bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adult Onset of Tethered Spinal Cord Syndrome Due to Fibrous Diastematomyelia: Case Report
Authors: Chehrazi Bahram , Haldeman Scott 
Published: May 2010

Abstract
Adult onset of the symptoms of tethered spinal cord is a rare entity that is occasionally associated with diastematomyelia. Only one case of fibrous diastematomyelia in an adult has been reported. The fibrous nature of this disease may present a diagnostic difficulty. A 32-year-old man with the adult onset of impairment of sacral functions with lumbar fibrous diastematomyelia is reported. Surgical release of the spinal cord was followed by improvement of the patient's function.
Cerebral Etiology of Acute Mountain Sickness: A Case Report
Authors: Wohns Richard N. W. , Colpitts Michael , Clement Tom , Karuza Anton 
Published: May 2010

Abstract
The authors report a case of acute mountain sickness (AMS) experienced by a support member of the Ultima Thule Everest Expedition. The subject arrived at the 17,000-ft base camp by truck and then developed the symptoms of AMS over the following 72 hours. Flash-induced visual evoked responses (VERs), tetrapolar impedance pulmonary plethysmography, and oxygen saturation measurements were performed. These changed from normal before the onset of his symptoms to abnormal during the height of the symptoms and reverted to normal after treatment. This is the first reported case of AMS monitored with VERs. It has been postulated that AMS may be an early form of cerebral edema, and this report corroborates this hypothesis.
Symptomatic Rathke's Cleft Cysts Located Entirely in the Suprasellar Region: Review of Diagnosis, Management, and Pathogenesis
Authors: Barrow Daniel L. , Spector Robert H. , Takei Yoshio , Tindall George T. 
Published: May 2010

Abstract
Three cases of an entirely suprasellar symptomatic Rathke's cleft cyst, two of which were associated with normal sella turcicas, are reported. In all cases, the cysts caused compression of the optic chiasm, and two produced hypothalamic dysfunction. The diagnosis of these entirely suprasellar masses was enhanced by metrizamide cisternography. Two cases were treated by frontal craniotomy and one was treated transsphenoidally, with good results in all cases. The radiology, pathology, and surgical treatment of these unusual cases is presented. An embryological pathogenesis for the occurrence of an entirely suprasellar Rathke's cleft cyst is discussed.
Tuberous Sclerosis with an Atypical Radiological Skull Change: Case Report
Authors: Terada Tomoaki , Nakai Ekini , Moriwaki Hiroshi , Hayashi Seiji , Komai Norihiko 
Published: May 2010

Abstract
The authors describe a case of tuberous sclerosis with atypical radiological skull change in a 8-year-old Japanese child. A plain roentgenogram showed thinning and convolution of the left occipital bone, and a cortical tuber adjacent to the thinned bone was shown by computed tomography. This kind of skull change may suggest the existence of a cortical tuber in patients with tuberous sclerosis, although this finding has not been reported previously, The mechanism of this skull change is discussed.
Ruptured Intracranial Aneurysms in Cases of Sickle Cell Anemia
Authors: Love Lucy C. , Mickle Parker J. , Sypert George W. 
Published: May 2010

Abstract
The authors present two cases of ruptured cerebral aneurysms in patients with sickle cell anemia. Only three previous cases with similar presentations have been reported. The various complications of sickle cell anemia and ruptured aneurysms are reviewed. The importance of early aggressive adjunctive medical management, including the use of partial exchange transfusions and surgical intervention, is emphasized.
Metastasis of an Occult Gastric Carcinoma Suggesting Growth of a Prolactinoma during Bromocriptine Therapy: A Case Report with a Review of the Literature
Authors: van Seters Arnoud P. , Bots Gerard T.A.M. , van Dulken Hans , Luyendijk Willem , Vielvoye Jan G. 
Published: May 2010

Abstract
The treatment of a slowly growing invasive prolactinoma with bromocriptine for 8 months resulted in a substantial decrease in plasma prolactin levels despite rapid suprasellar tumor expansion. On exploration, this uncommon observation could be attributed to hematogenous metastasis from an occult gastric adenocarcinoma to the pituitary tumor. Apart from infiltration of neighboring parts of the hypothalamus, autopsy revealed no other hematogenous metastases. This extraordinary type of neoplasm-to-neoplasm metastasis was not shown by computed tomography. This possibility should be considered whenever progressive growth of a pituitary mass is accompanied by a decrease in hormonal overproduction.
Bifrontal Osteoplastic Craniotomy Utilizing the Anterior Wall of the Frontal Sinus: Technical Note
Authors: Colohan A.R.T. , Jane J.A. , Park T.S. , Persing J.A. 
Published: May 2010

Abstract
There are various flaps for bifrontal exposure of the anterior fossa classically described in the neurosurgical literature. This article describes a bifrontal split osteoplastic flap that is characterized by removal of the anterior wall of the frontal sinus without the placement of burr holes on the external surface of the frontal bone. The procedure is safe and rapid, gives the same exposure as other techniques, and allows a superior cosmetic result.
Aneurysms of the Distal Posterior Inferior Cerebellar Artery: Experience with Three Cases and Review of the Literature
Authors: Nishizaki Tomoyuki , Tamaki Norihiko , Nishida Yoshimitsu , Fujita Katsuzo , Matsumoto Satoshi 
Published: May 2010

Abstract
We report 3 surgically treated aneurysms of the distal posterior inferior cerebellar artery (PICA) and review 36 cases in the literature. More than half of the distal PICA aneurysms arose distal to the choroidal arch. These lesions often arose at a turning point (i.e., a hairpin curve) of an artery instead of at a junction of vessels. Distal PICA aneurysms are likely to be missed and it is necessary to investigate carefully with four-vessel angiography even if computed tomography is done. Eighty-two per cent of the surgically treated 39 patients had good recoveries and 8% had fair results. The mortality rate was 10%. Although clipping of the aneurysm neck is preferable, trapping is useful when neck clipping is impossible in segments distal to the choroidal arch.
Synovial Cyst of a Cervical Facet Joint: Case Report
Authors: Cartwright Mont J. , Nehls Daniel G. , Carrion Carlos A. , Spetzler Robert F. 
Published: May 2010

Abstract
Intraspinal synovial cysts are rare. Those reported have occurred in the lumbar region. We report a case of an extradural true synovial cyst of the cevical spine causing spastic paraparesis. The cyst occurred after a cervical spine fracture and, hence, was probably related to trauma. Surgical therapy resulted in a satisfactory recovery.
Multiple Intracranial Arteriovenous Malformations: Case Report
Authors: Zellem Ronald T. , Buchheit William A. 
Published: May 2010

Abstract
The authors describe a case of multiple supratentorial intracranial arteriovenous malformations in a patient with a family history of cerebrovascular disease. There was no sign of any other vascular dysplasia. A brief review of this rare entity is given. (Neurosurgery 17:88-93, 1985)
Use of Acrylic in Anterior Cervical Discectomy: Technical Note
Authors: Alemo-Hammad Saeid 
Published: May 2010

Abstract
Acrylic was inserted into the intervertebral space after anterior cervical discectomy in five patients. The application of the acrylic was simple and quick to perform and atraumatic to the patient. The intervertebral space was preserved satisfactorily and consistently in all five patients. With this technique, the complications associated with bone grafts can be avoided. (Neurosurgery 17:94-96, 1985)
The Chymopapain Clinical Trials
Authors: Haines Stephen J. 
Published: May 2010

Abstract
The three published randomized clinical trials of chymopapain injection vs. placebo injection for the treatment of herniated lumbar discs are reviewed. Despite some differences, the similarities in selection criteria, technique, and outcome assessment are great enough to justify pooling the results to obtain an overall assessment of chymopapain efficacy. These pooled results suggest that the odds of successful outcome (at least some improvement in symptoms after injection) are 2.6 times as great with chymopapain injection as those after placebo injection. This corresponds to a 50% greater probability of success with chymopapain than with placebo or a 23% increase in the number of patients successfully treated with chemonucleolysis over those successfully treated with placebo. The fact that data from 234 patients evaluated in randomized clinical trials could resolve a controversy over therapeutic efficacy that the uncontrolled evaluation of over 20,000 patients could not answer suggests that the current controversy over the relative efficacy of chymopapain and discectomy should be studied in the same way. The difficulties of such a study are discussed. (Neurosurgery 17:107-110, 1985)
Moyamoya-like Diseases Associated with Ventricular Hemorrhages: Report of Three Cases
Authors: Sato Masaharu , Kohama Akitsugu , Fukuda Atsuhiro , Tanaka Shigeru , Fukunaga Masao , Morita Rikushi 
Published: May 2010

Abstract
Three rare cases of moyamoya-like diseases with moyamoya type vessels caused by spontaneous internal carotid artery occlusion, spontaneous middle cerebral artery occlusion, and internal carotid artery occlusion due to cervical irradiation are presented. They resulted in ventricular hemorrhages. One patient died and two survived. Postoperatively, the collateral circulation of the survivors was evaluated by single photon emission tomography using N-isopropyl-[123I]-p-iodoamphetamine. The effectiveness of reconstructive surgery is shown, and moyamoya-like diseases that have been reported are reviewed.
Complications of Cerebral Revascularization with Autogenous Vein Grafts
Authors: Diaz Fernando G. , Pearce Jeffrey , Ausman James I. 
Published: May 2010

Abstract
Autogenous veins were used for cerebral revascularization 29 times. There were 17 long grafts to the cortex and 12 shorter grafts for reconstruction of cervical vessels. Of the long cortical grafts, 5 occluded and 3 patients developed intracerebral hemorrhage. With the shorter grafts, all remained patent and there were no hemorrhagic complications. A combination of a relatively low flow rate and endothelial damage in the graft was thought to be largely responsible for early graft failure. Revascularization of an infarct and hypertension were implicated in cases with intracerebral hemorrhage.
Axis Fractures: A Comprehensive Review of Management and Treatment in 107 Cases
Authors: Hadley Mark N. , Browner Carol , Sonntag Volker K.H. 
Published: May 2010

Abstract
The combination of movement, location, and anatomy of the axis predisposes it to multiple and varied fracture/dislocations distinct from other vertebrae. We examine all forms of axis fractures and address the appropriate treatment for each specific fracture type. In a retrospective review of 625 cervical spine fractures during an 8-year period, we found 107 axis fractures. There were 25 hangman's fractures (23%), 59 odontoid fractures (55%), and 23 miscellaneous fractures (22%), Each case was characterized by age, sex, the presence of associated injuries, presenting symptoms and findings, initial treatment, and results of that treatment. Excluding 6 early deaths, 90 of 101 patients were located for a median follow-up of 3.2 years. We found that 17% of cervical fractures involve the axis. Axis fractures have a high association with head and other cervical spine injuries, 40% and 18%, respectively. Few neurological deficits result from a fracture of the 2nd cervical vertebra. Hangman's fractures are effectively treated with external stabilization, preferably with a halo vest. We noted a shorter period of treatment using the halo vest as compared to the SOMI brace. Nonunion occurred in 26% of odontoid Type II fractures, but occurred in 67% of those with dens displacement of 6 mm or greater, regardless of age or direction of dislocation. We recommend early surgical therapy for this subgroup. There is no correlation between age and the rate of nonunion. In patients with odontoid Type II fractures with dens displacement of 0 to 5 mm, fusion occurs with external stabilization alone. Odontoid Type III fractures are one-half as common as Type II fractures, and all heal well with external stabilization. Twenty-two per cent of acute axis fractures are not hangman's or odontoid fractures. Miscellaneous fractures of the axis generally do well with external stabilization and immobilization.
Paranasal Sinusitis: A Common Complication of Nasotracheal Intubation in Neurosurgical Patients
Authors: Deutschman Clifford Scott , Wilton Peter B. , Sinow Jordan , Thienprasit Phudiphorn , Konstantinides Frank N. , Cerra Frank B. 
Published: May 2010

Abstract
Sinusitis secondary to nasotracheal intubation has not been reported to occur in neurosurgical patients. Over a 1-year period, 11 patients admitted to the Intensive Care/Trauma Unit at St. Paul Ramsey Medical Center developed this entity. The mean age of these patients was 36 ± 4 years; 7 were trauma victims, 3 had each had a subarachnoid hemorrhage, and 1 had suffered hypertensive hemorrhage. The patients presented with fever of unknown origin (FUO) and evidence of persistent hypermetabolism without an obvious cause. In 8 cases, the diagnosis was not suspected until mucopurulent nasal discharge was noted. Three additional cases were evaluated for suspected sinusitis before the occurrence of discharge. The mean duration of intubation before the diagnosis of sinusitis was 7.8 ± 1.5 days. The diagnosis was confirmed by sinus films with a Waters view in 7 cases or by computed tomographic scanning in 4 cases and by bacteriological cultures. Two cases involved only the maxillary sinus on the side of intubation; the rest were polysinusites. The organisms involved included gram-positive and gram-negative species; all were polymicrobial with a single organism predominant. Secondary pulmonary involvement was common, and 4 patients revealed a bacteremia consistent with the major sinus organism. One patient developed septic shock. Treatment involved either orotracheal intubation or tracheostomy. This was curative in all cases. It is concluded that neurosurgical patients nasally intubated are at risk for sinusitis, which can have untoward effects such as septicemia or pulmonary infection. A high degree of suspicion will permit early diagnosis and treatment.
High Altitude: An Unusual Cause of Neurological Deterioration in a Patient with an Arteriovenous Malformation
Authors: Tranmer B.I. , Kindt G.W. 
Published: May 2010

Abstract
High altitude associated with neurological deterioration is an unusual presentation for an arteriovenous malformation (AVM). A case report of a man with a left temporal occipital AVM who developed symptoms that were markedly intensified by exposure to high altitude is presented. The AVM was removed surgically, and all symptoms resolved. The pathogenesis of this unusual AVM symptom complex is discussed in this report.
Treatment of Cerebrospinal Fluid and Syringosubarachnoid Shunt Infection with Systemic and Intrathecal Antibiotics
Authors: Tomaszek David E. , Powers Stephen K. 
Published: May 2010

Abstract
We present a case of a patient with two preexisting Silastic syringosubarachnoid shunt catheters who developed Enterobacter meningitis. The infection was treated successfully with systemic and intrathecal antibiotics without removal of the catheters. With careful sequential clinical and laboratory monitoring, even this type of cerebrospinal fluid shunt infection can be eradicated without catheter removal and replacement.
Ipsilateral Sensory Symptoms Caused by a Temporal Lobe Glioma
Authors: Bucci Michael N. , Farhat Saeed M. , Papadopoulos Stephen M. 
Published: May 2010

Abstract
Sensory symptoms can occasionally occur ipsilateral to lesions of the insula. We report a patient with left-sided sensory symptoms preceding the diagnosis of a left temporal lobe glioma. The anatomical basis for this clinical phenomenon is reviewed. This patient illustrates the complex neuroanatomical pathways and the clinical correlations from lesions in this region.
Myelomeningocele Occurring within a Lumbosacral Teratoma: Case Report
Authors: Reid Steven A. , Mickle Parker J. 
Published: May 2010

Abstract
The occurrence of a myelomeningocele completely embodied within a lumbosacral teratoma is extremely rare. We report on the clinical presentation, radiological appearance, surgical treatment, and histological make up of such a lesion.
Lateral Atlantooccipital Dislocation: Case Report
Authors: Watridge Clarence B. , Orrison William W. , Arnold Hendrick , Woods Gregory A. 
Published: May 2010

Abstract
A case of lateral atlantooccipital dislocation is presented, and its successful management is outlined, demonstrating the importance of the physical examination and the utilization of computed tomography. Open reduction and stabilization with direct visualization of the spinal axis is the preferred method of treatment.
Ventriculitis after Metrizamide Lumbar Myelography
Authors: Budny James L. , Hopkins L. N. 
Published: May 2010

Abstract
A 62-year-old man underwent lumbar metrizamide myelography complicated initially by a bout of aseptic chemical meningitis. Afterward, he suffered persistent headache, nausea, and blurred vision and, 12 weeks after his myelography, computed tomographic scans showed abnormalities consistent with a chronic ventriculitis. The case is presented; its pathological substrate and clinical implications are discussed.
Spinal Intradural Ependymal Cyst: A Case Report and Review of the Literature
Authors: Findler Gideon , Hadani Moshe , Tadmor Rina , Bubis Jose J. , Shaked Itzhack , Sahar Abraham 
Published: May 2010

Abstract
Spinal intradural ependymal cysts are extremely rare. The case presented is the sixth reported in the literature. The symptoms are consistent clinically and radiologically with a spinal intradural space-occupying lesion. The cyst wall is lined with both ciliated and nonciliated cells, resting directly on connective tissue. The exact embryonal origin of these cysts is obscure.
Primary Intracranial Chondrosarcoma: A Report of Two Cases
Authors: Adegbite Andrew B. O. , McQueen Donald J. , Paine Kenneth W. E. , Rozdilsky Bohdan 
Published: May 2010

Abstract
Two cases of primary intracranial chondrosarcoma are presented. The cases were similar in that they both arose from the temporal bone, contained both myxomatous tissue and material of cartilaginous consistency, and were avascular. Histological studies excluded the diagnosis of chondroid chordoma. A brief review of the subject is presented.
Unruptured Fusiform Aneurysms of the Posterior Circulation with Thalamic Infarction
Authors: Graff-Radford Neill R. , Adams Harold P. , Smoker Wendy R. K. , Biller José , Boarini David J. 
Published: May 2010

Abstract
Three patients with unruptured fusiform aneurysms of the posterior circulation presented with nonhemorrhagic thalamic infarctions. All of the aneurysms were seen on enhanced computed tomographic (CT) scans preangiographically. Although unruptured fusiform aneurysms are probably a rare cause of nonhemorrhagic thalamic infarction, their importance lies in the therapeutic implications of this diagnosis. In patients with nonhemorrhagic thalamic infarction, we suggest careful scrutiny of the blood vessels on enhanced CT scans.
Concurrent Pineoblastoma and Unilateral Retinoblastoma: A Forme Fruste of Trilateral Retinoblastoma?
Authors: Whittle Ian R. , McClellan Katherine , Martin Frank J. , Johnston Ian H. 
Published: May 2010

Abstract
A 10-month-old boy who presented with strabismus and symptoms of intracranial hypertension was found to have a pineoblastoma and a unilateral ocular retinoblastoma. Despite enucleation of the eye, subtotal removal of the pineoblastoma, and craniospinal axis irradiation, the patient died 6 months later from disseminated intracranial neoplasm. As there was no clinical evidence of bilateral retinoblastoma, this case may represent a forme fruste of the trilateral retinoblastoma complex. The clinicopathological features of this unusual syndrome are reviewed.
Traumatic Intracavernous Carotid Aneurysm with Massive Epistaxis
Authors: Liu Ming-Ying , Shih Chun-Jen , Wang Yeou-Chih , Tsai Shin-Han 
Published: May 2010

Abstract
Five cases of traumatic intracavernous carotid aneurysm are presented. All of the patients were young men with a history of severe head injury. The clinical manifestations were massive epistaxis and an ipsilateral cavernous sinus syndrome. The diagnosis was made correctly by carotid angiography. All of the patients developed another episode of massive epistaxis after admission. Emergency trapping of the internal carotid artery was performed. An urgent rescue method was used in one of our patients to prevent exsanguination before definitive surgical treatment. One patient died of exsanguination in spite of emergency ligation of the internal carotid artery. In the other four patients, no epistaxis was experienced after the operation.
Expanded Role of the Cerebrospinal Fluid Reservoir in Neurooncology: Indications, Causes of Revision, and Complications
Authors: Machado Miguel , Salcman Michael , Kaplan Richard S. , Montgomery Elizabeth 
Published: May 2010

Abstract
Advances in chemotherapy have increased the indications for insertion of cerebrospinal fluid (CSF) reservoirs in the treatment of both primary and secondary central nervous system neoplasia. There have been no recent evaluations of the current indications and complications of this procedure in a general neurooncology practice. We undertook a retrospective review of our total experience of 60 patients who were implanted with CSF reservoirs between November 1977 and October 1983. The mean age of those implanted was 38 years (range, 22 months to 79 years). The reasons for insertion were: drug instillation, 35 cases (58.3%); drug level monitoring, 15 cases (25.0%); intermittent tumor cyst drainage, 6 cases (15.0%); and syrinx drainage, 1 case (1.6%). Drug level monitoring was most often done in conjunction with specific experimental chemotherapy protocols. There were no complications after primary insertion. but 9 of 60 reservoirs (15%) required revision for technical failure. Revision was much more likely to occur in the presence of an intracranial mass lesion (7 of 34. or 20.5%). The revision rate in cases of meningeal carcinomatosis was only 7.6% (2 of 26). Patients requiring revision included 5 with glioblastoma, 2 with metastatic tumors. and 2 with meningeal carcinomatosis. Four of the 9 patients requiring revisions developed complications (44%). There were three infections with positive CSF cultures and one subdural hematoma. Infected patients included those with multiple craniotomies. prior cranial irradiation. or some form of chemotherapy. We conclude that primary insertion of a CSF reservoir in a patient with neoplastic involvement of the central nervous system is extremely safe, that technical failure tends to occur in the presence of mass lesions, and that the complication rate of repeated insertion is quite high.
Topographic Electroencephalographic Study with Power Ratio Index Mapping in Patients with Malignant Brain Tumors
Authors: Nagata Ken , Gross Cordell E. , Kindt Glenn W. , Geier J. Michael , Adey Geoffrey R. 
Published: May 2010

Abstract
A variant of electroencephalogram (EEG) power spectral mapping called power ratio index (PRI) mapping was used to monitor 15 patients with malignant brain tumors. This index is generated by dividing the low frequency (delta, theta) power by the high frequency (alpha, beta) power. Because the nonparoxysmal effect of a brain tumor on the EEG is reflected as a relative loss of high frequency power and a gain in low frequency power, utilization of the PRI has the effect of placing the epicenter of the “power dysfunction” coincident with the epicenter of the tumor.