bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distal Anterior Choroidal Artery Aneurysm: Intraoperative Localization and Treatment
Authors: Knuckey Neville W. , Epstein Mel H. , Haas Richard , Sparadeo Frank 
Published: May 2010

Abstract

Distal anterior choroidal artery aneurysms with intraventricular hemorrhage are rare and difficult to treat. We report the case of a 46-year-old woman with a left distal anterior choroidal artery aneurysm presenting as a typical subaraehnoid hemorrhage from which she had no focal neurological signs. Because the aneurysm was located within the dominant deep temporal lobe, we used intraoperative computed tomography to guide a probe to the aneurysm to allow minimal dissection. This is the first report of a successfully treated distal anterior choroidal artery aneurysm. Reports of this unusual aneurysm and methods of approaching deep temporal lesions are reviewed.
Anaplastic Astrocytomas Associated with Previous Radiotherapy: Report of Three Cases
Authors: Dierssen G. , Alvarez G. , Figols J. 
Published: May 2010

Abstract

In a group of 132 patients with malignant astrocytomas treated between 1971 and 1983, there were 3 patients who had received radiotherapy to the head several years before developing the glioma. The cases are described, and the evidence supporting the view that the gliomas might be radiation-induced is discussed.
Bilateral Cholesterol Granuloma of the Skull Base: Case Report and Review of the Literature
Authors: Gamache Francis W. , McLure Thomas , Deck Michael , Linstrom Christopher 
Published: May 2010

Abstract

A unique case of bilateral cholesterol granuloma of the skull base and its treatment is presented. Cholesteatoma, a pathological entity often confused with cholesterol granuloma, is differentiated from cholesterol granuloma. Cholesterol granuloma is not rare. This tumor seems to derive from an inflammatory process at the skull base that results in bony erosion surrounding a cyst wall of inflammatory tissue. Neurological abnormalities reflect the location of the tumor in relation to the brain stem. Radiographically, the cyst wall enhances with the administration of i.v. contrast agent, and the center of the lesion is isodense with brain on computed tomography, unlike cholesteatoma. Magnetic resonance imaging characteristics are currently being defined. At operation, cholesterol granuloma consists primarily of a viscous fluid within a capsule of inflammatory tissue. Treatment requires establishing a pathway for drainage of the granuloma. The advantages of transsphenoidal, transclival drainage of such lesions are outlined.
Intraoperative Ventricular Puncture
Authors: Paine Jonathan T. , Batjer H. Hunt , Samson Duke 
Published: May 2010

Abstract

Modem neuroanesthetic techniques frequently provide the neurosurgeon with adequate brain relaxation for an atraumatic frontotemporal or transylvian dissection. Circumstances such as recent subarachnoid hemorrhage with brain edema and acute hydrocephalus can mandate significant frontal lobe retraction before access to cerebrospinal fluid (CSF) drainage from the basal cisterns is gained. A simple technique can give the “early” aneurysm surgeon reliable access to the frontal horn of the lateral ventricle for intraoperative drainage of CSF before brain retraction.
Zygomaticotemporal Approach to the Basis Cranii and Basilar Artery
Authors: Neil-Dwyer Glenn , Sharr Michael , Haskell Richard , Currie David , Hosseini Massoud 
Published: May 2010

ABSTRACT
When using the zygomaticotemporal approach, one removes the whole of the zygomatic bone with its attachment to the masseter muscle, allowing a lower and more anterior approach to the interpeduncular cistern along the inferomedial surface of the temporal lobe. Minimal brain retraction is required to give an excellent view of the bifurcation of the basilar artery and of the suprasellar region. (Neurosurgery 23:20-22, 1988)
Regrowth Patterns of Glioblastoma Multiforme Related to Planning of Interstitial Brachytherapy Radiation Fields
Authors: Bashir R. , Hochberg F. , Oot R. 
Published: May 2010

ABSTRACT
Recognition of the local nature of glioblastoma has generated an increasing interest in treatment using radioactive implants (interstitial brachytherapy). A key issue in such implantation is the configuration of the radiation field in relation to the resected tumor. In particular, should radiation be provided to the area from which the tumor has been resected? To clarify this issue, we evaluated patterns of tumor regrowth into this resected area in 62 patients. Three patterns of computed tomographic scan-documented tumor regrowth were recognized: preferential (regrowth to refill the resected area only), circumferential (regrowth into the resected area and previously uninvolved contiguous brain) and away (local regrowth into noncontiguous brain, sparing the surgical bed). Regrowth of the tumor 6.3 to 6.8 months after resection was seen in 59 of 62 patients (95.2%). Preferential regrowth was seen in 32 of 62 patients (51.6%), and circumferential regrowth was seen in 27 of 62 patients (43.5%). Regrowth away was seen in 3 of 62 patients (4.8%). Radiation fields planned for interstitial brachytherapy must adequately include the resected area because of the high incidence of tumor regrowth into that area.
Acute Traumatic Atlas Fractures: Management and Long Term Outcome
Authors: Hadley Mark N. , Dickman Curtis A. , Browner Carol M. , Sonntag Volker K. H. 
Published: May 2010

ABSTRACT
Fractures of the 1st cervical vertebra (C1) represent 7% of all acute cervical spine fractures. Isolated atlas fractures are most commonly bilateral or multiple fractures through the ring of C1. Frequently (44% of cases), the atlas will be fractured in combination with the axis. Treatment of isolated C1 fractures should be governed by the rules of Spence. The treatment of combination C1-C2 fractures is dictated by the type and severity of the C2 fracture. Experience with 57 cases of acute atlas fractures is reviewed. Nonoperative external immobilization was used in 53 patients (with 1 failure), and early surgical wiring and fusion were performed in 4 patients. The long term outcome from an atlas fracture is good (median follow-up, 40 months).
Thoracic Intervertebral Disc Herniations: Diagnostic Value of Magnetic Resonance Imaging
Authors: Blumenkopf Bennett 
Published: May 2010

ABSTRACT
Thoracic disc herniation is relatively rare and frequently poses a challenge in clinical diagnosis. These protrusions have been categorized into two major anatomical types and three main clinical syndromes. A number of characteristic radiographic features have been reported. Recently, magnetic resonance imaging (MRI) has gained popularity as a neurodiagnostic imaging tool. A series of nine cases of thoracic intervertebral disc herniation is reported. The clinical aspects of the cases are discussed, and the potential value of spine MRI for thoracic disc herniation diagnosis is emphasized.
Microsurgical Anatomy of the Posterior Fossa Cisterns
Authors: Matsuno Haruo , Rhoton Albert L. , Peace David 
Published: May 2010

ABSTRACT
The microsurgical anatomy of the posterior fossa cisterns was examined in 15 cadavers using 3× to 40× magnification. Liliequist's membrane was found to split into two arachnoidal sheets as it spreads upward from the dorsum sellae: an upper sheet, called the diencephalic membrane, which attaches to the diencephalon at the posterior edge of the mamillary bodies, and a lower sheet, called the mesencephalic membrane, which attaches along the junction of the midbrain and pons. Several other arachnoidal membranes that separate the cisterns were identified. These include the anterior pontine membrane, which separates the prepontine and cerebellopontine cisterns; the lateral pontomesencephalic membrane, which separates the ambient and cerebellopontine cisterns; the medial pontomedullary membrane, which separates the premedullary and prepontine cisterns; and the lateral pontomedullary membrane, which separates the cerebellopontine and cerebellomedullary cisterns. The three cisterns in which the arachnoid trabeculae and membranes are the most dense and present the greatest obstacle at operation are the interpeduncular and quadrigeminal cisterns and the cisterna magna. Numerous arachnoid membranes were found to intersect the oculomotor nerves. The neural and vascular structures in each cistern are reviewed.
Direct Puncture of the Cavernous Sinus for Obliteration of a Recurrent Carotid-Cavernous Fistula
Authors: Teng Michael Mu Huo , Guo Wan-Yuo , Lee Liang-Shong , Chang Tsuen 
Published: May 2010

ABSTRACT
The authors report direct transcutaneous puncture of the cavernous sinus through an intact orbit for embolization of a recurrent carotid-cavernous fistula (CCF) after 10 prior operations. The fistula was obliterated completely with this technique. No significant complication was noted except temporary ptosis for about 2 months. When other approaches are difficult or impossible, this technique can be an alternate way to treat a recurrent CCF after a trapping procedure.
Intracranial Phycomycosis: Case Reports
Authors: Tang Lok-Ming , Ryu Shan-Jin , Chen Tong-Jong , Cheng Shaw-Yi 
Published: May 2010

ABSTRACT
Cerebral phycomycosis is a rare disease. We describe two patients with unusual features of focal intracranial phycomycosis: a diabetic patient with chronic epidural abscess and a healthy individual with an isolated intracerebral abscess. Biopsy established the diagnosis in both patients. Treatment was successful in the patient with intracerebral abscess.
Spinal Subependymoma Presenting as an Extramedullary Tumor: Case Report
Authors: Matsumura Akira , Hori Akira , Spoerri Otto 
Published: May 2010

ABSTRACT
A rare case of cervicothoracic subependymoma in a 25-year-old man is described. The tumor appeared as an extramedullary mass lesion, but a discrete, less well-demarcated portion was observed in the lateral part of the cord at the T2 level. Previous reports of spinal subependymomas are reviewed, and nosological possibilities of extramedullary presentation are discussed.
Unusual Clinical Presentation of a Presumed Pineal Germinoma with Two Disseminated Lesions
Authors: Nakano Shinichi , Uehara Hisao , Kinoshita Kazuo 
Published: May 2010

ABSTRACT
We report a case of a presumed pineal germinoma in a 28-year-old man. Although the pineal body, the presumed primary lesion, was small, there were two disseminated tumors, one in the posterior fossa and the other in the left parietal region. The initial symptom was cerebellar ataxia. These two disseminated tumors had attachments to the inferior surface of the cerebellar tentorium and the dura mater of the parietal convexity, respectively, and they were fed by external carotid artery branches, like meningiomas. Neither angiography nor magnetic resonance imaging could provide the differential diagnosis between germinoma and meningioma. Computed tomographic scanning revealed slight enlargement of the pineal body suggestive of a germinoma.
Isolated Hypoglossal Nerve Palsy Due to Metastatic Germinoma in the Neck: A Ventriculoatrial Shunt-related Complication
Authors: Woo Edmund , Yu Yuk-Ling 
Published: May 2010

ABSTRACT
A 12-year-old boy with suprasellar germinoma was treated with a right-sided ventriculoatrial shunt at diagnosis. He subsequently developed a metastatic neck mass that presented with an isolated right hypoglossal nerve palsy. Radiological investigations showed a vascular tumor and thrombosis of the right internal jugular vein. It is hypothesized that thrombosis at the venous inflow channel allowed local proliferation of the tumor cells that exited from the intracranial cavity via the shunt.
Magnetic Resonance Imaging in the Diagnosis and Treatment of Lhermitte-Duclos Disease (Dysplastic Gangliocytoma of the Cerebellum)
Authors: Reeder Ralph F. , Saunders Richard L. , Roberts David W. , Fratkin Jonathan D. , Cromwell Laurence D. 
Published: May 2010

ABSTRACT
Lhermitte-Duclos disease is a rare disorder characterized by a slowly enlarging mass lesion in the cerebellum. The pathophysiology of the disease is poorly understood, but recent reports have suggested that a clinically significant mass may recur many years after total gross removal of the tumor. Computed tomography and angiography have been relatively insensitive in imaging the tumor either at presentation or during the postoperative period. The authors present three patients with histologically proven Lhermitte-Duclos disease who have undergone magnetic resonance imaging (MRI). In the first case, preoperative T1- and T2-weighted images clearly demonstrated the location and extent of the lesion, which was verified at operation. In the other two cases, only postoperative images were obtained. These demonstrated the extent of residual tumor and indicate a high probability of lesion expansion during periods of 4 and 10 years, respectively. We conclude that MRI is an important tool in both the diagnosis and the treatment of patients with Lhermitte-Duclos disease.
Facial Nerve Palsy Secondary to a Dural Cavernous Angioma of the Middle Cranial Fossa Eroding the Tegmen Tympani
Authors: Pozzati Eugenio , Giuliani Giuliano , Ferracini Romano , Gaist Giulio 
Published: May 2010

ABSTRACT
A patient with a dural cavernous angioma of the middle cranial fossa eroding the tegmen tympani and causing an isolated palsy of the facial nerve is presented. The rarity of this lesion is stressed, as are the peculiar clinical findings and the magnetic resonance imaging.
Transient Late Magnetic Resonance Imaging Changes Suggesting Progression of Brain Stem Glioma: Implications for Entry Criteria for Phase II Trials
Authors: Longee Darryl C. , Friedman Henry S. , Djang William T. , Halperin Edward , Schold Clifford S. , Oakes Jerry W. 
Published: May 2010

ABSTRACT
An 8-year-old boy was treated with irradiation (66 Gy) for a brain stem glioma. Five months after the completion of radiotherapy, magnetic resonance imaging demonstrated apparent tumor progression despite the patient's neurological improvement. The child continued to improve, with subsequent radiographic evidence of tumor regression, without additional therapeutic intervention. The evaluations of response and recurrence of brain tumors as well as entry criteria for Phase II studies are discussed.
Transoral Removal of Missile Fragments from the C1-C2 Area: Report of Four Cases
Authors: Mangiardi John R. , Alleva Michael , Dynia Richard , Zubowski Robert 
Published: May 2010

ABSTRACT
Low velocity firearm damage to the upper cervical spine without neurological deficit occurs infrequently. Four cases of gunshot fragments involving the anterior elements of C1 and C2 are presented. In all four cases, the fragments were removed via a transoral approach without neurological complications or mechanical instability.
Prolonged Therapeutic External Ventricular Drainage: A Prospective Study
Authors: Chan Kwan-Hon , Mann Kirpal S. 
Published: May 2010

Abstract
Over a 2½-year period, 34 patients underwent therapeutic external ventricular drainage with a valve-regulated system. The mean duration of drainage was 16 days. There was no incidence of ventricular infection, nor was there blockage of the ventricular catheter requiring revision. Eventually, 13 patients required ventriculoperitoneal shunts. All survivors remained free from complications after more than 6 months of follow-up. The system proved safe and reliable in patients requiring prolonged ventricular drainage.
Cavernous Malformations of the Spinal Cord
Authors: McCormick Paul C. , Michelsen Jost W. , Post Kalmon D. , Carmel Peter W. , Stein Bennett M. 
Published: May 2010

Abstract
Six patients with intramedullary cavernous malformations of the spinal cord are presented. Four men and two women presented with acute, subacute, or episodic signs and symptoms of spinal cord dysfunction, ranging in duration from 3 days to 25 years. All patients underwent operative resection of the malformation. Complete removal was achieved in five patients. Neurological function either stabilized or improved postoperatively in all patients; follow-up ranged from 4 to 84 months. The increasing awareness of the propensity for recurrent hemorrhage, clinical features, and resectability of these malformations are discussed.
Treatment of Extraneural Metastatic Medulloblastoma with a Combination of Cyclophosphamide, Adriamycin, and Vincristine
Authors: Chamberlain Marc C. , Silver Pamela , Edwards Michael S. B. , Levin Victor A. 
Published: May 2010

Abstract
Seven patients with extraneural metastases from medulloblastoma were treated with a combination of cytoxan, adriamycin, and vincristine (CAV). None of the patients had evidence of active neural axis disease. All patients with bone metastases responded with a reduction in bone pain and improvement on the radionuclide bone scan. One patient presenting with lymph node metastases showed initial reduction in the size of the palpable nodes. In this group, the median time to the development of extraneural metastasis was 18 months from the time of original diagnosis of central nervous system medulloblastoma. The median duration of response to CAV, after extraneural metastasis, was 17 months (4-65 months). Four of seven patients died of disease-related causes, one patient presumed well was lost to follow-up, and two of seven are still without evidence of active disease at 37 and 65 months. The combination of CAV is well tolerated and provides reasonably good palliation for extraneural medulloblastoma.
Unruptured Cerebral Arteriovenous Malformations Presenting with Intracranial Hypertension
Authors: Barrow Daniel L. 
Published: May 2010

Abstract
Two cases of unruptured pial arteriovenous malformations (AVMs) presenting with intracranial hypertension and papilledema are reported. In the absence of previous hemorrhage or associated hydrocephalus, such a manifestation of pial AVMs is quite unusual. Both patients experienced prompt and sustained resolution of papilledema after surgical removal of the malformation. One case was complicated by the normal perfusion pressure breakthrough phenomenon postoperatively. The pathophysiology of intracranial hypertension associated with unruptured pial AVMs and the relationship to pseudotumor cerebri are discussed.
Surgical Excision of a Cavernous Hemangioma of the Rostral Brain Stem: Case Report
Authors: Ondra Stephen L. , Doty James R. , Mahla Michael E. , George Eugene D. 
Published: May 2010

Abstract
A 23-year-old pregnant woman presented with sudden diplopia, ataxia, hemiparesis, and headache secondary to a brain stem hemorrhage. Magnetic resonance imaging (MRI) revealed a hematoma associated with a probable cavernous hemangioma of the rostral brain stem. In this report, we discuss the MRI findings leading to the preoperative diagnosis, as well as the surgical techniques involved in the successful resection.
Cavernous Sinus Syndrome as the Presentation of Malignant Lymphoma: Case Report and Review of the Literature
Authors: Delpassand Ebrahim S. , Kirkpatrick Joel B. 
Published: May 2010

Abstract
Cavernous sinus syndrome (CSS) is an unusual presentation of malignant lymphoma. We report a patient with lymphoma that presented with CSS, and we review the literature on nine other reported cases. Sharp retroorbital pain, paresthesia around the orbit, and complete 6th nerve palsy were dominant presenting symptoms. In all cases, the tumor developed on the right side. The computed tomographic scan was abnormal in only two of the nine patients during the early stages of the disease. The dominant histological type was large cell lymphoma. The mean age of the patients was 45 years. The mean survival time after the first presenting symptom was 8.7 months. Two of the reported patients as well as our patient had disseminated disease, which became evident at autopsy.
Tension Pneumocephalus after Transsphenoidal Surgery: Case Report
Authors: Altinörs Nur , Arda Nuri , Kars Zafer , Türker Ayhan , Şenveli Engin , Çepoğlu Cengiz , Çinar Nusret 
Published: May 2010

Abstract
The authors present a patient who underwent transsphenoidal surgery for a pituitary adenoma and afterward developed late, severe rhinorrhea and tension pneumocephalus. The patient was treated conservatively.
Presentation and Management of Pediatric Chiari Malformations without Myelodysplasia
Authors: Dyste Gregg N. , Menezes Arnold H. 
Published: May 2010

Abstract
Chiari malformations without myelodysplasia are rarely diagnosed in the pediatric age group. With current neurodiagnostic techniques, however, they are being seen more frequently. Unfortunately, the prognosis is not clear because publications have included a number of different entities, used a variety of surgical approaches, and lacked long term follow-up. Sixteen patients younger than 20 years were treated for Chiari malformations (without myelodysplasia) between 1975 and 1985. The average age was 11 years, and the average duration of symptoms was 20 months. The common symptoms were isolated motor weakness (56%), pain (37.5%), and sensory loss (25%). Frequently seen signs were motor deficit (81%), sensory loss (50%), scoliosis (50%), and cranial nerve palsy (50%). The surgical procedures used were foramen magnum decompression (3 transoral clivus odontoid resections and 15 posterior fossa decompressions with dural grafting), alteration of cerebrospinal fluid (CSF) pathways at the cervicomedullary junction (plugging the foramen cecum and a 4th ventricle to subarachnoid shunt with posterior fossa decompression), and ventriculoperitoneal shunting (2 cases). In follow-up, 37.5% of the patients are asymptomatic, 50% are improved, and 12.5% are stable after an average follow-up period of 43 months. The asymptomatic group was younger (9.3 years) and had a shorter symptom duration (7.2 months) than both the improved (11.9 years, 16.4 months) and the stable groups (15 years, 20 months). Optimal outcome depends on complete evaluation of the abnormal CSF pathways and bony abnormalities at the craniovertebral junction. Operation is then directed toward correction of these abnormalities as delineated radiographically. Of our patients, 87.5% have at least shown improvement, which has been long term in all cases.
Thrombosed Arteriovenous Malformations: A Type of Occult Vascular Malformation
Authors: Ebeling John D. , Tranmer Bruce I. , Davis Kathleen A. , Kindt Glenn W. , DeMasters B. K. 
Published: May 2010

Abstract
Thrombosed arteriovenous malformations (AVMs) are the predominant type of occult vascular malformation and do not seem to differ significantly in clinical or radiographic presentation from other types of occult vascular malformations. Thrombosed AVMs and occult vascular malformations occasionally present with symptoms secondary to subacute or occult hemorrhage that requires operation. The histopathology of thrombosed AVMs and occult vascular malformations does not seem to have prognostic significance. Five patients with histologically verified thrombosed AVMs are reported. Two patients had previous incomplete resection of histologically proven thrombosed AVMs and presented with recurrence and bleeding. Two patients presented with seizures and headaches, and one patient presented with hemiparesis and headache. All histology specimens had evidence of hemorrhage. The pathological findings of these lesions seem variable; two specimens contained a mixture of cavernous angioma and AVM. Two previously resected lesions had been defined histologically as thrombosed AVMs. Successful excision of the lesions was accomplished in four patients, and one patient had stereotactic biopsy. The magnetic resonance imaging characteristics of lesions seem to add a degree of specificity over computed tomography and angiography. We have found that the literature poorly describes the natural history and histology of these lesions. Conservative management for seizures and headaches due to thrombosed AVMs may not be warranted because of a propensity for hemorrhage and recurrence.