bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Determination of Speech Organization in a Patient with an Arteriovenous Malformation
Authors: Close Richard A. , O'Keefe Anne Marie , Buchheit William A. 
Published: May 2010

Abstract
A case is reported of an arteriovenous malformation in the left motor speech area which was successfully excised without aphasia in a right-handed man. Preoperative sodium amobarbital carotid infusion testing demonstrated that the patient had right hemisphere dominance for speech. A review of the literature suggests that this is not an uncommon occurrence in individuals with congenital lesions of the left cerebral hemisphere. Lateralization of speech dominance should be established through definitive testing in these cases, especially if surgical removal of the malformation is contemplated.
A Technical Modification of Cloward's Posterior Lumbar Interbody Fusion
Authors: Lin Paul M. 
Published: May 2010

Abstract
The concept of interbody (intercorporal) fusion as a useful treatment for intervertebral disc disease in the cervical area has been well received. Thirty-two years have passed since Cloward first introduced his technique of posterior lumbar intervertebral fusion. The author believes that the delayed acceptance of this procedure is due to fear of technical difficulties. A technical modification of Cloward's posterior lumbar interbody fusion is introduced. It entails better technique in controlling epidural bleeding by careful positioning of the patient and the use of oxidized cellulose as a tampon in the epidural space. The integrity of the facet is preserved through a more limited interlaminal approach. Osteosynthesis of the grafts is assured by multiple perforations of the cortical plate in accordance with Robinson's principle utilized in cervical interbody fusion. The author believes that the modification simplifies the Cloward posterior lumbar interbody fusion. It also assures better stability after surgery by retention of the facet and lessening the dangers of settlement of the graft by preservation of the cortical plate. In a series of 75 cases, tomograms made 4 months after operation have shown a viable graft with active osteosynthesis between the graft and the adjoining vertebral bodies in 94%.
Chronic Ventricular Cerebrospinal Fluid Sampling, Drug Injections, and Pressure Monitoring Using Subcutaneous Reservoirs in Monkeys
Authors: Wood James H. , Poplack David G. , Flor William J. , Gunby Neal E. , Ommaya Ayub K. 
Published: May 2010

Abstract
Animal models enabling reliable access to ventricular cerebrospinal fluid (CSF) are crucial to the study of neuropharmacological and neurotoxicological effects of cytotoxic agents used to treat central nervous system neoplasms. This investigation concludes that 4th ventricular catheterization using subcutaneous CSF reservoirs in rhesus monkeys: (a) provides chronic access to sterile CSF without chronic immobilization, (b) enables mixing of injected drugs with lateral ventricular CSF, (c) permits sensitive monitoring of intraventricular pressure and (d) does not produce tissue damage during cannula implantation or breakdown of the blood-brain barrier.
Saccular Aneurysm of Infancy and Early Childhood
Authors: Becker Dennis H. , Silverberg Gerald D. , Nelson Denver H. , Hanbery John W. 
Published: May 2010

Abstract
A case of intracranial saccular aneurysm occurring in early childhood and presenting with sudden dysphasia and hemiplegia is reported. A review of the literature emphasizes the rarity of this lesion. Despite a significant preoperative neurological deficit, the patient tolerated ancurysm clipping and recovered well. The majority of reported cases involve males under 2 years old. Aneurysms in infants have a distribution different from that seen in adults. Microscopic examination of these lesions fails to show any evidence of inflammation or atherosclerosis. The data suggest that the pathogenesis of these rare childhood lesions differs from that of adult saccular aneurysms.
Spinal Dysraphism
Authors: James Hector E. , Oliff Michael , Mulcahy John 
Published: May 2010

Abstract
Twelve patients with the clinical findings of spinal dysraphism form the basis for this report. In eight patients, physical findings, plain x-rays, and unenhanced spinal computed tomography allowed for precise diagnosis and subsequent therapy, without contrast myelography. All patients in the study had intravenous pyelography, and this revealed evidence of renal deterioration in two. The other 10 patients had radiographically normal upper urinary tracts. Urodynamic assessment was performed in seven; three were abnorma. The pattern of the abnormal studies (three “flaccid type” with an adequate urethral pressure profile and one with detrusor-sphincter dyssynergia) allowed for appropriate therapy to be employed for bladder emptying and continence. Both spinal computed tomography and urodynamic testing serve as noninvasive studies that can be employed in the follow-up and management of patients with spinal dysraphism.
Measurement of Spinal Cord Blood Flow by the Microsphere Technique
Authors: Smith Donald R. , Smith Howard J. , Rajjoub Rodwan K. 
Published: May 2010

Abstract
Differential spinal cord blood flow was measured in dogs by the radioactive microsphere injection method. The mean spinal cord blood flow was 10.8 ± 0.53 (SE) ml/100 g/minute. The flow values for the white and gray matter were 7.1 ± 0.65 (SE) and 26.3 ± 2.2 (SE) ml/100 g/minute, respectively.
Air Embolism during Trans-sphenoidal Pituitary Operations
Authors: Newfield Philippa , Albin Maurice S. , Chestnut Julian S. , Maroon Joseph 
Published: May 2010

Abstract
Doppler ultrasonic cardiac monitoring of patients undergoing trans-sphenoidal pituitary operations in the semisitting position has revealed the occurrence of venous air embolism in 3 of 31 consecutive cases. One such case is presented. Air may be drawn into the venous system whenever a gradient exists between the site of operation and the right heart. During trans-sphenoidal operations the most likely portals of venous air entry include the intercavernous connections within the sella, venous channels through nonpneumatized bone, inadequately sealed subnasal vessels, and vascularized metastatic tissue in the pituitary. Because the potential for morbidity and mortality from air embolism is so great, rapid diagnosis with the Doppler unit and prompt treatment, including aspiration of air from the right atrial catheter, administration of 100% oxygen, performance of the Valsalva maneuver, saline irrigation of the wound, and hemostasis of open vessels, are essential. Technetium-macroaggregated albumin (T EMAA) lung scans are helpful in postoperative verification of venous air embolism.
Melanotic Schwannoma
Authors: McGavran William L. , Sypert George W. , Ballinger William E. 
Published: May 2010

Abstract
Reports of melanotic nerve sheath tumors of Schwann cell origin are rare, only three having been found in the literature. Two new cases of spinal intradural melanotic nerve sheath tumors are reported and the literature is reviewed. Controversy has arisen in regard to the origin of melanin within these tumors. Electron microscopic study of one of our cases indicates that the Schwann cell is capable of producing melanin. The available evidence suggests that ultrastructural identification of the cell type in these pigmented tumors is essential in plotting the therapy and prognosis of patients with melanotic nerve sheath tumors.
Ring Formation on Computerized Tomography in the Postoperative Patient
Authors: Grand Walter , Kinkel William R. , Glasauer Franz E. , Hopkins L.N. 
Published: May 2010

Abstract
Ring formation with contrast infusion in computerized tomography has been described with various entities. The current report demonstrates its appearance in three postoperative patients from whom cerebral tumors had been removed. These examples of postoperative ring formation are compared with the ring formation in the scan of an unoperated patient with an intracerebral hematoma.
Anterior Approach for Removal of a Cervical Intradural Tumor
Authors: Giroux J.-Cartier , Nohra Chaouky 
Published: May 2010

Abstract
A case of an intradural extramedullary meningioma of the cervical spine excised through an anterior approach is reported. This permitted a complete excision without manipulation of the cord followed by a rapid and complete recovery. The technique of excision and bone grafting is described.
Cerebral Herniation from Ventricular Dilatation after Craniectomy
Authors: Kaufman Howard H. , Miller Mark H. 
Published: May 2010

Abstract
Local cerebral herniation due to ventricular dilatation was observed in a patient who had had removal of a bone flap and whose dura had previously been left open. The explanation of this problem was suggested by experimental and clinical evidence relating the development of ventricular enlargement to loss of support of the brain. Such an explanation also suggested that head wrapping to buttress the brain and promote transependymal absorption of cerebrospinal fluid could reverse the condition. This treatment was employed with apparent success.
Intracranial Teratocarcinoma in a Child with Anterior Sacral and Intrasacral Meningocele
Authors: Holness Renn O. , Hoffman Harold J. , Mancer Kent , Armstrong Dawna 
Published: May 2010

Abstract
A very rare combination of two rare entities is reported. The patient had anterior sacral and intrasacral meningoceles, which were repaired at age 3 years, and 7 years later he presented with hypopituitarism due to a suprasellar teratocarcinoma. There has been no evidence of tumor recurrence in the 2.5 years since subtotal excision and radiotherapy (patient was last seen in 1977). Two aspects of the case are reviewed; the unusual nature of the spinal defect and the implications of its association with an intracranial tumor of developmental origin.
Cerebral Arterial Revascularization: The Value of Repeated Angiography in Selection of Patients for Operation
Authors: Fox John L. 
Published: May 2010

Abstract
Three patients with occlusive cerebrovascular disease were evaluated for possible extracranial-intracranial arterial anastomosis. Cerebral angiography repeated at a later date revealed disappearance of the initial vascular stenosis or occlusion and development of extensive collateral circulation. It was concluded in these cases that surgical revascularization would not improve upon natural revascularization. Repeated angiography provides information of value to the physician who must make a decision about such surgical treatment.
Preliminary Experience with Ultrasonic Aspiration in Neurosurgery
Authors: Flamm Eugene S. , Ransohoff Joseph , Wuchinich David , Broadwin Alan 
Published: May 2010

Abstract
A new instrument utilizing ultrasonic energy to fragment and aspirate normal and pathological tissue has been evaluated for neurosurgical use. The instrument has been tested in several animal models to assess its efficacy and safety. The instrument has been used clinically in 38 cases for removal of meningiomas, acoustic neurinomas, and other tumors. Future modifications and applications are discussed.
Carcinoembryonic Antigen in a Metastatic Brain Tumor
Authors: Feinberg Stephen Brent , Hoffman Joseph F. 
Published: May 2010

Abstract
A case is presented in which 10 ml of cystic fluid from a metastatic brain tumor contained a high concentration of carcinoembryonic antigen (CEA). The use of CEA as a prognostic indicator and adjunctive therapeutic monitor in tumors is reviewed.
Revascularization of the Scalp by Microsurgical Techniques after Complete Avulsion
Authors: Chater Norman L. , Buncke Harry , Brownstein Michael 
Published: May 2010

Abstract
A total scalp replantation was performed after a complete traumatic avulsion of the scalp with skull fracture. Multiple arterial and venous anastomoses were required. Satisfactory healing occurred, and the patient has had a subsequent uneventful cranioplasty to fill a bony defect, with normal scalp healing.
CT Scan in Intraventricular Hemorrhage
Authors: McCallum J.E. , LoDolce Dolores , Boehnke Manfred 
Published: May 2010

Abstract
Twenty-three adults who had evidence of intraventricular hemorrhage were identified, and their charts were reviewed. Thirteen patients died and 10 survived. Eleven of the 13 who died were hypertensive. All had severe neurological deficit and evidence of brain stem dysfunction at the time of admission and progressed rapidly to coma and death. Two of the survivors had periventricular arteriovenous malformations. They presented neurologically intact and remained so. The other eight survivors had a distinct clinical course. They presented with focal deficits and abnormalities of mental status. These persisted, and at follow-up 3 to 20 months later they all had profound deficits of recent memory and intellect, and none was capable of daily self-care. Computerized tomographic (CT) scans were not useful in predicting outcome. The presence of parenchymal clot, multiple chamber involvement, 3rd ventricular involvement, ventriculomegaly, and midline shift were seen in all groups. Illustrative examples are presented.
The Lumbar Shield
Authors: Feild James Rodney , McHenry Hugh 
Published: May 2010

Abstract
Postoperative perineural adhesions between the lumbar nerve root and the partially removed intervertebral disc are thought to be a cause of failure of the standard operative procedure for the removal of a ruptured lumbar intervertebral disc. Attempts have been made to reduce postoperative perineural adhesions by the use of epidural muscle, fat, gelatin sponge, silicone, and steroids. The present communication introduces a new implantable silicone device, a lumbar shield. designed to: (a) provide a radiopaque marker on the dorsal perimeter of the excavated lumbar disc so that the presence or absence of a recurrent disc herniation can easily be determined on plain postoperative x-ray films, (b) provide ready access to the operative site in the event of a recurrent disc herniation. (c) prevent postoperative perineural adhesions between the lumbar dura and the nerve root and the partially removed intervertebral disc, and (d) prevent postoperative adhesions between the lumbar dura and the nerve root and the paraspinal muscles. Satisfactory results of lumbar disc surgery over the past 44 years have occurred in about 90% of routine patients. The value of the lumbar shield in 82 patients (59 routine and 23 workmen's compensation/medicolegal patients) followed for 6 months is described. A satisfactory result, i.e., relief of pain or the presence of occasional postoperative pain, occurred in 85% of routine patients at 1 month, 97% at 3 months. and 95% at 6 months.
Neural and Vascular Tissue Reaction to Aneurysm-coating Adhesive (Ethyl 2-Cyanoacrylate)
Authors: Diaz Fernando G. , Mastri Angeline R. , Chou Shelley N. 
Published: May 2010

Abstract
The effect of ethyl 2-cyanoacrylate (Aaron-2-Alpha) obtained from two different manufacturers was evaluated in 37 cats divided into two groups. The first group (n = 28) received a 9-year-old preparation. The second group (n = 9) received recently acquired adhesive. Aaron-2-Alpha was applied to the left cruciate cortex and left femoral neurovascular bundle under barbiturate anesthesia. Normal saline was applied on the right side for control. Survival was allowed for 2, 4, 7, and 14 days after application of the adhesive. The 2-day survival was excluded in the second group. Neuropathological examination revealed meningeal necrosis, neuronal and axonal degeneration, vascular wall degeneration, thrombosis, and inflammatory reaction in both groups of cats. The compounds tested are far from satisfying the ideal requirements for their safe use. Chemical degradation may take place in the adhesives stored for prolonged periods of time. Adhesives obtained from two different sources may contain adjuvants of different toxicity. Severe local tissue reaction could produce marked neurological deficits when adhesives are applied in critical areas.
Bilateral Optic Canal Meningiomas
Authors: Trobe Jonathan D. , Glaser Joel S. , Post Judith D. , Page Larry K. 
Published: May 2010

Abstract
In the case presented, bilateral optic canal meningiomas produced binocular visual loss. Correct diagnosis was delayed because of inadequate and misinterpreted radiological studies. Careful radiological and surgical examination of the planum sphenoidale later suggested this as the source of both canalicular masses. The pertinent aspects of this case are reviewed in relation to information from similar cases reported previously. In the future, increased clinical suspicion and more accurate neuroradiological studies should improve the detection and afford earlier surgical treatment of meningiomas of the optic canal.
Extracranial-Intracranial (EC-IC) Arterial Bypass
Authors: Samson Duke S. , Boone Stephen 
Published: May 2010

Abstract
The authors present a review of published experience with intracranial-extracranial arterial bypass grafting. The procedure is technically feasible and has a relatively low morbidity and mortality when performed by experienced microvascular surgeons. However, its therapeutic value is still unproven.
Microsurgical Evaluation of the Pterional Approach to Aneurysms of the Distal Basilar Circulation
Authors: Samson Duke S. , Hodosh Richard M. , Clark Kemp W. 
Published: May 2010

Abstract
The microsurgical correlates of the pterional approach to the distal basilar circulation were evaluated in 20 cases of posterior circulation aneurysms, 50 human cadaver dissections, and a variety of other intracranial surgical lesions. The pterional approach permitted successful clipping of the aneurysm in 13 of 15 basilar bifurcation aneurysms, 1 of 2 basilarposterior cerebral aneurysms, and 2 of 3 basilar-superior cerebellar aneurysms. In each of the failed attempts via the pterional approach, the subtemporal route ultimately resulted in proper clip application. The interposition of the posterior clinoid process was the impediment to successful clipping in three of the four cases that could not be managed via the pterional approach. All 3 of these patients had a basilar bifurcation that was below the level of the posterior clinoid on angiography, whereas none of the remaining 17 aneurysm patients demonstrated a low-lying bifurcation. Posterior displacement of the basilar artery away from the posterior clinoid exceeded 1 cm in only 13% of our cases and was not an impediment to successful clipping of the aneurysm via the pterional route. We conclude that, when the anatomical situation is appropriate, the pterional approach offers the advantages of less brain retraction and better visualization of the parent arteries and important perforating branches when compared to the subtemporal approach.
Shunt-associated Glomerulonephritis
Authors: Wald Steven L. , McLaurin Robert L. 
Published: May 2010

Abstract
Six patients with glomerulonephritis in association with a ventriculovascular shunt were treated with three basic modes of therapy. Direct intraventricular instillation of antibiotic was used on seven occasions in five patients either as the definitive mode of therapy or as an adjunct to shunt removal. Ventricular fluid antibiotic concentrations were monitored in two patients and demonstrate that effective levels as compared to the specific minimal inhibitory concentration can only be achieved by this method. With resolution of the shunt infection, improvement in the clinical and laboratory parameters of renal function was noted. A recommended treatment protocol is outlined, including specific dosages for intraventricular antibiotics. The need for detailed and frequent post-treatment examination including serum immunoglobulin profile is stressed.
Stereotactic Surgery with Image Processing of Computerized Tomographic Scans
Authors: Penn Richard D. , Whisler Walter W. , Smith Charles A. , Yasnoff William A. 
Published: May 2010

Abstract
The three-dimensional information from computerized tomographic scans has been transformed by image processing for use in stereotactic surgery. A lateral image of the target and calvarium can be superimposed on the lateral x-ray film taken at operation. Computer processing also eliminates extraneous data on the scan and gives the precise distance of the target from the midline. Testing the technique on a phantom shows it to be accurate to better than 0.5 cm. Application of the method for the stereotactic biopsy of a deep tumor is illustrated.
Posterior Fossa Subdural Hematoma in a Hemophiliac
Authors: Raggio John F. , Fleischer Alan S. , Corley Charles C. 
Published: May 2010

Abstract
A successfully managed case of posterior fossa subdural hematoma occurring in a hemophiliac is reported, and the rarity of this lesion is mentioned. The management of the hemophiliac who is a victim of craniocerebral trauma is discussed, with emphasis on the use of computerized tomographic scanning to obtain rapid diagnosis. The importance of prophylactic Factor VIII replacement is emphasized, and appropriate methods of Factor VIII administration are outlined.
Cerebellar Infarction
Authors: Feely Michael P. 
Published: May 2010

Abstract
Cerebellar infarction has been inadequately recognized by clinicians. A review of 75 cases showed that in 55 of them the infarct acted as an expanding mass lesion and compressed the brain stem. Once this occurred, the mortality without operation was very high. With surgical treatment, the mortality was reduced considerably. The computerized tomographic scan is the diagnostic test of choice.
A Reticulothalamic System Mediating Proprioceptive Attention and Tremor in Man
Authors: Velasco Francisco , Velasco Marcos 
Published: May 2010

Abstract
This report describes the electrophysiological characteristics of thalamic and subthalamic targets used to control tremor. In these targets exploratory electrodes recorded one or more of the following events. Electrical stimulation produced enhancement of tremor or other complex motor responses. Somatic evoked potentials (SEPs) induced by proprioceptive stimulation showed only late components, the amplitudes of which changed in various attentive situations. Multiunit activity showed spontaneous 3- to 6-Hz rhythmic bursts. And a lesion produced neglect of contralateral extremities and an ipsilateral decrease of scalp-recorded SEP late components. In contrast, in the areas located immediately posterior and dorsal, electrical stimulation produced contralateral paresthesias. Early components of SEPs could be recorded, as were rhythmic bursts of multiunit activity after the occurrence of peripheral tremor. Lesions produced sensory deficits in the contralateral extremities and ipsilateral blocking of all components of scalp SEPs. The latter areas are identified as the lemniscal system, but the former seem to be extralemniscal. Their electrophysiological characteristics suggest that they are probably involved in the process of selective attention and motor control