bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic Headache Associated with a Functioning Shunt: Usefulness of Pressure Monitoring
Authors: Abbott Rick , Epstein Fred J. , Wisoff Jeffrey H. 
Published: April 2011

Abstract
Chronic headaches in a shunt-dependent patient with small ventricles has long been treated with little or no regard to intracranial pressure. In this study, pressure monitoring on 12 such patients demonstrated that they fell into three distinct categories: 3 had headaches caused by intracranial hypertension, 2 had headaches from hypotension, and 7 showed no relation of symptoms to pressure. As therapeutic procedures for treating these three categories are entirely different and sometimes opposing, it is clear that intracranial pressure monitoring is essential to successful management of this complaint.
Ectopic Retinoblastoma within the 3rd Ventricle: Case Report
Authors: Katayama Yoichi , Tsubokawa Takashi , Yamamoto Takamitsu , Nemoto Norimichi 
Published: April 2011

Abstract
Ectopic intracranial retinoblastomas arc rare. These tumors usually occur in the pineal, parasellar. or suprasellar regions several years after the successful treatment of ocular retinoblastomas with no evidence of direct extension or distant metastasis. We report here a case of ectopic retinoblastoma occurring within the third ventricle. The tumor was surgically excised by the transventricular approach. Ectopic retinoblastomas exhibit greater differentiation than one would expect to observe in a metastatic lesion of this tumor. The distinction of ectopic retinoblastomas and metastasis from ocular retinoblastomas is important, since ectopic retinoblastomas, unlike metastasis, can be successfully managed by intensive therapy including radical excision.
Epidural Tuberculoma of the Spine: Case Report
Authors: Hamada Junichirou , Sato Kyouichi , Seto Hiroshi , Ushio Yukitaka 
Published: April 2011

Abstract
Epidural tuberculomas of the spine have been reported only rarely during the past few decades. A case of a surgically treated epidural tuberculoma of the thoracic spine in a 76-vear-old woman is presented.
Asymptomatic versus Symptomatic Herniated Thoracic Discs: Their Frequency and Characteristics as Detected by Computed Tomography after Myelography
Authors: Awwad Eric E. , Martin David S. , Smith Kenneth R. , Baker Bradley K. 
Published: April 2011

Abstract
We retrospectively reviewed the myelograms of 433 patients and identified those who had no symptoms or signs referable to the thoracic cord, roots, or nerves. By post-myelography computed tomographic scan criteria, our frequency of asymptomatic thoracic herniated dises (ATHDs) was calculated. Post-myelography computed tomographic scans of 68 ATHDs were analyzed. Their imaging characteristics were compared with our own series of 5 symptomatic thoracic herniated discs and symptomatic thoracic herniated discs in the literature. We were unable to identify any imaging features that could reliably classify a disc as an ATHD or a symptomatic thoracic herniated disc. Our results call into question the propriety of prophylactic surgery for ATHDs, even when the lesions are radiographically impressive.
Cerebrospinal Fluid Flow Dynamics in Children with External Ventricular Drains
Authors: Drake James M. , Sainte-Rose Christian , DaSilva Marcia , Jean-François Hirsch 
Published: April 2011

Abstract
Fifty-five children had 64 external ventricular drains (EVDs) placed predominantly (95%) for cerebrospinal fluid (CSF) shunt infections. In 9 children, a computer monitoring system measured the CSF output each second continuously for up to 24 hours. The monitoring was repeated daily for up to 9 days. The state of arousal of the patients was recorded simultaneously. In all children, daily EVD outputs were related to age, sex, weight, method of establishing the EVD, height of the drip chamber, time since insertion, and type of infecting organism. Computer monitoring revealed wide fluctuations in flow rate, with peak rates frequently &gt;20 ml/h and periods of flow arrest. These changes were usually associated with increased arousal, but also occurred with sleep. The mean EVD flow rate for all children was 6.3 ml/h. EVD output increased with age and weight. EVD output decreased with Gram-negative or multiple-organism infections and with elevation of the drip chamber. Resolution of the infection, sex of the patient, and method of establishing the EVD had no effect on output. These results predict that CSF production increases with brain growth in humans; that CSF production is depressed by Gram-negative and multiple-organism infections; that implanted CSF shunts with standard valves flow at equivalent rates to an EVD in the supine position; and that the CSF drainage requirements in this group are approximately equal to their EVD outputs.
An Experimental Compartmental Flow Model for Assessing the Hemodynamic Response of Intracranial Arteriovenous Malformations to Stereotactic Radiosurgery
Authors: Lo Eng H. , Fabrikant Jacob I. , Levy Richard P. , Phillips Mark H. , Frankel Kenneth A. , Alpen Edward L. 
Published: April 2011

Abstract
Stereotactic radiosurgery has proven to be an effective method of treating selected inaccessible or inoperable arteriovenous malformations (AVMs) of the brain. Radiation-induced obliteration of successfully-treated AVMs, however, occurs only after some latent period after treatment, depending on size, location, and dose. An experimental compartmental flow model is proposed to describe the hemodynamic alterations in the AVM as a result of the pathophysiological changes after radiosurgery, and to analyze temporal alterations in AVM blood flow rates and pressure gradients before complete obliteration. In representative small (low-flow, 150 ml/min) and large (high-flow, 440 ml/min) AVMs, it is found that increases in pressure gradients across certain vascular structures within the AVM occur during the normal course of radiation-induced flow decrease and AVM obliteration. The magnitude of these pressure alterations, however, may be within the normal physiological variations in cerebrovascular blood pressure. The effects of partial-volume irradiation of the AVM is examined by limiting radiosurgical treatment to varying portions of the flow compartments within the model. It is found that alterations in pressure gradients persist in unirradiated vascular shunts, even after complete obliteration of the treated AVM volume. These pressure alterations may increase the probability of hemorrhage from the untreated shunts of the AVM and cause redistribution of regional cerebral blood flow resulting in increased flow through these untreated shunts.
Percutaneous Transvenous Catheterization and Embolization of Vein of Galen Aneurysms
Authors: Casasco Alfredo , Lylyk Pedro , Hodes Jonathan E. , Kohan Gabriel , Aymard Armand , Merland Jean-Jacques 
Published: April 2011

Abstract
Seven cases of vein of Galen aneurysms treated by percutaneous transvenous endovascular occlusion of the aneurysmal vein are presented. In one case, the approach was via the femoral vein, and in the other six cases, by the jugular vein. All of the malformations were multipedicular and, additionally, in six of the seven there was an intervening arterial-arterial network between the posterior thalamoperforating arteries and the wall of the venous aneurysm. This fistulous network was interpreted as purely arterial and not as an associated arteriovenous malformation. For this reason, the transvenous approach was considered justified, and was performed without risk of hemorrhage caused by retrograde venous hypertension. Measurement of intra-aneurysmal pressure during the course of treatment allowed better understanding of the hemodynamics of the lesions, guided the amount of occlusion to be accomplished during each treatment session, and thus may have prevented the phenomenon of normal perfusion pressure breakthrough. The percutaneous transvenous approach offers all the advantages of the transtorcular approach but avoids surgery. Because of our excellent angiographic and clinical results—five complete and two partial occlusions, with favorable outcomes and no major complications—we believe that this technique is better for the treatment of multipedicular vein of Galen aneurysms than transarterial embolization or surgery.
Reversible Hearing Loss from Cerebellopontine Angle Tumors
Authors: Vellutini Eduardo A. S. , Cruz Oswaldo L. M. , Velasco Otavio P. , Miniti Aroldo , Almeida Gilberto M. 
Published: April 2011

Abstract
We report two patients who presented with a dramatic recovery from severe sensorineural hearing loss after total surgical removal of cerebellopontine angle tumors (meningioma and jugular foramen neurinoma). The factors that differentiate these “non-acoustic tumors” in relation to the prognosis for hearing are discussed. A surgical approach that maintains the labyrinthine structure and preserves the arachnoid membrane of the superior cerebellopontine angle cistern during tumor removal is stressed.
The Relevance of Anatomic and Hemodynamic Factors to a Classification of Cerebral Arteriovenous Malformations
Authors: Pasqualin Alberto , Barone Giovanni , Cioffi Fabrizia , Rosta Luisa , Scienza Renato , Da Pian Renato 
Published: April 2011

Abstract
Potential prognostic anatomic and hemodynamic factors were evaluated in 248 patients with cerebral arteriovenous malformations (AVMs), all treated by direct microsurgical removal. The size of each AVM was calculated by its volume, obtained by the multiplication of the three AVM diameters by 0.52. A surgical classification of AVM location (in 11 groups) is proposed. Types of feeders and of drainage were classified as superficial or deep; the extent of the drainage system was classified according to a four-degree scale. The mean flow velocity in the main AVM feeder, detected using transcranial Doppler ultrasonography, was used as an indirect measure of AVM shunt flow in a small number of patients (n = 29). AVM volume was a very important prognostic factor: the incidence of hyperemic complications and the morbidity and mortality rate were significantly higher when the volume of the lesion was &gt;20 cm3 (P&lt; 0.0001 for hyperemic complications; P &lt; 0.001 for permanent morbidity and mortality). The incidence of hyperemic complications and the morbidity rate were higher in AVMs in rolandic, inferior limbic, and insular locations than in AVMs in other locations. As for other anatomic factors: a) the presence of deep feeders significantly increased the incidence of hyperemic complications, as well as the morbidity and mortality rate; b) the presence of deep drainage significantly increased permanent morbidity only; c) the extension of the venous system was significantly related to the development of hyperemic complications, and to morbidity and mortality. Transcranial Doppler examination showed that mean flow velocities &gt;120 cm/s in the main feeder were associated with a significantly higher rate of postoperative hematomas and transient deficits. A classification of cerebral AVMs that takes into account AVM volume and location, the type of feeders, the extent of the drainage system, and the main feeder flow velocity is suggested.
Gonadotroph Adenoma of the Pituitary Mimicking a Prolactinoma
Authors: Yamada Shozo , Horvath Eva , Kovacs Kalman , Aiba Tadashi , Shimizu Taeko , Shishiba Yoshimasa , Hara Mitsuru 
Published: April 2011

Abstract
In a 41-year-old woman with mild hyperprolactinemia and amenorrhea, preoperative hormonal and neuroradiological findings suggested the diagnosis of a macroprolactinoma. She underwent transsphenoidal surgery since the tumor size had not changed in spite of bromocriptine administration for 5 months. Consequently. this case was diagnosed as a female-type gonadotroph adenoma on the basis of its characteristic ultrastructural features including a honeycomb Golgi complex, even though endocrinological and immunohistochemical findings were not those of a typical gonadotroph adenoma.
Delayed Facial Nerve Palsy after Temporal Lobectomy for Epilepsy: Report of Four Cases and Discussion of Possible Mechanisms
Authors: Anderson James , Awad Issam A. , Hahn Joseph F. 
Published: April 2011

Abstract
Four cases of idiopathic peripheral facial nerve palsy were documented after 110 consecutive resections of the temporal lobe for intractable epilepsy. In 3 of the 4 cases, the palsy was ipsilateral to the side of the temporal lobectomy. The onset of facial weakness was delayed 7 to 13 days after surgery (mean, 9.7 days). One patient underwent facial electroneurography, which documented 17% of normal facial motor function at the height of his weakness and the absence of the acoustic stapedius reflex. All patients were treated with prednisone (60-80 mg per day by mouth for 10-14 days, tapering off throughout the subsequent week). Facial function recovered fully in all patients within 6 to 8 weeks. Possible mechanisms are discussed, including heat and/or mechanical trauma to the facial nerve near the geniculate ganglion during resection of mesial temporal lobe structures.
Effect of Whole Brain Radiation on Local Cerebral Glucose Utilization in the Rat
Authors: d'Avella Domenico , Cicciarello Rocco , Albiero Francesca , Mesiti Mario , Gagliardi Maria Ester , Russi Elvio , d'Aquino Antonio , Princi Pietro , d'Aquino Saverio 
Published: April 2011

Abstract
We assessed, by means of the [14C]-2-deoxy-D-glucose autoradiography method, the effect of whole-brain x-radiation on local cerebral glucose utilization in the rat brain. Animals were exposed to conventional fractionation (200 ± 4 cGy/day, 5 days/week; total dose, 4000 cGy);. Metabolic experiments were made 2 to 3 weeks after completion of the radiation exposure. In comparison with control and sham-irradiated animals, cerebral metabolic activity was diffusely decreased after irradiation. Statistically significant decreases in metabolic activity were observed in 13 of 27 brain regions studied. In general, the brain areas with the highest basal metabolic rates showed the greatest percentage of decrease in glucose utilization. The concept that radiation suppresses glucose utilization before any morphological change takes place in the cell structures was the basis of this study. Metabolic alterations after irradiation may explain the syndrome of early delayed deterioration observed in humans after whole-brain radiotherapy. These studies have applications to observations made with the [18F]-fluorodeoxyglucose method in conjunction with positron emission tomographic scans in patients receiving radiation therapy for intracranial malignancies. The data reported here also have potential clinical implications for the evaluation of a risk/benefit ratio for radiotherapy in patients with benign neurosurgical diseases or children undergoing prophylactic treatment of the central nervous system.
Motor Evoked Potentials Elicited from Pyramidal Stimulation and Recorded from the Spinal Cord in the Rat
Authors: Ryder John , Zappulla Rosario , Nieves Julia 
Published: April 2011

Abstract
This study investigated the spinal evoked response to focal electrical stimulation of the sensorimotor cortex in 32 rats. The results demonstrate a long-latency response (beginning at 8 milliseconds); elicited by electrical stimulation, which is distinct from the short-latency motor evoked potential previously reported. The conduction velocity of this later response is similar to that reported for the pyramidal tract in the rat. Experiments confirm that the longer latency response depends upon the integrity of the pyramidal system. Focal stimulation outside the sensorimotor cortex failed to elicit a response. Experimental lesions of the pyramidal tract or ablating the sensorimotor cortex eliminated the spinal cord evoked response. The results demonstrate that focal stimulation of the sensorimotor cortex results in a spinal cord evoked response that represents activity within the pyramidal system. The utility of this response in the rat model for assessing experimental cord injury is discussed.
Neurenteric Cyst Located Dorsal to the Cervical Spine: Case Report
Authors: Macdonald R. Loughlin , Schwartz Michael L. , Lewis Anthony J. 
Published: April 2011

Abstract
A patient with a neurenteric cyst located dorsal to the cervical spine and associated with occult cervical spinal dysraphism is described. The embryological theories that might explain the occurrence of such a lesion are discussed.
Pineal Teratoma and Its Relationship to Intracerebral Development: Case Report
Authors: Sekhon Lali H. S. , Morgan Michael K. 
Published: April 2011

Abstract
A teratoma of the pineal region in a 20-year-old Australian Aborigine is presented in which an unusual location of the straight sinus and tentorium cerebelli suggests that the tumor arose before 4 months of gestation. In addition, this case provides some insight into the development of the falx cerebri, which might arise from the midline fusion of the left and right tentoria cerebelli caused by the dorsal development of the telencephalon.
Lymphoproliferative Lesion of the Hypoglossal Nerve: Case Report
Authors: Takaki Shuichi , Jun-Ichi Kuratsu , Mihara Yosuke , Takada Akira , Seto Hiroshi , Ushio Yukitaka 
Published: April 2011

Abstract
A rare case of a lymphoproliferative lesion in the hypoglossal nerve is reported. The patient, a 52-year-old woman, had symptoms identical with those of hypoglossal neurinoma. Computed tomography and magnetic resonance imaging revealed a lesion at the left cerebellomedullary angle. The tumor was removed, and histopathological studies revealed that the tumor consisted predominantly of lymphocytes.
Infected Intracranial Aneurysm in an Infant: Case Report
Authors: Whitfield Peter Cyril , Bullock Ross 
Published: April 2011

Abstract
The case of a ruptured, infected intracranial aneurysm occurring in a 34-day-old child is reported. The child was brought for examination after a sudden onset of screaming and pallor, followed by focal seizures. Blood cultures grew Staphy-lococcus aureus, and a computed tomographic scan revealed a large hematoma in the region of the left sylvian fissure. An angiogram demonstrated a 17-mm aneurysm arising from a small branch of the middle cerebral artery. At craniotomy, the hematoma was evacuated and an infected aneurysm was removed. The etiology, pathogenesis, and management of infected intracranial aneurysms is discussed. Our patient is the youngest in whom such an aneurysm has yet been reported.
Brain Tumor Resection Aided with Markers Placed Using Stereotaxis Guided by Magnetic Resonance Imaging and Computed Tomography
Authors: Hassenbusch Samuel J. , Anderson James S. , Pillay Prem K. 
Published: April 2011

Abstract
In the operative resection of brain tumors, defining and locating edges of deep-seated tumors or those with indistinct color and consistency can be difficult. This report presents a simple yet precise, alternative method, using the basic Brown-Roberts-Wells or Cosman-Roberts-Wells stereotactic frame, for placement of visual markers to aid in tumor resections. The method can also be extended to the Leksell system. Using routine computed tomographic scanning or magnetic resonance imaging after stereotactic frame application, multiple points along tumor edges were used as target points. In the operating room, standard techniques were used for the skin incision, removal of the bone flap, and opening the dura. At each target point, after opening the dura and using stereotactic coordinates and equipment, a microbiopsy forceps was used to place “micropatties” (each with a string tail) or small catheters with pledgets or catheter tips located at tumor edges. After removing the arc, the tumor resection was accomplished in a conventional nonstereotactic manner by simply following string tails or catheters to the tumor. Gross tumor edges were determined from positions of actual patties or catheter tips. These simple but accurate techniques offer the possibility of tumor resections under stereotactic guidance with equipment readily available to most neurosurgeons. The fidelity of marker placement is also maintained in relation to tumor edges despite shifts in the tumor and/or brain as cystic areas are drained or large amounts of the tumor are resected.
Prevention of Vasospasm by Clot Removal and Intrathecal Bolus Injection of Tissue-Type Plasminogen Activator: Preliminary Report
Authors: Mizoi Kazuo , Yoshimoto Takashi , Fujiwara Satoru , Sugawara Takayuki , Takahashi Akira , Koshu Keiji 
Published: April 2011

Abstract
In this study, we evaluated the efficacy of postoperative intrathecal injections of tissue-type plasminogen activator (tPA) in preventing cerebral vasospasm in cases with a diffuse severe subarachnoid hemorrhage. All 10 cases were graded Group 3 according to the classification of Fisher and associates, and the CT number (Hounsfield number) of the subarachnoid clot was over 75. After clipping the aneurysm and removing the clot, three cisternal drainage catheters were inserted into both sylvian cisterns and the prepontine cistern, and continuous ventricular drainage was performed routinely. Postoperatively, tPA (0.5 mg/2.5 ml) was infused as a bolus into both basal cisterns and the lateral ventricle twice daily for about 6 days. Angiography and cerebral blood flow studies using single photon emission computed tomography were performed on Day 4 or 5 and between Days 7 and 10 after onset of the hemorrhage. To date, there have been no cases that have shown angiographic vasospasm or delayed ischemic neurological deficits. This preliminary study indicates that the intrathecal bolus injection of tPA produces a marked effect on vasospasm.
Computed Tomography of the Postoperative Intervertebral Disc and Lumbar Spinal Canal: Serial Long-Term Investigation in 19 Patients after Successful Operation for Lumbar Disc Herniation
Authors: Heilbronner Raoul , Fankhauser Heinz , Schnyder Pierre , de Tribolet Nicolas 
Published: April 2011

Abstract
The first part of this work, published in 1988, included 25 patients who had computed tomographic (CT) scans without contrast enhancement and plain x-rays of the lumbar spine before, 1 week after, and 6 to 7 weeks after a successful operation for lumbar disc herniation. The present study extends the follow-up period to 3 years in 19 of the 25 original patients. Clinical examinations, lateral plain x-rays, and CT scans without contrast enhancement of the operated disc were repeated. The results indicate a decrease or even a disappearance of the hyperdense extradural material thought to represent fibrosis. An image suggestive of persistent disc herniation was still present in 5 of 8 patients with this finding on early postoperative CT scans. Persistent intradiscal gas was seen in nearly half of the patients. Total normalization of the posterior extraspinal structures was the rule. There was no correlation between CT appearance and residual complaints of the patients. CT scans without contrast enhancement may be sufficient to guide the surgeon in postoperative patients with massive signs and symptoms of recurrent root compression in whom a second operation is indicated on clinical grounds. In all other cases, myelography followed by CT scans is considered appropriate to investigate failed back surgery syndrome. (Neurosurgery 29:1-7, 1991)