bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined Intraarterial and Systemic Chemotherapy for Intracerebral Tumors
Authors: Stewart David J. , Grahovac Zvonimir , Hugenholtz Herman , Russell Neville , Richard Michael , Benoit Brien 
Published: May 2010

Abstract
Twenty-six patients with intracerebral tumors (predominantly gliomas) were treated with intraarterial BCNU, VM-26, and cisplatin combined with the systemic administration of VM-26, methotrexate, vincristine, bleomycin, and procarbazine. Oral glycerol was given before i.v. VM-26. Twelve patients responded (46% of all patients and 63% of the fully evaluable patients). The response rate for gliomas was 50% if all patients were considered and 71% if only fully evaluable patients were considered. The response rate did not seem to be affected by glioma grade, prior chemotherapy, or pretreatment performance status. Median time to tumor progression for responders was 19 weeks. Median survival from initiation of treatment was 21 weeks for evaluable patients and 17 weeks for all patients. Median survival from initial diagnosis was 55 weeks. Myelosuppression was dose-limiting for the systemic chemotherapy. Reversible neurological toxicity was common, but tolerable. One patient developed ipsilateral blindness, and two patients developed prolonged neurological toxicity. Pulmonary toxicity was also seen. Vertebral artery infusions proved feasible, although difficult and more toxic than carotid infusions. Overall, this regimen was not more active than the intraarterial combination of BCNU, VM-26, and cisplatin without the systemic chemotherapy. Further studies of more intensive intracarotid therapy combined with different systemic drugs are being initiated.
Spinal Granular Cell Tumor with Subarachnoid Hemorrhage: Case Report
Authors: Strümblad Lars-Güran , Brun Arne , Cameron Robert , Cronquist Sten 
Published: May 2010

Abstract
A granular cell tumor in the spinal canal that presented with subarachnoid hemorrhage is reported. The tumor was totally excised. The pathogenic and clinical aspects are discussed.
Magnetic Resonance Imaging of Syringomyelia Associated with an Extramedullary Spinal Cord Tumor: Case Report
Authors: Rhyner Patricia A. , Hudgins Roger J. , Edwards Michael S. B. , Brant-Zawadzki Michael 
Published: May 2010

Abstract
The association of syringomyelia and extramedullary spinal cord tumors is rare. We present the case of a patient with this association documented by magnetic resonance imaging and discuss the unusual features of the syrinx.
Malignant Recurrence of Childhood Cerebellar Astrocytoma: Case Report
Authors: Ushio Yukitaka , Arita Norio , Yoshimine Toshiki , Ikeda Takuya , Mogami Heitaro 
Published: May 2010

Abstract
A 15-year-old boy developed a glioblastoma in a cerebellar hemisphere 7 years after surgical excision and local irradiation of a pilocytic astrocytoma in the cerebellar vermis. Clinical and histopathological details are presented, and the literature on late malignant recurrence of childhood cerebellar astrocytoma is reviewed.
Intragastric Migration of a Ventriculoperitoneal Shunt Catheter
Authors: Oi Shizuo , Shose Yoshiteru , Asano Noboru , Oshio Takehito , Matsumoto Satoshi 
Published: May 2010

Abstract
A child developed bacterial meningitis and shunt dysfunction 2 years after the insertion of a ventriculoperitoneal shunt for posttraumatic hydrocephalus. The distal end of the shunt catheter had penetrated the gastric wall. We found no other report of intragastric shunt catheter migration with successful treatment
Intrahepatic Migration of a Peritoneal Shunt Catheter: Case Report
Authors: Touho Hajime , Nakauchi Mikio , Tasawa Toshiaki , Nakagawa Jyoji , Karasawa Jun 
Published: May 2010

Abstract
The intrahepatic migration of a peritoneal shunt tube of a ventriculoperitoneal shunt system (low pressure Pudenz valve and low pressure Pudenz peritoneal catheter) is reported. This is a rare complication of ventriculoperitoneal shunting and was diagnosed by metrizamide shuntography and abdominal computed tomography. To our knowledge, this is the second case complicated with migration of a peritoneal shunt tube into the liver.
Management of Inoperable Cerebral Aneurysms by the Navigational Balloon Technique
Authors: Weil Stuart M. , van Loveren Harry R. , Tomsick Thomas A. , Quallen Barbara L. , Tew John M. 
Published: May 2010

Abstract
Intravascular navigation with nondetachable balloons is a safe, effective method of treatment for inaccessible aneurysms of the internal carotid artery. The rate of ischemic complications is lower than that associated with carotid ligation, and the rate of subsequent hemorrhage is lower than that associated with either carotid ligation or direct clipping. Therefore, for many internal carotid artery aneurysms that originate at or proximal to the ophthalmic artery, the nondetachable balloon technique is an alternative treatment choice. During a 7-year period, 21 aneurysms of the internal carotid artery were treated by the nondetachable balloon technique. All 21 aneurysms were successfully excluded from the circulatory system by either proximal occlusion or trapping of the aneurysm neck. This series consisted of 8 carotid-ophthalmic artery aneurysms, 11 carotid-cavernous aneurysms (6 spontaneous, 5 traumatic), 1 petrous segment aneurysm, and 1 cervical segment aneurysm. At 3 years of follow-up, the following incidences were noted: transient ischemia, 4.7%; infarction, 9.6%; and hemorrhage, 0%. The complications were 1 case of transient hemiparesis and 2 late ischemic events. Fifty per cent of the patients underwent follow-up computed tomography, and thrombosis of the aneurysm was confirmed in all except one case, which was partially thrombosed.
Effects of Intravascular Volume Expansion on Cerebral Blood Flow in Patients with Ruptured Cerebral Aneurysms
Authors: Yamakami Iwao , Isobe Katsumi , Yamaura Akira 
Published: May 2010

Abstract
To clarify the effect of intravascular volume expansion on cerebral blood flow (CBF) in patients after subarachnoid hemorrhage (SAH), we performed 55 pairs of regional CBF measurements using the xenon-133 inhalation method before and after volume expansion in 35 patients with ruptured cerebral aneurysms. CBF was calculated as the hemispheric mean value of the initial slope index. To accomplish volume expansion, we transfused 500 ml of 5% human serum albumin in half an hour. After volume expansion with albumin, the hemoglobin value decreased significantly (P &lt; 0.005). Volume expansion did not change the mean arterial blood pressure. During the first 2 weeks after SAH, CBF decreased significantly after volume expansion (P &lt; 0.005). During the 3rd week after SAH and subsequently to the 4th week after SAH, volume expansion produced no change in CBF. In patients with symptomatic vasospasm, CBF decreased significantly after volume expansion (P &lt; 0.005). In patients without symptomatic vasospasm, volume expansion produced no change in CBF. The results of this study suggest that increasing the intravascular volume above normal by volume expansion does not increase CBF or reverse symptomatic vasospasm.
Subarachnoid Hemorrhage of Unknown Cause
Authors: Suzuki Shinsuke , Kayama Takamasa , Sakurai Yoshiharu , Ogawa Akira , Suzuki Jiro 
Published: May 2010

Abstract
After the institution of computed tomography (CT), 814 cases of spontaneous subarachnoid hemorrhage (SAH) were treated during a period of 6 years and 9 months (April 1978 through December 1984). In 9 (22.0%) of 41 patients whose cause of SAH was not determined by the first four-vessel study (cerebral panangiography), ruptured aneurysms were found by repeated four-vessel study. Thus, of 814 cases, only 32 (3.9%) were diagnosed as cases of unknown etiology at discharge. The 32 cases were monitored by follow-up examination for 5 to 67 months (median, 27.1 months) after onset. No recurrence of SAH was reported, and all patients were rehabilitated except 2 who suffered terminal carcinoma. A third follow-up four-vessel study was performed 8 to 44 months (median, 22.0 months) after the second study in 14 of the 16 patients with SAH initially demonstrated by CT. In 1 of these cases, an aneurysm found 9 months after the initial SAH was treated surgically. Ultimately, 31 cases (3.8%) were diagnosed as cases of SAH of unknown cause. This incidence is low when compared with those in previous reports. Because of the strict examination schedule including repeated angiography, the incidence is lower and the prognosis is relatively favorable.
Intradural Spinal Lipomas
Authors: McGillicuddy Gerald T. , Shucart William , Kwan Edward S. K. 
Published: May 2010

Abstract
Intradural spinal lipomas are rare, and their origin is unknown. Although the clinical presentation may not be distinctive, the neuroradiographic presentation is. Total excision is usually not possible, although subtotal resection is easily accomplished using an ultrasonic aspirator.
Pituitary Tumors Composed of Adenohypophysial Adenoma and Rathke's Cleft Cyst Elements: A Clinicopathological Study
Authors: Nishio Shunji , Mizuno Junichi , Barrow Daniel L. , Takei Yoshio , Tindall George T. 
Published: May 2010

Abstract
Nine cases of pituitary tumors composed of mixed tissue elements of adenohypophysial adenoma and Rathke's cleft cyst are reported. All cases were associated with hyperprolactinemia and were managed by transsphenoidal adenomectomy with good results. The clinical and pathological features are presented, and embryological pathogenesis for the occurrence of this unique association is discussed in connection with the high incidence of immunoreactive S-100 protein cells identified in tumor tissues. Patients with this kind of pituitary tumor can be managed in the same fashion as patients with other types of pituitary adenoma.
Median Nerve Somatosensory Evoked Potentials as an Indicator of Ischemia in a Case Involving an Aneurysm of the Internal Carotid Artery
Authors: Hyman Steve Alan , Skelley Cynthia C. , Arendall Rex , Woncik Karen S. , Berman Lawrence M. 
Published: May 2010

Abstract
We present a case report demonstrating that somatosensory evoked potentials (SEPs) suggested ischemia when an internal carotid aneurysm ruptured during surgical clipping. SEPs were also recorded from the contralateral cortex and subcortical and peripheral sites and remained unchanged. The use of multiple bilateral recording sites for SEP recording simplified the interpretation of acute changes.
Preservation of the Supraspinous Ligament for Spinal Stenosis: A Technical Note
Authors: Joson Raymond M. , McCormick Kathryn J. 
Published: May 2010

Abstract
Laminectomies and bilateral laminotomies for spinal stenosis have been performed over a period of 16 years at the Mercy Catholic Medical Center by preserving the supraspinous ligament along with the tips of the lumbar spines. More recently, this has been done utilizing a unilateral approach. This operation is technically feasible and with practice can be done routinely for extensive spine decompression, even for spinal tumor resection or spinal fusion.
Supraorbital-Pterional Approach to Skull Base Lesions
Authors: Al-Mefty Ossama 
Published: May 2010

Abstract
A surgical approach to the skull base is described. It allows excellent exposure of the cranial base with minimal brain retraction. Deep lesions can be handled via subfrontal, transsylvian, or subtemporal routes during the same operation. This approach is most suitable for large lesions in the suprasellar, parasellar, and retrosellar areas and for those that extend into the cavernous sinus, along the tentorial notch, or into the orbit. After the single bone flap is replaced, there is little or no functional, anatomical, or cosmetic deficit. Our experience in 16 cases and suggestion for the use of this approach are presented.
Radiofrequency Hyperthermia for Malignant Brain Tumors: Preliminary Results of Clinical Trials
Authors: Tanaka Ryuichi , Kim Choong Hong , Yamada Nobuhisa , Saito Yoshiaki 
Published: May 2010

Abstract
Local hyperthermia by 13.56-MHz radiofrequency (RF) capacitive heating was evaluated in 16 patients with malignant brain tumors. Intracranial heating during operation was performed in 4 patients. RF applicators with a cooling system were placed on the cerebral convexity and medial brain surface with the tumor between them. RF power was controlled to maintain the brain temperatures under 40°C. Under this condition, the highest temperature of each tumor varied from 44 to 49°C. After heating for about 60 minutes, 2 tumors showed regression on computed tomographic (CT) scans. Extracranial heating was performed in 12 patients with cerebral glioblastoma. RF applicators were placed on the lateral sides of the scalp and applied to diametrically opposite sides of the tumor. To avoid the influence of the skull on RF conduction, we performed a bilateral craniectomy slightly larger than the applicator at the initial operation. Heating was performed for approximately 60 minutes at each session and was repeated twice a week for a total of 4 to 10 times in combination with radiation and ACNU chemotherapy. No anesthetic agent was used during heating. Brain temperatures were maintained under 42°C. The scalp under the applicators remained at 28-35°C during heating, and no heat injury of the scalp was observed after repeated heating. The highest temperatures of the tumor or cavity after tumor removal were 45-46°C in 3 cases, 43-44°C in 3 cases, 42-43°C in 4 cases, and 40-41°C in 2 cases, respectively. Six of 10 evaluable tumors on CT scan showed regression after treatment. Low density lesions appeared transiently in the RF field in the brains of 2 patients. The present study showed that RF capacitive heating can be used safely to heat malignant tumors in the human cerebrum.
Intramedullary Fibrosarcoma of the Cervicomedullary Junction: A Case Report
Authors: Rappaport Harry Z. , Constantini Shlomi , Sigal Tali , Shuger Lucia 
Published: May 2010

Abstract
A 17-year-old girl presented with signs of increased intracranial pressure. On computed tomography, an enhancing intraaxial lesion in the region of the foramen magnum was demonstrated. Surgical excision was performed. The pathological diagnosis was low grade fibrosarcoma. Her subsequent course was complicated by cerebrospinal fluid seeding, a posterior fossa recurrence, and repeated subarachnoid hemorrhage with cerebral vasospasm. A combination of radiotherapy and intraventricular chemotherapy has left the patient symptom-free 2 years after operation. The intramedullary appearance of fibrosarcoma and the unusual subsequent clinical course are discussed. (Neurosurgery 21:551-553, 1987)
Idiopathic Massive Osteolysis of Skull Bones: A Case Report
Authors: Rao Ranga S. V. , Reddy Raja D. , Reddy Madhav G. , Reddy Kantha P. , Mohan U. L. , Reddy Mohan 
Published: May 2010

Abstract
A rare case of idiopathic massive osteolysis involving cranial bone is reported. Radiological and computed tomographic findings are discussed, along with a brief review of the literature. (Neurosurgery 21:564-566, 1987)
Cervical Carotid Artery Dissection Secondary to Malignant Fibrous Histiocytoma
Authors: Kaplan Barry J. , Day Arthur L. 
Published: May 2010

Abstract
A rare case of malignant fibrous histiocytoma of the cervical carotid artery is presented. Erosion of the vessel wall by this neoplasm resulted in dissection and pseudoaneurysm formation. The etiology and diagnosis of and the therapeutic alternatives for this unique disorder are discussed briefly. (Neurosurgery 21:571-574, 1987)
Ganglioglioma of the Cerebellum: Case Report
Authors: Mizuno Junichi , Nishio Shunji , Barrow Daniel L. , Davis Patricia C. , Tindall George T. 
Published: May 2010

Abstract
The authors report a rare case of a cerebellar ganglioglioma. A review of 12 previously reported cases and our case suggest that surgical removal of this neoplasm carries a good prognosis.
Proposal for Bipolar Coagulation of the Sella Turcica Wall during Pituitary Tumor Operation
Authors: Levy Walter J. 
Published: May 2010

Abstract
Convoluted morphology, limited visualization, and the lack of appropriate instruments limit the surgical approach to the walls of the sella turcica. They are, however, a site of local invasion and retained tumor fragments in cases of pituitary lesions. Effective bipolar coagulation within the sella turcica could reduce recurrence from local invasion, but it is made difficult because rigid bipolar forceps cannot fit effectively or safely against the complex contours of the walls there. Effective coagulation and thorough tumor removal are further frustrated by the lack of direct visualization of either the sella walls or the part of the floor adjacent to the surgical opening. It would be desirable, however, to coagulate the dura mater and retained tumor fragments. As an aid in this problem, we are reporting the use of a flexible bipolar coagulation system in two forms and of a mirror system for visualization in the sella without requiring the removal of one hand from surgical maneuvers. A pair of parallel flexible wire extensions to the standard bipolar forceps can be shaped by the surgeon into a contour that will coagulate the specific local terrain. A web of wire woven into one surface of a cotton patty, which is a bipolar coagulation system, supplements the wire loops. This allows the walls of the sella turcica to be coagulated more effectively where the contours are difficult to gauge and not well visualized. For visualization of the sella turcica walls and floor, we have used a small front surface mirror 1.0 mm thick. With a small suction-cotton patty placed behind the mirror, the mirrior can be used to dry fields or those with a mild ooze. It provides good visualization of the sellar walls when focused on by an operating microscope. In 11 cases, this system was an aid in control of bleeding and allowed coagulation of the sella walls. Furthermore, it has allowed identification of persistent tumor fragments on the sella wall in 3 cases. These fragments were then removed, and their attachment was coagulated. This capability may allow identification and coagulation of tumor that cannot be reached currently. If these sites are so treated, recurrence rates may be reduced significantly.
Reoperation for Recurrent Glioblastoma and Anaplastic Astrocytoma
Authors: Harsh Griffith R. , Levin Victor A. , Gutin Philip H. , Seager Margaret , Silver Pamela , Wilson Charles B. 
Published: May 2010

Abstract
The advisability of a second operation for recurrent glioblastoma multiforme or anaplastic astrocytoma depends on the expected duration and quality of subsequent survival. We reviewed the results in 70 consecutive patients who underwent reoperation for supratentorial glioblastoma multiforme (n = 39) or anaplastic astrocytoma (n = 31) between 1975 and 1984. The operative morbidity rate was 5.7% (4 of 70 patients); the 6-week postoperative mortality rate was 4.3% (3 of 70 patients). The median duration of survival after reoperation was 36 weeks in patients with glioblastoma multiforme and 88 weeks in those with anaplastic astrocytoma. The median duration of high quality survival (defined as the period during which the patient had a Karnofsky performance score of at least 70) after reoperation was 10 weeks for patients with glioblastoma multiforme and 83 weeks for patients with anaplastic astrocytoma. Age and preoperative Karnofsky score in patients with glioblastoma multiforme and age in patients with anaplastic astrocytoma had statistically significant effects on the duration of high quality survival after reoperation, but not on postoperative survival independent of quality. Although age and functional status do not significantly affect the duration of survival after reoperation, they do have a significant effect on the quality of life after reoperation. Frequently, a patient can expect to spend a greater portion of his life at a higher level of function than he would have without reoperation. As adjunctive forms of therapy improve, reoperation will play an increasingly prominent role in the management of recurrent malignant astrocytic tumors. (Neurosurgery 21:615-621, 1987)
Diagnostic Potential of Magnetic Resonance in Cases of Foramen Magnum Meningiomas
Authors: Wagle V. G. , Melanson D. , Ethier R. , Bertrand G. , Feindel W. 
Published: May 2010

Abstract
Meningioma is a histologically benign tumor that is second in frequency only to gliomas among primary intracranial tumors. Its extracerebral development and generally clear demarcation from the brain does not make it easier to detect on magnetic resonance (MR) scanning. Only 2 to 3% of meningiomas occur in the foramen magnum, and these tumors are often clinically misdiagnosed. We discuss four cases of foramen magnum meningioma, with emphasis on MR scanning.
Neuropsychological Function in Patients after Subarachnoid Hemorrhage
Authors: Bornstein R. A. , Weir B. K. A. , Petruk K. C. , Disney L. B. 
Published: May 2010

Abstract
Neuropsychological testing of 48 patients who had undergone operation for subarachnoid hemorrhage (SAH) due to aneurysm was performed. Before this, the patients had their level of neurological recovery classified by neurosurgeons (37 good outcome vs. 9 poor outcome). These clinical categories correlated well with the results of neuropsychological testing. The degree of psychological impairment was related to age. The mean duration between SAH and clipping of the ruptured aneurysm was 4.6 days (range, 1-16 days), and 59% had operations on or before Day 3 post-SAH. Of the 37 patients with good neurological outcome, 26 patients had good neuropsychological outcome (no more than mild deficit). Poor neuropsychological outcome was associated with age and anterior communicating artery aneurysms. The incidence of significant neuropsychological deficit was considerably less than in previous reports, and possible explanations are discussed.
Spontaneous Subarachnoid Hemorrhage in Young Adults
Authors: Biller José , Toffol Gilbert J. , Kassell Neal F. , Adams Harold P. , Beck David W. , Boarini David J. 
Published: May 2010

Abstract
We evaluated 95 hospitalized patients (50 women and 45 men) aged 15 to 45 who had nontraumatic subarachnoid hemorrhage (SAH). Aneurysmal SAH was identified in 75 patients. Other causes for SAH were ruptured arteriovenous malformations (2 cases), amphetamine arteritis (1 case), and leptomeningeal melanoma (1 case). The cause of SAH was undetermined in 16 (17%) patients. Thirteen patients had histories of hypertension, 5 used oral contraceptives, and 4 had consumed large quantities of alcohol during the day before SAH. Only 1 patient had Type I diabetes mellitus. Diagnosis was delayed in 21 patients. Operation was performed in 71 patients, with only 3 (4.2%) deaths. The overall mortality was 8.4% (8 of 95), with all deaths due to neurological causes. Our data suggest that the overall management and surgical results of treatment of ruptured aneurysms in young adults are excellent, diabetes is rare among young adults with SAH, recent alcohol consumption does not seem to be a major factor predisposing to SAH in young adults, and misinterpretation of the early symptoms of SAH continues to be a serious problem. (Neurosurgery 21:664-667, 1987)