bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Management of Cerebellar Peduncle Lesions in Children
Authors: Tomita Tadanori 
Published: May 2010

Abstract
Four children with intrinsic cerebellar peduncle lesions (three benign astrocytomas and one histiocytic encephalitis) are reported. Each patient underwent a resection of mass lesions through posterior fossa craniotomy with microsurgical techniques and a surgical laser. None showed permanent neurological deficits postoperatively. A brief anatomical consideration of cerebellar peduncle lesions and the surgical approach used are described.
Scheuermann's Dorsal Kyphosis and Spinal Cord Compression: Case Report
Authors: Klein David M. , Weiss Richard L. , Allen James E. 
Published: May 2010

Abstract
Although Scheuermann's disease (juvenile dorsal kyphosis) is a common problem of late childhood and adolescence, its potential for neurological complications is not widely appreciated. In rare instances, spinal cord compression appears to be produced by the kyphotic protrusion alone, and we present an example of this unusual problem. Although the results of surgical treatment in this situation cannot be substantiated, anterior spondylotomy and decompression followed by posterior fixation appear to offer the best mechanical relief. Spinal cord compression can also be produced by extradural cysts, with which Scheuermann's disease is frequently associated. Scheuermann's disease also is reported to occur in combination with thoracic disc protrusion, but the coincidence here may be random. Pertinent literature is reviewed.
Intraoperative Aneurysmal Rupture: Incidence, Outcome, and Suggestions for Surgical Management
Authors: Batjer Hunt , Samson Duke 
Published: May 2010

Abstract
Intraoperative rupture of an intracranial arterial aneurysm can dramatically interrupt a deliberate microsurgical procedure and jeopardize the patient's chances for a favorable outcome. Intraoperative rupture occurred in 58 of 307 (19%) consecutive aneurysm procedures done at The University of Texas Health Science Center. Rupture occurred during three specific periods: early or predissection in 7%, dissection in 48%, and clip application in 45%. Outcome after rupture during the predissection interval was poor, with only 1 of 4 patients surviving. Aneurysmal rupture during dissection could be attributed to blunt dissection techniques in 75% of the cases and to sharp subarachnoid dissection in 25%. The outcome was favorable in only 50% of the patients sustaining blunt dissection errors, whereas all patients sustaining intraoperative rupture during sharp dissection recovered well. Rupture during clip application was attributed to incomplete dissection in 65%, poor clip application in 31%, and a mechanical clip failure in 1 case. Eighty-eight per cent of the patients who underwent uneventful operative procedures had favorable outcomes, whereas only 62% of the patients suffering intraoperative rupture recovered well. The use of sharp microsurgical techniques with a systematic contingency plan for dealing with sudden hemorrhage and the judicious use of temporary clips should minimize the adverse effect of intraoperative rupture on overall management morbidity and mortality.
Retinal Artery Pressure and Cerebral Artery Perfusion Pressure in Cerebrovascular Occlusive Disease
Authors: Little John R. , Tomsak Robert L. , Ebrahim Zeyd Y. , Furlan Anthony J. 
Published: May 2010

Abstract
The objectives of the investigation were to measure the retinal artery pressure (RAP) and cortical artery pressure (CAP) in patients undergoing superficial temporal artery to middle cerebral artery (STA-MCA) bypass, to study the relationship between these pressures, and to evaluate our ability to predict CAP on the basis of RAP. The 44 patients undergoing bypass surgery included 26 with ipsilateral internal carotid artery (ICA) occlusion (Group I), 5 with bilateral ICA occlusion (Group II), 4 with inaccessible ICA stenosis proximal to the ophthalmic artery (OA) (Group III), 2 with ICA stenosis distal to the OA (Group IV), 3 with ICA occlusion distal to the OA (Group V), 2 with MCA stenosis (Group VI), and 2 with MCA occlusion (Group VII). Five patients undergoing craniotomy for an asymptomatic saccular aneurysm were used as controls. Mean RAP (MRAP) was measured by ophthalmodynamometry (ODM) and was expressed as a ratio of the mean systemic arterial blood pressure (i.e., MRAP/MSAP). The mean MRAP/MSAP for combined Groups I, II, and III with ICA occlusion proximal to the OA was significantly lower than both the control group (P = 0.0001) and the combined Groups IV, V, VI, and VII with occlusive lesions distal to the OA (P = 0.0001). Six patients in Groups I and II with venous stasis retinopathy had a mean MRAP/MSAP of 0.18 + 0.11. Mean cortical artery pressure (MCAP) was measured by inserting a 26 gauge needle into a small cortical artery and was expressed as the MCAP/MSAP ratio. Mean MCAP/MSAP was less than 0.50 for all groups except Group III. The mean MCAP/MSAP for combined Groups IV, V, VI, and VII was significantly lower than in combined Groups I, II, and III (P = 0.02). RAP measured by ODM was moderately predictive of CAP in patients with an occlusive lesion of the ICA proximal to OA (r = 0.50). The degree of correlation was highest for those patients with a very low MCAP/MSAP (i.e., &lt;0.25) ratio (r = 0.74). These findings indicate that ODM may be helpful in identifying patients with severe cerebral hypoperfusion secondary to ICA occlusive disease proximal to the OA.
Comparison among Three Methods of Intracranial Pressure Recording
Authors: North Brian , Reilly Peter 
Published: May 2010

Abstract
Fluid-coupled recording systems are the most popular method of recording intracranial pressure (ICP), but they can be prone to blockage and infection. A series of 378 recordings of ICP was analyzed to identify complications and cases in which recording had to be discontinued prematurely because of catheter blockage. Three different methods of ICP recording were used: a ventricular catheter, a Richmond screw, and a subdural catheter. Richmond screws became blocked more often (16%) than subdural catheters (2.7%) or ventricular catheters (2.5%). Complications of infection and intracerebral hemorrhage were observed mostly in the ventricular catheter patients. Of these three methods, a subdural catheter is the preferred method of recording ICP.
Bilateral Carotid Siphon Involvement in Giant Cell Arteritis
Authors: Vincent Frederick M. , Vincent Tish 
Published: May 2010

Abstract
A 60-year-old woman with inadequately treated giant cell arteritis developed an acute unilateral ischemic optic neuropathy associated with bilateral carotid artery and orbital bruits. Angiography demonstrated vascular changes compatible with arteritis localized to the cavernous and petrous segments of both internal carotid arteries. After treatment with high dose steroids, the bruits disappeared.
Reversal of Fixed Pupils after Spontaneous Intraventricular Hemorrhage with Secondary Acute Hydrocephalus: Report of Two Cases Treated with Early Ventriculostomy
Authors: Hochman Seth M. 
Published: May 2010

Abstract
Rapid reversal of fixed pupils, complete external 3rd nerve ophthalmoplegia, and coma occurred after early ventricu-lostomy in two hypertensive male patients with spontaneous intraventricular hemorrhage and secondary acute hydro-cephalus. Putative pathophysiology of fixed pupils secondary to transtentorial herniation from obstructive hydrocephalus is discussed. Cases such as the present ones are unsettling because they are exceptions to the usually reliable negative prognosis indicated by fixed puplis. Nonetheless, it is important to report these cases to delineate which patients with this important clinical sign may benefit from aggressive management.
Choroid Plexus Papilloma with Chondroma: Case Report
Authors: Salazar Jorge , Vaquero Jesùs , Aranda Ignacio F. , Menèndez Josefa , Jimenez Dolores M. , Bravo Gonzalo 
Published: May 2010

Abstract
The authors report the successful total removal of a rare intracranial tumor in the right lateral ventricle of a 15-year-old girl with epileptic seizures. Histopathological examination showed a benign tumor formed by mature cartilage and choroid plexus papilloma. From our review of the literature, a mixed tumor with these histological features has not been reported previously in this location. The diagnosis, surgical approach, etiology, and prognosis of this lesion are discussed.
Case Report: Childhood Cerebellopontine Angle Teratoma Associated with Congenital Hydrocephalus
Authors: Waters David C. , Venes Joan L. , Katrina Zis 
Published: May 2010

Abstract
A case of childhood teratoma in the cerebellopontine angle associated with shunted congenital hydrocephalus is presented. The need for detailed computed axial scanning with and without contrast in congenital hydrocephalus not associated with intraventricular hemorrhage or myelodysplasia is emphasized.
Computed Tomography-based Stereotactic Third Ventriculostomy: Technical Note
Authors: Kelly Patrick J. , Goerss Stephan , Kall Bruce A. , Kispert David B. 
Published: May 2010

Abstract
This report describes a computed tomography-based computer-assisted stereotactic technique for performing 3rd ventriculostomy. The procedure has been performed on seven patients with acquired obstructive hydrocephalus of various etiologies. None of these patients have yet required shunting. (18:791–794, 1986)
Anterior Cerebral Artery Reconstruction
Authors: Yokoh Akira , Ausman James I. , Dujovny Manuel , Diaz Fernando G. , Berman S. Kim , Sanders James , Mirchandani Haresh G. 
Published: May 2010

Abstract
Anterior cerebral artery end-to-end, end-to-side, and side-to-side anastomoses and grafting procedures including bypass and interposition using segments of the posterior cerebral artery harvested from the same specimen were performed. The reconstruction procedures were accomplished experimentally with the A1 and A2 segments of the anterior cerebral artery. the recurrent artery of Heubner (RAH), and the orbitofrontal and frontopolar arteries in end-to-end or end-to-side anastomosis to the A1 segment. Side-to-side anastomoses between both A2 or A3 segments were completed without difficulty. We utilized the anatomical and experimental reconstruction data in the performance of three surgical procedures for aneurysms in this area. An A1 to A2 end-to-end anastomosis, an A2 to A2 end-to-side anastomosis, and an end-to-end anastomosis of the RAH were performed with no technical difficulties or complications. This study shows the feasibility of these microvascular reconstruction procedures in the anterobasal part of the interhemisphere, where cerebral aneurysms frequently develop.
Craniotomy versus Transsphenoidal Excision of Large Pituitary Tumors: The Usefulness of Magnetic Resonance Imaging in Guiding the Operative Approach
Authors: Snow Robert B. , Lavyne Michael H. , Lee Benjamin C. P. , Morgello Susan , Patterson Russell H. 
Published: May 2010

Abstract
Fifteen patients with large pituitary tumors were studied with computed tomography (CT) and magnetic resonance imaging (MRI). CT was performed using General Electric 8800 and 9800 scanners (General Electric Co., Medical Systems Division, Milwaukee, Wisconsin). MRI was performed utilizing a Technicare superconducting scanner (Technicare, Cleveland, Ohio) at 0.5 tesla. Based on the operative findings, the tumors were divided into two groups. Tumors in Group 1 (n = 12) were described by the surgeon as soft or partially necrotic and easily removed by suction and curettage. Tumors in Group 2 (n = 3) were firm and required sharp dissection or the laser for removal. The tumors were divided into four categories based on MRI signal: (a) isointense with surrounding brain on spin echo (SE) 30 and SE 90, (b) increased signal intensity on SE 30 and SE 90, (c) decreased signal intensity on SE 30 and increased signal intensity on SE 90, and (d) isointense signal on SE 30 and increased signal intensity on SE 90. All three of the firm tumors were isointense with brain on MRI appearance. The tumor consistency (firm vs. soft) was not differentiable on CT scan. The transsphenoidal approach is less satisfactory than craniotomy in cases of firm, fibrous pituitary tumors. Based on our preliminary data, if the MRI signal in the tumor is isointense, then the surgeon should be prepared to deal with a fibrous tumor and might elect a transcranial rather than a transsphenoidal approach.
Primary Ewing's Sarcoma of the Base of the Skull
Authors: Steinbok Paul , Flodmark Olof , Norman Margaret Grace , Chan Ka Wah , Fryer Christopher John Hugh 
Published: May 2010

Abstract
The authors report a case of primary Ewing's sarcoma of the petrous bone. The radiological features, including the computed tomographic sean and angiographic findings, are described in detail.
Candida albicans Shunt Infection: Report of Two Cases
Authors: Gower David J. , Crone Kerry , Alexander Eben , Kelly David L. 
Published: May 2010

Abstract
Infection of cerebrospinal fluid shunts with Candida albicans is reported in two patients. Scanning electron microscopy in one case demonstrates the relationship of the Candida hyphae to the white blood cells and to silicone plastic. A review of 10 previously reported cases of Candida shunt infection indicates that the infection usually follows a major bacterial infection or direct contamination or occurs spontaneously, Previous therapy has usually involved removal of the shunt, and the role of parenteral antifungal therapy is still unclear. Overall mortality to date is 25%.
Perineurioma: A Benign Peripheral Nerve Tumor
Authors: Tranmer Bruce I. , Bilbao Juan M. , Hudson Alan R. 
Published: May 2010

Abstract
A unique benign peripheral nerve tumor, called a perineurioma, is described in this report. Light and electron microscopy and immunohistochemistry indicate that this tumor was derived from the perineurial cell. We discuss the ultrastructure, histogenesis, and management of this neoplasm.
Surgical Approaches for the Correction of Metopic Synostosis
Authors: Delashaw J. B. , Persing John A. , Park T.S. , Jane John A. 
Published: May 2010

Abstract
Premature closure of the metopic suture results in a deformity ranging from a minor variation to a severe cosmetic deformity. The three principal abnormalities comprising metopic synostosis are trigonocephaly secondary to the restriction of growth of both frontal bones, deficient lateral supraorbital rims, and hypotelorism. Seventeen of 18 patients evaluated for metopic synostosis had surgical correction of their anomalies. For a minor degree of prominence at the metopic suture, a bicoronal flap followed by shaping at the suture with a shaping burr was sufficient and yielded favorable cosmetic results. A more extensive procedure for cosmetic resolution of trigonocephaly and hypotelorism was required for those patients with more pronounced deformities. In patients with moderate to severe metopic synostosis, the following procedures were important in achieving excellent cosmetic results: (a) a bicoronal subgaleal flap down to the supraorbital rims with preservation of continuity of pericranium with an intact periorbita; (b) bifrontal craniotomy with complete removal of the metopic suture; (c) dural plication in midline to achieve an immediate aesthetically pleasing contour; d) removal or remodeling of the supraorbital rims and nasion with replacement of the remodeled frontal bone anteriorly in order to rebuild the orbital rim and release the supraorbital bar from the anterior cranial base; and e) securement of the bifrontal bones anteriorly and laterally, but not posteriorly, to allow further anterior and lateral displacement of the supralateral orbital margin.
Inaccurate Pressure Readings for Subarachnoid Bolts
Authors: Miller Jimmy D. , Bobo Hunt , Kapp John P. 
Published: May 2010

Abstract
The subarachnoid bolt has been used extensively to monitor intracranial pressure in a variety of conditions. We have had two patients who had subarachnoid bolts in place that were thought to be functional in whom evidence of increased pressure was present. In one case, the patient had Reye's syndrome with seizure activity, decerebrate posturing, fixed and dilated pupils, and cardiac arrest. Although autopsy revealed evidence of cerebellar and uncal herniation, verifying the presence of pressure cones, the subarachnoid bolt pressure was never elevated and had a good wave form. In the other case, the patient developed an epidural hematoma postoperatively while a subarachnoid bolt was in place. The subarachnoid bolt was measuring pressures of less than 15 mm Hg with a good wave form despite clinical and, subsequently, computed tomographic evidence of an evolving mass. The use of a pressure monitor such as the subarachnoid bolt should not replace frequent clinical assessment of the patient.
Metamorphopsia and Permanent Cortical Blindness after a Posterior Fossa Tumor
Authors: Brau Ricardo H. , Lameiro Juan , Llaguno Alousius V. , Rifkinson Nathan 
Published: May 2010

Abstract
A case of posterior fossa tumor associated with supratentorial symptoms is presented. The pattern of symptoms that developed after operation follow the description of metamorphopsia. The condition progressed to permanent cortical blindness. Tumoral vasospasm is suggested as a possible etiological mechanism for the clinical picture.
Spontaneous Hemorrhage in a Mixed Glioma of the Cerebellum: Case Report
Authors: Specht C.S. , Pinto-Lord C. , Smith T.W. , DeGirolami U. , Suran E. , Marshall P.C. , Davidson R.I. 
Published: May 2010

Abstract
An 8-year-old boy presented in coma and was found to have a massive posterior fossa hemorrhage on computed tomographic scan. Autopsy disclosed a large cerebellar hematoma within a mixed glioma containing both juvenile pilocytic astrocytoma and oligodendroglioma. It is postulated that the hemorrhage originated from the oligodendroglial component of the tumor.
Multiple Peripheral Aneurysms of the Posterior Inferior Cerebellar Artery
Authors: Beyerl Brian D. , Heros Roberto C. 
Published: May 2010

Abstract
Peripheral aneurysms of the posterior inferior cerebellar artery (PICA) are rare. The authors describe a case in which five distinct peripheral aneurysms of the PICA were diagnosed and microsurgically clipped while preserving the parent vessel. One of the aneurysmal sacs was excised and examined pathologically, and no evidence of an infectious etiology was found. The surgical approach to peripheral PICA aneurysms is discussed and the literature concerning these unusual aneurysms is reviewed.
Delayed Intracerebral Hemorrhage after Ventriculoperitoneal Shunting
Authors: Snow Robert B. , Zimmerman Robert D. , Devinsky Orrin 
Published: May 2010

Abstract
A rare complication of ventriculoperitoneal shunting is presented. In this case, a moderate-sized intracerebral hemorrhage (3 to 5 cm in maximal diameter) occurred 1 week after operation for idiopathic hydrocephalus in a 43-year-old woman. The patient recovered fully without operative intervention. No other case of delayed intracerebral hemorrhage after a ventricular shunting procedure was found in a review of the literature. The presumed mechanism in the present case is delayed erosion of a cerebral blood vessel by the ventricular catheter.
Entrapped Lumbar Nerve Root in Pseudomeningocele after Laminectomy: Report of Three Cases
Authors: Hadani Moshe , Findler Gideon , Knoler Nahshon , Tadmor Rina , Sahar Abraham , Shacked Itzchak 
Published: May 2010

Abstract
The authors report three patients with symptomatic postlaminectomy pseudomeningocele. At operation a loop of a nerve root was found to be trapped within the dural defect. All three patients exhibited a delayed onset of radicular symptoms and signs after disc surgery. The pseudomeningocele was demonstrated by computed tomography and myelography, but the entrapped root could be identified only at operation. (Neurosurgery 19:405-407, 1986)
Enchondroma of the Cervical Spine
Authors: Willis Brian K. , Heilbrun Peter M. 
Published: May 2010

Abstract
Enchondroma is a benign cartilaginous tumor rarely found in the vertebral column. The authors report a case of a 24-year-old woman with upper extremity paresthesias and weakness secondary to bony destruction of multiple vertebral bodies by an enchondroma. The tumor was treated by block excision of the involved vertebral bodies followed by placement of a bone graft.
Distal Cervical Carotid Dissection after Carotid Endarterectomy: A Complication of Indwelling Shunt?
Authors: Loftus Christopher M. , Dyste Gregg N. , Reinarz Stephen J. , Hingtgen William L. 
Published: May 2010

Abstract
Technical factors and surgical techniques in carotid endarterectomy remain a controversial subject. The use of an indwelling arterial shunt has theoretical advantages in assuring intraoperative hemispheric perfusion and affording a more relaxed surgical environment. There has been little clinical demonstration, however, of superior results with carotid shunting. Although champions of routine shunting argue that it is a benign protective intervention, the possibilities of distal embolization or intimal disruption exist. The authors report a case of cervical carotid dissection far distal to the operative site that they postulate resulted from intimal disruption after routine shunt placement. This devastating complication from an otherwise benign procedure prompts reconsideration of the benefits and risks of routine shunt placement.
Bilateral Hearing Loss after Unilateral Removal of an Acoustic Neuroma by the Suboccipital Approach: Case Report
Authors: Chovanes George I. , Buchheit William A. 
Published: May 2010

Abstract
Contralateral hearing loss is a very rare complication of acoustic neuroma surgery. A case of immediate postoperative contralateral hearing loss is reported. Possible causes and the pertinent literature are reviewed.
Intramedullary Neurilemomas of the Spinal Cord: Report of Two Cases and Review of the Literature
Authors: Ross Donald A. , Edwards Michael S. B. , Wilson Charles B. 
Published: May 2010

Abstract
Two patients harboring intramedullary neurilemomas of the spinal cord are presented. Published reports of these rare lesions and possible mechanisms of their origin are reviewed. Based on the authors' experience and review of the literature, they think that the treatment of choice for these rare lesions is laminectomy and resection and that intraoperative frozen section diagnosis is essential. Incorrect interpretation of the biopsy material that suggests an original diagnosis of infiltrating glioma, perhaps because a neurilemoma was not expected, has made second operations necessary.
Acute Subdural Hematoma with Rapid Resolution in Infancy: Case Report
Authors: Nagao Takeki , Aoki Nobuhiko , Mizutani Hiroshi , Kitamura Koichi 
Published: May 2010

Abstract
An infant who suffered acute subdural hematoma due to minor head trauma twice in a short period is presented. Each subdural hematoma, showing high density on computed tomographic scanning, resolved with unusual rapidity, resulting in full recovery after nonsurgical management. The mechanism of this rapid resolution of each hematoma was thought to be participation of cerebrospinal fluid secondary to a tearing of the arachnoid membrane.
Auditory Brain Stem Responses in the Prognosis of Late Postconcussional Symptoms and Neuropsychological Dysfunction after Minor Head Injury
Authors: Schoenhuber Rudolf , Gentilini Massimo 
Published: May 2010

Abstract
Thirty patients suffering from minor head injury were examined with auditory brain stem responses (ABR), neuropsy-chological tests for assessment of higher nervous functions, and a questionnaire on postconcussional symptoms. Comparison of the 6 patients with altered ABR with the other 24 showed no statistical difference in either the number of long-lasting postconcussional symptoms or the scores on neuropsychological tests. Subclinical brain stem involvement as shown by ABR does not seem to correlate with impaired mental function or symptoms of the postconcussion syndrome. This greatly limits the use of ABR in forensic medicine.