bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experience with Surgical Decompression of the Arnold-Chiari Malformation in Young Infants with Myelomeningocele
Authors: Park Tae Sung , Hoffman Harold J. , Hendrick Bruce E. , Humphreys Robin P. 
Published: May 2010

Abstract
Forty-five infants with myelomeningocele in whom hydrocephalus was absent or adequately controlled developed signs and symptoms of the Arnold-Chiari malformation before the age of 3 months. All of them underwent laminectomy and opening of the dura mater for hindbrain decompression. The clinical presentation included swallowing difficulty, apneic episodes, stridor, bronchial aspiration, arm weakness, and opisthotonos. Within 2 weeks of the initial clinical presentation, the neurological status of 14 patients (31%) deteriorated dramatically and culminated in irreversible neurological deficits. In all patients, compression of the brain stem occurred in the spinal canal. A transverse dural band constricting the dural sac at the C-1 level was noted in 41% of the patients, and a mild degree of arachnoidal adhesion was noted in 23%. The lowermost level of the cerebellar tongue or medullary kink was located at C-1 to C-4 in 28 cases and at C-5 to T-1 in 17 cases. Twenty-eight (62%) of the patients were alive and 17 (38%) had died at the last follow-up assessment. All survivors showed improvement of their overall neurological function. Twenty-four made a complete recovery. The majority of deaths were attributed to respiratory failure. Early recognition of symptoms and prompt decompressive laminectomy are essential for successful management of the Arnold-Chiari malformation in infants.
Colonic Complications of Ventriculoperitoneal Shunts
Authors: Abu-Dalu Khalil , Pode Dov , Hadani Moshe , Sahar Abraham 
Published: May 2010

Abstract
Late perforation of the large bowel by the abdominal catheter of a ventriculoperitoneal (VP) shunt is extremely rare. Four of the five reported patients subsequently died. We report here three patients who presented with this complication and were treated successfully. Bowel perforation by a VP shunt catheter should be considered when a shunt infection is secondary to gram-negative enteric organisms. It can occur without evidence of peritonitis, and the abdominal catheter can be removed percutaneously, thus avoiding a laparotomy.
Simple Plastic Stereotactic Unit for Use in the Computed Tomographic Scanner
Authors: Levy Walter J. 
Published: May 2010

Abstract
The marriage of computed tomography (CT) and stereotactic surgery offers an opportunity to provide sophisticated and effective treatment to discrete areas of the brain. An important part of this capability is the development of stereotactic frames that are compatible with the CT scanner, i.e., that do not degrade the CT image. A number of technically elegant and ingenious stereotactic frames have been reported. However, they have the drawback of technical complexity and, particularly, great exposure. We are reporting a simple ball and socket skull-mounted stereotactic device that allows solid fixation of probes for use in brain needle biopsies, ventricular catheterization, and similar activities.
Intratemporal Schwannoma of the Facial Nerve
Authors: Tew John M. , Yeh Hwa-Shain , Miller Gale W. , Shahbabian Set 
Published: May 2010

Abstract
Two patients with schwannomas that originated from the region of the geniculate ganglion of the facial nerve are reported. They presented with progressive facial nerve paralysis and variable disturbance of hearing. Computed tomograms demonstrated a mass lesion eroding the temporal bone (petrous portion) and extending into the middle fossa. The treatment consisted of complete excision of the tumor, and a hypoglossal-facial nerve anastomosis. Computed tomography should be performed on all patients with facial palsy of a progressive nature. Early diagnosis and surgical treatment of facial schwannoma should permit preservation of function of the facial and the acoustic nerves.
Extracranial-Intracranial Arterial Bypass and Basilar Artery Ligation in the Treatment of Giant Basilar Artery Aneurysms
Authors: Hopkins L. N. , Budny James L. , Castellani Daniel 
Published: May 2010

Abstract
Two patients with giant aneurysms of the basilar artery treated with prophylactic extracranial-intracranial arterial bypass (EIAB) to the rostral brain stem before basilar artery ligation are presented. In both cases, the bypass provided considerable collateral flow to the upper basilar, posterior cerebral, and superior cerebellar arteries. Basilar artery ligation has been shown to be an effective, albeit dangeours, means of treating giant aneurysms of the basilar artery. The risk of significant brain stem ischemia after ligation is at least 30%. EIAB to the rostral brain stem should be considered whenever basilar artery ligation is performed, especially in cases where angiography demonstrates poor collateral circulation to the distal basilar artery.
Stereotactic Aspiration of a Brain Stem Hematoma
Authors: Beatty Robert M. , Zervas Nicholas T. 
Published: May 2010

Abstract
A medical student developed a progressive mesencephalic lesion found to be cystic in nature by computed tomographic (CT) scanning. Stereotactic aspiration of a pontomesencephalic hematoma was carried out twice, and the patient recovered. Angiography and CT scanning demonstrated a vascular lesion compatible with a venous angioma.
Evoked Potentials in Trigeminal Neuralgia
Authors: Bennett M. H. , Jannetta P. J. 
Published: May 2010

Abstract
Trigeminal evoked potentials and sensory thresholds in response to maxillary gum stimulation were obtained in patients with a complaint of unilateral face pain. The patients and the volunteer, normal control groups had undergone no prior surgical or other procedures involving cranial or cervical structures. For statistical purposes, patient data were analyzed with respect to the diagnostic classification of classical trigeminal neuralgia, atypical trigeminal neuralgia, or other face pain states in which the pain extended beyond the trigeminal nerve distribution. Latencies of trigeminal evoked potentials on the affected side were significantly increased (compared to normal control group responses) in patients with classical but not in those with atypical trigeminal neuralgia nor other face pain syndromes. All three patient groups had statistically significant threshold elevations on the affected side compared to the unaffected side. A high level of significance for this test was obtained for the classical trigeminal neuralgia group. Ratings for patients based upon the preoperative electrophysiological findings were highly correlated with long term results of microvascular decompression of the 5th nerve root for classical, but not for atypical trigeminal neuralgia patients. These results support the view that atypical and classical trigeminal neuralgia symptom complexes are caused by different types of physiological dysfunction and that classical trigeminal neuralgia is associated with compression of the trigeminal nerve root. It was suggested that the rating system may be a useful, objective, clinical adjunct in evaluating patients with classical trigeminal neuralgia.
Management and Outcome of Pineal Region Tumors
Authors: Hitchon P. W. , Abu-Yousef Monzer M. , Graf Carl J. , Turner Donn M. , VanGilder John C. 
Published: May 2010

Abstract
The management and outcome of 45 patients with tumors in the pineal region are reviewed. The overall male to female ratio was 2:1, and over one-half of the patients presented during the 2nd decade of life. Sixteen of the 21 survivors are presently gainfully employed and suffer only minor deficits. Two of 3 survivors in whom the lesion was biopsied harbored germinomas, while the third had an epidermoid. Among the 18 nonsurvivors, all of whom died of their tumors, 15 succumbed within 2 1/2 years of hospital admission. Twelve of the 13 nonsurvivors in whom histological confirmation was obtained by operation or autopsy had malignant tumors. Computed axial tomography was helpful in making the diagnosis of tumor type in 7 of the 11 cases with confirmed pathology. Cerebrospinal fluid cytology disclosed malignant cells in 4 of 11 patients with proven pineal malignancy. Irradiation and shunting were performed in nearly all survivors and in a little over one-half of the nonsurvivors. Where noninvasive studies are equivocal for malignancy, biopsy may be indicated.
Preoperative Embolization of Intracranial Meningiomas
Authors: Richter Hans-Peter , Schachenmayr Walter 
Published: May 2010

Abstract
The operative and histopathological findings in 31 cases of intracranial meningioma after preoperative embolization with Gelfoam and/or lyophilized dura mater are reported. Removal of the tumor after embolization was facilitated in those meningiomas fed exclusively or mainly by branches of the external carotid artery (29 of 31). Large areas of tumor necrosis were never seen on histopathological examination, even when suggested by large regions of decreased density on the postembolization computed tomographic scan. Preoperative embolization of the feeding vessels arising from the external carotid artery system has proven to be a useful adjunct before the resection of intracranial meningiomas.
Stereotactic Implantation of Deep Brain Electrodes Using Computed Tomography
Authors: Lunsford L. D. , Latchaw R. E. , Vries J. K. 
Published: May 2010

Abstract
The selection of intracranial targets for stereotactic functional neurosurgical procedures traditionally has relied on information derived from pooled brain atlases and supplemented by contrast encephalographic or angiographic data from the individual patient. The integration of stereotaxy with computed tomography (CT) has permitted direct identification of intracranial targets based on multiplanar reformatted CT images from each individual patient. Four patients underwent the CT stereotactic implantation of a single deep brain electrode for the control of chronic pain (two cases) or of multiple depth electrodes for long term electroencephalographic recordings in the management of seizure disorders (two cases). In all patients, accurate and precise electrode placement was achieved from CT images alone. The use of CT permitted detailed anatomical stereotactic study of each patient's brain, the preplotting of electrode trajectories before probe insertion, and the rapid confirmation of precise electrode placement. Intraoperative contrast encephalography was not necessary. Functional neurosurgery was performed successfully and advantageously using CT stereotactic technique alone
Comparison of High Resolution Real Time Ultrasonography and High Resolution Computed Tomography in an Infant with Spinal Dysraphism
Authors: James Hector E. , Scheible William , Kerber Charles , Hilton Saskia v. W. 
Published: May 2010

Abstract
An infant with a lumbosacral spinal subcutaneous and intraspinal lipoma involving the conus medullaris was studied with computed tomography and high resolution real time ultrasonography to determine the extent and location of the disease before operation. The high resolution ultrasonogram demonstrated the abnormality with good detail and the added advantage of real time display of the lack of pulsatile mobility of the neural elements, confirming spinal cord tethering. Spinal high resolution ultrasonography is a noninvasive diagnostic tool in infants with spinal abnormalities and should be an important part of a neurosurgeon's diagnostic support system.
Fibrosarcoma of the Heart Metastatic to the Brain
Authors: Saris Stephen , Vavoulis George , Linder James , Friedman Allan 
Published: May 2010

Abstract
A right parietal lobe metastasis of a fibrosarcoma originating in the left atrium of the heart was resected twice in a 33-year-old man. Light microscopy showed lightly packed, pleomorphic spindle cells with abundant collagen production and an alcian blue-positive matrix. Electron microscopy confirmed the fibroblastic character of these cells. Review of the literature reveals one other cardiac fibrosarcoma metastatic to the brain. The case presented is the first reported example of successful surgical resection of this unusual metastatic sarcoma. Although he succumbed to metastatic disease, the patient remained neurologically intact until the time of death.
Autogeneic Fat Transplants in the Epidural Space in Routine Lumbar Spine Surgery
Authors: Bryant Michael S. , Bremer Alfonso M. , Nguyen Tai Q. 
Published: May 2010

Abstract
This report presents our experience with the use of autogeneic fat patch grafts to protect the exposed dura mater during lumbar spine operations. A total of 44 consecutive surgical procedures was performed primarily for discogenic or spondylotic disease from 1979 to 1982. Prophylactic antibiotics were used in 21 (48%) cases. The autogeneic fat transplants were well accepted by all recipients during 10.4 (1 to 32) months of follow-up. Fat grafts, greater than 1 cm in thickness, were easily identified on subsequent computed tomographic (CT) scans. There were no postoperative wound infections. However, 1 patient developed a large subcutaneous sterile fluid accumulation at the fat donor site, which required surgical intervention. Our results, both short and long term, indicate that autogeneic fat transplants may be well tolerated in the lumbar spine area. The fat graft viability as demonstrated by CT scanning and histological examination supports the contention that autogeneic fat interposed between dura mater and overlying musculature may serve as a barrier limiting the growth of cicatrix into the spinal canal.
Indwelling Epidural Morphine for Control of Post-Lumbar Spinal Surgery Pain
Authors: Ray Charles D. , Bagley Russel 
Published: May 2010

Abstract
The epidural instillation of morphine for pain control has been utilized for some time, although primarily intraoperatively or for patients with chronic severe pain, as in terminal cancer. Long term indwelling catheter or subarachnoid administration of epidural morphine are both potentially hazardous. However, in relatively brief applications, up to a few days, the epidural administration of morphine sulfate is effective, safe, and well tolerated when used according to a carefully controlled plan. We report the use of this method as an improved means for the control of post-lumbar surgery pain in 25 cases. These patients were compared with 25 others receiving standard doses of parenteral and oral narcotics. The two groups were quite similar preoperatively. However, patients receiving epidural morphine were more comfortable, had fewer side effects such as nausea and lassitude, and exhibited no respiratory depression. Further, they ambulated sooner, showed no definitive orthostatic hypotension and less ileus, and remained much more alert and cooperative during the initial 48 hours after operation. Hospitalizations were usually shorter by 1 or 2 days. The administration of very small doses (1.0 to 2.5 mg) of morphine every 12 to 24 hours was usually adequate for good to excellent postoperative pain control. Hydroxyzine was sometimes used to potentiate the analgesia between doses. The epidural catheters were routinely removed within about 72 hours. The technique for the intraoperative placement of the epidural catheter and drug administration are detailed. Precautions for catheter placement were carefully followed to prevent dural penetration or intrathecal injection.
Vasospasm and Regional Cerebral Blood Flow (rCBF) in Patients with Ruptured Intracranial Aneurysm: Serial rCBF Studies with the Xenon-133 Inhalation Method
Authors: Yamakami Iwao , Isobe Katsumi , Yamaura Akira , Nakamura Takao , Makino Hiroyasu 
Published: May 2010

Abstract
To clarify the relationship of vasospasm to the reduction of cerebral blood flow (CBF) and the delayed ischemic neurological deficit, serial rCBF studies with the use of the xenon-133 inhalation method were conducted in 35 postoperative patients with ruptured intracranial aneurysms. The CBF was calculated as an initial slope index (ISI) derived from the desaturation curve of each head probe, and the hemispheric mean value of the ISI (mean ISI) was calculated in both hemispheres. The mean ISI in the hemisphere ipsilateral to the operation was low compared to that of the contralateral hemisphere. In relation to the presence of vasospasm, angiographic findings were classified into the following five types: diffuse, peripheral, proximal-severe, proximal-mild, and no spasm. Patients with vasospasm of the diffuse, peripheral, and proximal-severe types showed a markedly decreased mean ISI, and vasospasm of the diffuse type caused the greatest degree of reduction. The mean ISI of the patients who developed delayed ischemic neurological deficit (DIND) due to vasospasm was significantly decreased (37.4± 4.6) compared to that of the patients who did not develop DIND (52.2± 5.6). None of 3 cases of no spasm and only 1 of 14 cases of proximal-mild spasm developed DIND. On the other hand, all of 4 cases of diffuse, 2 of 3 cases of peripheral, and 2 of 6 cases of proximal-severe spasm developed DIND. Thus, if these three types of vasospasm are joined together as severe vasospasm, 8 of 13 cases with severe vasospasm developed DIND. These results suggest that severe vasospasm causes a reduction of CBF and that the reduced CBF brings about DIND.
Evaluation of the Histopathology of Brain Tumor Tissue Obtained by Ultrasonic Aspiration
Authors: Richmond Isabelle L. , Hawksley Carlene A. 
Published: May 2010

Abstract
Ultrasonic aspiration has been widely adopted in the resection of tumors of the central nervous system. In the past, the tumor tissue fragments obtained have been discarded. To evaluate these fragments as possible sources of material for histopathological study and tissue culture, we compared the microscopic features and viability in tissue culture of CUSA tissue fragments and biopsies obtained by conventional methods. Two cases (a meningioma and a subependymal astrocytoma) are presented to demonstrate that these tissue fragments retain good preservation of histological detail and tissue culture viability. Because the quantity of tumor tissue available from the CUSA tissue trap is consistently greater than that obtained by standard biopsy methods, utilization of this material may facilitate pathological interpretation by providing a more representative sample of tumor histology as well as providing an adequate and sterile source of material for tissue culture studies.
Intraarterial 1,3-Bis(2-chloroethyl)-1-nitrosourea (BCNU) and Systemic Chemotherapy for Malignant Gliomas: A Follow-up Study
Authors: West Charles R. , Avellanosa Anthony M. , Barua Nilou R. , Patel Arun , Hong Chung I. 
Published: May 2010

Abstract
Twenty-five adults who harbored malignant gliomas received 72 courses of intraarterial 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) (100 mg/m2) and 67 courses of systemic vincristine (1.0 mg/m2) and procarbazine (100 mg/m2) as induction therapy (BVP) followed by 106 courses of systemic 1-(2-chloroethyl)-3-(4-methylcyclohexyl)-1-nitrosourea (methyl-CCNU) (130 mg/m2), vincristine, and procarbazine as maintenance therapy (MVP). With a 6-week interval between each treatment, the median and range for the number of courses of BVP were 3 and 1 to 4 and those for MVP were 3 and 0 to 14, respectively. Fifteen patients (60%) responded to both BVP and MVP, and 10 (40%) did not. The overall median survival time was 12.7 months (range, 1.8 to 48.5+ months). Two of 3 patients who had recurrent gliomas responded and survived for 37+ to 45+ months. Seven of 10 who had nonirradiated glioblastomas responded and survived for 9 to 22 months. Four who had nonirradiated anaplastic astrocytomas all responded and survived for 38+ to 48.5+ months. Two who also received radiotherapy (1 glioblastoma and 1 primitive neuroectodermal tumor) benefited and survived for 16.9 and 28.5+ months. All who did not respond favorably died within 8 months. During the infusion of BCNU, complications included transient orbital and head pain, periorbital and scleral erythema in all patients, and a focal seizure in 1 (4%). During the 6-month induction periods, leukopenia and thrombocytopenia occurred in 1 (4%), deep vein thrombosis occurred in 9 (36%), pulmonary emboli occurred in 8 (32%), upper respiratory infections occurred in 6 (24%), pneumonia occurred in 9 (36%), and herpes zoster occurred in 1 (4%). During maintenance therapy, seizures occurred in 4 (16%) and leukopenia and/or thrombocytopenia occurred by the fifth course in 6 of 9 who received 5 to 14 treatments.
Percutaneous Glossopharyngeal Thermocoagulation Complicated by Syncope and Seizures
Authors: Ori Carlo , Salar Giuseppe , Giron Giampiero 
Published: May 2010

Abstract
We describe the case of a patient who, during the percutaneous thermocoagulation of the petrous ganglion of Andersch, suffered a serious vagal response resulting in cardiac arrest, collapse, and generalized convulsions. Notwithstanding such major symptoms, the postoperative examination revealed no lesions of the vagus nerve and the glossopharyngeal lesion was shown to be isolated and selective.
Hormone Binding in Brain Tumors
Authors: Glick Roberta P. , Molteni Agostino , Fors Ellen M. 
Published: May 2010

Abstract
Brain tumors from 64 patients were studied for the presence of hormone binding. Estradiol binding was detected in 34 patients: 13 of 21 meningiomas, 4 of 8 schwannomas, 1 oligodendroglioma, 1 of 5 benign gliomas, 4 of 5 malignant gliomas, 5 of 11 metastatic tumors, and 6 of 11 pediatric tumors: 1 medulloblastoma, 2 malignant ependymomas, 1 benign astrocytoma, 1 malignant sarcoma, and 1 malignant teratoma, Eleven patients were studied for progesterone binding, which was measurable in 7: 1 schwannoma, 3 meningiomas, 1 malignant sarcoma (pediatric group), 1 astrocytoma—gemistocytic (pediatric group), and 1 metastatic adenocarcinoma. There were 41 females and 23 males in the study, Fifteen females were premenopausal, 18 were postmenopausal, and 8 were in the pediatric age group. Of the 34 tumors with measurable estradiol binding, 23 occurred in females. In the progesterone group, 4 of the 7 tumors with measurable binding activity were from female patients. In the pediatric group, estradiol binding was detected in 1 medulloblastoma, 2 malignant ependymomas, 1 malignant teratoma, 1 malignant sarcoma, and 1 astrocytoma. Five of the 6 pediatric tumors with estradiol binding were malignant, and both pediatric tumors with progesterone binding were also malignant. Of the 10 gliomas studied, 4 of the 5 malignant tumors had estradiol binding, whereas only 1 of the 5 benign tumors showed binding. Our studies with the pediatric tumors and the gliomas suggest that a relationship exists between the malignancy of the tumor and the presence of hormone binding. The ubiquitous nature of the presence of hormone binding is discussed, as is the possible correlation between age, sex, histological grade, and significance of hormone binding in brain tumors.
Three-Dimensional Reconstruction of Craniofacial Deformity Using Computed Tomography
Authors: Hemmy D.C. , David D.J. , Herman Gabor T. 
Published: May 2010

Abstract
The computed tomographic studies obtained routinely in the examination of patients with congenital or acquired defects of the skull and facial bones can be utilized as a substrate to provide an accurate three-dimensional representation of osseous abnormalities. The total dose of x-irradiation is reduced as other means of radiological examination are eliminated. Osseous structures are faithfully reproduced. Complete inspection of the reproduced structure can be made from any viewpoint, including internal inspection.