bluuebunny/crossref_metadata_2025_split huggingface dataset:
Central Nervous System Anomalies Associated with Meningomyelocele, Hydrocephalus, and the Arnold-Chiari Malformation: Reappraisal of Theories Regarding the Pathogenesis of Posterior Neural Tube Closure Defects
Authors: Gilbert James N. , Jones Kenneth L. , Rorke Lucy B. , Chernoff Gerald F. , James Hector E. 
Published: May 2010

Abstract
Complete gross and microscopic neuropathological examinations of 25 children who died with meningomyelocele, the Arnold-Chiari malformation, and hydrocephalus revealed a wide range and frequency of associated central nervous system malformations. The most remarkable of these anomalies were hypoplasia or aplasia of cranial nerve nuclei (20%), demonstrable obstruction of cerebrospinal fluid flow within the ventricular system (92%), cerebellar dysplasia (72%), a disorder of migration of cortical neurons (92%), fusion of the thalami (16%), agenesis of the corpus callosum (12%), and complete or partial agenesis of the olfactory tract and bulb (8%). The anomalies associated with posterior neural tube closure defects can no longer be considered secondary, but rather must be considered part of a spectrum of malformations caused by an unidentified primary insult to the central nervous system. The frequency and pattern of brain malformations associated with neural tube defects of some children with meningomyelocele suggest that such malformations may seriously affect intellectual outcome.
Common Origin of the Arterial Blood Flow for an Arteriovenous Medullar Fistula and the Anterior Spinal Artery: A Case Report
Authors: Clavier Erick , Tadie Marc , Thiebot Jacques , Presles Olivier , Benozio Michel 
Published: May 2010

Abstract
A common origin of the blood supply to a dural arteriovenous malformation and to the spinal cord from the same segmental artery is very rare. This obviously contraindicates embolization of the fistula. Demonstrating the location of the normal spinal blood supply system is therefore mandatory to avoid postoperative complications. The visualization of the normal blood vessels can be masked by a steal phenomenon, but it must at all costs be obtained. The authors describe one such case.
Spontaneous Healing of Acute Extradural Hematomas: Study of Twenty-two Cases
Authors: Pozzati Eugenio , Tognetti Francesco 
Published: May 2010

Abstract
A series of 22 patients with acute extradural hematomas that were not evacuated surgically is presented. Patients were asymptomatic or had only minimal neurological disturbances on admission. In all cases, serial computed tomographic scanning documented the progressive resolution of these clots, the great majority within 1 month of injury. The decision of conservative vs. surgical treatment may be guided by the thickness, configuration, location, and possible association with intradural parenchymal lesion.
Attempts at Prevention or Treatment of Intracranial Arterial Spasm: An Update
Authors: Wilkins Robert H. 
Published: May 2010

Abstract
Numerous approaches to the prevention and treatment of intracranial arterial spasm have been made during the past three decades. In the present article, the author has assembled data about such attempts that were not included in a similar compilation published in 1980. Since 1980, there has been some progress toward the satisfactory management of this detrimental condition, but much remains to be done. (18:808–825, 1986)
Ossification of the Posterior Longitudinal Ligament in Caucasians: Diagnosis and Surgical Intervention
Authors: Klara Peter M. , McDonnell Dennis E. 
Published: May 2010

Abstract
Six cases of ossification of the posterior longitudinal ligament (OPLL) in Caucasians have been diagnosed during a 2-year period at Walter Reed Army Medical Center. Five cases were in men and one was in a woman. Three cases presented as myelopathy and three as radiculopathy. Diagnosis was best confirmed with computer-assisted tomography. All six cases were treated surgically via an anterior approach, microsurgical resection of the OPLL, and autograft fusion. Patients with radiculopathy had immediate pain relief after operation. Those with myelopathy required vertebrectomy and regained strength after operation. All patients improved with operation. OPLL is not a rare condition in Caucasians. With diagnosis and proper surgical intervention, prognosis for improvement is good.
Use of Extracranial-Intracranial Bypass in the Management of Symptomatic Vasospasm
Authors: Batjer Hunt , Samson Duke 
Published: May 2010

Abstract
Delayed ischemic deficits from vasospasm after subarachnoid hemorrhage remain a major source of death and disability to patients surviving subarachnoid hemorrhage. Ideal treatment for this condition would prevent or reverse spasm in major subarachnoid vessels. This goal remains elusive. Considerable success has been obtained with augmentation of flow in ischemic regions by induced hypertension and hypervolemia. Some patients are not good candidates for this therapy because of underlying cardiovascular disease or the presence of unsecured aneurysms. A total of 11 patients have recently undergone extracranial-intracranial bypass for the treatment of symptomatic vasospasm. Bypass was performed in 4 patients due to failure of medical management and in 7 patients due to our reluctance to induce hypertension in the setting of unsecured aneurysms. Eight of the 11 patients responded neurologically to the bypass procedure within 24 hours. In 6 cases, neurological deficits either improved or resolved. After operation, all 8 patients maintained their preoperative neurological status with lower mean arterial blood pressures than before bypass. Noncomatose patients with focal middle cerebral ischemic deficits and secured aneurysms in whom medical management has failed or in whom these measures are contraindicated may indeed benefit from extracranial-intracranial bypass. Patients with unsecured aneurysms remote from an ischemic middle cerebral territory should probably be revascularized if cautious hypertension fails to improve their conditions.
Leptomeningeal Metastasis from Supratentorial Malignant Gliomas
Authors: Awad Issam , Bay Janet W. , Rogers Lisa 
Published: May 2010

Abstract
The clinical and diagnostic findings in 13 patients with leptomeningeal metastasis from supratentorial malignant gliomas are reported. Criteria for inclusion in this study were positive myelographic examination, positive cerebrospinal fluid cytology on two or more samples, or evidence of leptomeningeal seeding at autopsy. Eight patients had premortem symptoms of leptomeningeal metastasis, with the diagnosis confirmed during life in 5 patients. Average survival after the onset of symptoms was 3 months (range, 1 to 5 months). Comparison of the autopsied group with 10 concurrent autopsied patients without leptomeningeal gliomatosis did not reveal any significant differences in age, but leptomeningeal gliomatosis was more prevalent in patients with longer postoperative survival. Leptomeningeal involvement at autopsy was more extensive in symptomatic patients. Cerebrospinal fluid examination often gave nondiagnostic or nonspecific results. Computed tomography of the brain showed evidence of ventriculomegaly, periventricular contrast enhancement, or multifocal tumor involvement in every case. Iophendylate myelography was the most reliable diagnostic tool and established the diagnosis whenever performed. The natural history and clinical significance of leptomeningeal metastasis from supratentorial malignant gliomas are discussed.
Patient Positioning and Nasal Intubation for Carotid Endarterectomy
Authors: Weiss Robert M. , Smith Harold P. , Smith Harold P. , Patterson Knox A. , Weiss Robert M. 
Published: May 2010

Abstract
Exposure of a very rostral carotid bifurcation for endarterectomy may occasionally be difficult. We are reporting a simple yet effective way to gain several centimetres of exposure of the distal cervical portion of the internal carotid artery in this circumstance.
Multiple Progressive Familial Thrombosed Arteriovenous Malformations
Authors: Bucci Michael N. , Chandler William F. , Gebarski Stephen S. , McKeever Paul E. 
Published: May 2010

Abstract
Thrombosed arteriovenous malformations initially diagnosed as low-grade gliomas in a child and her maternal uncle are presented. In both patients, there was progression of the disease as evidenced by the formation of new lesions at distant sites in the brain.
Trigeminal Neurinoma Associated with Suprasellar Arachnoid Cyst: Case Report
Authors: Amagasa Masaharu , Sato Hiroo , Niizuma Hiroshi , Suzuki Jiro 
Published: May 2010

Abstract
The first case of trigeminal neurinoma associated with suprasellar arachnoid cyst is presented. Coexistence of these two lesions may be accidental, but it is also possible that the arachnoid cyst was secondary to the neurinoma. (Neurosurgery) 19:454-457, 1986)
Traumatic Aneurysm of the Extracranial Vertebral Artery
Authors: Rahimizadeh Abolfazl , Sabouri-Daylami Manouchehr , Amir-Moezi Naser , Haddadian Karim 
Published: May 2010

Abstract
Aneurysms of the extracranial vertebral artery are rare because of the protection afforded by the bony canal, and the literature contains only a few limited reports on this subject. In the view of its rarity, we present the case of a 20-year-old soldier with a traumatic aneurysm of the vertebral artery at the C-2 level. Because of occlusion of the ipsilateral carotid artery, reconstruction of the vertebral artery by autogenous vein graft was undertaken through a posterior approach; because of inadequate mobilization of the artery, continuity was preserved using aneurysmorrhaphy. The literature is reviewed, and the various treatments are discussed.
Extracranial-Intracranial Bypass Surgery: A Critical Analysis in Light of the International Cooperative Study
Authors: Awad Issam A. , Spetzler Robert F. 
Published: May 2010

Abstract
The ability of extracranial-intracranial bypass surgery to alter favorably the natural history of ischemic cerebrovascular disease remains in question. A recently completed prospective randomized multicenter cooperative trial failed to confirm the hypothesis that the procedure prevents further cerebral ischemia in patients with atherosclerotic internal carotid artery or middle cerebral artery disease. We analyze findings of the study in detail, including possible effects on the natural history of the disease beyond the immediate perioperative period. Potential sources of bias that may have unpredictably affected the study are discussed. These include observational bias (patient and therapist not blinded), “randomization-to-treatment” bias (high morbidity after randomization but before operation), and “prerandomization” or allocation bias (patients in the study representing a selected sample of the population with cerebrovascular disease). The extensive analysis of secondary subgroups with small numbers of patients is discussed in light of the statistical methods used. Two particular classes of patients not addressed in the study who might benefit from the procedure are defined. They are patients failing the best available medical therapy and patients with clearly documented hemodynamic compromise. Possible indications for bypass surgery are suggested for the various lesions in light of the trial and of recent reports on the natural history and pathophysiology of ischemic cerebrovascular disease. Selected cases illustrating these indications are presented.
Models of Spinal Cord Injury: Part 1
Authors: Perry Black , Ronald S. Markowitz , Viraf Cooper , Alan Mechanic , Harvey Kushner , Ivan Damjanov , Sydney D. Finkelstein , Kenneth C. Wachs 
Published: May 2010

Abstract
Testing of potential therapies for spinal cord injury has been significantly hampered by the unavailability of a standardized, reproducible animal model with predictable outcome at a given force of injury (dose-response). The rat was selected in the development of this model in preference to larger animals for economy and availability; this permits use of large numbers of animals to increase statistical validity. In the experiments reported in this article, a static load method (weight placed gently on cord) of inducing cord injury was evaluated. A total of 198 Sprague-Dawley rats were used. Under general anesthesia, a one-level laminectomy was carried out at T-12 with the dura mater intact. Weights varying from 80 to 150 g were lowered onto the dorsal surface of the intact dura mater for durations of 0 to 300 seconds. Recovery of motor function was assessed for up to 8 weeks using two behavioral tests, a modified Tarlov scale and an inclined plane test of hind limb motor function. A statistically significant relationship was found between force of injury and motor recovery as measured by the Tarlov scale, but this did not correlate with inclined plane performance; the duration that the weight rested on the cord did not influence outcome. Pathologically, there was variation in the extent of damage for a given injury load. A semiquantitative pathological assessment of cord injury showed a statistically significant correlation between pathological score and behavioral deficit as measured by the Tarlov scale, but this did not correlate with inclined plane performance. In view of these deficiencies, the static load technique does not seem to be an ideal model for spinal cord injury research.
Sacrococcygeal Rhizotomy for Perineal Pain
Authors: Stephen C. Saris , Jon M. Silver , Jose F. S. Vieira , Blaine S. Nashold 
Published: May 2010

Abstract
Chronic pain in the perineum is a difficult neurosurgical problem. This article evaluates the effectiveness of sacrococcygeal rhizotomy in 28 patients who had cancer-related pain or coccydynia, underwent rhizotomy, and were followed for an average of 3 years. Good pain relief was obtained in 53% (10 of 19 patients) with malignant pain, as opposed to 22% (2 of 9 patients) with nonmalignant pain. Sacral rhizotomy is a reasonable treatment for cancer-related perineal pain, but it is ineffective for coccydynia and other benign perineal pain problems.
Intranasal Schwannoma with Extension into the Intracranial Compartment: Case Report
Authors: John Zovickian , David Barba , John F. Alksne 
Published: May 2010

Abstract
The authors present a case of intranasal schwannoma with extension into the intracranial compartment. Computed tomographic findings are presented, and a combined intranasal and subfrontal operative approach is described. The pathology, origin, and clinical characteristics of intranasal schwannomas are reviewed.
Histiocytosis-X of the Spinal Cord: A Case Report
Authors: Nayef R. F. Al-Rodhan , Ossama Al-Mefty , John T. Godwin , John R. Jinkins , John L. Fox 
Published: May 2010

Abstract
A rare case of histiocytosis-X of the spinal cord with evidence of intramedullary infiltration and epidural spinal cord compression is reported. The clinical, radiological, and histopathological features are discussed, and the pertinent literature is reviewed.
Primary Myxoma in the Pituitary Fossa: Case Report
Authors: Nagatani Masaaki , Mori Shintaro , Takimoto Noboru , Arita Norio , Ushio Yukitaka , Hayakawa Toru , Gen Moritetsu , Uozumi Tohru , Mogami Heitaro 
Published: May 2010

Abstract
A case of primary myxoma in the pituitary fossa is described. The tumor presented as an intrasellar and suprasellar mass and was successfully removed during a transsphenoidal operation. It was verified as a myxoma by histopathological studies, and there was no evidence that it was a metastasis. This is thought to be the first report of this tumor occurring in the pituitary fossa.
Brain Grafting as a Treatment for Parkinson's Disease
Authors: Perlow Mark J. 
Published: May 2010

Abstract
Parkinson's disease is an illness with neuropathological and neuroanatomical abnormalities in many areas of the central nervous system. Some clinical manifestations of this illness are correlated with pathological changes in the substantia nigra and with a loss of dopamine in the nigra and striatum. The most effective pharmacological treatments have used agents that either replace the lost dopamine or act as agonists on dopamine receptors. Recent studies in animal models of Parkinson's disease demonstrate that the loss of dopamine and many clinical manifestations of dopamine reduction can be reversed by transplantation of fetal dopamine-containing cells to specific dopamine-depleted areas of the brain. Long term viability of these transplants has also been demonstrated. The author suggests that the transplantation of dopamine neurons, even across species barriers, is a reasonable consideration for the treatment of human Parkinson's disease. This article reviews in detail the results of recent experiments and how the experience in these models might be utilized in determining a transplantation strategy for the treatment of specific clinical aspects of this illness.
Ganglioglioma: A Correlative Clinicopathological and Radiological Study of Ten Surgically Treated Cases with Follow-Up
Authors: Kalyan-Raman Uma P. , Olivero William C. 
Published: May 2010

Abstract
Gangliogliomas are rare benign tumors of the central nervous system containing neoplastic ganglion and low grade glial cells. In studying 10 surgically treated cases, we evaluated the clinical, pathological, radiological, and immunocytochemical features, with follow-up. Ranging from 18 to 58 years in age, 7 patients were women, and 3 were men. The most common presenting symptom was seizure. Computed tomographic scan showed a low density enhancing mass in 8 and calcification in 5. Six had minimally abnormal vascularity on angiography. Seven patients had total and 3 had subtotal resections of the tumor. The temporal lobe was the location of the tumor in 6 cases. All of the cases met the histological criteria of Russell and Rubinstein for ganglioglioma. Four patients received postoperative radiotherapy because of subtotal resection or aggressive histological makeup. On follow-up, from 2.5 to 7 years, 8 patients are alive and tumorfree, and 7 are also seizure-free. Two died after operation: one immediately and the other of a glioblastoma that developed 5 years later. Our study confirms that ganglioglioma is a distinct histological entity, anatomically localized, with characteristic clinical and radiological findings and long term survival. Aggressive histological makeup is not a definite indication of malignant potential. The definitive role of follow-up radiotherapy for this tumor needs further study. Malignant evolution is rare, but warrants follow-up.
Radiation Therapy in the Treatment of Partially Resected Meningiomas
Authors: Barbaro Nicholas M. , Gutin Philip H. , Wilson Charles B. , Sheline Glenn E. , Boldrey Edwin B. , Wara William M. 
Published: May 2010

Abstract
To address the question of whether radiation therapy is beneficial in the management of partially resected meningiomas, we reviewed the records of all patients admitted to the University of California, San Francisco, between 1968 and 1978 who had a diagnosis of intracranial meningioma. The patients were divided into three groups: 51 patients had gross total resection and did not receive radiation therapy, 30 patients had subtotal resection and no radiation therapy, and 54 patients had subtotal resection followed by radiation therapy. The subtotal resection groups were similar in average age, male: female ratio, and tumor location, which allowed a valid comparison of the effects of irradiation. The recurrence rate in the total resection group was 4% (2 of 51 patients). Among patients in the subtotal resection groups, 60% of nonirradiated patients had a recurrence, compared with only 32% of the irradiated patients. The median time to recurrence was significantly longer in the irradiated group than in the nonirradiated group (125 vs. 66 months, P &lt; 0.05). There was no complication related to irradiation. These results provide convincing evidence that radiation therapy is beneficial in the treatment of partially resected meningiomas.
Functional Recovery after Decompressive Spine Operation for Cervical Spine Fractures
Authors: Benzel Edward C. , Larson Sanford J. 
Published: May 2010

Abstract
Ninety-nine patients with cervical spine fractures from C-4 through C-7 were operated upon from 1975 to 1981. Operation was performed to restore normal relationships between the spinal cord and roots and the spinal canal and foramina and to maintain these relationships by fusion when necessary. Neurological function was recorded pre- and postoperatively using a functional scale. Satisfactory fusion without adverse change in vertebral alignment was achieved in each patient. The average interval between injury and operation was 29 days. When neurological recovery was observed, it began promptly after operation, suggesting a cause and effect relationship.
Meningioangiomatosis Not Associated with von Recklinghausen's Disease
Authors: Sakaki Saburo , Nakagawa Kou , Nakamura Kou , Takeda Sadanori 
Published: May 2010

Abstract
We report a rare case of meningioangiomatosis unassociated with von Recklinghausen's disease. The patient was a 30-year-old woman with a 25-year history of seizures. The lesion was confined to the right temporal cortex and consisted of a proliferation of angiomatous blood vessels and meningocytic cells. Her seizures have been well controlled after excision of the lesion.
Effect of the Acute Administration of High Dose Pentobarbital on Human Brain Stem Auditory and Median Nerve Somatosensory Evoked Responses
Authors: Drummond John C. , Todd Michael M. , Schubert Armin , Hoi Sang U 
Published: May 2010

Abstract
Brain stem auditory (BAERs) and median nerve somatosensory evoked responses (MnSSERs) were recorded from normal neural pathways during the induction of pentobarbital coma in six patients undergoing elective excision of complex arteriovenous malformations. Each patient received a 33-minute infusion of pentobarbital at a rate of 0.6 mg/kg (total dose. 19.8 mg/kg). This regimen resulted in burst suppression or isoelectricity of the electroencephalogram in all patients. Although statistically significant changes in latency and amplitude occurred, both BAERs and MnSSERs were readily recordable in all patients throughout the infusion. For the BAER, there were significant increases in the latencies of Waves III and V. However, these increases are sufficiently small that misinterpretation of these changes as an evolving neurological injury is unlikely, e.g., Wave V latency increased from 6.25 ± 0.25 (SD) to 6.58 ± 0.16 ms (P &lt; 0.006). For the MnSSER, changes of greater potential clinical relevance were observed. There were substantial increases in the latencies of the early components of the primary cortical response and in the central conduction time (e.g., CCT of 6.1 ± 0.6 ms preinduction vs. 7.7 ± 1.1 ms at t = 33 min, P &lt; 0.003), and the amplitude of the early cortical response (N20-P25) decreased by a mean of 45% (P &lt; 0.02). By contrast, subcortical components of the MnSSER (brachial plexus, upper cervical spine) were only minimally affected. We conclude that, in patients who are initially neurologically intact, BAERs and MnSSERs can be monitored effectively during pentobarbital coma and that the loss of these responses should not be ascribed to the effects of this drug alone. However, the interpretation of evoked response changes, particularly MnSSER changes, that occur during pentobarbital administration should take into account the dose-related changes in latency and amplitude that we have observed.