bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diaphragm Pacing in Spinal Muscular Atrophy
Authors: Richardson Robert R. , Roseman Bruce , Singh Naunihal 
Published: May 2010

Abstract
A patient with a diagnosis of intermediate or benign spinal muscular atrophy was severely incapacitated from respiratory complications and alveolar hypoventilation and was confined to mechanical ventilatory support. After extensive diagnostic evaluation of her pulmonary status, including transcutaneous stimulation of the phrenic nerves associated with nasogastric and surface electrode recording of the diaphragmatic response, this patient had a phrenic neurostimulation system implanted bilaterally for diaphragm pacing. Although spinal muscular atrophy has not been previously recognized as an indication for diaphragm pacing, her subsequent social, physical, and psychological improvement indicate that it may be significantly beneficial in selected cases of alveolar hypoventilation due to spinal muscular atrophy or neuromuscular disease.
Hydromyelia:
Authors: Sehlesinger Edward B. , Antunes John L. , Michelsen Jost W. , Louis Kenneth M. 
Published: May 2010

Abstract
The clinical and radiographic features of 60 cases of hydromyelia are discussed. A combination of motor and sensory symptoms and signs is the usual presentation. but pure motor or sensory forms of the disease are not infrequent. Pain and scoliosis are usually associated with a high degree of blockage. A normal spinal fluid protein content in the presence of an enlarged spinal cord is of diagnostic value. Important radiographic clues include widening of the spinal cord without venous stagnation and collapse of the spinal cord visualized with the patient in the upright position. Metrizamide computed tomography is now used routinely. and the contrast agent may at times appear in the dilated central spinal canal. Decompression of the foramen magnum is the treatment of choice in the presence of an associated Arnold-Chiari malformation and is the treatment most likely to succeed. In selected cases. Decompressive laminectomy and syringostomy may be indicated. Percutaneous spinal cord puncture is a safe diagnostic-therapeutic procedure which. surprisingly, may afford relief equal to that of more drastic measures. Therefore, percutaneous spinal cord puncture may be an option of therapeutic value in a disorder that is frustrating to treat.
Disposable Ventricular Catheter
Authors: Ray Charles D. 
Published: May 2010

Abstract
A new 1.6-mm-diameter (5 French), flexible, plastic disposable ventricular catheter is described. It has a self-attached sealing cap and fits standard Luer terminations of syringes. There are a self-contained stylette, a radiopaque stripe, and a single, smooth, lateral hold drilled throgh to the lumen. It has been used primarily for selective catheterization of the 3rd ventricale for the injection of contrast media and the collection of ventricular fluid for neurotransmitter analysis during the implantation of deep brain stimulators, but may be used for perfusion, drainage, or connection to pressure transducers.
Spontaneous Ventral Spinal Epidural Hematoma with Anterior Cord Syndrome
Authors: Phillips Timothy W. , Kling Thomas F. , McGillicuddy John E. 
Published: May 2010

Abstract
The authors report a case of spontaneous ventral thoracic epidural hematoma presenting as an anterior cord syndrome. The epidural hematoma ws evacuated through a posterolateral approach to the spinal canal. A disseminated intravascular coagulopathy appeared intraoperatively. By 3 months after operation the neurological deficits had cleared.
Diagnosis of Acoustic Neuroma
Authors: Hart Robert G. , Davenport John 
Published: May 2010

Abstract
The acquistion and application of new techniques in diagnostic screening have changed the approach to patients with suspected acoustic neuroma. In this paper, we review the extensive recent literature on acoustic tumors and present a critical analysis of the various diagnostic investigations. The older tests for cerebrospinal fluid protein. vestibular testing, and arteriography have been supplanted by modern audiometry with acoustic reflex testing. brain stem evoked responses, and computed tomography (CT). The various types of plain radiography are confirmed as an extremely useful screening modality. CT is insufficiently sensitive to serve as a primary screening procedure, but is a valuable confirmatory test. We propose a logical method of screening patients suspected of having an acoustic neuroma that can be applied by any practitoner in any clinical situation.
Vertebral Artery Disease
Authors: Pritz Michael B. , Chandler William F. , Kindt Glenn W. 
Published: May 2010

Abstract
The neuroradiological evaluation, perioperative medical management, and microsurgical treatment of variously located vertebral artery lesions are presented. Four types of surgical procedures were undertaken: proximal vertebral artery to common carotid artery end-to-side anastomosis; external carotid artery to midcervical vertebral artery end-to-side anastomosis; external carotid artery to distal cervical vertebral artery end-to-end anastomosis; and occipital artery to posterior inferior cerebellar artery end-to-side anastomosis. Each case is used to demonstrate the evaluation and management involved, the type of and rationale for the surgical procedure selected, and the patency of the anastomosis performed. Two points are emphasized. One is that, after careful angiographic evaluation and improved perioperative medical management, lesions of the vertebral artery are indeed amenable to microsurgical intervention with relatively low risk to the patient. The other is that, whenever possible, anastomosis of the largest caliber of vessels with the least number of suture lines is the surgical treatment of choice.
Prevention of Intracranial Hypertension during the Insertion of a Pulmonary Artery Catheter
Authors: Bowe Edwin A. , Wolf Steven 
Published: May 2010

Abstract
The placement of a pulmonary artery catheter may be indicated to assess cardiac filling pressures and cardiac output during the treatment of intracranial hypertension. Because many patients with intracranial hypertension are hypovolemic, flotation of the catheter may be difficult and can cause an increase in intracranial pressure. We describe a method of catheter placement using barbiturates and calcium that prevented a rise in intracranial pressure.
Fungal Aneurysm
Authors: Mielke Bruce , Weir Bryce , Oldring Derald , von Westarp Christian 
Published: May 2010

Abstract
We report a 58-year-old woman with acromegaly whose invasive adenoma was treated by trans-sphenoidal removal and radiation. Six months after therapy, she experienced progressive headache and retro-orbital pain. At 10 months she developed unilateral blindness, mild proptosis, opthalmoplegia. and trigeminal sensory loss. Studies failed to show an expanding mass lesion. About 1 year after her operation, she suddenly became comatose and died. An autopsy examination revealed subarachnoid hemorrhage from a ruptured fungal aneurysm of the basilar artery. The literature on such aneurysms is reviewed.
Tuberculous Optochiasmatic Arachnoiditis
Authors: Navarro Ignacio Madrazo , Peralta Victor Hugo Rosas , Leon Jose Antonio Maldonado , Varela Enrique Antonio Sanchez , Cahrera Jose Maria Sanchez 
Published: May 2010

Abstract
Eighl cases of optochiasmatic arachnoiditis secondary to tuberculous leptomeningitis were treated with microsurgical intervention at the Department of Neurosurgery of La Raza Medical Center of the Mexican Social Welfare Institute. All of the patients had been amaurotic before the operation and displayed complete recovery of their vision during the immediate postoperative period. Microsurgical and pharmacological (antituberculous chemotherapy and steroids) treatment can cure such patients.
Improved Relapse-free Survival in Medulloblastoma Utilizing Modern Techniques
Authors: Norris Donald G. , Bruce Derek A. , Bruce Derek A. , Bruce Derek A. , Byrd Rebecca L. , Schut Luis , Schut Luis , Schut Luis , Littman Phillip , Bilaniuk Larissa T. , Zimmerman Robert A. , Capp Ronald 
Published: May 2010

Abstract
Between 1969 and 1979, 22 patients with medulloblastoma were treated by the same surgical group and radiation therapy group. The patients were divided into two groups because of the clinical availability in December 1974 of the computed tomographic (CT) scanner and of the operating microscope used in the initial surgical procedure. There were 11 patients in each group. The percentage of patients with a relapse-free survival in the group treated between 1969 and 1974 (Group 1) was 38% at 4 years. The survival in the 11 patients treated between 1974 and 1979 (Group 2) was 84% at 4 years. This improvement is statistically significant (P ≤ 0.001). All patients received the same dose of radiation. Efforts to minimize the tumor burden by total surgical resection did not increase postoperative morbidity or mortality. These results are discussed, along with the relative impact of the CT scan, total resection at operation. and increased focus for radiation therapy on the improved outcome.
Primary Dural Melanoma
Authors: Naravan Raj K. , Rosner Michael J. , Povlishock John T. , Girevendulis Alexander , Becker Donald P. 
Published: May 2010

Abstract
This study reviews the literature pertaining to primary meningeal melanoma and reports the clinical and ultrastructural findings in a case where the tumor appeared to be of pachymeningeal (dural) origin. This is clearly a departure from all previously described cases, in which a leptomeningeal (pial-arachnoidal) origin was either defined or assumed. Clinically. this case was remarkable in its rarity. its presentation as a cerebellopontine angle syndrome, and its occurrence in a Negro. a race in which melanomas are uncommon. Ultrastructurally. the tumor did demonstrate the presence of basement membrane abnormalities and numerous endothelial fenestrations. However, it was found to be made up of a homogenous cell population, consisting only of electron-lucent, melanin-laden cells. The mixed cell population noted previously in a primary leptomeningeal melanoma was not found in this tumor. In view of the fact that this patient continues to do well 1/12; years after operation, with no evidence of tumor recurrence, it is suggested that a homogenous cell population noted on electron microscopy could indicate a better prognosis. In addition, it may also indicate a pachymeningeal rather than a leptomeningeal origin for the tumor. A plea is made for greater specificity in terminology when describing primary meningeal melanomas and for a concerted effort to distinguish between those of dural and those of leptomeningeal origin.
Interstitial Irradiation of Brain Tumors
Authors: Bernstein Mark , Gutin Philip H. 
Published: May 2010

Abstract
As an adjuvant to surgery, radiation therapy has consistently proven to be the most successful form of treatment for primary and secondary malignant brain tumors and possibly for inoperable benign tumors. Because the risk of radiation necrosis of normal brain limits the amount of radiation that can be given by external beam therapy at conventional dose rates, interstitial radiation of brain tumors is a logical alternative treatment approach. We discuss the radiobiological advantages of low dose rate irradiation and intratumoral placement of sources that make interstitial irradiation an attractive treatment for brain tumors and review the history of clinical brachytherapy for intracranial neoplasia.
Chronic Cerebellar Stimulation for Cerebral Palsy
Authors: Penn Richard D. 
Published: May 2010

Abstract
Chronic cerebellar stimulation for cerebral palsy is a controversial procedure. It is difficult to evaluate objectively because cerebral palsy is not a single disease entity and the clinical syndrome may vary over time. Tests of neurophysiological function, signs of spasticity, and tests of motor function have documented changes, but double-blind evaluations have not. These studies are reviewed, as are the inherent problems in cerebellar stimulation and the physiology of cerebral palsy.
Microsurgical Anatomy of the Posterior Inferior Cerebellar Artery
Authors: Lister Richard J. , Rhoton Albert L. , Matsushima Toshiom , Peace David A. 
Published: May 2010

Abstract
Fifty cerebellar hemispheres from 25 adult cadavers were examined. The posterior inferior cerebellar artery (PICA), by definition, arose from the vertebral artery. The vertebral artery was present in 49 and the PICA was present in 42 of the 50 hemispheres. Forty-one of the 42 PICAs arose as a single trunk and 1 arose as a duplicate trunk. The PICA was divided into five segments: the anterior medullary segment lay on the front of the medulla; the lateral medullary segment coursed beside the medulla and extended to the origin of the glossopharyngeal, vagal, and accessory nerves; the tonsillomedullary segment coursed around the caudal half of the cerebellar tonsil; the telovelotonsillar segment coursed in the cleft between the tela choroidea and the inferior medullary velum rostrally and the superior pole of the cerebellar tonsil caudally; and the cortical segment was distributed to the cerebellar surface. Thirty-seven of the 42 PICAs bifurcated into a medial and a lateral trunk. The medial trunk supplied the vermis and the adjacent part of the hemisphere, and the lateral trunk supplied the cortical surface of the tonsil and the hemisphere. The PICA gave off perforating, choroidal, and cortical arteries. The cortical arteries were divided into vermian, tonsillar, and hemispheric groups. Sixteen of the 42 PICAs passed between the rootlets of the accessory nerve, 10 passed between the rootlets of the vagus nerve, 13 passed between the vagus and the accessory nerves, 2 coursed rostral to the glossopharyngeal nerve, and 1 passed between the glossopharyngeal and the vagus nerves.
Blood Pressure Response during Percutaneous Rhizotomy for Trigeminal Neuralgia
Authors: Kehler Chris H. , Brodsky Jay B. , Samuels Stanley I. , Britt Richard H. , Silverberg Gerald D. 
Published: May 2010

Abstract
We observed a consistent and marked hypertensive response during trigeminal rhizotomy with methohexital anesthesia in 11 consecutive patients. Percutaneous trigeminal rhizotomy should not be regarded as a benign surgical procedure in view of the potential morbidity associated with such acute hypertension. We recommend that patients undergoing this operation be continuously monitored.
Structural Changes in Human Pituitary Tumor after Bromocriptine Therapy
Authors: Rengachary Setti S. , Tomita Tatsuo , Jefferies Barry F. , Watanabe Itaru 
Published: May 2010

Abstract
The histological appearance of a prolactin-producing tumor and of a growth hormone-producing tumor after short term bromocriptine therapy was studied in detail using light microscopy with conventional and immunocytochemical methods and using transmission electron microscopy. The findings were correlated with clinical, radiological, and biochemical data. Histological changes consisting of clumping of nuclear chromatin and a marked reduction in cytoplasmic volume due to loss of ribosomes, rough endoplasmic reticulum, and Golgi complexes were observed only in the prolactin-producing tumor. Normalization of elevated serum prolactin levels and reduction in size of the tumor observed in serial computed tomograms correlated with striking histological changes found in the tumor. These changes were interpreted to represent a reversible inhibition of the protein-synthetic machinery of the neoplastic cell. Comparable clinical, biochemical, radiological, or structural changes were not observed in the growth hormone-secreting tumor.
Computer-assisted Stereotactic Laser Microsurgery for the Treatment of Intracranial Neoplasms
Authors: Kelly Patrick J. , Alker George J. , Goerss Stephan 
Published: May 2010

Abstract
This paper describes a stereotactic CO2 laser system for the removal of intra-axial, intracranial neoplasms. The volume of the neoplasm is transferred into stereotactic space by computer reconstruction of data derived by computed tomography (CT) performed under stereotactic conditions. The tumor volume is sliced in a plane orthogonal to the surgical approach, and slices at specific distances from the focal point of the stereotactic frame are displayed on a graphics monitor in the operating suite along with a cursor representing the position of the surgical laser. Laser vaporization of sequential slices of the tumor results in a cavity, the formation of which is monitored by anteroposterior and lateral roentgenograms. Fifteen stereotactic laser procedures have been performed on 13 patients, and the results are discussed. By this method, it is theoretically possible to remove all of an intracranial neoplasm detected by CT scanning.
Role of Radiation Therapy in the Management of Meningioma
Authors: Carella Richard J. , Ransohoff Joseph , Newall Joseph 
Published: May 2010

Abstract
Surgery is the accepted form of treatment of meningioma; the role of radiotherapy has not been clearly established. With this in mind, we have reviewed our experience with radiation therapy in the management of meningiomas at New York University Medical Center. Sixty-eight patients fell into three groups. Forty-three (Group A) underwent operation followed by radiation therapy, 14 patients (Group B) had radiation for recurrence after operation, and 11 patients (Group C) had radiation therapy as the primary treatment. In Group A, 41 of 43 are alive. During a follow-up of 1 to 10 years, only 2 have deteriorated. Five of 14 Group B patients showed neurological improvement and 7 showed deterioration, including 5 who died of tumor. All 11 patients in Group C are alive with follow-up periods of 3 to 6 years; 9 of these show improvement in neurological function. Eleven patients had malignant meningioma, of whom 8 are alive and stable. We present 4 case reports, including computed tomographic scans that show evidence of tumor necrosis after radiation therapy. Pathological verification of tumor necrosis is presented in 1 case. We believe that radiation therapy has an established role in the treatment of incompletely excised, recurrent, or malignant meningiomas and, in some cases, as the initial management of meningiomas. Indications for treatment and guidelines are presented.
Management of Infected Cerebellar Stimulation Systems
Authors: Davis Ross , Kudzma Joanne , Ratzan Kenneth 
Published: May 2010

Abstract
Over a 7-year period (February 1974 through February 1981), 318 patients underwent the implantation of cerebellar stimulation systems for the reduction of spasticity (98%) or epilepsy (2%). A total of 518 procedures were carried out to implant and maintain the equipment during this period. Fourteen patients developed infections in the tissue around their implanted systems, which represented 4.4% of the patients or 2.7% of the procedures performed. Staphylococcus aureus was the infectious agent in 7 cases (50%), the clinical features of which occurred usually within 1 month. Staphylococcus epidermidis infected 5 patients with features presenting late (more than 2 years) after the initial implantation. The management involved antibiotic therapy for 2 weeks in all 14 patients. In 12 patients, the entire system was removed, with 100% eradication of the infection. In the other 2 patients, the radio receiver and lead wires up to but not including the cerebellar electrode pads were removed. One of these 2 patients has been free of infection for 4 years. The other had S. aureus cultured from removed electrode pads after 6 weeks. Of the 14 cases, morbidity was severe in only 1 patient. Seven patients underwent reimplantation 6 weeks after the infection.
Spontaneous Intracranial Hemorrhage Caused by Brain Tumor
Authors: Wakai Susumu , Yamakawa Kenta , Manaka Shinya , Takakura Kintomo 
Published: May 2010

Abstract
Hemorrhage from brain tumor was confirmed clinically, surgically, or on autopsy in 94 of 1861 cases (5.1%) treated during the past 18 years: 49 of 311 pituitary adenomas (15.8%) and 45 of 1550 other brain tumors (2.9%). The higher incidence of hemorrhage from pituitary adenoma was statistically significant (Neurosurgery &lt; 0.001). In brain tumors other than pituitary adenoma, the incidence of hemorrhage was significantly higher in the patients under 14 years old (17 of the 322 cases, 5.3%) than in the patients over 15 years old (28 of the 1228 cases; 2.3%) (Neurosurgery &lt; 0.001). Nineteen patients showed no evidence of clinical symptoms related to bleeding. Twenty-six patients had a definite history of an acute episode that suggested sudden bleeding. In 11 of these, the apoplectic syndrome was the initial presenting symptom. The incidence of hemorrhage was not statistically correlated with sex. The hemorrhage was intratumoral in 30 cases, intracerebral in 7, subarachnoid in 7, and subdural in 1. The tumors were supratentorial in 36 cases, pineal in 1, and infratentorial in 8. Primary and metastatic choriocarcinoma and primary embryonal carcinoma seemed to cause hemorrhage most frequently. The following precipitating factors were found in 7 of the 17 patients aged under 14: ventricular drainage in 2, ventriculoperitoneal shunt in 2, carotid angiography in 1, head injury in 1, and leukemia in 1. Seven of the 17 patients under 14 years old died of massive bleeding from the tumor. Unless there is evidence of vascular disease such as cerebral aneurysm, vascular malformation, or hypertensive cerebrovascular disease, intracranial hemorrhage should be suspected of being due to a brain tumor.
Hemangiopericytomas of the Spine
Authors: Muraszko Karin M. , Antunes J. Lobo , Hilal Sadek K. , Michelsen Jost W. 
Published: May 2010

Abstract
Four cases of hemangiopericytoma of the spine are reported. These are rare tumors that arise from the pericytes. Due to their invasive nature and marked vascularity, a detailed radiological work-up including computed tomography and spinal angiography should be obtained before a direct surgical attack is performed. Embolization of the tumor may also be quite helpful before surgical excision and has allowed a gross total removal of the tumor in two of the cases.
Persistent Cervical Intersegmental Artery as a Cause of Recurrence of a Traumatic Carotid-Cavernous Fistula
Authors: Keller Herbert M. , Imhof Hans-Georg , Valavanis Anton 
Published: May 2010

Abstract
In a 16-year-old boy, minor symptoms of an arteriovenous shunt into the cavernous sinus recurred 3 months after the performance of a trapping operation of the internal carotid artery on the side of a traumatic carotid-cavernous sinus fistula. An arterial and venous cerebrovascular Doppler examination demonstrated increased blood flow in the periorbital veins of both sides, with a pathological flow direction, i.e., from intra- to extracranial. Furthermore, an internal-like artery was found at the level of the carotid bifurcation on the side of the trapped internal carotid artery, and increased blood flow was registered in the homolateral vertebral artery. Angiography confirmed occlusion of the internal carotid artery 0.5 cm distal to the carotid bifurcation, but showed blood flow from the homolateral vertebral artery through a persistent 3rd cervical intersegmental artery into the trapped portion of the internal carotid artery. The latter fed blood into the cavernous sinus through the still-existing arteriovenous fistula. Insufficient involution of the 3rd cervical intersegmental artery was assumed. Obviously, this collateral artery dilated in the presence of a major blood pressure gradient between the vertebral artery and the trapped segment of the internal carotid artery. Thus, a persistent cervical intersegmental artery can be a cause for a recurrent carotid-cavernous sinus fistula.