bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrathecal Morphine for Postoperative Analgesia in Children after Selective Dorsal Root Rhizotomy
Authors: Harris Mark M. , Kahana Madelyn D. , Park T. S. 
Published: April 2011

Abstract
The authors report their experience with low doses (0.007-0.015 mg/kg);, moderate doses (0.016-0.025 mg/kg);, and high doses (0.026-0.035 mg/kg); of intrathecal morphine for postoperative analgesia after selective dorsal root rhizotomy surgery in 50 children, aged 3 to 12 years. After closure of the dura, a single dose of preservative-free morphine was injected into the subarachnoid space, and patients were assessed for 48 hours for level of comfort and side effects. The three doses of morphine provided equivalent analgesia and similar side effects. The duration of postoperative analgesia ranged from 3 to 48 hours (mean, 12.2 ± 9.5 h);. Common side effects were limited to nausea and vomiting (42%); and mild facial pruritus. No patient experienced late respiratory depression or generalized pruritus. The authors conclude that low doses of intrathecal morphine is as effective as moderate or high doses of morphine for reducing pain in the immediate postoperative period. Intrathecal morphine provides excellent analgesia after selective dorsal rhizotomy.
Gonadotropin-secreting Pineal Teratoma Causing Precocious Puberty
Authors: Cohen Alan R. , Wilson John A. , Sadeghi-Nejad Ab 
Published: April 2011

Abstract
A case of precocious puberty in a 7-year-old boy with a tumor of the pineal region is reported. Human chorionic gonadotropin levels were elevated in the serum and cerebrospinal fluid. Endocrinological evaluation of the hypothalamic-pituitary axis demonstrated a normal prepubertal response. The tumor was resected and proved to be an immature teratoma. Human chorionic gonadotropin levels were markedly elevated in the tumor cyst fluid. Sexual precocity regressed and human chorionic gonadotropin levels in the serum and cerebrospinal fluid fell to normal after surgery, suggesting that the precocious puberty was secondary to ectopic human chorionic gonadotropin production by the pineal teratoma.
Bilateral Symmetrical Striopallidodentate Calcification Associated with Pseudohypoparathyroidism Demonstrated in a Patient with Cerebellar Astrocytoma
Authors: Markov Lubomir L. 
Published: April 2011

Abstract
A case of calcification in the striopallidodentate system associated with pseudohypoparathyroidism, clinically manifested after operation for a cystic astrocytoma of the cerebellar vermis, is reported. Bilateral symmetrical striopallidodentate calcification accompanying a disturbance in calcium metabolism is rare. Only a few cases have been described previously in the literature, of which only six were accompanied by pseudohypoparathyroidism. The importance of identifying hypoparathyroidism, especially pseudohypoparathyroidism, early in the course of investigation is discussed.
Double Compartment Hydrocephalus in an Adult
Authors: Fedder Stephen L. , Richter Howard A. 
Published: April 2011

Abstract
A case of double-compartment hydrocephalus in an adult is presented. Although this entity is infrequently noted in children, it is diagnosed even more rarely in the adult population. A discussion of the spectrum of abnormal cerebrospinal fluid dynamics of the 4th ventricle and treatment options are presented.
Diagnosis and Monitoring of Subarachnoid Hemorrhage by Transcranial Color-Coded Real-Time Sonography
Authors: Becker G. , Greiner K. , Kaune B. , Winkler J. , Brawanski A. , Warmuth-Metz M. , Bogdahn U. 
Published: April 2011

Abstract
Thirty-six patients with acute spontaneous subarachnoid hemorrhage (26 caused by rupture of an aneurysm) were examined by transcranial color-coded real-time sonography by using a 2.25-MHz ultrasound transducer. In 20 of these 26 patients (76%), the aneurysm could be identified by a characteristic abnormal blood flow pattern within the aneurysm in coronal and axial scanning planes by transcranial color-coded real-time sonography. Blood within the basal cisterns, on top of the tentorium, and within the ventricles and parenchyma was sonographically detected by increased echodensity in 75%. In addition, cerebrospinal fluid circulation disturbances and cerebral vasospasm were detected in two-dimensional B-mode images in 85% and 100%, respectively. In Doppler mode, intravascular blood flow velocity could be quantified. We conclude that transcranial color-coded real-time sonography, a new, noninvasive method for diagnosis and follow-up of patients with subarachnoid hemorrhage, allows detection of the primary vascular lesion and monitoring of complications.
Millipore Analysis of Valvular Fluid in Sterile Valve Malfunctions
Authors: Traynelis Vincent C. , Willison Crystl D. , Follett Kenneth A. , Chambers Janet , Schochet Sydney S. , Kaufman Howard H. 
Published: April 2011

Abstract
Malfunctions of sterile shunts may result from valvular dysfunction. The cerebrospinal fluid shunt valves of 14 patients were excised during surgery for sterile shunt malfunctions. In 6 patients, the malfunction was due specifically to a valve malfunction. Cerebrospinal fluid from each valve was passed through a millipore filter, which was then stained using either hematoxylin and eosin or periodic acid-Schiff. The stained millipore filters were examined by a neuropathologist who was unaware of the cause of the shunt malfunction. Although inflammatory cells were detected in all cases, the patients with valve malfunctions were found to have numerous macrophages and giant multinucleated reactive cells within their valves, while cerebrospinal fluid from valves that had been removed during shunt revisions for reasons other than a malfunctioning valve contained only rare mononuclear cells or macrophages. No valve contained erythrocytes, fibrinous matter, neural or glial tissue, or choroid plexus. The possible causes of valve malfunction, including infection and allergic reactions, are discussed. All patients did well after simple replacement of the valve.
Prolonged Lumbar Spinal Drainage after the Resection of Tumors of the Skull Base: A Cautionary Note
Authors: Snow Robert B. , Kuhel William , Martin Stanley B. 
Published: April 2011

Abstract
A combined transcranial and facial approach was used for an en bloc resection of a malignant angiosarcoma of the ethmoid sinuses. The patient awoke neurologically intact and was monitored in the Intensive Care Unit. A lumbar subarachnoid drain was placed for the continuous removal of the cerebrospinal fluid (CSF). Approximately 36 hours after surgery, she deteriorated neurologically and demonstrated bilateral extensor posturing to painful stimuli. A computed tomographic scan demonstrated obliteration of the basal cisterns indicative of transtentorial herniation and a small amount of extradural air. Eight hours after the lumbar drain was turned off, the patient had recovered completely. We propose that the patient manifested transtentorial herniation caused by a pressure gradient between the supratentorial and lumbar cistern compartments brought on by the continuous removal of the CSF from the lumbar subarachnoid space. We suggest that ventricular drainage should be considered for these cases rather than lumbar drainage. This offers the same advantage of removing the CSF and maintaining low-to-normal intracranial pressure without the risk of transtentorial herniation.
Malignant Prolactinomas
Authors: Popovic Emil A. , Vattuone John R. , Siu Kevin H. , Busmanis Inny , Pullar Michael J. , Dowling John 
Published: April 2011

Abstract
Six cases of malignant prolactinoma have been reported; an additional two cases are presented here and the literature is reviewed. Diagnosis rests upon evidence of metastasis rather than histological criteria perse. Cases have arisen from known adenomas, particularly the invasive type. Bromocriptine is a useful palliative. The features and treatment of malignant prolactinoma are discussed. (Neurosurgery 29:127-130, 1991)
Herniated L4-L5 Disc after Placement of Harrington Instrumentation for a Fracture of the Thoracolumbar Spine
Authors: Segal Ricardo , Pollack Ian , Segal Eduardo , Hanley Edward , Scalbassi Robert , Hirsch William 
Published: April 2011

Abstract
The authors report a case in which L5 radiculopathy developed acutely after surgery for placement of Harrington rod instrumentation for an L1 body fracture. Computed tomographic myelography demonstrated a large L4-L5 herniated disc that had not been present in preoperative studies. An emergency laminectomy was performed, and a large, free, subligamentous disc fragment was removed. The patient subsequently regained L5 sensorimotor function. The postoperative development of lumbar radiculopathy is an uncommon complication of Harrington rod instrumentation that may result from several biomechanical features of the instrumentation. These injuries may not be detected by intraoperative monitoring of somatosensory evoked potentials, and therefore, the postoperative neurological examination assumes a crucial role in the early diagnosis of these lesions. As our case demonstrates, these radicular deficits may be reversible if their cause is promptly recognized and treated. (Neurosurgery 29:135-136, 1991)
Spinal Cord Herniation Associated with an Intradural Spinal Arachnoid Cyst Diagnosed by Magnetic Resonance Imaging
Authors: Isu Toyohiko , Iizuka Takashi , Iwasaki Yoshinobu , Nagashima Masafumi , Akino Minoru , Abe Hiroshi 
Published: April 2011

Abstract
Two rare cases of spinal cord herniation associated with intradural spinal arachnoid cyst are reported. A preoperative magnetic resonance imaging scan demonstrated the presence of spinal cord herniation, identified as a protrusion continuous with the spinal cord. Surgery upon the intradural spinal arachnoid cyst improved progressive neurological dysfunction. The authors postulate that spinal cord herniation occurred for the following reason: The pressure of the intradural arachnoid cyst on the dorsal aspect of the spinal cord caused thinning of the dura, leading to a tear and, thus, the development of an extradural arachnoid cyst. Along with the enlargement of intradural arachnoid cyst, the spinal cord herniated through the tear in the dura into the extradural arachnoid cyst. (Neurosurgery 29:137-139, 1991)
Chronic Perineal Pain Related to Sacral Meningeal Cysts
Authors: Van de Kelft Erik , Van Vyve Michel 
Published: April 2011

Abstract
Chronic perineal pain is an often encountered problem that is difficult to evaluate. Based on a series of 17 patients in whom urological, gynecological, and anorectal pathology was excluded, the authors compared magnetic resonance imaging (MRI) with computed tomographic (CT) scan with myelography in the investigation of chronic perineal pain. After a clinical neurological examination, patients underwent radiodiagnostic imaging of both techniques. Thirteen patients (76%) had one or more sacral meningeal cysts (MC) on MRI scan, whereas CT scan with myelography of the lumbar and sacral region revealed 7 patients (41%) with sacral MC. Sacral MC may be the etiology of chronic perineal pain in many instances, and MRI scan appears to be superior to CT scan with myelography in demonstrating sacral MC. Ten patients with sacral MC were operated on with moderate to excellent results 6 months after operation. Early postoperative results are encouraging, but further follow-up and larger series are required.
Evaluation and Treatment of Aneurysms of the Vertebral Artery: Different Strategies for Different Lesions
Authors: Pritz Michael B. 
Published: April 2011

Abstract
Aneurysms of the vertebral artery and its branches are relatively uncommon lesions. Their anatomy and presentation can be quite variable. A spectrum of aneurysms of the vertebral artery is presented to illustrate the neuroradiological evaluation, surgical treatment, and perioperative management of these complex lesions.
Ataxic Hemiparesis Associated with Ipsilateral Cerebellar Syndrome Caused by a Paracentral Gyrus Lesion
Authors: Donnet A. , Graziani N. , Njee B.T. , Vincentelli F. , Grisoli F. 
Published: April 2011

Abstract
The authors report a case of ataxic hemiparesis and an ipsilateral cerebellar syndrome in relation to a glioblastoma of the paracentral gyrus region. The physiopathology of this clinical presentation caused by compression of the corticopontine tract is discussed.
Radiation-induced Cerebellar Glioblastoma Multiforme Subsequent to Treatment of an Astrocytoma of the Cervical Spinal Cord
Authors: Rappaport Zvi H. , Loven David , Ben-Aharon Uriel 
Published: April 2011

Abstract
A cerebellar glioblastoma multiforme was diagnosed in a 22-year-old woman. This originated in the zone adjacent to a field irradiated 14 years earlier after the removal of a noncontiguous astrocytoma of the spinal cord. The accepted criteria for radiation-induced tumors of the central nervous system are discussed.
Pituitary Apoplexy and Its Effect on Vision
Authors: McFadzean Robert M. , Doyle David , Rampling Roy , Teasdale Evelyn , Teasdale Graham 
Published: April 2011

Abstract
A series of 15 patients with a clinical diagnosis of pituitary apoplexy is reviewed. Clinical features are highlighted, with stress on the defects of visual function and ocular motility, and the associated endocrine abnormalities are described. Potential diagnostic errors and their significance are considered. The incidence of this complication in a large series of pituitary adenoma patients is measured, and the radiological and pathological findings are recorded. The results of treatment by surgery and/or radiotherapy and/or bromocriptine are assessed, particularly in relation to visual consequences, and compared with previous reports in the literature, which are reviewed.
The Importance of Cerebral Ischemia during Carotid Endarterectomy
Authors: Zampella Edward , Morawetz Richard B. , McDowell Holt A. , van Zeiger H. E , Varner Pamela D. , McKay Robert D. , Halsey James H. 
Published: April 2011

Abstract
The importance of cerebral ischemia produced by carotid clamping during carotid endarterectomy remains controversial. In an effort to determine the importance of cerebral ischemia during carotid endarterectomy. 369 patients undergoing 431 consecutive carotid endarterectomies were studied by Xenon-133 (133Xe) clearance and electroencephalogram (EEG) monitoring. None of the patients was shunted during the procedures. The severity of ischemia as indicated by 133 Xe clearance from the ipsilateral hemisphere during 20 to 30 minutes of carotid occlusion did not predict the appearance of complications in this group of patients (x2 = 1.417: P = 0.841). There was a highly significant relationship between the depth of cerebral ischemia as demonstrated by 133Xe clearance and the appearance of abnormalities on the EEG (x2 = 42.043, P &lt; 0.0001). In the subgroup of patients developing abnormalities as shown by EEG. there was a negative correlation (x2 = 17.495; P &lt; 0.002) between reduction in blood flow and the appearance of complications, in that the higher the blood flow during occlusion the more likely the patient developing EEG changes would develop complications.
Vestibular Nerve Injury as a Complication of Microvascular Decompression
Authors: Sekiya Tetsuji , Iwabuchi Takashi , Hatayama Toru , Shinozaki Naoko 
Published: April 2011

Abstract
We report a case of hemifacial spasm in which hearing was well preserved after microvascular decompression, but the vestibular nerve was injured selectively. We review the pathophysiological mechanisms relevant to this complication in the light of results of animal experimental studies we have conducted. In addition, we discuss the clinical significance of this particular type of cranial nerve injury.
Subintimal Dissection of the Vertebral Artery in Subluxation of the Cervical Spine
Authors: Jabre Anthony 
Published: April 2011

Abstract
The vertebral arteries appear to be particularly susceptible to injury in trauma of the cervical spine because of their close anatomical relationship to the spine; however, traumatic subintimal disscction of the vertebral artery is rare judging from the paucity of cases reported in the literature. The case of a patient who developed a visual field defect secondary to a fracture-subluxation of the cervical spine is reported. Angiography demonstrated an intimal dissection of the vertebral artery at the site of the fracture-subluxation resulting in thrombus formation and subsequently in emboli occluding the posterior temporal branch of the posterior cerebral artery. Early angiography is recommended if extracranial injury of the vertebral artery is suspected, and the institution of heparin therapy is necessary if a subintimal dissection is demonstrated.
Hernia of the Spinal Cord: Case Report and Review of the Literature
Authors: Tronnier Volker M. , Steinmetz Anton , Albert Friedrich K. , Scharf Johannes , Kunze Stefan 
Published: April 2011

Abstract
A rare case of a true hernia of the spinal cord through a dural defect without evidence of acute trauma is presented. The cause and the differentiation from other congenital and traumatic spinal cord lesions, especially arachnoid cysts, are discussed.
Intradural Extramedullary Cavernous Angioma: Case Report
Authors: Mastronardi Luciano , Ferrante Luigi , Scarpinati Marco , Gagliardi Franco Maria , Celli Paolo , Fortuna Aldo 
Published: April 2011

Abstract
Cavernous angiomas represent 5 to 12% of spinal vascular malformations and usually are located at the vertebral body level with possible extension into the extradural space. The intradural intramedullary cavernoma occurs in about 3% of cases, whereas extramedullary localization is extremely rare. A new case of an intradural extramedullary cavernous angioma is reported, and the clinical, diagnostic, and therapeutic aspects of this rare malformation are analyzed.
Oscillopsia and Primary Cerebellar Ectopia: Case Report and Review of the Literature
Authors: Gingold Scott I. , Winfield Jeffrey A. 
Published: April 2011

Abstract
Oscillopsia, the visual sensation of stationary objects swaying back and forth or vibrating, has been described in association with downbeat nystagmus in patients with primary cerebellar ectopia (Chiari I malformation). A patient with symptomatic oscillopsia without downbeat nystagmus, who was diagnosed by magnetic resonance imaging to have displaced cerebellar tonsils below the foramen magnum, is presented here. Suboccipital craniectomy and upper cervical laminectomy completely relieved the visual disturbance of the patient. The pathogenesis and surgical management of oscillopsia are discussed with respect to the current literature. Early recognition and surgical decompression of cerebellar ectopia may lead to complete recovery in patients with minimal symptomatology.
Glycated Hemoglobin Predicts All-Cause, Cardiovascular, and Cancer Mortality in People Without a History of Diabetes Undergoing Coronary Angiography
Authors: Silbernagel Guenther , Grammer Tanja B. , Winkelmann Bernhard R. , Boehm Bernhard O. , März Winfried 
Published: April 2011

OBJECTIVE
Glycated hemoglobin has been suggested to be superior to fasting glucose for the prediction of vascular disease and death from any cause. The aim of the present work was to analyze and compare the predictive value of glycated hemoglobin and fasting glucose on all-cause and cause-specific mortality in subjects who underwent coronary angiography.

RESEARCH DESIGN AND METHODS
We studied 2,686 participants of the Ludwigshafen Risk and Cardiovascular health study without a history of diabetes. The majority of this cohort had coronary artery disease. Glycated hemoglobin was measured at the baseline examination. The mean (± SD) duration of the follow-up for all-cause, cardiovascular, and cancer mortality was 7.54 ± 2.1 years.

RESULTS
A total of 508 deaths occurred during the follow-up. Of those, 299 were accounted for by cardiovascular diseases and 79 by cancer. Baseline glycated hemoglobin was predictive of all-cause, cardiovascular, and cancer mortality. The multivariable-adjusted hazard ratios (HR) (95% CI) for glycated hemoglobin values of &lt;5.0, 5.0–5.4, 5.5–5.9, 6.0–6.4, 6.5–7.4, and ≥7.5% for all-cause mortality were 1.36 (0.85–2.18), 1.00 (0.76–1.32), 1.00 (reference), 1.11 (0.88–1.41), 1.39 (1.07–1.82), and 2.15 (1.32–3.53), respectively. Similar J-shaped relationships were found between glycated hemoglobin and cardiovascular and cancer mortality. The associations of glycated hemoglobin with all-cause and cardiovascular mortality remained significant after inclusion of fasting glucose as a covariate. However, fasting glucose was not significantly related to mortality when adjusting for glycated hemoglobin.

CONCLUSIONS
Glycated hemoglobin significantly and independently of fasting glucose predicts all-cause and cardiovascular mortality in whites at intermediate to high cardiovascular risk.
Primary Dietary Intervention Study to Reduce the Risk of Islet Autoimmunity in Children at Increased Risk for Type 1 Diabetes
Authors: Hummel Sandra , Pflüger Maren , Hummel Michael , Bonifacio Ezio , Ziegler Anette-G. 
Published: April 2011

OBJECTIVE
To determine whether delaying the introduction of gluten in infants with a genetic risk of islet autoimmunity is feasible, safe, and may reduce the risk of type 1 diabetes–associated islet autoimmunity.

RESEARCH DESIGN AND METHODS
A total of 150 infants with a first-degree family history of type 1 diabetes and a risk HLA genotype were randomly assigned to a first gluten exposure at age 6 months (control group) or 12 months (late-exposure group) and were followed 3 monthly until the age of 3 years and yearly thereafter for safety (for growth and autoantibodies to transglutaminase C [TGCAs]), islet autoantibodies to insulin, GAD, insulinoma-associated protein 2, and type 1 diabetes.

RESULTS
Adherence to the dietary-intervention protocol was reported from 70% of families. During the first 3 years, weight and height were similar in children in the control and late-exposure groups, as was the probability of developing TGCAs (14 vs. 4%; P = 0.1). Eleven children in the control group and 13 children in the late-exposure group developed islet autoantibodies (3-year risk: 12 vs. 13%; P = 0.6). Seven children developed diabetes, including four in the late-exposure group. No significant differences were observed when children were analyzed as per protocol on the basis of the reported first gluten exposure of the children.

CONCLUSIONS
Delaying gluten exposure until the age of 12 months is safe but does not substantially reduce the risk for islet autoimmunity in genetically at-risk children.