepehrnia Abholgasse 
Published: May 2010

Abstract
Twenty-four patients with petroclival meningiomas were operated upon at the neurosurgical clinic of the City Hospital of Hannover between 1978 and 1987. Seventeen were women and seven men; the mean age was 45 years. Symptoms were usually present for more than 2 years before the diagnosis was made. The most common symptom was disturbance of gait; the most common preoperative sign was cranial nerve deficit, mainly of the 7th and 8th nerves. Preoperative neuroradiological evaluation included computed tomography and four-vessel cerebral angiography. Fifteen patients (62%) had a tumor larger than 2.5 cm in its major diameter. The surgical approaches used were the retromastoid, pterional, subtemporal, and combined retromastoid-subtemporal. We developed a modification of the retromastoid-subtemporal approach with preservation of the transverse sinus and used this in the last 2 patients. There was no postoperative death; 11 patients (46%) suffered postoperative complications, mainly in the form of cranial nerve deficits, often reversible. “Total” tumor removal was achieved in 17 patients (71%). Twenty patients (83%) were independent at the time of discharge from the hospital. With accurate neuroradiological evaluation, careful choice of the surgical approach, and sound application of microsurgical techniques, petroclival meningiomas may be “totally” and safely resected in a significant number of patients.
Histiocytosis X of the Hypothalamus
Authors: Ober K. Patrick , Alexander Eben , Challa Venkata R. , Ferree Carolyn , Elster Allen 
Published: May 2010

Abstract
An 18-year-old woman presented with visual disturbance and endocrine dysfunction (diabetes insipidus, delayed puberty, hypothyroidism, hypoadrenalism, and hyperprolactinemia). Computed tomography and enhanced cisternography showed a single hypothalamic mass, which proved at biopsy to be histiocytosis X. Further studies showed the disease to be restricted to the hypothalamus. The patient was treated with hormonal replacement therapy, but her visual acuity continued to worsen. Visual acuity improved after low-dose irradiation of the pituitary fossa and hypothalamus, which also led to disappearance of the mass. This case shows that localized hypothalamic histiocytosis X can be diagnosed and treated successfully before other systems become involved.
Spinal Cord Compression: A Complication of Silicone-Coated Dacron Dural Grafts. Report of Two Cases
Authors: Gomez Heldo , Little John R. 
Published: May 2010

Abstract
Two case reports of compression of the cervical spinal cord associated with silicone-coated Dacron dural grafts are presented. In both cases, the cervical spinal cord was distorted and compressed by an intense tissue reaction that encapsulated the synthetic graft. At least two factors are thought to play a role in precipitating this reaction: (1) the introduction of surface contaminants into the wound, and (2) repeated motion at the graft site.
Stereotactic Radiosurgery of the Brain Using the First United States 201 Cobalt-60 Source Gamma Knife
Authors: Lunsford L. Dade , Flickinger John , Lindner Glenn , Maitz Ann 
Published: May 2010

Abstract
The first United States 201 cobalt-60 source gamma knife for stereotactic radiosurgery of brain tumors and arteriovenous malformations became operational at the University of Pittsburgh on August 14, 1987. Four and one-half years of intensive planning, regulatory agency review, and analysis of published results preceded the first radiosurgical procedure. Installation of this 18,000-kg device and loading of the 201 cobalt-60 sources posed major challenges in engineering, architecture, and radiophysics. In the first 4 months of operation, we treated 52 patients (29 with arteriovenous malformations, 19 with extra-axial neoplasms of the skull base, and 4 with intra-axial malignant tumors). Most patients either had lesions considered “inoperable” or had residual lesions after attempted surgical resection. Neither surgical mortality nor significant morbidity was associated with gamma knife radiosurgery. As compared with treatment by conventional intracranial surgery (craniotomy), the average length of stay for radiosurgery was reduced by 4 to 14 days, and hospital charges were reduced by as much as 65%. Based on both the previously published results of treatment of more than 2,000 patients worldwide and on our initial clinical experience, we believe that gamma knife stereotactic radiosurgery is a therapeutically effective and economically sound alternative to more conventional neurosurgical procedures, in selected cases.
Critical Analysis of Extensive Cervical Laminectomy
Authors: Ishida Yoshihiro , Suzuki Kazuhiro , Ohmori Kazuo , Kikata Yoji , Hattori Yoshiaki 
Published: May 2010

Abstract
Conventional extensive laminectomy has been widely performed to reduce spinal cord compression, and is greatly facilitated by the use of an air drill. Laminectomy is recognized, however, as the occasional cause of problems after surgery, such as spinal instability or deformity, acceleration of spondylotic change, constriction of the dura mater caused by extradural scar formation, and lack of posterior bony protection for the spinal cord. In an effort to eliminate these negative aspects of conventional laminectomy, a surgical technique called suspension laminotomy has been used. Fiftyfive patients treated with conventional extensive laminectomy and 55 others treated with suspension laminotomy were followed up clinically and compared. Flexibility and alignment of the cervical spine were assessed by plane radiographs, and dural configuration by computed tomographic scans. Neurologic improvement was also evaluated. Decrease of spinal movement after laminectomy was observed, notably during extension, probably as a result of functional insufficiency of paraspinal muscles. The incidence of postoperative spinal deformity was lower and the relief of dural constriction better in the patients treated with suspension laminotomy than in those treated with conventional laminectomy. Neurological recovery was significantly better in fully decompressed cases than in insufficiently decompressed cases.
Magnetic Resonance Imaging after Closed Head Injury in Children
Authors: Levin Harvey S. , Amparo Eugenio G. , Eisenberg Howard M. , Miner Michael E. , High Walter M. , Ewing-Cobbs Linda , Fletcher Jack M. , Guinto Faustino C. 
Published: May 2010

Abstract
Magnetic resonance imaging (MRI) was performed in a series of 21 children and adolescents who had been hospitalized after sustaining closed head injuries of varying severity at least 6 months previously. Areas of high intensity in the parenchyma were present in 8 of the 11 severely injured patients, whereas MRI findings were normal in all 10 patients with mild-to-moderate head injuries. Lesions involving the subcortical white matter were confined to severely injured patients whose clinical features were compatible with diffuse axonal injury. Neuropsychological assessment disclosed deficits primarily in the severely injured patients; these deficits were significantly associated with persistent lesions visualized by MRI. Serial MRI and neurobehavioral assessment following early injury may be useful in documenting cognitive impairment in relation to structural alterations of the young brain.
Ectopic Prolactinoma within the Sphenoid Sinus
Authors: Heitzmann Anne , Jan Michel , Lecomte Pierre , Ruchoux Marie-Magdeleine , Lhuintre Yves , Tillet Yves 
Published: May 2010

Abstract
A case of an ectopic prolactin-producing tumor located within the sphenoid sinus is reported. It was discovered in a girl who experienced secondary amenorrhea without galactorrhea. We discuss the different diagnoses proposed before immunocytochemical staining results were available. This case presented unusual radiological, surgical, and histopathological aspects.
Stereotactic Radiosurgery with the Linear Accelerator: Treatment of Arteriovenous Malformations
Authors: Betti Osvaldo O. , Munari Claudio , Rosler Roberto 
Published: May 2010

Abstract
An original stereotactic radiosurgical approach coupling a) Talairach's stereotactic methodology, b) a specially devised mechanical system, and c) a linear accelerator is detailed. The authors present their preliminary results on 66 patients with nonsurgical intracranial arteriovenous malformations. The doses delivered for treatment varied from 20 to 70 Gy. Doses of no more than 40 Gy were used in 80% of patients. An angiographic study was performed when the computed tomographic scan controls showed relevant modifications of the lesion volume. Total obliteration was obtained in 27 of the 41 patients (65.8%) who were followed up for at least 24 months. The percentage of the cured patients is significantly higher when a) the entire malformation is included in the 75% isodose (96%) and b) the maximum diameter of the lesion is less than 12 mm (81%). Two patients died of rebleeding at 18 and 29 months after treatment.
An Orbitocranial Approach to Complex Aneurysms of the Anterior Circulation
Authors: Smith Robert R. , Al-Mefty Ossama , Middleton Troy H. 
Published: May 2010

Abstract
A surgical approach to the skull base was developed in cadavers and then used in the treatment of patients with complex aneurysms of the anterior circulation. The operative method involves removal of portions of the orbital rim, orbital roof, and sphenoid bone. By removing the orbital rim and a portion of the orbital roof, multidirectional viewing is possible. This is important when dealing with the anterior aspect of the cavernous sinus and anterior clinoid process, as must frequently be done when isolating the neck of an ophthalmic aneurysm. The optic canal is opened wide and the optic nerve mobilized, allowing resection of the dura propria covering the cavernous carotid artery. Clip placement is performed in an anteroposterior plane, thus lessening the chance for compromise of the internal carotid artery. The low approach alleviates brain retraction and the small flap minimizes brain exposure. The approach also allows preservation of the arterial and neural supply to the frontalis and temporalis muscles, thereby preventing postoperative cosmetic deficits. During the past year and a half, this approach has been employed in 25 patients with difficult aneurysms of the anterior circulation. The difficulties of these cases stemmed from their odd location, size, or complex anatomy. Although periorbital edema may have been more severe during the first postoperative week, overall improved cosmesis was achieved.
Intracranial Meningiomas in the Aged: Surgical Outcome in the Era of Computed Tomography
Authors: Awad Issam A. , Kalfas Iain , Awad Joseph F. , Awad John R. 
Published: May 2010

ABSTRACT
Seventy-five patients older than 60 years of age underwent surgical resection of intracranial meningiomas during a 10-year period at a single institution. All patients had a computed tomographic scan preoperatively, and all were followed for at least 3 months postoperatively. There were 50 patients 61 to 70 years of age (Group A), and 25 patients older than 70 years (Group B). Sixteen patients (21%) were asymptomatic, and no patient was severely disabled preoperatively. Operative morbidity and mortality and outcome at 3 months were assessed and correlated with age, preoperative neurological status, and tumor size and location. Operative mortality was 6.6% (6% in Group A; 8% in Group B). Perioperative morbidity (including medical and surgical complications and worsening in neurological status) was 48% (46% in Group A; 52% in Group B). Neurological status 3 months after surgery was improved by at least one grade as compared to before surgery in 40% of patients (38% in Group A; 44% in Group B), unchanged in 29% (34% in Group A; 20% in Group B), and worsened in 31% (28% in Group A; 36% in Group B). While nearly half of the patients were asymptomatic 3 months after surgery, 11 patients (15%) had died or remained seriously disabled. Outcome at 3 months correlated significantly with low neurological grade preoperatively and with a tumor location over the cortical convexity. There was no significant correlation with age or tumor size. We conclude that resection of intracranial meningiomas is associated with significant morbidity and mortality in the elderly. Figures from large series of mostly younger patients with meningiomas do not reflect surgical outcome in the aged. The best outcome is seen in patients who do not have advanced neurological symptoms preoperatively and in patients with meningioma location in the cortical convexity.
Intracranial Plasma Cell Granuloma
Authors: Gangemi Michelangelo , Maiuri Francesco , Giamundo Arcangelo , Donati Pierarturo , De Chiara Annarosaria 
Published: May 2010

ABSTRACT
An exceptional case of intracranial plasma cell granuloma, located in the right frontoparietal convexity in a 16-year-old boy is reported. Reports of these rare inflammatory lesions locate them primarily in the lungs and in other regions of the body, and only exceptionally in the nervous system; indeed, only three intracranial cases and one other arising from the spinal meninges have been reported. The computed tomographic and surgical aspects suggested a falx meningioma in our case. The pathological diagnosis differentiating these from other intracranial lesions with a plasma cell component, including meningioma with plasma cell infiltration and plasmacytoma, is discussed.
Occult Intrasacral Meningocele: Clinical and Radiographic Diagnosis
Authors: Doty James R. , Thomson Jeffrey , Simonds Gary , Rengachary Setti S. , Gunby E. Neal 
Published: May 2010

ABSTRACT
We evaluated four patients who had occult intrasacral meningocele with multimodality radiographic imaging techniques. The clinical features, radiological findings, gross appearances of the lesion at surgery, surgical technique, histopathological features of the cyst wall, and surgical outcome are described. The role of magnetic resonance imaging in the preoperative evaluation compared with standard radiographic techniques is discussed. Theories regarding the pathogenesis of this lesion are reviewed.
The Incidence and Significance of Hemostatic Abnormalities in Patients with Head Injuries
Authors: Olson John D. , Kaufman Howard H. , Moake Joel , O'Gorman Thomas W. , Hoots Keith , Wagner Karen , Brown Kice C. , Gildenberg Philip L. 
Published: May 2010

Abstract
Abnormal coagulation and fibrinolysis is a frequent complication in patients with head injury. This complication can be severe enough to lead to hemorrhage or thrombosis. A study was undertaken to determine if the hemostatic abnormalities are reliable indicators of outcome. Hemostasis in 269 patients with head injuries alone was screened using platelet count (PC), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin clotting time (TCT), fibrinogen assay (FIB), level of fibrin-fibrinogen degradation products (FDP), and disseminated intravascular coagulation (DIC) score in the first 24 hours after injury. Test results were compared with the outcome (discharged or dead) in the entire group and in subgroups divided on the basis of the severity of injury as determined by the Glasgow coma score (GCS). Increased consumptive coagulopathy at admission, as reflected in the DIC score, predicts the outcome of head-injured patients with a high degree of accuracy. The degree of increase of the initial FDP level and prolongation of TCT also correlated positively with the outcome. Prolongation of the APTT correlated strongly with unfavorable outcome in a large group of patients, and in a small group, markedly accelerated APTT also predicted death. Stepwise logistic regression analysis demonstrated that GCS, FDP level, and DIC score predicted outcome. Other tests did not provide additional predictive value. Abnormal hemostasis frequently complicates the course of patients with head injuries. This study demonstrates that hemostasis tests are predictors of outcome in these patients.
The Microsurgical Anatomy of the Infratentorial Lateral Supracerebellar Approach to the Trigeminal Nerve for Tic Douloureux
Authors: Matsushima Toshio , Fukui Masashi , Suzuki Satoshi , Rhoton Albert L. 
Published: May 2010

ABSTRACT
The increasing use of microsurgical decompression for trigeminal neuralgia has created a need for more detailed anatomical information about the approach. To define better this anatomy, 10 cerebellar specimens obtained at autopsy were examined, and intraoperative findings in 30 patients with trigeminal neuralgia were analyzed. Since the infratentorial subdural space on the tentorial cerebellar surface is exposed to explore the trigeminal nerve in the infratentorial lateral supracerebellar approach, attention was directed to the following: the anterolateral margin of the cerebellar hemisphere, bridging veins on the tentorial surface, superior petrosal veins, and relationships between blood vessels and the trigeminal nerve. The lateral mesencephalic segment of the superior cerebellar artery at or near the bifurcation often compressed the nerve laterally at more than one point. With this approach, the relationship of the superior cerebellar artery to the nerve could be observed from the medial side of the tentorial surface. The infratentorial lateral supracerebellar approach is discussed and compared to Dandy's cerebellar route.
Firing Tests on Clay-Rich Raw Materials from the Algarve Basin (Southern Portugal): Study of Mineral Transformations with Temperature
Authors: Trindade Maria José , Dias Maria Isabel , Coroado João , Rocha Fernando 
Published: May 2010

AbstractIn cases where the provenance of raw materials used in the manufacture of local archeological ceramics is of interest, a detailed study of thermal transformations of minerals may be useful. The purpose of this study was to measure mineralogical transformations of different types of clays obtained during experimental firing runs, carried out at different temperatures, with the main goal of establishing Algarve reference groups based on the composition of raw material and high-temperature mineralogy, which may be compared with ceramics in studies of provenance. Eleven samples of clay-rich raw materials from the Algarve Basin (southern Portugal) were fired to temperatures ranging from 300 to 1100°C in increments of 100°C under oxidizing conditions. These were chosen to have variable chemical and mineralogical compositions, representing the main compositional range of the clay deposits from the region. Mineralogical and geochemical characterizations of the original clays were carried out by X-ray diffraction (XRD) and X-ray fluorescence (XRF), respectively. Mineral transformations on the fired products were also studied by XRD.Three groups of clays were distinguished according to the type of neoformed high-temperature minerals: (1) non-calcareous clays; (2) clays containing calcite as the only carbonate; and (3) clays with dolomite or dolomite + calcite. Firing of non-calcareous clays produced mullite at 1100–1200°C. Gehlenite and wollastonite formed by firing calcite-rich clays above 900°C, accompanied by anorthite or larnite in samples with small or large calcite contents, respectively. Firing of dolomite-rich clays at temperatures >900°C yielded a member of the gehlenite-åkermanite group and diopside. Anorthite, enstatite, periclase, forsterite, and monticellite may also form in the firing products.
The Role of H3O+ in the Crystal Structure of Illite
Authors: Nieto Fernando , Mellini Marcello , Abad Isabel 
Published: May 2010

AbstractIn spite of decades of research on the subject, the crystal structure of illite is still poorly understood. The purpose of this study was to address this problem by investigating the nature of the interlayer content in illite IMt-2 from Silver Hill, Montana, using analytical transmission electron microscopy (ATEM), thermogravimetry (TG), and X-ray powder diffraction (XRPD) analyses. The ATEM data, together with literature and TG results, yielded the formula K0.70a0.01(H2O)0.42 (Al1.53Fe2+0.06Fe3+0.19Mg0.28)Σ−2.06(Si3.44Al0.56)O10(OH)2 or, assuming the presence of H3O+, K0.69Na0.01(H3O)+0.28(Al1.47Fe2+0.06Fe3+0.19Mg0.28)Σ−1.99(Si3.40Al0.60)O10(OH)2. The first formula indicates surplus interlayer and octahedral species, whereas the second shows no excess. The XRPD data were refined by Rietveld techniques, down to an Rp factor of 10.48–13.8%. The mineral composition consists largely of illite-2M1, illite-1M, and minor quartz. Although the refinement accuracy is limited by the intrinsic poor quality diffraction of the illites, the partially refined model is consistent with the chemical composition; in particular, attempts to introduce octahedral cations in excess of 2 were fruitless. All the results support the simple structural model, by which the illite structure strictly corresponds to a dioctahedral mica with H3O+ replacing K. As a consequence, the crystalchemical formula of illites should be calculated on the basis of six tetrahedral plus octahedral cations.