bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estrogen and Progesterone Receptors in Meningiomas: Comparison of Nuclear Binding, Dextran-Coated Charcoal, and Immunoperoxidase Staining Assays
Authors: Halper Jaroslava , Colvard Douglas S. , Scheithauer Bernd W. , Jiang Nai-Siang , Press Michael F. , Graham Mark L. , Riehl Elizabeth , Laws Edward R. , Spelsberg Thomas C. 
Published: April 2011

Abstract
We studied the status of estrogen (ER) and progesterone (PR) receptors in meningiomas removed from 52 patients, comparing dextran-coated charcoal (DCC), nuclear binding (NB), and immunoperoxidase (IP) assays. Each of the assays was performed independently by investigators well-experienced with these assays. The NB assay is a new assay that measures functional steroid receptors—that is, the activation of the receptor and its binding to the nucleus. The assay is very sensitive and requires a relatively small amount of tissue as compared with the DCC assay. In agreement with data from other studies, PR were detected in most meningiomas by all 3 methods: in 69% of the cases by NB, in 76% by DCC, and in 89% by IP. ER were detected in only a few cases: in 33% by NB, in 2% by DCC, and in none by the IP assay. The agreement for PR sites was 62% for all 3 assays, it was 66% between the NB and DCC assays, 67% between the NB and IP assays, and 86% between the DCC and IP assays. Of 26 cases that were positive by the DCC assay, 6 (23%) were negative by NB. The overall agreement for all three ER assays was 65%. The data suggest that the majority of meningiomas contain high-affinity receptors for progesterone, that estrogen receptors are present in only a few meningiomas, and that some of these estrogen and progesterone receptors appear to be functional.
Microsurgical Treatment of Glossopharyngeal Neuralgia: Case Reports
Authors: Fraioli Bernardo , Esposito Vincenzo , Ferrante Luigi , Trubiani Lanfranco , Lunardi Pierpaolo 
Published: April 2011

Abstract
Three patients with excruciating glossopharyngeal neuralgia underwent microsurgical operations in the posterior cranial fossa. In each patient, neurovascular compression was found involving the posteroinferior cerebellar artery and involving the 9th and 10th cranial nerves. In two of the patients, the compression was caused by arachnoiditis and in the other by an arterial loop. In each patient, neuralgia was successfully eliminated by microvascular decompression and by section of the upper rootlets of the vagus nerve. In one patient, partial section of the 9th cranial nerve was also performed. Because of the frequent involvement of the vagus nerve in the pathogenesis of this condition, open surgery should be preferable to percutaneous thermorhizotomy, which is unable to act selectively on the 10th cranial nerve.
Modified Application of Three-Point Skull Clamp for Infants
Authors: Aoki Nobuhiko , Sakai Tatsuo 
Published: April 2011

Abstract
A standard three-point skull clamp is modified for application to infants. Rubber plugs (usually used for antibiotic bottles) pierced by the skull pins are used to avoid intracranial penetration of the pins. The upper surface of the rubber plugs attached to the scalp contributes to support of the head. Four infants were successfully treated in a prone position with this technique.
The Benefits of Early Jejunal Hyperalimentation in the Head-Injured Patient
Authors: Grahm Thomas W. , Zadrozny Donna B. , Harrington Timothy 
Published: April 2011

Abstract
To determine the efficacy of early jejunal hyperalimentation as nutritional support in the head-injured patient, 32 head-injured patients with Glasgow Coma Scale scores less than 10 were studied for the first 7 days after injury. The experimental (E) group had nasojejunal feeding tubes placed fluoroscopically. Within 36 hours of injury, they received nutritional support equal to their measured resting energy expenditure. The control (C) group was fed gastrically when bowel sounds returned. There were no significant differences (P &gt; 0.05) in age, Glasgow Coma Scale score, type of neurological injury, or associated injuries between the two groups. The mean resting energy expenditure, serum albumin, glucose, lymphocyte count, body weight, and total nitrogen loss were nearly identical for both groups. With the jejunal feedings, daily caloric (E = 2102 kcal versus C = 1100 kcal) and nitrogen intake (E = 11.1 g versus C = 5.6 g) and daily nitrogen balance (E = -4.3 g versus C = -11,8 g) improved. The incidence of bacterial infections (E = 3 versus C = 14) and days of intensive care unit hospitalization (E = 6 versus C = 10) were significantly reduced (P &lt; .05). Headinjured patients will tolerate early jejunal hyperalimentation despite the presence of a clinically silent abdomen, and the cost and complications of total parenteral nutrition are avoided. The increased caloric and nitrogen intake and improved nitrogen retention markedly reduced infections and days of stay in the intensive care unit. (Neurosurgery 25:729-735, 1989)
Arterial Wall Changes in Cerebral Vasospasm
Authors: Findlay J. M. , Weir B. K. A. , Kanamaru K. , Espinosa F. 
Published: April 2011

Abstract
A right-sided subarachnoid hemorrhage (SAH) was created in 12 monkeys. Only the right (clot-side) cerebral arteries developed angiographic vasospasm (VSP), which was maximal 7 days after SAH. Eight animals were killed at this time and the remainder at 14 days. At the time of killing the middle cerebral arteries (MCAs) were harvested, and four normal, left (non-clot-side) MCAs were vasoconstricted in vitro with prostaglandin F2… All MCAs were studied with scanning and transmission electron microscopy. Right MCAs in maximal VSP 7 days from SAH were undistinguishable on scanning electron microscopy from normal arteries vasoconstricted in vitro: both groups demonstrated a mean 57% reduction in vessel caliber and a 5-fold increase in vessel wall thickness compared to normal, nonvasoconstricted left MCAs. On transmission electron microscopy, however, arteries in SAH-induced VSP showed degenerative changes in the tunica intima and media. These changes were still evident at 14 days. despite considerable resolution of VSP. These findings, as well as those from other pathological studies of animal and human cerebral arteries in VSP, suggest that the arterial narrowing and vessel wall thickening seen within several weeks of SAH is due primarily to medial contraction, but unlike simple vasoconstruction, is associated with degenerative ultrastructural changes in the endothelium and vascular smooth muscle cells which may denote a temporarily irreversible state.
Zygomatic Temporopolar Approach for Basilar Artery Aneurysms
Authors: Shiokawa Yoshiaki , Saito Isamu , Aoki Nobuhiko , Mizutani Hiroshi 
Published: April 2011

Abstract
For surgery of upper basilar artery aneurysms, we have modified the temporopolar approach proposed by Sano by detaching the zygomatic arch to obtain a wide, shallow operating field. This approach seems to be suitable for anteriorly protruding, high-positioned, or large aneurysms of the upper basilar artery. We have used this zygomatic temporopolar approach in 4 patients with such aneurysms and obtained satisfactory results. In this paper, we detail the operative procedure and emphasize certain technical points to minimize temporal lobe retraction and to prevent oculomotor and facial nerve injuries.
Zygomatic Approach for Resection of Mesial Temporal Epileptic Focus
Authors: Shimizu Hiroyuki , Suzuki Ichiroh , Ishijima Buichi 
Published: April 2011

Abstract
By using the zygomatic approach, temporal mesial and polar epileptic foci are easily accessible through an incision in the inferior temporal gyrus. In this approach, a major part of the superior and middle temporal gyrus is preserved, and there is no risk of postoperative dysnomia even on the dominant side for speech. Combined use of depth and subdural electrodes is advisable for precise determination of focus distributions throughout the mesial and lateral structures of the temporal lobe. We have applied this approach in 5 patients with satisfactory results.
Isolated Injection Injury to the Posterior Femoral Cutaneous Nerve
Authors: Iyer Vasudeva G. , Shields Christopher B. 
Published: April 2011

Abstract
The sciatic nerve is by far the most common nerve accidentally injured during intramuscular injection. Despite its close proximity to the sciatic nerve, however, injury to the posterior femoral cutaneous nerve is apparently quite rare. In this report, clinical features of a patient with isolated injection injury to the posterior femoral cutaneous nerve are described.
Long-Term Results of the Surgical Treatment of Spinal Dermoid and Epidermoid Tumors.
Authors: Lunardi Pierpaolo , Missori Paolo , Gagliardi Franco M. , Fortuna Aldo 
Published: April 2011

Abstract
The clinical findings and the results of surgical treatment in 16 patients with spinal dermoid or epidermoid tumors are reported. In 9 patients the tumor capsule adhered so tightly to the nervous tissue that part of it was left in situ. In a follow-up study ranging from 5 to 30 years with a mean of 14.2 years only 1 patient had a recurrence of the tumor and 10 patients resumed a normal working life.
Anterior Cervical Fusion and Osteosynthetic Stabilization According to Caspar: A Prospective Study of 41 Patients with Fractures and/or Dislocations of the Cervical Spine
Authors: Goffin Jan , Plets Christian , Van den Bergh Raymond 
Published: April 2011

Abstract
Between June 1984 and April 1988, 41 patients with severe posttraumatic lesions of the cervical spine between the C2-C3 and the C7-T1 level seen consecutively were treated by an anterior cervical fusion and osteosynthetic stabilization according to Caspar. These patients were prospectively studied. Seven patients had a bilateral facet dislocation, 5 a unilateral facet dislocation, 9 an anterior subluxation, 9 an anterior compression fracture, 5 a hangman's fracture, and 6 a hyperextension injury at a lower cervical level. From a neurological point of view, there were 12 patients with an initial complete transverse lesion and 14 with an incomplete transverse lesion, and the remaining 15 patients did not have any deficit initially. Four patients died during the first 3 months after the operation. In 38 patients good anatomical position was obtained, generally by the intraoperative use of the vertebral distractor of Caspar. In all patients excellent immediate postoperative stability of the spine was obtained, although in 2 patients a second operation was necessary a few days after the first one. Postoperatively all patients were “immobilized” by a soft collar for 3 months. Four patients with an initial complete transverse lesion showed some neurological recovery in the postoperative period, and all patients with an incomplete transverse lesion improved. There were no postoperative neurological disturbances in the group of patients who were neurologically normal from the beginning. The mean postoperative hospitalization time was 13.6 days. These results were compared to the results from the literature, concerning other conservative and operative treatments for posttraumatic lesions of the cervical spine.
Causes of Infections in Penetrating Head Wounds in the Iran-Iraq War
Authors: Aarabi Bizhan 
Published: April 2011

Abstract
Factors seemingly influential in postoperative central nervous system infections were evaluated in 379 patients who sustained missile wounds to the head during the Iran-Iraq War. The mean wound age was 49 hours. The site of injury and presence of retained bone and/or shell fragments did not have a significant effect on infection rate. Thirty-three of 379 patients developed cerebrospinal fluid (CSF) fistulas of which 12 (36%) were associated with infection. The infection rate was 6 of 346 (1.7%) in the absence of CSF leaks. There was a statistically significant association between CSF fistula and infection. All 6 positive cultures in patients with CSF fistulas were gram-negative. Thirty-two patients died during the study, a mortality rate of 8.4%. The mortality rate from infection was 1.8%. Two hundred seventy-seven of 347 patients were followed for a mean of 22 ± 17 months during which time 2 patients were readmitted with central nervous system infections, both due to CSF leakage. CSF fistulas were the main predisposing factor in postdebridement central nervous system infections in this study.
Pterional Approach for Surgical Treatment of Olfactory Groove Meningiomas
Authors: Hassler W. , Zentner J. 
Published: April 2011

Abstract
We present our experience with the surgical treatment of olfactory groove meningiomas using a pterional approach. This approach provides the advantages of previous techniques, such as preserving the frontal brain and superior sagittal sinus, early devascularization of the tumor, and late dissection of tumor borders. Moreover, it also compensates for the shortcomings of other techniques, e.g., compression of frontal bridging veins, late dissection of dorsal tumor aspects involving vessels and optic nerves as well as facultative infection and cerebrospinal fluid fistula-related complications caused by opening of frontal sinuses. To date, 11 patients were treated in this way. As we encountered no surgical complications in our series we are encouraged to present our procedure.
Intramedullary Epidermoid Cyst Evaluated by Computed Tomographic Scan and Magnetic Resonance Imaging: Case Report
Authors: Penisson-Besnier Isabelle , Guy Gilles , Gandon Yves 
Published: April 2011

Abstract
The authors have treated a 20-year-old man with a dorsal intramedullary epidermoid cyst in whom magnetic resonance imaging was performed both before evacuation of the cyst and 3 months later. Intraspinal epidermoid tumors are rare, and the intramedullary location is quite uncommon. To our knowledge, this is the first description of magnetic resonance imaging of an intramedullary epidermoid cyst. The frequency, possibilities, and limits of surgical treatment of such intraspinal benign tumors are reviewed.
Benign Brain Stem Lesions in Pediatric Patients with Neurofibromatosis: Case Reports
Authors: Raffel Corey , McComb Gordon J. , Bodner Sara , Gilles Floyd E. 
Published: April 2011

Abstract
The symptoms and clinical courses of 4 patients with neurofibromatosis and lesions of the brain stem identifiable on computed tomographic and/or magnetic resonance imaging scans are described. Two patients underwent biopsy and both had low-grade astrocytomas with no evidence of anaplasia. Both received radiation and chemotherapy. The other 2 patients have been monitored without biopsy or treatment. Three patients are alive and clinically stable, having been followed up for an average of 4 years; neuroimaging studies have shown no change in their tumors. The fourth patient died of a supratentorial primitive neuroectodermal tumor. Imaging studies had shown no change in his brain stem lesion, which at autopsy was found to be a focal collection of fibrillary astrocytes. These data suggest that some patients with brain stem lesions and neurofibromatosis may have a prognosis distinctly different from that of the typical patient with a brain stem glioma. We recommend caution against aggressive operative and adjuvant therapy for brain stem lesions in patients with neurofibromatosis, unless progression of the lesion is documented clinically and/or by imaging.
The Results of Treatment of Gunshot Wounds to the Brain in Children
Authors: Miner Michael E. , Ewing-Cobbs Linda , Kopaniky Dennis R. , Cabrera Juan , Kaufmann Paul 
Published: April 2011

Abstract

Thirty-three children ranging in age from 8 months to 15 years were treated for gunshot wounds to the brain. Half of the children were less than 10 years old. Fifty-eight percent died. Mortality was influenced by the trajectory of the bullet, intent to commit suicide, and the neurological status immediately after injury. The age and sex of the child and the caliber of the bullet did not influence survival. Three-fourths of the deaths occurred within 24 hours of injury, suggesting these patients had a mortal wound from the onset. Eleven of the children were attempting suicide, 9 of whom died; 13 were playing with a gun, 5 of whom died; 2 were shot as innocent bystanders to crimes in progress; 1 was shot while involved in a criminal act; 1 was shot in a hunting accident; and in 2 who died within minutes of arrival, the circumstances of the shooting were not documented. Of the survivors, none was left vegetative after 6 months, 3 had severe disabilities, 9 were moderately disabled, and 2 had a good outcome. The mortality rate is strikingly similar to that of adults with similar injuries; however, the morbidity appears to be less. On the other hand, with simple preventative measures, virtually each injury would have been avoided. (Neurosurgery 26:20-25, 1990)
Intramedullary Spinal Cord Abscess
Authors: Koppel Barbara S. , Daras Michael , Duffy Kent R. 
Published: April 2011

Abstract

Viral myelitis and bacterial epidural infections are common in intravenous drug abusers, but primary infections of the spinal cord are extremely rare. We report a 50-year-old active intravenous drug user who developed tetraplegia from an intramedullary abscess caused by Pseudomonas cepacia. Despite neurosurgical drainage and appropriate antibiotic therapy, no improvement was seen. Earlier intervention and a high index of suspicion is required in patients with a history of intravenous drug abuse and spinal cord symptoms. (Neurosurgery 26:145-146, 1990)
The Relationship between Ventricular Fluid Pressure and Body Position in Normal Subjects and Subjects with Shunts: A Telemetric Study
Authors: Chapman Paul H. , Cosman Eric R. , Arnold Michael A. 
Published: April 2011

Abstract
Using a chronically implanted telemetric pressure sensor, we have determined the quantitative relationship between changes in body position and ventricular fluid pressure in normal subjects and subjects with shunts. The method allows accurate, reliable measurement of negative as well as positive pressures. We describe the derangement of postural intraventricular pressure regulation caused by placement of a shunt, as well as the influence of various shunt systems and the antisiphon device on this problem. Ventriculoatrial, ventriculoperitoneal, and ventriculopleural shunts all caused similar severely abnormal postural intracranial pressure relationships. The antisiphon device was generally effective in restoring normal pressures in patients in the upright position. We discuss the implications of our findings for understanding the mechanisms of postural intracranial pressure regulation in patients without hydrocephalus.
Automated Percutaneous Discectomy: A Prospective Multi-Institutional Study
Authors: Onik Gary , Mooney Vert , Maroon Joseph C. , Wiltse Leon , Helms Clyde , Schweigel Joseph , Watkins Robert , Kahanovitz Neil , Day Arthur , Morris James , McCullough John A. , Reicher Murray , Croissant Paul , Dunsker Stewart , Davis William G. , Brown Courtney , Hochschuler Stephen , Saul Thomas , Ray Charles 
Published: April 2011

Abstract
A prospective multi-institutional study was carried out to evaluate automated percutaneous discectomy in the treatment of lumbar disc herniations. Of the 327 patients who prospectively met the study criteria and were followed for longer than 1 year, 75.2% were successfully treated. When patients (n = 168) who prospectively did not meet the study criteria were treated, the success rate was 49.4%. One case of discitis was reported; otherwise, no other serious complications were noted, and specifically no vascular or nerve damage was encountered. This study indicates that automated percutaneous discetomy can be used successfully to treat lumbar disc herniations with minimal morbidity and emphasizes the need for proper patient selection.
L-Buthionine-Sulfoximine-Mediated Radiosensitization in Experimental Interstitial Radiotherapy of Intracerebral D-54 MG Glioma Xenografts in Athymic Mice
Authors: Lippitz Bodo E. , Halperin Edward C. , Griffith Owen W. , Colvin Michael O. , Honore Gerard , Ostertag Christoph B. , Bigner Darell D. , Friedman Henry S. 
Published: April 2011

Abstract
An intracranial (i.c.) interstitial radiotherapy model in athymic nude mice bearing i.c. D-54 MG human glioma xenografts was developed, allowing evaluation of the therapeutic benefits seen after L-buthionine-S, R-sulfoximine (L-BSO)-mediated depletion of tumor glutathione levels. Administration of L-BSO [2.5 mmol/kg intraperitoneal injections x 4 doses plus concomitant availability in acidified (pH 3.0) drinking water at a concentration of 20 mM] resulted in depletion of tumor glutathione levels to 0.15 mmol/g wet weight (7.9% of control). The therapeutic activity of i.c. interstitial radiotherapy with an 125I seed was enhanced after L-BSO-mediated glutathione depletion, with increases in median survival of 13.4 to 30.5% over that seen with 125I seeds alone. These studies demonstrate a potential role for BSO in enhancing the therapeutic activity of interstitial radiotherapy.
Transcranial Magnetic Stimulation of the Facial Nerve: Recording Technique and Estimation of the Stimulated Site
Authors: Seki Yojiro , Krain Larry , Yamada Thoru , Kimura Jun 
Published: April 2011

Abstract
We compared transcranial magnetic and conventional electrical stimulation in 20 facial nerves of 10 normal subjects. A magnetic coil was placed tangentially over T5 or T6 (10-20 electroencephalogram electrode placement system) and electrical stimulation was applied 1 cm below the anterior tragus. Compound muscle action potentials recorded from the ipsilateral nasalis muscle showed onset latencies (mean ± SD) of 4.48 ± 0.50 ms with magnetic stimulation and 3.15 ± 0.40 ms with electrical stimulation, a mean difference of 1.33 ± 0.14 ms. Stimulation of the extracranial facial nerve at two sites yielded a conduction velocity of 59.6 ± 4.5 m/s. Based on these findings, the magnetically stimulated site was estimated to fall 79.0 ± 8.6 mm proximal to the point of electrical stimulation. Taking the average length of the nerve trunk and histological specificity of the root exit zone into consideration, evidence indicates that the root exit zone of the facial nerve is the most likely initiating site of excitation with magnetic stimulation.
Multilevel Lumbar Laminotomies: An Alternative to Laminectomy in the Treatment of Lumbar Stenosis
Authors: Aryanpur John , Ducker Thomas 
Published: April 2011

Abstract
The traditional treatment for lumbar stenosis is a wide laminectomy. This procedure has a high success rate and a low, but not insignificant, incidence of complications. Recently, however, a better understanding of the pathophysiology of spondylotic lumbar stenosis has led several authors to propose a more limited decompression directed specifically toward the offending area of compression. Over the past 5 years, we have treated 32 patients with lumbar stenosis using decompressive laminotomies. Our patients all had focal lateral recess stenosis that was diagnosed by computed tomography or magnetic resonance imaging. We performed decompressive laminotomies and foraminotomies at appropriate levels. This procedure is less disruptive than a full laminectomy and. in experienced hands. requires less operating time. At last follow-up. 90% of the patients so treated reported an excellent outcome-namelv. total relief of symptoms and/or return to normal daily activities. There was no significant postoperative morbidity or mortality. We conclude that in a selected subgroup of patients with lumbar stenosis, multilevel laminotomies may be an acceptable alternative to laminectomy.