bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lumbar Synovial or Ganglion Cysts
Authors: Kjerulf Terrell D. , Terry Daniel W. , Boubelik Richard J. 
Published: May 2010

Abstract
Most reports regarding synovial cysts of the spinal canal have been presentations identifying an unusual pathological entity that is to be included in the differential diagnosis of cauda equina compression syndromes. Most of the 26 cases reported represent isolated examples of this pathological process. We present five cases of lumbar synovial cysts encountered in our practice in the past 8 years. Patients with lumbar synovial cysts do not demonstrate any predictable clinical picture. They may present with a unilateral sciatica or neurogenic claudication. Lumbar extension is usually restricted, whereas flexion is full. Mechanical signs of nerve root entrapment or lumbosacral plexus irritation are unimpressive. Neurological deficits are usually mild, if present. Radiological findings include degenerative spondylosis, spondylolisthesis, and a rounded posterolateral extradural mass of low attenuation value adjacent to a facet shown on computed tomographic scan. The etiology of lumbar synovial cysts is not known. Histological findings of myxoid degeneration, microcystic change, calcification, and hemosiderin deposits suggest that chronic microtrauma with occasional focal hemorrhage may play a major role in the etiology of the cysts. With resection of the cyst, the postoperative course is usually uneventful. Recurrences have not yet been encountered in our patients.
Congenital Supratentorial and Infratentorial Peripheral Neurogenic Tumor: A Clinical, Ultrastructural, and Immunohistochemical Study
Authors: Moss David S. , Haines Stephen J. , Leonard Arnold S. , Dehner Louis P. 
Published: May 2010

Abstract
Congenital neoplasms of the central nervous system are extremely rare, although they have been well documented since the earliest reports from the mid-19th century. Medulloblastoma, other primitive neuroectodermal tumors, and various types of gliomas have comprised the majority of cases. This report describes a highly unusual infratentorial and supratentorial tumor presenting as a scalp mass in a neonate who experienced in utero distress. The supratentorial mass extended through a defect in the skull to the parietooccipital lobe, and the infratentorial aspect involved the 9th and 10th cranial nerves in the region of the cerebellopontine angle. A complex spindle cell neoplasm incorporating peripheral nerve sheath and vascular characteristics was further characterized by electron microscopy and immunohistochemistry. Based upon these studies, the tumor was interpreted as a congenital schwannoma with divergent vascular differentiation. The child has been tumor-free for approximately 2 years after the initial operative procedure.
Late Intracranial Metastasis from Esthesioneuroblastoma: Case Report and Review of the Literature
Authors: Rodas Raul A. , Erkman-Balis Bayzar , Cahill David W. 
Published: May 2010

Abstract
Review of the literature reveals much disparity regarding the incidence, natural history, and survival rate in patients harboring esthesioneuroblastoma (olfactory neuroblastoma). The metastatic tendencies of this tumor have been highly variable in the literature. and reported intracranial involvement has been via local extension from the tumor's origin near the cribiform plate. Our present case describes a metastasis of esthesioneuroblastoma to the right parietal cortex and meninges in a patient without evidence of local recurrence after combined surgical and radiation therapy 5 years previously. The broad spectrum of biological behavior of this tumor, and its response to various therapies are discussed. The immunohistochemical and ultrastructural features of this unusual tumor are also presented. Recommendations are made for the management of these patients, including regular serial neurological examinations, serial computed axial tomography or magnetic resonance imaging of the head and neck, and, in the initial management, chemotherapy.
Fusiform Basilar Artery Aneurysm in a 33-Month-Old Child
Authors: Little John R. , Larkins Mark V. , LÜders Hans , Hahn Joseph F. , Erenberg Gerald 
Published: May 2010

Abstract
A 33-month-old girl presented with acute subarachnoid hemorrhage from a ruptured multilobulated fusiform aneurysm of the midbasilar artery. This rare lesion was treated surgically by occluding the basilar artery. Intraoperative brain stem auditory evoked potential and somatosensory evoked potential monitoring results did not change with basilar artery occlusion, suggesting that the occlusion would be tolerated. However, the amplitudes of brain stem auditory evoked potential Waves III-V to right ear stimulation were transiently reduced during left pontine retraction during the aneurysm exposure. The patient made a complete clinical recovery.
Models of Spinal Cord Injury: Part 2
Authors: Harvey Kushner , Ronald S. Markowitz , Alan Mechanic , Perry Black 
Published: May 2010

Abstract
A mathematical model was constructed to predict motor performance in rats for 8 weeks after spinal cord injury. The model is based on experimental data generated from an investigation of the static-load technique of inducing cord injury and was derived using multiple linear regression. The regression coefficients for weight of the injury-producing load were statistically significant (P &lt; 0.001), and it was found that the weight of the load contributes over 95% of the posttrauma motor deficit, whereas the time duration of the load resting on the cord contributes less than 5% to the deficit. Sex, pretrauma motor performance, and pretrauma body weight are insignificant covariates. The model may be used to establish expected motor deficits and to derive dose-response curves.
Reactive Gliosis Simulating Butterfly Glioma: A Neuroradiological Case Study
Authors: Craig Cazenave , Steven Reid , Chat Virapongse , Stephen Hunter 
Published: May 2010

Abstract
Reactive gliosis was found in a 40-year-old man who presented with intractable seizures thought to be due to a malignant neoplasm. Although two separate lesions located bilaterally in the frontal lobes were evident on the computed tomographic scan, a connection between these lesions along the fibers of the corpus callosum was clearly demonstrated on T2-weighted magnetic resonance images. The unusual radiological appearance of this gliosis, which simulated a malignant butterfly glioma on magnetic resonance imaging (MRI), is reported. Because MRI is still a new modality, its images should be interpreted with judicious caution.
Case-Control Study of Clinical Outcome after Aneurysmal Subarachnoid Hemorrhage
Authors: Brott Thomas , Mandybur Thaddeus I. 
Published: May 2010

Abstract
The clinical and neuropathological features of 84 nonsurvivors of aneurysmal subarachnoid hemorrhage (consecutive autopsy series) were compared with those of 51 survivors (consecutive clinical series). The groups differed significantly in the type of bleeding: 58% of the nonsurvivors had massive subarachnoid hemorrhage (MSAH) compared to 10% of the survivors (P &lt; 0.00001); 54% of the nonsurvivors had intraventricular hemorrhage (IVH) compared to 29% of the survivors (P &lt; 0.008); 45% of the nonsurvivors had intracerebral hematoma (ICH) compared to 8% of the survivors (P &lt; 0.00001). Only 1 of the 19 patients with both MSAH and ICH survived. The incidence of cerebral infarction was similar in nonsurvivors (31%) and survivors (29%). In the absence of associated MSAH, IVH, or ICH, cerebral infarction was uncommon (11%). Documented in-hospital rebleeding was uncommon in nonsurvivors (13%) and survivors (2%). Admission neurological status did not predict outcome independent of the extent of the initial bleeding. Comparison of the two groups suggests that the type and extent of initial bleeding are the most important determinants of mortality in aneurysmal subarachnoid hemorrhage.
Inflammatory Lesions of the Basal Ganglia and Thalamus: Review of Twenty-one Cases
Authors: Bhatia Ravi , Tandon Prakash , Misra Nalini Kant 
Published: May 2010

Abstract
We report a series of 21 patients with basal ganglia and thalamic granulomas or abscesses treated over 7 years. Among them, 15 were tubercular, 5 were pyogenic, and 1 was fungal. Pyogenic abscesses, usually hematogenous, also occurred secondary to osteomyelitis of the skull and chronic otitis media. The fungal abscess developed in a nonimmunocompromised patient with no intercurrent malignancy. Evidence of tuberculosis elsewhere in the body was detected in only 7 patients with tuberculomas. The computed tomographic (CT) image morphology characterizing an abscess or a tuberculoma was present in all except 2 patients with tuberculomas. The fungal abscess resembled a malignant glioma. The only hospital mortality occurred in a deeply unconscious patient with a thalamic pyogenic abscess. A 12-month or longer follow-up in 16 patients showed that 3 continued to be handicapped neurologically, and 2 died 13 and 16 months later, respectively. We conclude that inflammatory lesions at these sites are not uncommon and that CT scans are diagnostic in the great majority. Doubtful diagnosis merits stereotactic aspiration or biopsy of the lesion. Satisfactory results follow adequate medical therapy.
Superficial Temporal Artery to Proximal Middle Cerebral Artery Anastomosis: Clinical and Angiographic Long Term Results
Authors: Collice Massimo , Arena Orazio , Fontana Romero A. 
Published: May 2010

Abstract
Anastomosis of the superficial temporal artery (STA) with a proximal segment of the middle cerebral artery (MCA) has been proposed as a new cerebral revascularization technique alternative to the conventional bypass on the cortical surface. We introduced this procedure in our surgical practice in 1982 for patients with internal carotid artery (ICA) aneurysms not suitable for direct repair in whom occlusion of the ICA is considered necessary. One patient died because a conventional STA-MCA bypass did not prevent a major stroke caused by a therapeutic ICA occlusion. We are reporting our surgical technique and the immediate and long term clinical and angiographic results in five cases operated on during the period June 19, 1982, through January 19, 1983. The early and late patency rates were good. No neurological complications were observed after the bypass procedure or during a 3-year follow-up period. In our opinion, the use of proximal segments of the MCA as recipient arteries for supratentorial revascularization is a good alternative to the use of cortical surface arteries and, in selected cases, could be the first choice technique.
Subarachnoid Hemorrhage with Normal Cerebral Angiography: A Prospective Study on Sellar Abnormalities and Pituitary Function
Authors: Bjerre Per , Henrik VidebÆk , JÖrgen Lindholm 
Published: May 2010

Abstract
Ten consecutive patients with subarachnoid hemorrhage (SAH) of unknown cause were examined for sellar abnormalities and pituitary dysfunction. The diagnosis of SAH rested on a typical history and the demonstration of blood in the cerebrospinal fluid (computed tomography (CT), lumbar puncture). Initial CT and four-vessel angiography were performed in all patients, and five had repeat angiography. Endocrinological assessment was done after the initial angiography, and abnormal findings from this first study were reassessed 3 months later. The follow-up study included a high resolution CT scan of the sellar region. One patient had panhypopituitarism. Insufficient growth hormone secretion alone or combined with a low plasma concentration of estradiol or testosterone was found in another seven patients. The sella was ballooned or enlarged in three patients, and four patients had at follow-up a partly empty sella. A spontaneous development of a partly empty sella from an adenoma with suprasellar extension was observed in the patient with panhypopituitarism. This patient had experienced pituitary apoplexy with resulting SAH. Based on sellar enlargement, an empty sella, and pituitary dysfunction, this pathogenesis was suggested in another three patients. Our findings suggest that hemorrhagic necrosis in a pituitary adenoma may be an important cause of SAH with normal angiography.
Interstitial Brachytherapy of Malignant Brain Tumors Using Computed Tomography-guided Stereotaxis and Available Imaging Software: Technical Report
Authors: Coffey Robert J. , Friedman William A. 
Published: May 2010

Abstract
The implantation of radioactive sources into malignant intraaxial brain tumors, interstitial brachytherapy, is a theoretically attractive treatment for these nearly uniformly fatal lesions. Optimal application of this treatment modality requires careful preoperative planning, computer-assisted dosimetry, and computed tomography-guided stereotactic implantation of the isotope-bearing catheters. A method is presented by which available computed tomographic imaging software can be used with a standard radiotherapy treatment planning computer and the Brown-Roberts-Wells stereotactic system for preoperative imaging, dosimetry planning, and brachytherapy catheter insertion. Dedicated computer facilities are not required, making this method available to any neurosurgeon with access to a current generation computed tomographic scanner.
Meningioma Associated with Aneurysm and Subarachnoid Hemorrhage: Case Report and Review of the Literature
Authors: Bloomgarden Gary M. , Byrne Thomas N. , Spencer Dennis D. , Heafner Michael D. 
Published: May 2010

Abstract
A patient presented with spontaneous subarachnoid hemorrhage after a prolonged episode of coughing. A preoperative computed tomographic (CT) scan confirmed subarachnoid hemorrhage, but demonstrated no other lesion. Arteriography revealed an ophthalmic artery aneurysm. Operation revealed the aneurysm to be intracavernous without sign of prior rupture; however, a small hemorrhagic meningioma was removed from the ipsilateral anterior clinoid process. In this case, coincidental meningioma and aneurysm presented as a subarachnoid hemorrhage secondary to tumor hemorrhage. The follow-up of cases of subarachnoid hemorrhage with negative arteriography with sequential CT scans is discussed.
Benign Osteoblastoma of the Clivus Removed by a Transoral Approach: Case Report
Authors: Di Lorenzo Nicola , Palatinsky Emanuel , Bardella Lia , Maleci Alberto 
Published: May 2010

Abstract
A case of benign osteoblastoma of the lower clivus is reported. The clinical and radiological features and the surgical rationale for the transoral approach are briefly discussed.
Hemodynamic Method to Predict Whether Hunterian Ligation of the Basilar Artery Will Lead to Thrombosis of Basilar Bifurcation Aneurysms
Authors: Chang Jack , Roach Margot R. 
Published: May 2010

Abstract
In some cases, basilar artery aneurysms cannot be repaired surgically and the basilar artery is occluded near the neck of the aneurysm to stop flow into the aneurysm. After the operation, the aneurysm can fill only by flow through the posterior communicating arteries (PCoAs). Hemodynamically, if the flow were the same in both PCoAs and there were no phase lag in the pressures, there would be no pressure gradient for flow to go across the neck of the aneurysm and therefore the aneurysm would thrombose. We have assumed that the diameter of the artery is roughly proportional to the flow that goes through it chronically. We measured the diameters of the PCoAs in 25 patients who had hunterian ligation of the basilar artery. We also measured the maximal width, height, and depth of the aneurysms on angiograms obtained before and after operation. Eleven aneurysms thrombosed completely and had a diameter ratio of &gt; 0.6; 10 aneurysms thrombosed partially and had a diameter ratio of 0.46 ˜ 1.0; 4 aneurysms did not change and had a diameter ratio of &lt;0.45. The ratio of the sizes of the PCoAs pre- and postoperatively was comparable in most cases, so we believe that it is possible to predict reasonably accurately from this simple measurement whether the aneurysm is likely to thrombose if the basilar artery is ligated.
New Kneeling Attachment and Cushioned Face Rest for Spinal Surgery
Authors: Ray Charles D. 
Published: May 2010

Abstract
Surgical frames, kneeling attachments, and special operating tables for lumbar spinal surgery are designed to promote good positioning, lower the intraabdominal pressure, and reduce epidural bleeding. The frame reported here fulfills these objectives and produces either lumbar spinal extension to reduce paraspinal muscle tension or mild flexion to distract the neural arches. The new frame unit is made of lightweight fiberglass and aluminum, weighing only 14 lb (6.5 kg), and utilizes the hydraulic elevator pump of the operating table as a means to raise or lower the frame. Thus, adjusting the horizontal plane of the lumbar spine requires no separate crank system. The anterior tibial cushions, lying in hemicylindrical troughs, and the ergonomically designed cushions for chest and buttocks improve the distribution of body weight. A new, fully adjustable, cushioned face rest is used to maintain the neck in a neutral position, with the patient placed fully face-down.
Autogeneic Skull Bone Grafts to Reconstruct Large or Complex Skull Defects in Children and Adolescents
Authors: Edwards Michael S. B. , Ousterhout Douglas K. 
Published: May 2010

Abstract
Autogeneic split or free skull bone grafts harvested at the time of operation were used to repair large or complex skull defects in 19 children; in 2 children, autogeneic fresh rib grafts were also used. Follow-up examinations for periods of 1 and 7 years showed that the use of autogeneic grafts is superior to the use of materials such as acrylic or metals for cranioplasty in children.
Direct Delivery of Medication into a Brain Tumor through Multiple Chronically Implanted Catheters
Authors: Bouvier Guy , Penn Richard D. , Kroin Jeffrey S. , Beique Rene , Guerard Marie Jose 
Published: May 2010

Abstract
A recurrent malignant glioma was treated with cisplatin delivered directly into the tumor. The drug was delivered via 68 small catheters distributed evenly throughout the tumor area. Each catheter was connected to an osmotic minipump that delivered 0.5 ml of drug solution each hour for 10 days. There were no side effects from the catheter implantation, chemotherapy, or catheter removal. Although the chemotherapy halted progression of the tumor, it recurred, and the patient died 6 months after treatment.
Diagnostic Value of Computed Tomography in Recurrent Pain after Discectomy
Authors: Schell Gerald R. , Modesti Luciano M. , Cacayorin Edwin D. 
Published: May 2010

Abstract
Intravenously enhanced computed tomography (CT) was used in patients in whom the differential diagnosis between recurrent herniated disc and postoperative scar was considered. Enhanced CT images demonstrated postoperative herniated discs more accurately than clinical criteria, myelography, or plain or postmetrizamide CT. The scar tissue shows contrast enhancement, but recurrent disc herniation does not. Therefore, contrast-enhanced CT is considered to be a valuable aid in distinguishing between recurrent disc herniation and hypertropic scar formation.
Successful Removal of Air Gun Bullets from the Third Ventricle
Authors: Kojima Tadashi , Waga Shiro , Kubo Yoshichika , Shimizu Takeo 
Published: May 2010

Abstract
A patient with air gun bullets in the 3rd ventricle associated with delayed ventricular hemorrhage is presented. Through an anterior transcallosal approach, the surgeon successfully removed the bullets without any significant permanent sequelae.
Acute Brain Swelling during Evacuation of Subdural Hematoma Caused by Delayed Contralateral Extradural Hematoma: Report of Two Cases
Authors: Meguro Kotoo , Kobayashi Eiki , Maki Yutaka 
Published: May 2010

Abstract
Two patients experienced severe brain swelling during the evacuation of acute subdural hematomas. Postoperative computed tomographic (CT) scans revealed delayed extradural hematomas on the sides opposite the subdural hematomas. Extradural bleeding occurred in the area of the fractured skull. One patient improved neurologically after evacuation of the extradural hematoma, and the other was not operated because he was moribund. Drilling exploratory burr holes in the fractured area may have been a better strategy than awaiting a postoperative CT scan. The reduction of intracranial pressure after the removal of subdural hematoma was postulated to be the most important factor contributing to the formation of the extradural hematoma.
Factors Affecting Survival of Children with Malignant Gliomas
Authors: Al-Mefty Ossama , Al-Rodhan Nayef R. F. , Phillips Robert L. , El-Senossi Mohammed , Fox John L. 
Published: May 2010

Abstract
Forty-four patients (23 male and 21 female, aged 2 to 20 years (mean, 9.6)), harboring pathologically proven malignant glioma (Grades III and IV) were treated between 1976 and 1985. Tumor sites included the cerebral hemisphere (26 patients), thalamus (6 cases), brain stem (7 cases), and the cerebellum (5 cases). All patients underwent operation and initial treatment with steroids. Irradiation was given in 35 patients; 3 had adjuvant chemotherapy. At the time of study, 22 were deceased. The longest period of follow-up was 65 months. Survival curves were calculated from the date of the first visit to the date of the last evaluation or death. The mean survival times were 30 months for all patients, 14 months for cerebellar cases, 17 months for brain stem cases, 26 months for thalamic cases, and 33 months for cerebral hemisphere cases. However, the differences between mean survival times were not statistically significant. The patient's age was the single most significant factor, with those 5 to 10 years old having the worst survival curve (P= 0.0036). Irradiation was associated with an improved mean survival time (34 vs. 19 months); however, this was not statistically significant (P= 0.15). Girls had shorter mean survival times than boys (16.5 vs. 37 months, P= 0.0511). Otherwise, there was no clinical or radiological factor that indicated a better prognosis. This was also confirmed by x2analyses comparing 72 factors between patients with more than 24 months of survival and those with less than 24 months of survival. In particular, tumor size (greater or less than 5 cm), the presence of neurological deficits, the level of consciousness, increased intracranial pressure, hydrocephalus, calcium or cyst on a computed tomographic scan, and histological grading (III or IV) showed no significant correlations.
Stereotactic Resection of Juvenile Pilocytic Astrocytomas of the Thalamus and Basal Ganglia
Authors: McGirr Stephen J. , Kelly Patrick J. , Scheithauer Bernd W. 
Published: May 2010

Abstract
Six patients with juvenile pilocytic astrocytomas of the thalamus or basal ganglia underwent seven computer-assisted stereotactic laser craniotomies with complete or nearly complete removal of the tumor in all cases. The tumor was located in the right basal ganglia in one patient, the left basal ganglia in one patient, and the left thalamus in four patients. Postoperative assessment of the completeness of tumor removal was confirmed by contrast-enhanced computed tomographic scanning within the first 2 weeks after operation. None of the patients was neurologically worse after the procedure, and five were improved. The duration of follow-up ranged from 6 months to 3.5 years. In this group of patients, the computer-assisted, stereotactically guided resection of these deeply located, benign tumors was accomplished with no morbidity or mortality.