bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anatomical Study of the Cavernous Sinus Emphasizing Operative Approaches and Related Vascular and Neural Reconstruction
Authors: Sekhar Laligam N. , Burgess James , Akin Osman 
Published: May 2010

Abstract
The efficacy of three operative approaches to the cavernous sinus (CS) and the possibilities of vascular and cranial nerve reconstruction in and around the CS were studied in 50 cadaver specimens (25 heads). The lateral operative approach was through the lateral wall, between Cranial Nerves V1 and IV, or between Cranial Nerves V1 and V2. The superior approach was through the superior wall of the CS after removing the anterior clinoid process and unroofing the optic canal. The inferior approach followed the petrous internal carotid artery (ICA) into the CS after an extradural subtemporal exposure or after a combined subtemporal and infratemporal fossa exposure. The different exposures of the spaces of the CS and of the intracavernous structures provided by the superior and the lateral approaches were complementary. The exposure provided by the inferior approach was minimal; however, the junction of the petrous and cavernous ICA was best exposed by this route. The combined subtemporal and infratemporal fossa approach exposed the petrous ICA (for proximal control or for reconstruction) with the greatest ease and with the least temporal lobe retraction. The combination of the superior and lateral approaches and the complete mobilization of the intracavernous ICA facilitated its repair after experimental lacerations. Lacerations of either the inferior and the inferomedial aspects of any portion of the cavernous ICA or of the anterior surface of the posterior vertical segment of the artery were the most difficult to repair. End-to-end anastomosis was more difficult with the posterior third of the artery than with the anterior two-thirds. A vein graft with an average length of 3.5 cm could be sutured from the petrous to the supraclinoid ICA to bypass the cavernous ICA, with an average occlusion time of 45 minutes. End-to-end technique was judged better for the proximal anastomosis, but end (graft)-to-side anastomosis was easier to perform at the distal end because of the location of the ophthalmic artery. Resuture of Cranial Nerves III and VI could not be performed in fresh cadavers if the gap exceeded 0.3 cm. In 3 specimens, the exposure of Cranial Nerve VI in the posterior fossa through the petrous apex and in the orbital apex was followed by graft placement (bypassing the CS). The complex anatomy of the cranial nerves at the apex of the CS was also defined in 10 specimens. Surgeons who perform operations in and around the CS for neoplastic and vascular lesions will find these studies useful.
Higher Cortical Disorders: An Unusual Presentation of an Arteriovenous Malformation
Authors: Overbeeke J.J.v. , Bosma N.J. , Verdonck A. F. M. M. , Huffelen A. C. v. 
Published: May 2010

Abstract
The authors present a patient with a large arteriovenous malformation in the temperoparietooccipital region of the dominant hemisphere that caused seizures, a homonymous hemianopia, and broad neuropsychological disturbances probably caused by a cerebral steal syndrome. There was no history of hemorrhage. Surgical resection resulted in marked improvement of neuropsychological function and disappearance of the hemianopia. The authors discuss the pre- and postoperative neuropsychological findings, the pathogenesis of the steal phenomenon, and the indications concerning the resection of this large and deep-seated arteriovenous malformation in a functionally important region of the left hemisphere. They state that surgical resection is the method of choice.
Isolated Radial Nerve Palsy Due to Metastasis from a Primary Malignant Lymphoma of the Brain
Authors: vanBolden Vernon , Kline David G. , Garcia Carlos A. , vanBolden Georgia D. 
Published: May 2010

Abstract
A malignant lymphoma of the reticulum cell sarcoma variety developed in the right radial nerve of a 60-year-old man 3 years after he had presented with a primary malignant lymphoma of the brain. Serial evaluations and metastatic workups over several years failed to demonstrate evidence of extraneural metastasis.
Microsurgical Resection of Solitary Intramedullary Spinal Cord Metastases
Authors: Findlay Max J. , Bernstein Mark , Vanderlinden Graham R. , Resch Lothar 
Published: May 2010

Abstract
Two cases of solitary intramedullary spinal cord metastasis treated primarily by surgical excision are presented. It has been generally thought that appropriate management for the rare metastasis within the spinal cord is radiation and corticosteroids. The excellent palliative results obtained in our patients suggest that, in selected cases, surgical removal is technically feasible and can be of considerable benefit to the patient.
Painless Glossopharyngeal “Neuralgia” with Syncope: A Case Report and Literature Review
Authors: Reddy K. , Hobson D.E. , Gomori A. , Sutherland G.R. 
Published: May 2010

Abstract
Glossopharyngeal neuralgia is an uncommon craniofacial pain syndrome. An association with syncope is even less common. We report a case illustrating that the glossopharyngeal neuralgia-syncope syndrome can occur without pain in the sensory distribution of the glossopharyngeal nerve and that it can have similar consequences. We suggest that permanent cardiac pacing alone may be a viable option in the initial management of such cases.
Angiographic Revascularization of the Brain after Encephaloduroarteriosynangiosis: A Case Report
Authors: Matsushima Yoshiharu , Suzuki Ryuta , Ohno Kikuo , Masaoka Hiroyuki , Wakabayashi Shin-ichi , Maehara Taketoshi 
Published: May 2010

Abstract
Preoperative and postoperative angiograms of a 13-year-old Japanese girl with moyamoya disease are compared. She underwent an indirect extracranial/intracranial bypass operation called encephaloduroarteriosynangiosis (EDAS). Post-EDAS angiograms clearly show revascularization of the brain through the donor scalp artery and decrease in moyamoya vessels, leptomeningeal anastomoses, and preexisting spontaneous transdural anastomoses.
Preoperative Balloon Occlusion of Arteriovenous Malformations
Authors: Van Halbach V. , Higashida Randall T. , Yang Peter , Barnwell Stan , Wilson Charles B. , Hieshima Grant B. 
Published: May 2010

Abstract
Many materials have been utilized to embolize cerebral arteriovenous malformations (AVMs) preoperatively. Specific vascular anatomy with large feeding vessels deep to the nidus or aneurysms within feeding arteries favor the use of detachable balloons over other embolic agents. Detachable balloons allow test occlusion of a vascular pedicle before permanent occlusion and can obliterate aneurysms in feeding arteries. We describe 36 feeder arterial balloon occlusions performed in 31 patients. Twenty-nine patients subsequently had surgical resection. None of the patients developed normal perfusion pressure breakthrough or required blood transfusions. The preoperative balloon occlusion was judged by the neurosurgeon to decrease significantly the difficulty in surgical resection of the malformation. The remaining 2 patients underwent embolization before radiosurgery. One patient had aneurysms in the feeding artery, which was balloon-occluded to diminish the risk of hemorrhage. There were two neurological deficits and three asymptomatic arterial dissections related to the balloon procedure. Balloon occlusion of feeding arterial pedicles in selected cerebral AVMs may be a valuable surgical adjunct. (Neurosurgery 22:301-308, 1988)
Giant and Multiple Aneurysms of the Distal Posterior Inferior Cerebellar Artery
Authors: Dernbach Paul D. , Sila Cathy A. , Little John R. 
Published: May 2010

Abstract
A case involving giant and multiple aneurysms of the distal posterior inferior cerebellar artery (PICA) is presented. Of the 130 reported cases of peripheral aneurysms of the PICA, 6 have been described as giant aneurysms and 5 have involved multiple aneurysms located on a single PICA. The occurrence of multiple aneurysms including one giant aneurysm has not been reported previously. A clinical description of our case as well as a review of the literature is presented. (Neurosurgery 22:309-312, 1988)
Spinal Fixation after Anterior Decompression for Symptomatic Spinal Metastasis
Authors: Perrin Richard G. , McBroom Robert J. 
Published: May 2010

Abstract
Surgical strategies for the treatment of symptomatic spinal metastases must take into account both decompression of the spinal cord and stabilization of the spinal column. A method is described for securing spinal stabilization in patients who have undergone surgical decompression for symptomatic spinal metastases by an anterior approach. The fixation device used is a tailor-made prosthesis consisting of a U-shaped stainless steel plate permitting screw fixation to secure axial and rotational stability with an interposed methyl methacrylate strut to provide axial strength and support. The device has been used successfully in 51 patients who have undergone anterior decompression procedures for symptomatic spinal metastases. (Neurosurgery 22:324-327, 1988)
Comparison of Magnetic Resonance Imaging and Computed Tomography in the Preoperative Evaluation of Pituitary Adenomas
Authors: Nichols Douglas A. , Laws Edward R. , Houser O. Wayne , Abboud Charles F. 
Published: May 2010

Abstract
Twenty surgically verified pituitary adenomas were imaged in a systematic comparative fashion with high field strength magnetic resonance imaging (MRI) and computed tomography (CT) before operation. The study group included 11 microadenomas, 4 macroadenomas, 2 recurrent microadenomas, and 3 recurrent macroadenomas. The MRI and CT examinations were evaluated for lesion detection, pituitary stalk displacement, cavernous sinus displacement or invasion, hemorrhage, cystic degeneration within the adenoma, bony erosion, detection of suprasellar extension, and displacement of suprasellar structures. T1 and T2 relaxation characteristics of the adenomas were evaluated on MRI examinations, and contrast enhancement characteristics were evaluated on CT examinations. MRI was superior to CT for detecting the extrasellar extent of tumor. Within the sella turcica, MRI and CT were equivalent with regard to lesion detection, except for 1 patient in whom CT was able to detect a surgically confirmed 3-mm microadenoma that was not visualized on the MRI examination. (Neurosurgery 22:380-385, 1988)
Acute Subdural Hematoma Associated with Nontraumatic Middle Meningeal Artery Aneurysm: Case Report
Authors: Korosue Kazuyoshi , Kondoh Takeshi , Ishikawa Yoshihiro , Nagao Tomonori , Tamaki Norihiko , Matsumoto Satoshi 
Published: May 2010

Abstract
A rare case of acute subdural hematoma from rupture of a nontraumatic aneurysm of the middle meningeal artery is described. The subdural hematoma was evacuated and the aneurysm was removed. The literature on nontraumatic aneurysm of the middle meningeal artery is reviewed. The importance of cerebral angiography in the patient with an unexplained subdural hematoma is emphasized. (Neurosurgery 22:411-413, 1988)
Intraspinal Schwannoma Presenting Solely with Rectal Pain
Authors: Kornel Ezriel Edward , Vlahakos Demetrios 
Published: May 2010

Abstract
A cauda equina schwannoma presented solely with rectal pain. The tumor was found to have infarcted and hemorrhaged. A discussion of rectal pain is included, and it is speculated that some forms of rectal pain, especially those classified as proctalgia fugax or rectal neuralgia, may be due to cauda equina tumors. (Neurosurgery 22:417-419, 1988)
Amyloidoma of the Cervical Spine: A Case Report
Authors: Dickman Curtis A. , Sonntag Volker K.H. , Johnson Peter , Medina Marjorie 
Published: May 2010

Abstract
This is the first published report of an amyloidoma localized to the cervical spine. Primary amyloidosis of bone is rare. Only 5 cases involving the spine have been described. We present a 74-year-old man with cervical and occipital radicular pain as the manifestations of an amyloidoma involving the 2nd cervical vertebra. The signs and symptoms of this disease, when localized to the vertebrae, are nonspecific and result from bony destruction and compression of neural structures. Diagnosis requires a high index of suspicion and, ultimately, adequate tissue biopsy for histopathological studies. Curative resection is possible for well-localized lesions. Additionally, external immobilization with a halo vest and bony grafting for fusion may be indicated when the cervical spine is involved. (Neurosurgery 22:419-422, 1988)
Malignant Transformation in Craniopharyngioma
Authors: Nelson Glenn A. , Bastian Frank O. , Schlitt Michael , White Robert L. 
Published: May 2010

Abstract
Malignant transformation in a craniopharyngioma has not been described previously. A 49-year-old woman presented with recurrence of a suprasellar craniopharyngioma diagnosed 35 years previously. The patient had been treated surgically for recurrence on five occasions. Radiation therapy had been administered 7 years before the final presentation. Tissue obtained from the fifth operation revealed malignant degeneration in a typical craniopharyngioma. (Neurosurgery 22:427-429, 1988)
Use of Halifax Interlaminar Clamps for Posterior C1-C2 Arthrodesis
Authors: Cybulski George R. , Stone James L. , Crowell Robert M. , Rifai M.H.S. , Gandhi Yogesh , Glick Roberta 
Published: May 2010

Abstract
Eight patients with atlantoaxial instability secondary to trauma or rheumatoid arthritis were treated with posterior C1-C2 arthrodesis using the Halifax interlaminar clamp and autogenous bone graft or methylmethacrylate. Thus far, with an average follow-up of 6 months, satisfactory stability has been achieved with no instrument failure. (Neurosurgery 22:429-431, 1988)
Stereotactic Aspiration of Putaminal Hemorrhage Using a Double Track Aspiration Technique
Authors: Niizuma Hiroshi , Suzuki Jiro 
Published: May 2010

Abstract
Double track aspiration was used to remove the hematoma between 6 and 24 hours from onset in nine cases of putaminal hemorrhage. This technique was used in cases where an approach along the long axis of the hematoma was not feasible. With this method, aspiration is done at two target points lying anterior and posterior of the somewhat harder central region, at which aspiration is not attempted. This technique allows aspiration of most of the serum components, which are depicted as low density areas in computed tomographic (CT) scans, and some 53 to 85% of the main mass of the hematoma, which is seen on CT as high density areas. There was no rebleeding among these nine patients, and the remaining hematoma in all cases was located between two target points-a fact that is thought to indicate that the central portion of the hematoma is in fact somewhat harder than the peripheral portions. Although the double track aspiration technique has the disadvantage of producing two tracks, it is thought to be an effective method in such cases because it allows safe and thorough hematoma aspiration. (Neurosurgery 22:432-436, 1988)
Survival after Stereotactic Biopsy of Malignant Gliomas
Authors: Coffey Robert J. , Lunsford L. Dade , Taylor Floyd H. 
Published: May 2010

Abstract
For many patients with malignant gliomas in inaccessible or functionally important locations, stereotactic biopsy followed by radiation therapy (RT) may be a more appropriate initial treatment than craniotomy and tumor resection. We studied the long term survival in 91 consecutive patients with malignant gliomas diagnosed by stereotactic biopsy: 64 had glioblastoma multiforme (GBM) and 27 had anaplastic astrocytoma (AA). Sixty-four per cent of the GBMs and 33% of the AAs involved deep or midline cerebral structures. The treatment prescribed after biopsy, the tumor location, the histological findings, and the patient's age at presentation (for AAs) were statistically important factors determining patient survival. If adequate RT (tumor dose of 5000 to 6000 cGy) was not prescribed, the median survival was &lt;11 weeks regardless of tumor histology or location. The median survival for patients with deep or midline tumors who completed RT was similar in AA (19.4 weeks) and GBM (27 weeks) cases. Histology was an important predictor of survival only for patients with adequately treated lobar tumors. The median survival in lobar GBM patients who completed RT was 46.9 weeks, and that in lobar AA patients who completed RT was 129 weeks. Cytoreductive surgery had no statistically significant effect on survival. Among the clinical factors examined, age of less than 40 years at presentation was associated with prolonged survival only in AA patients. Constellations of clinical features, tumor location, histological diagnosis, and treatment prescribed were related to survival time. For patients with deep or midline malignant gliomas and for selected patients with lobar tumors in critical areas, stereotactic biopsy followed by RT and nonoperative adjuvant therapy is a rational treatment strategy to prolong survival and preserve neurological function. (Neurosurgery 22:465-473, 1988)
Cerebrovascular Hemodynamics in Arteriovenous Malformation Complicated by Normal Perfusion Pressure Breakthrough
Authors: Batjer H. Hunt , Devous Michael D. , Meyer Yves J. , Purdy Phillip D. , Samson Duke S. 
Published: May 2010

Abstract
Catastrophic hyperemic states are known complications after the treatment of certain types of intracranial arteriovenous malformations (AVMs). A case is presented in which a large AVM was preoperatively embolized and later resected. There was clear intra- and postoperative evidence of edema and hemorrhage, which resulted in a fatal outcome. Regional cerebral blood flow (rCBF) data from this patient obtained with single photon emission computed tomography (SPECT) both before and after embolization were compared with data from four patients with similar size supratentorial AVMs treated and studied in a similar protocol who did not develop perfusion breakthrough. Pretreatment hemispheric rCBF was significantly reduced in this patient's ipsilateral hemisphere (50 ml/100 g/min) compared to the control group mean (83 ± 9.5 ml/100 g/min). A similar relative depression was found in the contralateral hemisphere. After therapeutic embolization, the ipsilateral rCBF increased by 33 ml/100 g/min and the contralateral hemispheric rCBF increased by 30 ml/100 g/min; this embolization-induced increase in rCBF was significantly higher than in the control group. Acetazolamide, known to increase rCBF in normal tissue by 35 ± 3%, resulted in a 56% augmentation of ipsilateral hemispheric flow before embolization in the reported patient vs. a 22 ± 10% increase for the control group. Postembolization, this hyperresponsiveness to acetazolamide remained unchanged. It is possible that these hemodynamic derangements may indicate a dissociation between the vasoconstrictive and vasodilatory reactivity in chronically hypoperfused territories adjacent to AVMs such that pharmacological or metabolic stimuli may induce further vasodilation, but sudden redistribution of large volumes of flow will not promote protective vasoconstriction. (Neurosurgery 22:503-509, 1988)
Petrosal Approach for Petroclival Meningiomas
Authors: Al-Mefty Ossama , Fox John L. , Smith Robert R. 
Published: May 2010

Abstract
Thirteen patients harboring large petroclival meningiomas are reported. The evolution of the petrosal approach is discussed, and modifications for improvement in surgical technique are described. There was no mortality in this series, and total removal was achieved in all but two patients. Morbidity included cranial nerve deficit, pulmonary embolism, and hemiparesis. (Neurosurgery 22:510-517, 1988)
Intramedullary Spinal Cord Tumors Resected with CO2 Laser Microsurgical Technique: Recent Experience in Fifteen Patients
Authors: Herrmann Hans-Dietrich , Neuss Michael , Winkler Dietrich 
Published: May 2010

Abstract
We have operated upon 15 intramedullary spinal cord tumors with the aid of a CO2 laser attached to the microscope. The operative technique is described. Most of the tumors were localized within the cervical spinal cord. Nine tumors were benign gliomas: 4 ependymomas, 1 subependymoma, 3 astrocytomas, and 1 ganglioglioma. Six were removed totally, and 3 were removed subtotally. The remaining 6 tumors consisted of 3 hemangioblastomas, 1 intramedullary neurofibroma, 1 lipoma, and 1 primary intramedullary melanoma. Neurological function postoperatively compared to the preoperative function of the upper extremities was unchanged in 13 patients (86.5%), improved in 1, and worse in 1 patient. In the lower extremities, the preoperative neurological status was unchanged in 11 patients (73.3%), improved in 1 patient, and worse in 3 patients (20%). Magnetic resonance imaging was superior to myelography and computed tomography in localizing these lesions. Enhancement with paramagnetic substances (e.g., gadolinium-DTPA) helps to localize solid tumor within cysts. Histological evaluation of small tissue biopsies or frozen section histology is unreliable. The entire lesion should be exposed in all cases, and an attempt should be made to remove the tumor totally or, if this is not possible, to resect as much of the center of the tumor as is possible until the cord is decompressed. The decision to administer further treatment is based on the histological features of the tumor. (Neurosurgery 22:518-522, 1988)
Ruptured Aneurysm of the Posterior Spinal Artery of the Upper Cervical Spinal Cord: Case Report
Authors: Goto Yasunobu , Kamijyo Yoshinari , Yonekawa Yasuhiro , Kikuchi Haruhiko 
Published: May 2010

Abstract
A case of aneurysm of the posterior spinal artery of the upper cervical spinal cord is presented. The patient had severe intracranial subarachnoid hemorrhage with disturbance of consciousness. Four-vessel angiograms showed neither anomalous arrangement of the arteries nor arteriovenous malformation intracranially or in the spinal subarachnoid space. Operation disclosed a thrombosed aneurysm of the posterior spinal artery, which was radically excised and histologically examined. (Neurosurgery 22:558-560, 1988)
Restoration of Hearing after Removal of Cerebellopontine Angle Meningioma: Diagnostic and Therapeutic Implications
Authors: Maurer Paul Kurt , Okawara Shige H. 
Published: May 2010

Abstract
A case of cerebellopontine angle meningioma with restoration of hearing from a profoundly deaf state is presented. Meningiomas of the posterior fossa commonly present with decreased or absent hearing and can appear deceptively similar to acoustic neurinomas on radiographic and audiometric testing. Because total restoration of hearing can occur with meningioma, even with significant preoperative deficit, utilization of the translabyrinthine approach is less desirable if any preoperative question as to the diagnosis exists. Any hearing-impaired patient with a cerebellopontine angle mass that is not conclusively thought to represent acoustic neurinoma should be approached by the suboccipital technique to maximize the opportunity for restoration of hearing. (Neurosurgery 22:573-575, 1988)
Gangliocytoma of the Cerebellum: Ultrastructure and Immunohistochemistry
Authors: Izukawa D. , Lach B. , Benoit B. 
Published: May 2010

Abstract
A 31-year-old man presenting with a cerebellopontine angle syndrome underwent subtotal resection of a gangliocytoma of the left middle cerebellar peduncle. The tumor was positive for 68-kD neurofilament protein and vasoactive intestinal peptide. No glial cells were identified on immunohistochemical or ultrastructural examination. Electron microscopic study of neoplastic ganglionic cells revealed the presence of dense core vesicles, synaptic junctions, Hirano bodies, and marked dystrophic changes in the neuritic processes. The nosology of this lesion is discussed. Similarities between the morphological changes shown by mature neoplastic ganglion cells and comparable structural alterations seen in the physiological senescence of nonneoplastic neurons are stressed. (Neurosurgery 22:576-581, 1988)