bluuebunny/crossref_metadata_2025_split huggingface dataset:
High Dose Fentanyl-Oxygen Anesthesia for Intracranial Mycotic Aneurysm Surgery: A Clinical Report
Authors: Shupak Robert C. , Rosenwasser Robert H. , Harp James R. 
Published: May 2010

Abstract
The resection of a mycotic aneurysm in a patient with concurrent cardiac valvular disease was carried out successfully using high dose fentanyl-oxygen anesthesia followed by immediate postoperative naloxone reversal. The technique and benefits of this type of anesthesia in neurosurgical procedures are discussed.
Modification of the Gouda Frame to Allow Stereotactic Biopsy of the Brain Using the GE 8800 Computed Tomographic Scanner
Authors: Gouda Kasim I. , Freidberg Stephen R. , Larsen Carl R. , Baker Richard A. , Silverman Mark L. 
Published: May 2010

Abstract
The Gouda stereotactic frame has been modified to interface with the GE 8800 scanner. The patient, attached to the frame, is scanned and then moved to the operating room for a stereotactic biopsy. This is a safe, accurate method of obtaining biopsy specimens of otherwise inaccessible tumors of the brain.
Cushing's Disease in Childhood: Benign Intracranial Hypertension after Trans-sphenoidal Adenomectomy
Authors: Weissman Mark N. , Page Larry K. , Bejar Raphael L. 
Published: May 2010

Abstract
A 7-year-old girl presented with the physical and endocrinological stigmata of Cushing's disease. An adrenocorticotropic hormone (ACTH)-producing pituitary microadenoma was excised. Three weeks after trans-sphenoidal adenomectomy, the patient developed benign intracranial hypertension. Although ACTH levels had decreased to normal, the serum cortisol had fallen to subnormal levels. The child responded to exogenous steroid therapy, which was gradually tapered and discontinued after 5 months. Normal pituitary and adrenal functions persist 2 years later.
Atypical and Polymorphic Angioblastic Tumors of the Central Nervous System
Authors: Fabiani Armando , Torta Riccardo , Favero Maria , Brignolio Francesco , Benech Franco , Mostert Michael 
Published: May 2010

Abstract
Five central nervous system (CNS) polymorphic angioblastic tumors have been studied. Four were located in the posterior fossa and one involved the temporal lobe. In reviewing the literature, the authors point out the rarity of the supratentorial locations and of malignant hemangioblastomas. The clinical and anatomopathological peculiarities are discussed, as is the uncertain classification of two cases. The discrepancy between histology and outcome is focused upon in the other three cases. Finally, the diagnostic, prognostic, and nosographic difficulties posed by CNS angioblastic neoplasms are discussed.
Isodense Colloid Cysts of the Third Ventricle: A Diagnostic and Therapeutic Problem Resolved by Ventriculoscopy
Authors: Powell Michael P. , Torrens Michael J. , Thomson Gordon J. L. , Horgan Gerard J. 
Published: May 2010

Abstract
Eighteen patients with a colloid cyst of the 3rd ventricle presented to the Frenchay Hospital Neurosurgery Unit. The investigations included computed tomography (CT). Of these patients, 9 had radiographically isodense cysts that caused considerable diagnostic difficulties, being described only as an anterior 3rd ventricular space-occupying lesion and lateral ventricular dilatation in all but 2 cases. The clinical findings are described and the CT appearance is discussed. The new use of ventriculoscopy may resolve the problem rapidly; ventriculoscopy made the diagnosis in 5 cases and confirmed a CT diagnosis in 3 others. (It has also confirmed the diagnosis in 2 cases of hyperdense cysts.) Lately, it has been possible to aspirate the cyst contents endoscopically or, if the colloid is too viscous, to remove it with endoscopic rongeurs. After either of these procedures, the cyst wall can be coagulated with diathermy endoscopically. The method is described, and the advantages over other investigations and treatment are discussed.
Effect of Mannitol on Increased Intracranial Pressure
Authors: McGraw C. Patrick , Howard George 
Published: May 2010

Abstract
We studied 61 patients with a closed head injury and increased intracranial pressure (ICP). The ICP was monitored continuously, concomitant with the administration of 20% mannitol. If the ICP remained higher than 25 mm Hg for 10 minutes or more, the patient was included in the study. Analysis of monitoring records delineated four variables that were related to the response of ICP to mannitol: (a) the level of ICP 1 hour before mannitol was administered, (b) the level of ICP when mannitol was administered, (c) the amount of mannitol that was administered immediately before the resulting changes in ICP were measured, and (d) the cumulative amount of mannitol given over the 6 hours before the most recent mannitol dosage was administered. The level of the ICP measurements and the cumulative amount of preceding doses of mannitol influenced the response of ICP to mannitol more than did the size of the dose of mannitol. These findings imply that: (a) the initial administration of more mannitol than is absolutely needed may lead to larger doses being required to control ICP and (b) for that reason, mannitol given on a gram/kilogram, an hourly, or a serum osmolarity basis to control increased ICP has negative long term effects because more mannitol may be required to decrease ICP when an excessive amount of it has been given previously.
Computerized Electroencephalogram Monitoring and Carotid Artery Shunting
Authors: Rampil Ira J. , Correll James W. , Rosenbaum Stanley H. , Quest Donald O. , Holzer John A. 
Published: May 2010

Abstract
During carotid artery surgery, ischemic electroencephalogram (EEG) changes were detected by computerized analysis in 27 of 225 carotid clamping intervals. All but 7 of these changes resolved spontaneously before the restoration of blood flow, Restored flow was associated, after variable delay, with an improved EEG pattern in 6 of 7 cases. Of 27 EEG episodes, there were 5 cases in which the EEG event persisted for 10 minutes or longer. All 5 patients developed new neurological deficits; none of the other patients did. It is suggested that all patients undergoing carotid artery surgery be monitored with EEG and that a shunt be placed if a persistent EEG change is noted.
Palinopsia: Rare but Ominous Symptom of Cerebral Dysfunction
Authors: Lazaro R. P. 
Published: May 2010

Abstract
A 66-year-old man experienced palinopsia (visual perseveration) that lasted for several minutes. A malignant glioma of the right occipital lobe was demonstrated radiologically and histologically. The lesions that can give rise to this phenomenon are usually neoplasms and vascular disorders. This symptom can be confused with hysteria or psychosis, especially when no objective clinical findings are demonstrable. The mechanism of this symptom is still obscure.
Adult Arnold-Chiari Malformation and Intrinsic Brain Stem Neoplasm: A Difficult Differential Diagnosis
Authors: Phillips Timothy W. , McGillicuddy John E. , Hoff Julian T. , Latack Joseph 
Published: May 2010

Abstract
The occurrence of a brain stem neoplasm in three adults previously treated for an adult Arnold-Chiari malformation is reported. The diagnosis of adult Arnold-Chiari malformation had been confirmed by angiography and computed tomographic scanning. All patients were treated with a combination of ventricular shunts and posterior fossa decompression. The diagnosis of brain stem neoplasm was not made until late in the clinical course, and all patients died within 2 years of the onset of symptoms.
Postoperative Intervertebral Disc Space Infection
Authors: Rawlings Charles E. , Wilkins Robert H. , Gallis Harry A. , Goldner Leonard J. , Francis Robert 
Published: May 2010

Abstract
Intervertebral disc space infection is an uncommon, but serious, complication of disc surgery. By a retrospective chart review, we identified 27 patients at our institution who had a postoperative disc space infection; 14 were diagnosed and treated within the last 5 years. The characteristic symptoms were severe spinal pain and limited spinal mobility beginning 7 to 30 days postoperatively. The key physical findings were paravertebral muscle spasm and marked mechanical signs. The key laboratory findings were an elevated erythrocyte sedimentation rate and a mildly elevated white blood cell count. The diagnosis was based on the clinical presentation and early radiographic changes in the vertebral bodies adjacent to the involved disc, especially irregularities of the cortical margins seen best by tomography. Definitive bacteriological diagnosis by Craig needle biopsy was attempted in 14 patients; 7 had positive cultures and all yielded a Staphylococcus species. The usual treatment consisted of the administration of antistaphylococcal antibiotics and immobilization of the spine with a spica cast, a plastic body jacket, or complete bedrest. The final radiographic findings showed bony fusion or bridging in 19 patients, and 25 patients had a pain-free recovery after 1 to 9 months. There was 1 recurrent infection, and 3 patients eventually required an anterior discectomy and fusion. Based on a review of our own cases and those reported in the literature, we stress the importance of spinal tomography in establishing the diagnosis of postoperative disc space infection at a relatively early stage in a patient who is suspected of having this condition on the basis of typical symptoms and signs combined with an elevated sedimentation rate. We recommend treatment with both immobilization of the spine and the administration of appropriate antibiotics, first by the intravenous route and then orally.
Subarachnoid Hemorrhage with Normal Cerebral Panangiography
Authors: Béguelin Claude , Seiler Rolf 
Published: May 2010

Abstract
Forty-two nonhypertensive patients with a proven subarachnoid hemorrhage but normal cerebral panangiography were investigated. The follow-up period was 1 to 5 years, with a mean of 39.1 months. Treatment consisted of 2 weeks of bedrest and sedation, followed by progressive mobilization on the 3rd week. Thirteen patients (Group A) were treated with tranexamic acid, whereas 29 patients (Group B) received no antifibrinolytic therapy. Five patients of Group A died of ischemia caused by cerebral vasospasm. No patient of Group B died, and there was no early rebleeding in either group. Therefore, antifibrinolytic therapy is not indicated in these patients. Only 1 of 42 patients (2.4%) experienced late rebleeding, and he again had normal cerebral panangiography. Reangiography several weeks or months after the first hemorrhage seems not to be indicated. The overall prognosis of the surviving patients was good; almost all were able to return to their previous occupations within 6 months after the hemorrhage.
Treatment of Massive Intraoperative Brain Swelling
Authors: Marshall Lawrence F. , Hoi Sang U 
Published: May 2010

Abstract
Massive intraoperative brain swelling is an infrequent but catastrophic occurrence. In this report, we describe the use of very large doses of thiopental as a means of treating such swelling. In our initial 11 cases (5 arteriovenous malformations, 4 hematomas, and 2 penetrating injuries), this approach produced the following outcomes: 6 patients made a good recovery, 2 are moderately disabled, 1 is severely disabled, and 2 are dead. These results indicate that this condition, which once was considered unmanageable, can indeed be managed and that treatment often results in an acceptable outcome. More recent experience in an additional 6 patients suggests that the use of planned deep thiopental anesthesia, with induced cerebral silence, during intracranial surgery may even prevent the occurrence of this phenomenon.
Postsurgical Arachnoid Cyst: Report of Two Cases
Authors: Luerssen Thomas G. , Kalsbeck John E. 
Published: May 2010

Abstract
We present two cases that demonstrate the occurrence of symptomatic arachnoid cysts after craniotomy. Both patients presented 1 year postoperatively with generalized seizures as the only symptom. Focal or localizing neurological signs were not present. Both patients responded well to shunting procedures.
Posterior Fossa Hemorrhage in the Term Neonate
Authors: Menezes Arnold H. , Smith Douglas E. , Bell William E. 
Published: May 2010

Abstract
Posterior fossa hemorrhage (PFH) in the newborn term infant has been infrequently reported, and before computed tomographic (CT) scanning most were identified at postmortem examination. The origin and causes of PFH in the term neonate differ from those in adults. The main possible causes are: (a) tentorial and falx disruption with avulsion of bridging veins due to mechanical compression and distortion of the head during the birth process, resulting in posterior fossa subdural collections and vermis hematoma, and (b) occipital osteodiastasis associated with cerebellar hemisphere laceration, with intracerebellar hematoma and subdural collections. Three full-term neonates with PFH were operated on with good outcome. Both of the possible causes contributed to the hemorrhage. Review of the literature to date has led to the following conclusions: (a) PFH in the term infant is frequently associated with breech delivery, forceps instrumentation, and prolonged labor with cranial molding. (b) Massive PFH is associated with dural sinus laceration, rupture of the vein of Galen, or rupture of hematoma into the subdural space. Symptoms may be delayed up to 96 hours in cases where there is a small continuing hemorrhage. (c) CT scanning with reconstructions is essential to provide precise localization of the hemorrhage and thus avoid errors in interpretation. (d) Prompt removal of PFH improves survival and decreases sequelae. (e) Shunting procedures are necessary in 36% of the cases.
Aneurysmal Rebleeding: A Preliminary Report from the Cooperative Aneurysm Study
Authors: Kassell Neal F. , Torner James C. 
Published: May 2010

Abstract
It is generally considered that the peak incidence of rebleeding after aneurysmal subarachnoid hemorrhage is at the end of the 1st or the beginning of the 2nd week after the initial rupture. However, in a series of 2265 patients admitted within 3 days of their first subarachnoid hemorrhage, the peak of rebleeding occurred on the same day as the initial hemorrhage and there was no later peak. These data suggest that new management strategies for minimizing rebleeding must be considered for patients admitted soon after aneurysm rupture.
Role of Radiation Therapy in the Treatment of Cerebral Oligodendroglioma: An Analysis of 57 Cases and a Literature Review
Authors: Reedy Peter D. , Bay Janet W. , Hahn Joseph F. 
Published: May 2010

Abstract
Fifty-seven cases of histologically confirmed cerebral oligodendroglioma treated at the Cleveland Clinic between 1950 and 1980 were reviewed. No difference in the 5-year survival rate was seen in patients treated with postoperative radiation therapy vs. operation alone. These data are compared to previously published series with special emphasis on the role of radiation therapy.
Intraluminal Dilatation of the Innominate Artery before Extracranial-Intracranial Bypass: Case Report
Authors: Garrido Eddy , Garofola John H. 
Published: May 2010

Abstract
We are reporting a successful dilatation of the innominate artery with the Grüntzig balloon catheter before an extracranial-intracranial bypass procedure.
Triple Fossa Metastasis of Prostate Cancer
Authors: Kwee Ingrid L. , Nakada Tsutomu , St. John James N. 
Published: May 2010

Abstract
The radiological appearance of prostate cancer metastasis to the central nervous system often mimics meningioma. The bony change of prostate cancer metastasis resembles the hyperostosis of meningioma because of its blastic rather than lytic nature. On computed tomographic (CT) scan, like meningioma, prostate cancer metastasis enhances homogeneously after the infusion of contrast material. Triple fossa (middle, temporal, and orbital fossae) involvement by a solitary mass without bony destruction is thought to be highly specific for meningiomas. We report a case demonstrating the CT findings typical for a triple fossa meningioma caused by prostate cancer metastasis.
Intraoperative Use of Real Time Ultrasonography Applied to Aneurysm Surgery
Authors: Hyodo Akio , Mizukami Masahiro , Tazawa Toshiaki , Togashi Osamu 
Published: May 2010

Abstract
The intraoperative application of real time ultrasonography during 13 neurosurgical operations for intracranial aneurysms is reported. In 2 cases, the aneurysms themselves could be detected clearly by real time ultrasonic imaging. In the case of a large aneurysm, information about the nature of the aneurysmal wall was obtained. Other lesions coexisting with the aneurysm (namely, intracerebral hematoma, massive subarachnoid hemorrhage, and hydrocephalus) could be recognized clearly. Real time intraoperative ultrasonography is considered to be useful in aneurysm surgery.
Microvascular Anastomosis for the Treatment of Seizures in Patients with Cerebrovascular Ischemia: A Report of Five Cases
Authors: Ramos Morales F. , Albert P. , de Leon A. Ponce , Yagüe L. 
Published: May 2010

Abstract
The authors report five patients who had either generalized or focal seizures in association with occlusion of the internal carotid artery. Two of them developed a motor deficit after having had several seizures. The other three did not develop a fixed neurological deficit, but their seizures had continued in spite of anticonvulsant treatment. After an extracranial to intracranial (EC-IC) bypass, the seizures either stopped or became less frequent. Based on our experience with these patients and our review of the literature, we think that seizures may be the initial or at least an early manifestation of cerebrovascular insufficiency in some patients. An EC-IC bypass may be of help when angiographic evidence of cerebrovascular occlusive disease is found.
Evaluation of Level of Consciousness by the Glasgow Coma Scale in Children with Reye's Syndrome
Authors: Duncan Charles C. , Ment Laura R. , Shaywitz Bennett A. 
Published: May 2010

Abstract
The Glasgow Coma Scale, which was designed to evaluate level of consciousness after head trauma, has been compared to the Lovejoy scale in 21 patients with Reye's syndrome. Like other investigators, we have noted a poorer prognosis in those patients with higher peak NH3 levels and rapid progression of disease. However, we have also noted that the Glasgow coma scale provides a better, earlier indicator of progressive central nervous system disease than the Lovejoy scale and, therefore, helps physicians caring for such patients to institute intracranial pressure (ICP) monitoring and vigorous measures for the control of elevated ICP earlier than they might otherwise.
Surgical Exposure of the High Cervical Carotid Artery: Experimental Study and Review
Authors: Batzdorf Ulrich , Gregorius Karl F. 
Published: May 2010

Abstract
Difficulty in gaining access to the high cervical internal carotid artery (ICA) has thus far prevented effective operation for intimal repair and treatment of aneurysms at this level. Mobilization of the angle of the mandible by means of mandibular osteotomies considerably improves exposure to the high cervical ICA. This procedure has been performed in rhesus monkeys and in human cadavers. In monkeys, retromandibular external carotid artery-ICA anastomoses were carried out with no problems (neurological, wound healing, or other). This new technique should be considered for the management of some high cervical ICA lesions, particularly those occurring after closed cervical trauma.
Value of Computed Tomographic Myelography in Neurofibromatosis
Authors: Angtuaco Edgardo J. C. , Binet Eugene F. , Flanigan Stevenson 
Published: May 2010

Abstract
Computed tomographic myelography (CTM) is the procedure of choice in patients exhibiting spinal manifestations of neurofibromatosis. Due to the lack of specificity of several of the more important plain spine radiographic findings in this disease. CTM may be necessary to distinguish between surgical and nonsurgical entities. CTM will determine the size, shape, and intraspinal extension of posterior mediastinal neural tumors and separate them from the more common thoracic meningoceles. CTM will likewise elucidate the causes of posterior vertebral body scalloping, distinguishing between dural ectasia and neural tumor. CTM will also frequently demonstrate additional asymptomatic lesions at other levels.
Giant Basilar Artery Aneurysm Presenting as a Third Ventricular Tumor
Authors: Bose Bikash , Northrup Bruce , Osterholm Jewell 
Published: May 2010

Abstract
Giant aneurysm of the basilar artery presenting as a 3rd ventricular tumor is an unusual phenomenon. We are reporting a case in which a patient with a giant aneurysm of the basilar artery presented with symptoms of headaches and gait disturbance secondary to obstructive hydrocephalus. Although giant aneurysms presenting as mass lesions have been reported, the computed axial tomographic findings in our case were unique. Giant aneurysms of the basilar artery may be considered in the differential diagnosis of 3rd ventricular tumors.
Delayed Traumatic Intracerebral Hematoma: Report of 15 Cases Operatively Treated
Authors: Young Henry A. , Gleave John R. W. , Schmidek Henry H. , Gregory Susan 
Published: May 2010

Abstract
Fifteen cases of delayed traumatic intracerebral hematoma (DTICH) operatively treated are reported. Patients who are awake or only drowsy on admission (Coma Grades 1 and 2, Grady scale) often undergo dramatic sudden neurological deterioration 48 to 72 hours after admission. Emergency computed tomographic scanning and prompt craniotomy for hematoma evacuation yield excellent clinical results in the majority of cases. Patients presenting in deeper grades of coma (Grades 3 to 5. Grady scale) who develop DTICH do quite poorly, often because the diagnosis is difficult to make and consequently is delayed. The development of DTICH is in our experience highly unpredictable, and often no clear secondary cause (hypercapnia, hypoxia, bleeding diathesis) can be demonstrated.
Interhemispheric and Percallosal (Transcallosal) Approach to the Cingulate Gyri, Intraventricular Shunt Tubes, and Certain Deeply Placed Brain Lesions
Authors: Ehni George 
Published: May 2010

Abstract
The author reports 52 interhemispheric and percallosal operations carried out by himself and certain of his associated trainees upon 50 patients presenting 19 different pathological entities over a period of 38 years (1944 through 1982). The still too little appreciated advantages of this approach over transcortical avenues to the anterior ventricular system are described, together with specific indications, contraindications, and reliable and proven surgical techniques. The long term results are examined for four different outcomes: (a) recovery without deficit or with a deficit wholly chargeable to the lesion before its extirpation; (b) recovery, but with a deficit produced by or increased by the surgical procedure: (c) failure to benefit: and (d) death due to the operation. Eleven patients had invasive tumors that were not totally removable, and 6 died postoperatively, Five survived with disease-produced deficits that failed to disappear. Two had permanent deficits due to intraoperative misfortunes. Twenty-six made full recoveries. with return to work or school. Only 1 patient had a postoperative seizure problem.