bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute Tissue Tear Hemorrhages of the Brain: Computed Tomography and Clinicopathological Correlations
Authors: Wilberger James E. , Rothfus William E. , Tabas Janet , Goldberg Andrew L. , Deeb Ziad L. 
Published: April 2011

Abstract
Tissue tear hemorrhages (TTHs) are often seen on high-resolution computed tomographic scans after closed head injury. Generally, TTHs have been thought to be visible manifestations of more severe forms of diffuse axonal injury and thus portend a poor prognosis. Computed tomographic scans from 600 patients with head injuries were reviewed: 48 (8%) were found to have TTHs. The clinical spectrum of TTHs was characterized. No direct relationship could be established between either the presence or the number of TTHs and the severity and/or outcome from the head injury in this group, except that patients with TTHs in both the brain stem and the corpus callosum uniformly had a poor outcome. Magnetic resonance imaging provided more sensitive information than computed tomography in evaluating TTHs.
Blood Component Induction of Cerebral Vasospasm
Authors: Harada Tsutomu , Suzuki Yoshio , Satoh Shin-ichi , Ikegaki Ichiro , Asano Toshio , Shibuya Masato , Sugita Kenichiro 
Published: April 2011

Abstract
The role of blood components in cerebral vasospasm was evaluated using an in vivo canine model. An intracisternal injection of 5 ml of washed red blood cells (RBCs) and platelet-rich plasma (PRP) resulted in acute vasospasm of the basilar artery as seen by angiography. This was comparable with the degree of vasospasm induced by an injection of the same amount of whole blood. Repeated injections of blood components or whole blood on Days 1 and 3 induced chronic vasospasm. as shown by angiography on Day 7. Results clearly indicate that chronic vasospasm was produced by RBCs and PRP. and it was in a dose-dependent manner with increasing concentrations of RBCs (hematocrit: 30, 50. and 70%). The vasospasm induced by both components closely reproduced that seen with whole blood. Neither acute nor chronic vasospasm induced by blood component injection was associated with clot formation in the subarachnoid space, as confirmed by an autopsy. These results suggest that the extravasation of RBCs and PRP into the subarachnoid space produces cerebral vasospasm by mechanisms independent of blood clot formation.
Bilateral Arteriovenous Malformations of the Choroid Plexus and Retina
Authors: İplikçioğlu Celal A. , Özek Memet M. , Özcan Osman Ekin , Çizmeli Olcay , Sağlam Süleyman 
Published: April 2011

Abstract
A unique case is described in which an epileptic patient with bilateral vascular malformations of the retina was found to have bilateral arteriovenous malformations of the choroid plexus.
Extracerebral Cavernous Angiomas of the Middle Fossa
Authors: Rigamonti Daniele , Pappas Conrad T. E. , Spetzler Robert F. , Johnson Peter C. 
Published: April 2011

Abstract
Three cases of extracerebral cavernous angiomas of the cavernous sinus in the middle fossa are reported. These are rare lesions that primarily affect women and are usually associated with acute or subacute onset of visual symptoms: diplopia, exophthalmos, and decreased visual acuity. The growth of the lesion often erodes the bone in the area of the cavernous sinus. Angiography usually depicts a vascular mass. The lesions represent a formidable surgical problem because of their tendency to cause intraoperative life-threatening hemorrhages. Morbidity and mortality can be drastically reduced by not attempting to resect the lesion further after biopsy and by giving a course of radiation therapy before definitive surgical treatment.
Atypical Subependymoma of the Spinal Cord: Ultrastructural and Immunohistochemical Studies
Authors: Lach B. , Russell N. , Benoit B. 
Published: April 2011

Abstract
A 76-year-old woman with a 2-year history of progressive weakness of the left arm and leg underwent a laminectomy for an intradural, extramedullary, pedunculated subependymoma involving the meninges and spinal nerve roots at C7-T1. Eight months later, another operation was necessary for an intramedullary neoplasm at C3-T4. This latter tumor consisted of small. poorly developed cells, large atypical astrocytes, and ependymal cells. Neither ependymal rosettes nor papillary formations were present. Ultrastructural studies showed some features of ependymal differentiation of the large “astrocytic” cells. This case illustrates an unusual pattern of extramedullary and intramedullary presentations of subependymoma and a spectrum of cellular differentiation of neoplastic subependymal glia.
Functional Results of Facial Nerve Suture after Removal of Acoustic Neurinoma: Analysis of 25 Cases
Authors: Jääskeläinen Juha , Pyykkö Ilmari , blomstedt Göran , Porras Matti , Palva Tauno , Troupp Henry 
Published: April 2011

Abstract
The facial nerve is sometimes severed during the removal of acoustic neurinomas, either intentionally to ensure complete removal, or unintentionally because of difficulties in identification. In such cases we have, if possible, sutured the nerve stumps microsurgically, either end to end or by use of an intervening nerve graft. We analyzed the outcome of 25 instances of facial nerve suturing in a series of 219 patients operated on for acoustic neurinoma from 1979 to 1987. The first signs of recovery appeared at an average of 12 months, and there was continued improvement for several years. Recovery was graded from 1 to 6. The anastomosis was successful in 24 of the 25 sutured nerves, in that at least some facial movement and tone were restored (Grade 5 or higher). In 11 of the 25 cases, facial appearance at rest and with movement was moderately good (Grade 2 or 3). A Grade 1 result, with no perceivable facial dysfunction, was never achieved. Typically, oral muscles showed the most improvement and frontal muscles the least. Facial appearance was better at rest than with movement, which was always complicated by some degree of synkinesis. Closure of the eye was so good in 13 of the 25 cases that neither tarsorrhaphy nor an eyelid spring was necessary. When the facial nerve is severed, intraoperative suture is recommended, because it provides a chance for moderately good restoration of facial appearance.
Extracranial Repair of Cerebrospinal Fluid Fistulas: Technique and Results in 37 Patients
Authors: McCormack Bruce , Cooper Paul R. , Persky Mark , Rothstein Stephen 
Published: April 2011

Abstract
Although neurosurgeons have traditionally preferred intracranial repair for the management of cerebrospinal fluid (CSF) fistulas, this approach is associated with the complications of a craniotomy, anosmia, and a high incidence of recurrent fistulas. Extracranial repair, on the other hand, produces no central nervous system morbidity, preserves olfaction, and is associated with a low incidence of recurrence. Although there have been several reports of extracranial repair of CSF fistulas by otorhinolaryngologists, this approach has received scant mention in the neurosurgical literature. We report here our experience with 37 patients with CSF rhinorrhea or otorrhea who underwent extracranial repair. The etiology of the fistula was postoperative in 22, traumatic in 6, and spontaneous in 9. The fistulas were repaired using one of four techniques: external ethmoid-sphenoid in 18 patients, transmastoid in 9, transseptosphenoid in 7, and osteoplastic frontal sinusotomy in 3. In 32 of the 37 patients (86%) the fistulas were successfully repaired with the initial procedure. Of the 5 patients requiring a second operation, the fistula was successfully closed in 4 for an overall success rate of 97%. Complications were few and consisted of a transient facial paresis in a patient undergoing transmastoid repair and one death from meningitis. The authors conclude that because of low morbidity and mortality and a high success rate in closing fistulas, extracranial repair is the preferred technique for the operative management of CSF rhinorrhea and otorrhea.
Chronic Lyme Disease with an Expansive Granulomatous Lesion in the Cerebellopontine Angle
Authors: Mokry Michael , Flaschka Gerhard , Kleinert Gertrude , Kleinert Reinhold , Fazekas Franz , Kopp Wolfgang 
Published: April 2011

Abstract
Expansive granulomatous lesions in the posterior cranial fossa are rare and have not been reported in conjunction with Lyme disease. We report a patient with verified Borrelia burgdorferi infection who developed a tumor in the cerebellopontine angle. Rapid growth of the tumor led to signs of cerebral compression and to hydrocephalus. Surgical intervention was required despite florid meningitis. The histological examination showed inflammatory, nonspecific granulation tissue. The origin of this tissue is almost certainly causally related to the B. burgdorferi infection. Signs of inflammation resolved rapidly after subtotal resection. The clinical, radiological, and biochemical course is documented. This is the first report of an expansive cerebral lesion in the chronic phase of Lyme disease.
Vagal Schwannoma Associated with Syncopal Attacks and Postural Hypotension: A Case Report
Authors: Sawamura Yutaka , de Tribolet Nicolas 
Published: April 2011

Abstract
A case of vagal schwannoma in the cerebellomedullary angle is reported. Preoperatively, the patient had paroxysmal episodes of postural hypotension with syncope. After total removal of the vagal tumor, her systemic blood pressure returned to normal.
Traumatic Aneurysm of the Superior Cerebellar Artery: Case Report and Review of the Literature
Authors: Quattrocchi Keith B. , Nielsen Surl L. , Poirier Virginia , Wagner Franklin C. 
Published: April 2011

Abstract
Less than 10% of the 250 reported cases of traumatic intracranial aneurysms have involved the posterior circulation. Traumatic aneurysms of the superior cerebellar artery are extremely rare, with only three cases previously reported. This is the first report of a traumatic superior cerebellar artery aneurysm in which the diagnosis was suggested by computed tomographic scan. The potential for a good outcome suggests the value of early angiography when the history and diagnostic imaging studies suggest the possibility of a traumatic aneurysm.
An Unusual Complication of Silastic Dural Substitute: Case Report
Authors: Ng Thomas H. K. , Chan Kwan Hon , Leung Suet Yi , Mann Kirpal S. 
Published: April 2011

Abstract
A case is presented in which a patient developed an unusual complication after the use of Silastic dural substitute. In 1983. the patient underwent removal of a meningioma with the involved dura. Five years later, he developed around the graft material a very thick connective tissue capsule, which simulated a recurrent meningioma clinically and radiologically.
Serial Ultrasonographic Evaluation of Neonatal Vein of Galen Malformations to Assess the Efficacy of Interventional Neuroradiological Procedures
Authors: Ciricillo Samuel F. , Schmidt Klaus G. , Silverman Norman H. , Hieshima Grant B. , Higashida Randall T. , Halbach Van V. , Edwards Michael S. B. 
Published: April 2011

Abstract
Two-dimensional echocardiography complemented with color-flow imaging and pulsed Doppler ultrasound was used to evaluate one fetus and five neonates with a vein of Galen malformation who had severe high-output congestive heart failure and cranial bruits at birth. Intracranial blood flow through the vein of Galen malformations, cardiac status, and direction of aortic blood flow were assessed before and after staged interventional neuroradiological treatment with transarterial and transvenous embolization procedures. Color-flow imaging in each infant displayed the major vascular anatomy including feeding vessels and the patterns of filling of the vein of Galen malformations. Pulsed Doppler ultrasound performed on the descending aorta above the diaphragm showed the degree of diastolic flow reversal indicative of runoff into the vein of Galen malformations. A reduction in blood flow through the vein of Galen malformation was seen on color-flow imaging in four patients treated successfully by embolic procedures. The ratio of diastolic retrograde flow velocity in the descending aorta to systolic antegrade velocity decreased from 0.51 ± 0.15 (mean ± standard deviation) to 0.15 ± 0.20 (P &lt; 0.05). Color-flow imaging and pulsed Doppler ultrasonography provided anatomical and pathophysiological information regarding cardiac hemodynamics and intracranial blood flow; with the patient's clinical status, these methods provided a reliable, noninvasive means to evaluate the effectiveness of therapy and the need for further treatment in neonates with vein of Galen malformations.
Spinal Cord Thromboplastin-induced Coagulopathy in a Rabbit Model
Authors: Pattisapu Jogi V. , Miller Jimmy D. , Bell Warren N. , Smith Robert R. , O'Neal Robert M. , Reddy Vijay N. 
Published: April 2011

Abstract
Coagulopathy results from many diverse events, including several neurogenic causes. Using a rabbit model, we produced coagulopathy by injecting autologous spinal cord and extracted thromboplastin intravenously. Serial coagulation panels were performed to evaluate the activation of the thrombotic and fibrinolytic pathways. Group 1 animals (n = 4) received intravenous injections of homogenized spinal cord tissue. Coagulopathy was not produced with 36 mg of homogenized spinal cord tissue, but 50 mg or more resulted in death. Group 2 animals (n = 12) received intravenous injections of extracted rabbit cord thromboplastin, which contained approximately 60% activity of a commercially purified rabbit brain thromboplastin. Five animals receiving 2.5 to 5.5 mg of thromboplastin per kilogram of body weight survived with evidence of coagulopathy. Seven animals receiving 2.5 to 100 mg of thromboplastin per kilogram of body weight died. Group 3 (4 control animals) received normal saline injections without changes in clinical or laboratory status. The thrombotic pathway was activated in all animals as evidenced by decreased platelet counts and fibrinogen levels. Activation of the fibrinolytic system was demonstrated by increased concentrations of protamine sulfate and abnormal euglobulin clot lysis times. The most sensitive parameters were the platelet count, protamine sulfate concentration, and white cell count (margination), which became abnormal within 15 minutes after the injections and returned to normal within 1 hour.
Pharmacological Reversibility of Experimental Cerebral Vasospasm
Authors: Nakagomi Tadayoshi , Kassell Neal F. , Hongo Kazuhiro , Sasaki Tomio 
Published: April 2011

Abstract
Using a morphometric technique, the pharmacological reversibility of luminal narrowing after experimental subarachnoid hemorrhage (SAH) was investigated. For vasodilation, a “cocktail” consisting of 10−4 M papaverine, 2 × 10−4 M sodium nitroprusside, and 10−5 M adenosine was administered intra-arterially. Forty-two rabbits were divided into six groups: control (normal animals); control plus cocktail (normal animals perfused with the cocktail before fixation); SAH (animals sacrificed 48 hours subsequent to intracisternal injection of 1.5 ml/kg of arterial blood); SAH plus cocktail (SAH plus perfusion with the cocktail); BaCl2 (animals sacrificed 10 minutes after intracisternal injection of 2 ml of 3 × 10−3 M BaCl2); and BaCl2 plus cocktail (BaCl2 animals perfused with the cocktail). The diameter of the basilar arteries in the control and the control plus cocktail groups was not significantly different. BaCl2 reduced the diameter 44% and SAH reduced the diameter 27%. There were no significant differences between the diameter of the BaCl2 plus cocktail group and SAH plus cocktail group when compared with the control or the control plus cocktail group. Morphological examination by light and transmission electron microscopy showed luminal narrowing and corrugation of the elastic lamina with few degenerative or proliferative changes of the vessel wall in animals with SAH. These results suggest that cerebral vasospasm is caused initially by smooth muscle contraction rather than by proliferative vasculopathy and that it is not an irreversible process.
Maffucci's Syndrome with Bilateral Cartilaginous Tumors of the Cerebellopontine Angle
Authors: Bushe Karl-August , Naumann Markus , Warmuth-Metz Monika , Meixensberger Jürgen , Müller Justus 
Published: April 2011

Abstract
Maffucci's syndrome is characterized by the combination of multiple enchondromas (Ollier's disease) and hemangiomatosis. These hemangiomas develop in the subcutaneous tissue and form red-blue tumors dispersed over the whole body. Intracranial involvement is rare, making a preoperative radiological diagnosis and differentiation from other tumors rather difficult. The radiological characteristics and successful removal of the intracranial part of a chondrosarcoma of the cerebellopontine angle in a case of Maffucci's syndrome are reported in this paper.
An Operative Complication in a Patient with a True Posterior Communicating Artery Aneurysm: Case report and Review of the Literature
Authors: Kudo Tadashi 
Published: April 2011

Abstract
Intraoperative oculomotor nerve injury in a patient with a true posterior communicating artery aneurysm is reported in detail. A comparison of internal carotid artery aneurysms at the posterior communicating artery junction with true posterior communicating artery aneurysms deserves special attention, because the vascular relationships of the aneurysm are more complex. A clip along the internal carotid artery does not occlude blood flow to the aneurysm, and the aneurysmal neck and the distal posterior communicating artery are closer to the oculomotor nerve. This is the 27th reported case of a true posterior communicating artery aneurysm. The incidence of true posterior communicating artery aneurysms ranges from 0.1 to 2.8% of all aneurysm patients. Such aneurysms constitute 4.6 and 11% of so-called posterior communicating aneurysms in two series. Difficulty associated with a preoperative diagnosis has been documented in at least 4 cases. An awareness of this rare aneurysm is stressed in order to avoid operative complications.
Esthesioneuroblastoma with Intracranial Extension
Authors: Meneses Murilo S. , Thurel Claude , Mikol Jacqueline , Ramina Ricardo , Maniglia João J. , Arruda Walter O. , Cophignon Jean 
Published: April 2011

Abstract
The authors present five cases of olfactory neuroblastoma with intracranial extension operated on in the Department of Neurosurgery in collaboration with otorhinolaryngologists. This tumor is most frequently reported as growing inside the nasal cavities, and it can extend to the paranasal sinuses. Cases presenting initially as intracranial tumors have been infrequently reported. At present, histological diagnosis of this tumor is aided by the use of electron microscopy and immunocytochemistry. Total resection combined with radiation therapy remains the most satisfactory treatment.
Cryptic Osteoid Osteoma of the Cranium: Case Report
Authors: Neff Samuel , Hansen Kristine , Domanowski Gerald F. , Wu Julian 
Published: April 2011

Abstract
Osteoid osteoma is an uncommon benign tumor of bone that rarely involves the cranium. It often causes local pain that is worse at night, characteristically relieved by aspirin, and does not correlate with the size of the lesion. The diagnosis depends on skull radiographs and computed tomography. This report describes a case in which radiographs showed nothing abnormal. The diagnosis and operative localization were accomplished with radionuclide bone scanning. Thus, the possibility of radiographically cryptic lesions must be considered in the evaluation of atypical head pain syndromes.
Pregnancy and the Risk of Hemorrhage from Cerebral Arteriovenous Malformations
Authors: Horton Jonathan C. , Chambers Wiley A. , Lyons Susan L. , Adams Raymond D. , Kjellberg Raymond N. 
Published: April 2011

Abstract
We conducted a retrospective analysis of 451 women with an arteriovenous malformation (AVM) of the brain to determine whether pregnancy is a risk factor for cerebral hemorrhages. A total of 540 pregnancies occurred among our patient population, resulting in 438 live births and 102 abortions. There were 17 pregnancies complicated by a cerebral hemorrhage. The hemorrhage rate during pregnancy for women with an unruptured AVM was 0.035 ±0.005 per person-year. The hemorrhage rate for nonpregnant women of childbearing age with an unruptured AVM was 0.031 ± 0.002 per person-year. Pregnancy did not increase significantly the rate of first cerebral hemorrhage from an AVM (P = 0.35). We found that women with an AVM face a 3.5% risk of hemorrhage during pregnancy. Pregnancy is not a risk factor for hemorrhage in women without a previous hemorrhage. This conclusion assumes no selection bias exists in our study population; a bias would be introduced if the risk of fatal outcome after a hemorrhage were greater in pregnant women than in nonpregnant women.
Occult, Bilateral Anterior Sacral and Intrasacral Meningeal and Perineurial Cysts: Case Report and Review of the Literature
Authors: North Richard B. , Kidd David H. , Wang Henry 
Published: April 2011

Abstract
None of the more than 180 cases of anterior sacral meningocele reported in the past 150 years has been bilateral, and only two have been associated with occult intrasacral meningocele. We report a unique case of bilateral anterior sacral cysts, communicating with the subarachnoid space, associated with occult intrasacral meningeal and perineurial (Tarlov's) cysts, in an asymptomatic woman. The pertinent clinical and diagnostic imaging literature is reviewed.
Suppression of the Cerebral Vasospastic Actions of Oxyhemoglobin by Ascorbic Acid
Authors: Kawakami Masahisa , Kodama Namio , Toda Noboru 
Published: April 2011

Abstract
Oxyhemoglobin (Oxy-Hb) produced a concentration-dependent contraction of monkey, dog, and bovine cerebral artery strips. Treatment of Oxy-Hb with ascorbic acid suppressed the ability of Oxy-Hb to contract the arteries, especially in the monkey arteries. The ability of intracisternally applied Oxy-Hb to constrict the basilar artery in anesthetized dogs was diminished when Oxy-Hb was treated previously with ascorbic acid (AsA-Hb). The contraction caused by Oxy-Hb was suppressed by treatment with indomethacin and aspirin in isolated bovine cerebral arteries. Endothelium-dependent relaxations elicited by substance P and relaxations induced by stimulation of the vasodilator nerves with nicotine were suppressed by treatment with Oxy-Hb and AsA-Hb; however, the inhibitory effect of AsA-Hb was markedly less. Oxy-Hb attenuated nitroglycerin-induced relaxations in a dose-dependent fashion, whereas AsA-Hb in concentrations up to 1.6 x 10-5 M did not significantly influence the relaxations. It is concluded that incubation of Oxy-Hb with ascorbic acid alters markedly the biological activity of Oxy-Hb; the vasoconstrictor activity is suppressed, and the ability to diminish vasodilator actions is minimized. These findings provide a rationale for the use of ascorbic acid in cisternal irrigation to prevent the development of cerebral vasospasm after a subarachnoid hemorrhage.
Spinal Cord Stimulation: A Contemporary Series
Authors: Spiegelmann Roberto , Friedman William A. 
Published: April 2011

Abstract
Forty-three patients with chronic pain disorders of different causes were selected for spinal cord stimulation. All underwent implantation of a ribbon electrode through a small laminotomy, under general anesthesia. Thirteen patients (30%) failed to obtain significant pain relief during a period of trial stimulation, and their electrodes were removed. The remainder underwent a definitive implant and were followed for a mean of 13 months (range, 3-33 months). Nineteen of them (63%) continued to experience pain relief. A detailed analysis of this series, as well as a literature review, is presented.