bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic Intracerebral Hematoma
Authors: Yashon David , Kosnik Edward J. 
Published: May 2010

Abstract
Twelve patients with chronic intracerebral hematoma are reported. This condition may be unrecognized as possibly being benefited by relatively simple diagnostic and therapeutic measures. The neurological symptoms and signs may be acute but may also be intermittent and progressive. The etiology is usually systemic hypertension, but trauma, coagulopathics, and obscure etiologies have been implicated. After diagnosis by computerized tomographic scan and/or arteriography, aspiration of the liquid hematoma usually results in improvement. It is hypothesized that recovery is hastened by removal of the hematoma. Often complete recovery ensues, but mild to severe neurological signs may persist depending on the initial damage.
Evaluation and Surgical Treatment of Congenital Craniofacial Deformities
Authors: Maniscalco Jack E. , Habal Mutaz B. 
Published: May 2010

Abstract
The field of craniofacial surgery has rapidly developed over the last decade in the United States and abroad. Congenital malformations heretofore considered hopeless are now being corrected by a team of specialists working together in the cranial-facial junction. The evaluation of patients for craniofacial surgery must include consideration of associated neurological impairment, and in certain syndromes the incidence of brain malformation and mental retardation are extremely high. The method of evaluation and the various surgical techniques are presented. Mortality rates from this surgery have ranged from 0 to 5%, according to the severity of the deformities.
Regional Cortical Blood Flow at Craniotomy
Authors: Carter Philip L. , White William L. , Atkinson James R. 
Published: May 2010

Abstract
Regional cortical blood flow was monitored at craniotomy in 32 patients with a thermal diffusion flow probe in an attempt to assess the effects of surgical conditions on flow. Changes in flow due to vascular manipulation, retraction, hypotension, and hyperventilation were readily apparent. Eleven patients with supratentorial tumors had intermittent measurements of cerebral blood flow; the expected differences in blood flow with halothane anesthesia and hyperventilation were observed. Fourteen patients with aneurysms were monitored continuously and demonstrated a reduction in flow during hypotension; in two of these cases, the reduction was to disastrously low levels. Flow reduction occurred secondary to branch occlusion by the aneurysm clip in a patient with three middle cerebral artery aneurysms and was corrected by changing the clip position. Direct measurement of regional flow may be of value in estimating the safety of temporary clips and the degree of hypotension that can be tolerated.
Mechanism and Localization of Speech in the Parietotemporal Cortex
Authors: Van Buren J. M. , Fedio P. , Frederick G. Canal 
Published: May 2010

Abstract
Cortical stimulation of the supramarginal and angular gyri elicited dysphasia. Delays in verbal response, misnaming, and difficulties in speech production were also elicited from this region. In two patients speech arrest occurred when stimulation was extended into the occipital cortex and the cortex medial to the supramarginal gyrus, respectively. In a left-handed patient, with speech representation presumed to be in the right hemisphere, neither stimulation nor ablation of the angular gyrus resulted in dysphasia. After anterior temporal resections two patients exhibited dysphasia in association with cortical edema. In one of these an additional resection in the inferior temporo-occipital region produced a marked but transient dyslexia. Observations of the disintegration of speech function during stimulation suggest that such stimulation interferes with a search mechanism by which the nonverbal concept of a visual stimulus is linked to a specific word in memory that is then withdrawn for use. A review of autopsy specimens demonstrates how close the cortex bearing indispensable speech representation lies to the occipital pole and the parietal midline. Because the gyral pattern is obscured by the meninges and is subject to anomalies, elective resection in these areas should be preceded by cortical stimulation and functional mapping.
Diaphragm Pacing in Central von Recklinghausen's Disease
Authors: Richardson Robert R. , Johnson Norris , Cerullo Leonard J. 
Published: May 2010

Abstract
A patient with central von Recklinghausen's disease with multiple lower cranial nerve tumors developed nocturnal central hypoventilation that was successfully treated with diaphragm pacing. An unusual postimplant complication requiring an increased amplitude of stimulation occurred and was later found to be due to a neurofibroma that had partially displaced the electrode cuff off the phrenic nerve.
Value of Computed Tomography in the Diagnosis and Management of Subarachnoid Hemorrhage
Authors: Modesti Luciano M. , Binet Eugene F. 
Published: May 2010

Abstract
The diagnostic value of computed tomography is analyzed in 31 patients with documented spontaneous subarachnoid hemorrhage. In 50% of all cases, the computed tomogram confirmed the presence of subarachnoid hemorrhage. This figure rose to 68% for cooperative patients examined within 24 hours of their ictus. With enhanced tomography the responsible aneurysm was identified in 30% of the cases. The distribution of the subarachnoid hemorrhage correctly predicted the location of the aneurysm in an additional 35%. Intracerebral or intraventricular hemorrhages were present in 35%. They occurred most frequently within the first 24 hours, were most commonly associated with ruptured anterior communicating aneurysms, and carried a poor prognosis. Cerebral infarction was demonstrated in five patients. Ventricular dilatation was present in 11 (63%) of the 19 patients who were examined during the first 24 hours after the hemorrhage. Seven patients showed progressive hydrocephalus on serial scanning. Shunting before aneurysm surgery was required in four cases. Computed tomography is the procedure of choice for the detection of intracerebral and intraventricular hemorrhage and cerebral infarction: it is superior to angiography in this respect. Computed tomography is also helpful in detecting the presence of subarachnoid hemorrhage and determining ventricular size. Frequently the offending aneurysm can be identified or its location can be accurately predicted, allowing more effective management. We recommend that a computerized tomographic scan be performed (preferably within 24 hours of the ictus) on all patients suspected of having had a subarachnoid hemorrhage. The studies should be done before and after enhancement with a contrast medium.
Servo-controlled Lumbar Infusions
Authors: Sklar Frederick H. , Beyer Chester W. , Ramanathan Murugappan , Elashvili Ilya , Cooper Paul R. , Clark Kemp W. 
Published: May 2010

Abstract
The variable rate lumbar subarachnoid infusion technique allows rapid quantitative study of the cerebrospinal fluid (CSF) compartment. Numerous pressure plateaus are studied in a brief time period with a servo-controlled system. The test determines the difference between rates of CSF absorption and formation as a function of pressure. On-line computer data analysis increases experimental efficiency to guarantee statistical significance. Animal and patient data are presented in the report.
Cytotoxic Edema Produced by 6-Aminonicotinamide and Its Response to Therapy
Authors: James Hector E. , Bruce Derek A. , Welsh Frank 
Published: May 2010

Abstract
Cytotoxic brain edema was produced in rabbits with intraperitoneal administration of a metabolic inhibitor, 6-aminonicotinamide. Paraplegia, diminished feeding, globally diminished muscle tone, and poor coordination were evident 48 hours after the initial administration of the drug and the electroencephalogram (EEG) was characterized by pronounced slowing and diminished voltage. Cisternal monitoring of intracranial pressure (at a pACO2 of 38 to 42 torr) revealed that it was significantly higher than in controls (p &lt; 0.001). Measurements of phosphocreatine, lactate, and NADH did not differ from control values, but total nicotinamide adenine dinucleotide (NAD+/NADH) showed a significant decrease in the experimental group (p &lt; 0.001). Water content of the gray matter was significantly higher in the experimental group when compared to that in controls (p &lt; 0.001). Mannitol and furosemide produced a significant reduction in intracranial pressure (ICP) (p &lt; 0.001) and lowered the water content of the gray matter (p &lt; 0.001). Both agents improved the slow wave form of the EEG 20 minutes after their administration intravenously in 50% of the animals. Dexamethasone (1 mg/kg) was administered with 6-aminonicotinamide 2 days before the experimental day. In 50% of this group, the behavior and EEG were similar to those of normal rabbits, and on the experimental day ICP was slightly lower than that in untreated animals (p &lt; 0.01). The decrease in water content of the gray matter in the steroid group was significantly less than that produced by mannitol and furosemide.
Saccular Aneurysm Associated with Absence of the Left Cervical Carotid Arteries
Authors: Waga Shiro , Okada Masahiko , Kojima Tadashi 
Published: May 2010

Abstract
The authors report successful surgical treatment of a patient with an anterior communicating artery aneurysm associated with absence of all of the left cervical carotid arteries. A review of the previous reports of 15 cases of intracranial aneurysm in association with absence of the internal carotid artery emphasizes the rarity of this lesion. Aneurysms with such an association have a distinct distribution different from that observed in the usual population. The data suggest that intracranial aneurysm develops more frequently in the absence of the internal carotid artery as a result of altered hemodynamics.
Cystic Lesions Associated with Intracranial Meningiomas
Authors: Rengachary Setti , Batnitzky Solomon , Kepes John J. , Morantz Robert A. , O'Boynick Paul , Watanabe Itaru 
Published: May 2010

Abstract
Three unusual cases of large, peritumoral cystic lesions associated with intracranial meningiomas are reported. In each case, the cyst caused difficulty in the interpretation of the computed tomogram when the latter was considered as a diagnostic test by itself, but the composite information obtained from the clinical history, cerebral angiography, and a radionuclide brain scan led to the correct preoperative diagnosis. The cyst was extrinsic to the tumor and contained xanthochromic fluid with a high protein content. The cyst wall consisted of brain parenchyma that showed glial cell proliferation (confirmed by the presence of glial fibrillary acidic protein by immunoperoxidase staining).
Diagnostic Brain Biopsy
Authors: Kaufman Howard H. , Catalano Louis W. 
Published: May 2010

Abstract
A consecutive series of 50 diagnostic cerebral biopsies carried out over a 12-year period (1960 to 1972) at The Neurological Institute of New York is reported. The goal of the biopsy was to acquire a definitive diagnosis to aid the patient, counsel the family, and advance scientific knowledge. General indications for biopsy were either chronic bilateral cerebral findings associated with progressive dementia or profound retardation or acute unilateral cerebral findings, usually associated with signs of meningoencephalitis. Four patients were not suitable for analysis, leaving 46 patients to be surveyed. Diagnostic neuropathological features were judged to be present in 17 specimens (37%). Abnormal but not diagnostic pathological changes were found in 22 specimens (48%). Thus, 39 specimens (85%) displayed some abnormality. No apparent neuropathological changes were present in 7 specimens (15%). These findings correspond favorably with the results of others and suggest that a certain “irreducible minimum” of normal biopsies occurs with the techniques utilized. Fourteen (30%) of the patients were known to be alive at the conclusion of the study. Twenty-two patients (48%) had died, but necropsy findings were available for only 10 of these. Except in 2 cases in which biopsies had been normal, no discrepancy was noted between the basic neuropathological changes found at necropsy and those of the biopsy specimen. One death could be directly attributed to the procedure, and total morbidity and mortality was approximately 13%. The authors recommend that any biopsy program should be organized at an institutional level to take into account the patient's special illness and the capabilities of that institution. In addition, suitable material must be forwarded to appropriate experts who have the knowledge and facility to make full use of biopsy material.
Microsurgical Lumbar Discectomy
Authors: Wilson Donald H. , Kenning James 
Published: May 2010

Abstract
The application of microsurgical technique to lumbar discectomy may be of dual value: minimal disruption of the integrity of normal anatomy and meticulous hemostasis may help to speed the process of convalescence, and the retention of epidural fat around the nerve root may help to prevent adhesions, a common cause of the late, “failed disc” syndrome. The authors report their experience with 83 consecutive microdiscectomies for lumbar disc protrusions. The results must be considered as tentative because the follow-up period has been short and the authors found it difficult to quantify the quality of health during the convalescent phase, although this seemed to be excellent. Their short term results are similar to those of the larger series reported by Williams, whose experience with microsurgical lumbar discectomies began 6 years ago. No other series have been reported. The authors describe their technique and compare it to that of Williams.
Successful Management of Bilateral Carotid-Cavernous Fistulae with a Trans-sphenoidal Approach
Authors: Laws Edward R. , Onofrio Burton M. , Pearson Bruce W. , McDonald Thomas J. , Dirrenberger Richard A. 
Published: May 2010

Abstract
A patient with traumatic bilateral carotid-cavernous fistulae was successfully treated by an entirely extracranial approach. The larger fistula on the left was exposed via a transethmoidal, trans-sphenoidal route and was directly opened and packed while the cavernous carotid artery was stented open by an intraluminal balloon catheter. The balloon catheter provided temporary hemostasis and was removed after the fistula had been packed. The left carotid artery remained patent, and the smaller fistula on the right was subsequently obliterated by a balloon catheter. The fistulae have remained cured, and the left internal carotid artery supplies the cerebral circulation.
Cyanoacrylate Occlusion of Carotid-Cavernous Fistula with Preservation of Carotid Artery Flow
Authors: Kerber Charles W. , Bank William O. , Cromwell Laurence D. 
Published: May 2010

Abstract
We report a new treatment for carotid-cavernous fistula. Using a flow-guided, balloon-tipped microcatheter, we catheterize the fistula itself, verify balloon entry into the fistula with fluoroscopy and x-ray films, and then infuse the tissue adhesive isobutyl-2-cyanoacrylate with careful fluoroscopic control. Three patients have had their fistulas occluded, with preservation of flow through the internal carotid artery. This balloon microcatheter allows the radiologist to perform a reversible test occlusion. All three patients had neurological changes during or after the procedure, and in one we inadvertently occluded several distal middle cerebral artery branches without permanent neurological deficit. No patient became blind or developed 3rd, 4th, or 6th nerve palsy from the treatment. This technique seems to have promise as another method for the obliteration of carotid-cavernous fistula.
Spinal Subdural Cyst Associated with a Meningioma
Authors: Morley Thomas P. 
Published: May 2010

Abstract
An extensive spinal subdural cyst was unexpectedly encountered during an operation for the removal of a thoracic spinal meningioma. The gross and microscopic appearances of the cyst are described. It coexisted with a meningioma, but no definite conclusion can be drawn regarding the etiology of this cyst.
Primary Intraosseous Meningioma Presenting as a Solitary Osteolytic Skull Lesion
Authors: Pearl Gary S. , Takei Yoshio , Parent Andrew D. , Boehm Walter M. 
Published: May 2010

Abstract
Meningiomas that are either intraosseous in origin or osteolytic are rare. Intraosseous meningiomas are generally osteoblastic. Our case is the second reported case of a primary intraosseous meningioma presenting as an osteolytic skull lesion.
Enhancement of Experimental Cerebral Edema after Decompressive Craniectomy
Authors: Cooper Paul R. , Hagler Herbert , Clark Kemp W. , Barnett Peggy 
Published: May 2010

Abstract
Decompressive craniectomy has been advocated as a treatment for the cerebral edema associated with massive head injury. Although craniectomy has been successful in lowering intracranial pressure after head injury, a comparison of computerized tomographic scans of comparable patients with traumatic brain edema treated by medical means or decompressive craniectomy showed that bony decompression resulted in apparent exacerbation of edema. To investigate the possibility of enhancement of brain edema by craniectomy, we produced standardized cold lesions in the brains of 10 dogs. Five animals served as controls. In the other 5 animals we performed large decompressive craniectomies after lesioning. Physiological parameters were comparable in both groups. The dogs were killed 8 hours after lesioning. After fixation, their brains were cut into 1-mm-thick slices. We used an image analysis facility built around a PDP 11/05 computer to measure the volume of edema as outlined by Evans blue staining. The mean volume of the brain edema in the control animals was 0.27 ± 0.19 ml. Mean edema volume was over 7 times greater in craniectomized animals (1.96 ± 1.89 ml). This difference is statistically significant (p &lt; 0.05). The driving force for the formation of edema fluid is the difference between intravascular and interstitial pressure. Decompression of the brain by bone removal probably results in a reduction of interstitial fluid pressure and edema enhancement. The clinical literature contains no evidence that craniectomy decreases the morbidity or mortality of human head injury. In view of our experimental findings, this is not surprising. Indeed, pathological evidence indicates that severe edema (such as that accentuated by craniectomy) may produce permanent changes in the neuropil.
Recurrent Intracerebral Blastomycotic Granuloma
Authors: Morgan David , Young Ronald F. , Chow Anthony W. , Mehringer Mark C. , Itabashi Hideo 
Published: May 2010

Abstract
We present a patient with a recurrent intracerebral blastomycotic granuloma. The computerized tomographic scan appearance of this lesion is illustrated. Of the 81 reported cases of intracranial blastomycosis, only 35 have represented solid intracerebral lesions; the other patients have had spinal lesions or meningitis. This patient represents the first reported recurrence of an intracerebral blastomycotic granuloma. The treatment utilized, surgical resection combined with intravenous and intraventricular amphotericin B, represents a unique approach to this problem. The diagnosis and currently advocated treatment of intracranial blastomycosis is reviewed, particularly in regard to the potential for recurrence of blastomycosis.
Candida albicans Mycotic Aneurysm Associated with Systemic Lupus Erythematosus
Authors: Goldman John A. , Fleischer Alan S. , Leifer William , Parent Andrew , Schwarzman Stephen W. , Raggio John 
Published: May 2010

Abstract
A 16-year-old girl with systemic lupus erythematosus and diabetes mellitus who was receiving prednisone, azathioprine, and insulin developed headaches, fever, irritability, and seizures. Studies revealed a large proximal basilar artery aneurysm with subarachnoid hemorrhage. Despite intubation and a ventriculopleural shunt, she became decerebrate and died. Postmortem studies revealed that this patient had an intracranial mycotic aneurysm due to Candida albicans.
Xanthogranulomas of the Third Ventricle
Authors: Rush Jeffery L. , Kusske John A. , Porter Robert W. , Pribram Henry W. 
Published: May 2010

Abstract
Two patients with xanthogranuloma of the 3rd ventricle are described. In each instance the tumor obstructed the interventricular foramina and caused dilatation of the lateral ventricles and signs of increased intracranial pressure; computerized tomography demonstrated the dense, nonenhancing lesion in the anterior 3rd ventricle. The pathogenesis of these rare tumors is discussed. These cases affirm the need to consider xanthogranuloma in the differential diagnosis of anterior 3rd ventricle tumors in adults.
Cranioplasty
Authors: Rish Berkley L. , Dillon J. Daniel , Meirowsky Arnold M. , Caveness William F. , Mohr Jay P. , Kistler J. Philip , Weiss George H. 
Published: May 2010

abstract
A total of 491 cranioplasties performed in a population of 1030 cases of penetrating head injury are reviewed. The morbidity rate was 5.5%, and the mortality rate was 0.2%. The clinical criteria of improving cosmetic defects and restoring craniocerebral protection are established, based on the location and size of the skull defect. Cranioplasty after penetrating head injury should be deferred for a minimum of 1 year to control morbidity. Complications of the original injury and surgical debridement increase the morbidity rate of cranioplasty. Post-traumatic epilepsy is not related to skull defects per se; neither is it affected by cranioplasty. Acrylic is an acceptable cranioplasty material if there is strict adherence to good surgical technique.
Hydatid Cyst of the Skull
Authors: Gökalp Hamit Z. , Kanpolat Yücel , Gökben Bekir 
Published: May 2010

abstract
A rare case of hydatid cyst of the skull is presented. The presenting symptom was an acute increase of the intracranial pressure. The patient was operated upon under emergency conditions with the diagnosis of a cystic lesion of the brain. After a brief review of the literature, the symptomatology of the disease is discussed. It is emphasized that radiological studies, especially plain x-ray films of the skull, are most important in diagnosing the disease.
Distal Anterior Cerebral Artery Aneurysm
Authors: Becker Dennis H. , Newton Thomas H. 
Published: May 2010

abstract
The incidence of aneurysms of the distal anterior cerebral artery (DACA) has been reported at 2 to 4%. In this paper we report a series of 12 patients with DACA aneurysms diagnosed at various hospitals in the San Francisco area during the past 10 years. The clinical presentation, surgical approach, and anatomical location are reviewed. Comparisons are made between traumatic, mycotic, and berry DACA aneurysms.
Autonomic Hyper-reflexia Modulated by Percutaneous Epidural Neurostimulation
Authors: Richardson Robert R. , Cerullo Leonard J. , Meyer Paul R. 
Published: May 2010

abstract
Our clinical experience in the management of five paraplegic or quadriplegic patients with subjective complaints and objective findings of autonomic hyper-reflexia is presented. These five patients had epidural neurostimulation systems implanted percutaneously to regulate intractable spasticity. During a follow-up period varying from 2 months to almost 2 years, four of the five patients experienced no episodes of autonomic dysfunction with the use of a low frequency, low voltage, square wave pulse output. From their responses and from recent neurophysiological evidence, the potential benefit of percutaneous epidural neurostimulation in the modulation of autonomic hyper-reflexia without antihypertensive medication is suggested. Further follow-up of these patients and additional clinical research should be performed to confirm our initial clinical impressions.