bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcallosal Parafornicial Approach for Third Ventricle Tumors: Neuropsychological Consequences
Authors: Petrucci Ralph J. , Buchheit William A. , Woodruff Guy C. , Karian John M. , DeFilipp Gary J. 
Published: May 2010

Abstract
Five adult patients with 3rd ventricle tumors underwent a transcallosal intraventricular parafornicial approach. Pre- and postoperative cognitive reviews were conducted on all patients. Each review consisted of: (a) a standardized neuropsychological battery, (b) mental status reviews, (c) specific tests for disconnection, and (d) a personality variable, where possible. Computed tomography and magnetic resonance imaging are also presented. The three patients with colloid cysts and the two with oligodendrogliomas showed no significant postoperative cognitive deficits compared to the preoperative review. These additional subtle neuropsychometric measures, along with the methodological advantage of preoperative review, support a parafornicial approach where indicated to preserve cognitive abilities.
Malignant Meningioma within the Third Ventricle: A Case Report
Authors: Strenger Scott W. , Huang Yun Peng , Sachdev Ved P. 
Published: May 2010

Abstract
A case of a malignant meningioma within the 3rd ventricle is presented. Although malignant transformation of meningiomas has been described, occurrence within the ventricular system is extremely rare.
Intracarotid Chemotherapy with 1,3-Bis-(2-chloroethyl)-1-nitrosourea (BCNU) in 5% Dextrose in Water in the Treatment of Malignant Glioma
Authors: Johnson David W. , Parkinson David , Wolpert Samuel M. , Kasdon David L. , Kwan Eddie S. K. , Laucella Michael , Anderson Mary L. 
Published: May 2010

Abstract
After radiotherapy, 20 patients, 18 with documented progression of malignant glioma and 2 with Grade II astrocytoma, received a total of 52 courses of intracarotid 1,3-bis-(2-chloroethyl)-1-nitrosourea (BCNU) at a dose of 150 mg/m2 dissolved in 5% dextrose in water. The patients were treated at 6-week intervals for a maximum of five courses of chemotherapy per patient. Response to treatment was analyzed on computed tomographic scans by measuring the volume of the enhancing tumor and any central low density. From these data, tumor doubling times ranging from 110 to 968 days were obtained. An 11 to 60% reduction in enhancing tumor volume was noted in 8 patients, 2 of whom had a greater than 50% decrease in tumor volume. One patient had no change in tumor volume 110 weeks after the initiation of BCNU chemotherapy. Four patients had tumor in more than one vascular territory; tumor growth was arrested in the perfused territory, but continued in the nonperfused area. In 1 of the 4 patients, tumor also grew along a shunt catheter tract and spread over the surface of the ipsilateral hemisphere. One patient developed clinically asymptomatic leukoencephalopathy after five courses of BCNU. Two patients had postradiation leukoencephalopathy before BCNU treatment. Seventeen patients had peritumoral low density with mass effect after BCNU; thus, the true incidence of BCNU-related leukoencephalopathy could not be determined. All patients experienced transient unilateral orbital pain during the infusion and scleral erythema that lasted for several hours afterward. Loss of vision was noted in 2 patients, although it seemed to be related to the therapy in only 1 patient. In our group of patients, there was no significant myelosuppression or indication of other systemic toxicity.
Thoracic Spondylosis: An Unusual Cause of Myelopathy
Authors: Smith Douglas E. , Godersky John C. 
Published: May 2010

Abstract
Narrowing or stenosis of the spinal canal may result in myelopathy, radiculopathy, and neurogenic claudication. Degenerative changes, or spondylosis, are the most common causes of these symptoms throughout the spinal axis, but these changes are encountered least frequently in the thoracic region. The pathological changes consisting of laminar, articular process, and ligamentum flavum hypertrophy, with a variable degree of disc degeneration, are the same in the thoracic spine as the changes found in the lumbar and cervical regions. We present seven patients with symptomatic thoracic spondylosis evaluated over the past 4 years. Spinal computed tomography readily defined the abnormality. A predilection for the T10-T-12 levels is evident. The prognosis for at least partial recovery is good, even in those with long-standing disease and severely impaired function. The previous literature concerning this unusual cause of thoracic compression is reviewed, and the differential diagnostic possibilities are discussed.
Multiple Intraparenchymal Brain Plasmacytomas with Spontaneous Intratumoral Hemorrhage
Authors: Husain Muhammad M. , Metzer Steven W. , Binet Eugene F. 
Published: May 2010

Abstract
The case of a patient with two intraparenchymal brain plasmacytomas without cranial or dural attachment and with intratumoral hemorrhage is presented. Computed tomographic (CT) findings are described. Autopsy revealed two discrete intraparenchymal plasmacytomas with intratumoral hemorrhage, one cerebral and one cerebellar. There have been few case reports of brain plasmacytoma without cranial or dural attachment, and this case of multiple such intracranial, intraparenchymal plasmacytomas with hemorrhage is certainly unique. Intratumoral hemorrhage with intracranial plasmacytoma is extraordinarily rare. The literature of intracranial involvement with myeloma and plasmacytoma and the CT appearance of intracranial plasmacytoma are surveyed.
Enlargement and Rupture of Distal Basilar Artery Aneurysm after Iatrogenic Carotid Occlusion
Authors: Batjer Hunt , Mickey Bruce , Samson Duke 
Published: May 2010

Abstract
A case of angiographic enlargement and fatal rupture of a previously asymptomatic distal basilar aneurysm in a 12-year-old girl is reported. She had been treated by carotid sacrifice for a giant intracavernous carotid aneurysm. After superficial temporal-middle cerebral artery bypass, this patient underwent a trapping procedure and decompression of her symptomatic giant aneurysm. Despite postoperative patency of her bypass graft, the involved middle cerebral circulation was irrigated substantially by retrograde flow through her posterior communicating artery. An incidental distal basilar aneurysm involving the origin of her superior cerebellar arteries, posterior cerebral arteries, and multiple perforators was treated by a wrapping procedure. Eleven days after carotid ligation, she suffered a fatal subarachnoid hemorrhage from her basilar aneurysm. This catastrophe was undoubtedly produced by our failure to consider the additional hemodynamic stress placed upon the distal basilar artery by carotid sacrifice and may have been preventable by a more aggressive attack on this previously asymptomatic lesion.
Spontaneous Reduction of a Closed Depressed Skull Fracture: A Case Report
Authors: Cozzens Jeffrey W. , Eller Theodore W. 
Published: May 2010

Abstract
Presented is a single case of a 6-year-old child in whom a closed depressed skull fracture was found to be elevated spontaneously less than 2 days after the injury. There were no cosmetic or neurological sequelae at follow-up. This case demonstrates that these injuries do not always require operation and that they occasionally resolve spontaneously, even in school-age children.
Extradural Lymphoma Presenting as an Acute Surgical Emergency
Authors: Rabin David N. , Ramsey Ruth G. , Vedanthum Kizhanatham S. , Foust Robert J. , Rabin Michael 
Published: May 2010

Abstract
Extradural lymphoma can present as an acute neurosurgical emergency. The clinical presentation and radiological appearance may suggest epidural hematoma or meningioma. Lymphoma should be considered as a rare but possible diagnosis before operation. High resolution computed tomography using direct coronal imaging with and without contrast enhancement may aid in suggesting the correct preoperative diagnosis.
Agenesis of Internal Carotid Artery Presenting with Oculomotor Nerve Palsy after Minor Head Injury
Authors: Wakai Susumu , Watanabe Naofumi , Inoh Satoshi , Ochiai Chikayuki , Nagai Masakatsu 
Published: May 2010

Abstract
We report a patient with unilateral agenesis of the internal carotid artery in whom the oculomotor nerve was paralyzed on the same side as the agenesis after a minor head injury. It is conceivable that the palsy was caused by sudden tension of the nerve between the petroclinoid ligament and the enlarged posterior communicating artery.
Brachytherapy of Recurrent Tumors of the Skull Base and Spine with Iodine-125 Sources
Authors: Gutin Philip H. , Leibel Steven A. , Hosobuchi Yoshio , Crumley Roger L. , Edwards Michael S. B. , Wilson Charles B. , Lamb Sharon , Weaver Keith A. 
Published: May 2010

Abstract
Thirteen patients with recurrent, previously irradiated tumors of the skull base or spine were reirradiated with 125I sources implanted interstitially using microsurgical or stereotactic techniques. Patients harbored difficult, end-stage recurrences of chordoma, meningioma, malignant meningioma, fibrosarcoma, invasive pituitary adenoma, and malignant schwannoma. In two other patients with malignant meningioma, the dose of external radiation was augmented by implanting 125I sources during the initial operation for excision of the lesion or at a separate surgical procedure after conventional teletherapy. Microsurgical implantation of 125I sources into basal tumors was limited by the difficulties inherent in operating in this region; it is not possible to visualize the entire tumor that requires implantation. Three of five chordomas stabilized or regressed; these patients probably benefited from the procedure. Two patients with recurrent malignant meningiomas had long term remission after interstitial brachytherapy. Interstitial 125I brachytherapy for recurrent tumors at the base of skull or adjacent to the spine can be more successful only if more aggressive surgical exposures of these regions are attempted. Implantation of sources for a “boost” dose, either microsurgically during the initial surgical resection of the lesion before conventional teletherapy or stereotactically after conventional teletherapy, may be a valuable adjunct to external irradiation for the control of potentially devastating tumors (such as chordomas and malignant meningiomas) before they recur with the severe consequences seen in the patients reported here.
Pituitary Adenoma Composed of Two Compartments Each Secreting Prolactin or Growth Hormone
Authors: Tomono Yuji , Nose Tadao , Maki Yutaka 
Published: May 2010

Abstract
We report a case of pituitary adenoma with two compartments, i.e. a part within the sella turcica and a part infiltrating the sphenoid bone beneath the sella, producing growth hormone (GH) and prolactin. The patient had the amenorrhea-galactorrhea syndrome, but not acromegalic symptoms. Although the two compartments were united through a small dural perforation, immunohistochemical studies demonstrated that GH and prolactin were separately secreted from the intrasellar and extrasellar components, respectively. Somatotropic adenomas frequently produce prolactin, but it is unusual for these hormones to be secreted from distinctly different parts of the same lesion. (Neurosurgery 21: 56-59, 1987)
Malignant Melanoma Metastatic to Sphenoid Bone with an Unknown Primary Origin: Report of a Case with an Immunohistochemical Analysis of the Infiltrating Lymphocytes
Authors: Yamasaki Toshiki , Handa Hajime , Paine Jonathan T. , Moritake Kouzo 
Published: May 2010

Abstract
A rare case of hemorrhagic metastatic malignant melanoma from an unknown primary origin to the right sphenoid bone in a 37-year-old woman is presented. The tumor occupied an extensive intracranial extradural space with a mild orbital infiltration, but little involvement of the leptomeninges and parenchymal tissues. Immunohistochemical analysis of the tumor-infiltrating lymphocytes showed that the majority expressed pan-T or Leu-1 surface antigens and that the lymphocytes bearing the Leu-3 antigen, or helper phenotype, were predominant compared to the Leu-2 population representing both suppressor and cytotoxic T cells. Furthermore, most of the T lymphocytes stained with HLA-DR antigens. Because few B cells were seen, this observation indicates the presence of T cells in an activated state. The literature pertinent to associated organ involvement of metastatic melanomas and the correlations between the tumor and immunological cellular responses are discussed. (Neurosurgery 21: 73-77, 1987)
Tuboovarian Abscess Presenting as Sciatic Pain: Case Report
Authors: Andrews David W. , Friedman Neil B. , Heier Linda , Erickson Amelia , Lavyne Michael H. 
Published: May 2010

Abstract
The authors report the successful conservative treatment of a tuboovarian abscess in a 25-year old woman who presented with low grade fever and severe right sciatic pain. Computed tomography and ultrasonography corroborated a clinical diagnosis of tuboovarian abscess after an initial diagnosis of epidural abscess had been made. This is the first report of a tuboovarian abscess presenting principally as sciatic pain. The diagnosis and treatment of this lesion are discussed. (Neurosurgery 21: 100-103, 1987)
Spontaneous Intracerebellar Hematoma during Childhood
Authors: Freitas Paulo Eduardo , Aquini Mauro Guidotti 
Published: May 2010

Abstract
The case of a surgically treated spontaneous intracerebellar hematoma in a 6-year-old girl is reported. Such hemorrhages in this age group are very rare, but must be recognized and promptly treated. Usually associated with the rupture of vascular malformations, they are different from those occurring in adults, and operation is indicated to secure a favorable prognosis (Neurosurgery 21: 103-105, 1987)
Hemoglobinemia and Renal Failure from an Intracerebral Hematoma Simulating a Vein of Galen Aneurysm
Authors: Chovanes George I. , Truex Raymond C. 
Published: May 2010

Abstract
A case of an intracranial hematoma in a neonate causing the release of free hemoglobin into the plasma is presented. No previous such case has been described. The relationship between hemoglobinemia and the occurrence of acute renal failure in this neonate is discussed, with comments on the possible etiological role of the hemoglobinemia. (Neurosurgery 21: 107-109, 1987)
Pulmonary Complications of Acute Spinal Cord Injuries
Authors: Reines David H. , Harris Robert C. 
Published: May 2010

Abstract
The records of 123 consecutive patients admitted with spinal cord injury were examined for the presence of pulmonary complications. Forty-nine had tetraplegia and 23 had paraplegia; the remainder suffered a variety of neurological deficits. Multiple injuries were encountered in 36 patients. Fifty-three pulmonary complications were noted in 44 (35.7%) patients. The most common problems were atelectasis and pneumonia. There were 22 (18%) deaths. Fourteen deaths were related to pulmonary complications. The mean age of patients who died was 52 ± 13 (SE) compared to 28 ± 12 for survivors. A mean forced vital capacity (FVC) of 1127 ± 410 cc in patients suffering respiratory difficulties compared to a FVC of 1865 ± 85 cc in patients without complications (P &lt; 0.001). Oxygenation (PaO2 90 ± 19 torr) was normal in patients without respiratory problems and was abnormal in patients developing problems (PaO2 76 ± 30 torr; P &lt; 0.05). Twenty patients were treated with a rotating bed. The complication rate of patients on the bed was only 10%. In conclusion, respiratory problems remain a significant cause of morbidity and mortality in spinal cord injury. The forced vital capacity, blood oxygen tension, and age are predictors of pulmonary complications. The use of a multidisciplinary approach and a rotating bed may minimize these problems.
Cushing's Syndrome Caused by an Ectopic Pituitary Adenoma
Authors: Schteingart David E. , Chandler William F. , Lloyd Ricardo V. , Ibarra-Perez Gloria 
Published: May 2010

Abstract
A 49-year old woman with a 5-year history of Cushing's syndrome was evaluated. Biochemical measurements revealed high cortisol and adrenocorticotropic hormone (ACTH) levels consistent with the ACTH-dependent type of Cushing's syndrome. However, the source of ACTH seemed to be autonomous as she demonstrated abnormal feedback control, with lack of response to metyrapone and high doses of dexamethasone. A search for an ectopic ACTH-secreting nonpituitary neoplasm was unsuccessful. Transsphenoidal pituitary exploration revealed a normal pituitary gland, but an ectopic pituitary adenoma was found incidentally in the mucosa of the sphenoid sinus. This adenoma stained strongly positive for ACTH on immunocytochemical studies. Resection of this lesion led to remission of the Cushing's syndrome. This variant of ACTH-dependent Cushing's syndrome can mimic the ectopic ACTH-dependent type and should be looked for in patients who fail to respond to pituitary operation.
“Caval-Septal” Hematoma: Does It Exist?
Authors: Schulder Michael , Hirano Asao , Elkin Charles 
Published: May 2010

Abstract
A “caval-septal” hematoma shown by computed tomography has been described in cases of ruptured aneurysms arising from the anterior communicating artery. This term seems to imply that the hematoma is confined to the cavum septi pellucidi. This common finding almost always represents a hematoma in the anterior interhemispheric fissure.
Association of a Ganglioneuroma with an Arteriovenous Malformation: Case Report
Authors: Chovanes George I. , Truex Raymond C. 
Published: May 2010

Abstract
The unusual concurrence of a brain tumor and an arteriovenous malformation (AVM) is discussed in this case report. A 12-year-old child presented with a severe headache, and an intracerebral mass was found on neuroradiological study. At operation, we encountered a superficial AVM, not shown on the computed tomogram or arteriogram. At a second procedure, a ganglioneuroma was removed. The literature on the concurrence of these two entities is reviewed; comments are made on the pathology of ganglion cell tumors.
Staged Treatment of Arteriovenous Malformations of the Brain
Authors: Andrews Brian T. , Wilson Charles B. 
Published: May 2010

Abstract
Twenty-eight patients treated for arteriovenous malformations (AVMs) of the brain had staged therapy consisting of multiple surgical procedures or endovascular embolization followed by surgical treatment. There were 10 men and 18 women, aged 15 to 60 years (mean, 34 years). The clinical symptoms were those associated with intracranial hemorrhage in 13 patients, progressive neurological deficit not due to hemorrhage in 6, intractable headache in 5, and seizures in 4. Four groups were identified based upon the reason for staging therapy. Thirteen patients with large high flow AVMs (Group A) had staged treatment because of the risk of normal perfusion pressure breakthrough. The initial afferent artery occlusion was accomplished surgically in 9 patients and by endovascular embolization in 4. Postoperatively, no patient in this group had malignant cerebral edema or intracranial hemorrhage suggestive of normal perfusion pressure breakthrough, but 1 patient had an intraventricular hemorrhage after initial embolization. In 9 patients (Group B), the AVM had a complex multiple arterial supply that precluded resection from a single operative exposure. Seven had supratentorial AVMs, and 2 had AVMs of the posterior fossa. In 6 of these cases, the AVM was located in the midline and received bilateral arterial input. Six patients had staged surgical procedures, and 3 had an initial endovascular embolization followed by operation. Two patients had intracerebral hemorrhages, one after an initial surgical procedure and another after initial embolization. In 4 patients (Group C), the AVM had a major dural component that was treated separately from the parenchymal component. In 3 of these patients, embolization through the external carotid artery satisfactorily obliterated the dural component; in the remaining patient, a persistent internal carotid supply necessitated resection of the dural malformation. The parenchymal component was excised surgically in 2 patients. Two patients (Group D) had separate surgical procedures to treat an aneurysm associated with a parenchymal AVM. Overall, 19 of 28 patients had complete excision and 9 had partial obliteration of their AVMs. Late follow-up of 27 patients at a mean of 18.6 months showed that 16 patients were in excellent condition and 8 were in good condition. Three patients were in poor condition with debilitating neurological deficits. One patient had a delayed intracranial hemorrhage 22 months after incomplete obliteration of her AVM. Staged treatment of selected AVMs of the brain may avoid the occurrence of normal perfusion pressure breakthrough. This approach also allows satisfactory obliteration of selected malformations that have multiple complex arterial supplies or a dural component and those associated with an aneurysm.
T2 and T3 Sympathetic Ganglia in the Adult Human: A Cadaver and Clinical-Radiographic Study and Its Clinical Application
Authors: Yarzebski J. L. , Wilkinson H. A. 
Published: May 2010

Abstract
The technique of percutaneous radiofrequency (RF) upper thoracic sympathectomy mandates an exact knowledge of the anatomical location of the sympathetic ganglia. Because conflicting descriptions are given in anatomy texts, we examined the T2 and T3 sympathetic ganglia in 48 sympathetic chains in adult cadavers to measure the exact location of the ganglia. Measurements were made relative to their distances (a) dorsal to the ventral surface of the vertebral body and (b) rostral or caudal to the midpoint of the vertebral body. Median locations of T2 and T3 ganglia were 17 to 20 mm dorsal to the ventral surface of the vertebral body and 2 mm rostral to the T1-T2 and T2-T3 vertebral bodies. The sympathetic chains lay lateral to and between the heads of the ribs at these levels. A clinical-radiographic correlation study of the sympatholytic effectiveness of various needle electrode placement sites during sympathectomy confirmed these findings. These data have been used to modify the technique of percutaneous RF sympathectomy.
Metastasis within a Pituitary Adenoma Presenting with Bilateral Abducens Palsies: Case Report and Review of the Literature
Authors: Zager Eric L. , Hedley-Whyte Tessa E. 
Published: May 2010

Abstract
A 56-year-old woman with metastatic breast carcinoma presented on her terminal hospital admission with diplopia secondary to bilateral abducens nerve palsies. Postmortem examination revealed a sellar mass composed of an unsuspected pituitary adenoma infiltrated by metastatic carcinoma. Review of the literature revealed only seven patients with this rare neoplasm-to-neoplasm metastasis, none of whom were reported to have had abducens palsies.
Arteriovenous Malformation Associated with Multiple Aneurysms in the Posterior Fossa: A Case Report with a Review of the Literature
Authors: Noterman J. , Georges P. , Brotchi J. 
Published: May 2010

Abstract
The association of two aneurysms on the distal posteroinferior cerebellar artery with an arteriovenous malformation fed by the same artery is reported. A one-stage operation was performed. The other cases in the literature are analyzed with particular regard to the origin of the subarachnoid hemorrhage and the location of the aneurysms.
Reversible Somatosensory Evoked Potential Changes with Neodymium: Yttrium-Aluminum-Garnet Laser Use
Authors: Long Randall R. , Wirth Fremont P. 
Published: May 2010

Abstract
Reversible prolongation and dissolution of the tibial somatosensory evoked potential (SEP) was observed with operative use of the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser during extirpation of a foramen magnum meningioma. Rapid normalization of the SEP followed irrigation with cool saline. The absence of postoperative dorsal column deficit suggests that heat-related physiological changes occurred before the point of irreversible tissue injury. Should intraoperative SEP monitoring prove a reliable index of tissue temperature, it could enable safer use of the Nd:YAG laser in the vicinity of the spinal cord and brain stem.