bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute Middle Cerebral Artery Occlusion: Experience with Volume Expansion Therapy
Authors: Tranmer Bruce I. , Gross Cordell E. , Keller Ted S. , Kindt Glenn W. 
Published: May 2010

Abstract
Five consecutive patients with acute neurological deficits after middle cerebral artery (MCA) occlusion were given emergency treatment with colloidal volume expansion. In each case, the diagnosis was confirmed promptly by computed tomography and cerebral angiography. Aggressive volume expansion therapy was started 2 to 18 hours (mean, 11 hr) after the onset of the neurological deficit. The mean colloidal volume used was 920 ml/day for an average of 4 days. During volume expansion, the mean cardiac output increased 57% from 4.6 + 0.6 to 7.2 + 1.9 litres/min (P &lt; 0.05). The mean hematocrit decreased 19% from 46 + 3% to 37 + 4% (P &lt; 0.01). The mean arterial blood pressure remained stable, and the pulmonary artery wedge pressure was maintained at &lt; 15 mm Hg. Three patients improved dramatically with volume expansion therapy and have returned to their previous life-styles. Two patients made partial recoveries and manage at home with nursing care. The three patients who improved dramatically were young (aged &lt;34) and, when compared to the older patients, they had greater increases in cardiac output (67% vs. 19%). No major complications or deaths were attributed to the volume expansion therapy. We propose that intravascular volume expansion and its concomitant augmentation of the cardiovascular dynamics may be effective in the treatment of acute neurological deficits after acute MCA occlusion.
Neurocysticercosis: Surgical and Medical Management with Praziquantel
Authors: Leblanc Richard , Knowles Kathleen F. , Melanson Denis , MacLean John Dick , Rouleau Guy , Farmer Jean-Pierre 
Published: May 2010

Abstract
Eight cases of neurocysticercosis were encountered at the two major neurological centers affiliated with McGill University in Montreal in 4 years. All patients were immigrants who had been in Canada for a period of 1 to 18 years and came from South America (three cases), Haiti (three cases), and Greece (two cases). Five patients had parenchymal cysts and presented with epilepsy; three had the racemose form and presented with hydrocephalus. Four patients with parenchymal cysts were treated by removal of the cysticercus and did well. One patient with numerous cysts was treated with praziquantel with good clinical and radiological results. Two patients with the racemose form were treated by cyst aspiration, cerebrospinal fluid (CSF) diversion, and praziquantel and did well. Another patient with the racemose form, seen before the advent of praziquantel, died of cysticercosis infection. Neurocysticercosis is not uncommon in the immigrant population of large North American cities. Single symptomatic cysts can be evacuated surgically with good results; multiple parenchymatous cysts can be treated with praziquantel. Patients with the racemose form who are treated with CSF diversion and praziquantel do well, although those who are only treated surgically die of their disease.
Long Term Survival of a Patient with an Intracranial Ependymoma: Case Report
Authors: Grady Sean M. , Vandenberg Scott R. , Jane John A. 
Published: May 2010

Abstract
A patient with a posterior fossa ependymoma who has survived for over 49 years is presented. Inspection of the original specimen from 1936 and comparison to subsequent biopsies show no change in the benign morphology of the tumor. This case is unique not only in the patient's length of survival, but also in the sequential histological examination of the tumor.
Carotid Occlusion in a 27-Year-Old Man: A Case Report
Authors: Osgood Carroll P. , Karunaratne Esiri R. , Sandler Richard , Vandevander Dennis J. 
Published: May 2010

Abstract
A 27-year-old man developed premature carotid atherosclerosis some 15 years after mantle radiation to the head and neck for nasopharyngeal lymphoepithelioma.
Isolated C-2 Osteomyelitis of Hematogenous Origin: Case Report and Literature Review
Authors: Venger Benjamin H. , Musher Daniel M. , Brown Eugene W. , Baskin David S. 
Published: May 2010

Abstract
A case of hematogenous Staphylococcus aureus osteomyelitis isolated to the 2nd cervical vertebra is presented. To our knowledge, this is the second case to be reported of hematogenous infection involving only the body and odontoid process of the axis. The first report was published prior to the advent of computed tomography, bone scans, and halo orthosis. The pathophysiology of blood-borne atlantoaxial infection is described, as well as methods of diagnostic evaluation and therapeutic recommendations. The use of computed tomography to define the extent of the lesion is illustrated.
Cerebral Salt Wasting after Pituitary Exploration and Biopsy: Case Report
Authors: Andrews Brian T. , Fitzgerald Paul A. , Tyrell Blake J. , Wilson Charles B. 
Published: May 2010

Abstract
We report a case of hyponatremia associated with volume depletion after pituitary exploration and biopsy. The presence of clinical dehydration precluded diagnosis of the syndrome of inappropriate secretion of antidiuretic hormone. The absence of a hypoadrenal state and the patient's response to volume reexpansion were consistent with a diagnosis of primary cerebral salt wasting.
Management of Bilateral Locked Facets of the Cervical Spine
Authors: Maiman Dennis J. , Barolat Giancarlo , Larson Sanford J. 
Published: May 2010

Abstract
A total of 28 cases of cervical spine dislocation with bilateral locking of facets treated between 1976 and 1984 were analyzed to determine whether treatment modality had any effect on outcome based on cord or root function. Motor vehicle accidents were responsible for 19 cases; the most common levels of dislocation were C-5, C-6 and C-6, C-7, with 10 each. Twenty patients were admitted with complete myelopathies. Ten patients whose dislocations were successfully reduced with traction had no neurological changes, but 1 reduced elsewhere deteriorated from a C-5 to C-2 level. Eleven of these patients underwent posterior cervical fusions after delays of 1 to 17 days (mean = 6.3); 2 died, and 1 patient achieved slight root return. Seven underwent anterior decompression and fusion or combined anterior and posterior approaches after delays of 9 to 120 days. One patient died in the postoperative period, 1 had substantial recovery of cord function, and 5 had recovery of root function. There was no operation or improvement in 2 patients. Eight patients had incomplete myelopathies; 4 were initially reduced, with 2 improving slightly as a result. Three patients underwent posterior fusions with foraminotomies with minimal improvement. Five had anterior or combined approaches; these patients improved at least one neurological grade each, including 3 who became newly ambulatory. All 24 surviving patients achieved spinal stability, although it occurred slightly earlier in the anterior fusion groups. Surgical approaches designed to provide spinal stability and restore the normal anatomy of the spinal canal and neural foramina may be of functional benefit in the management of these dislocations.
Laser Resection of Fifty Spinal Lipomas
Authors: McLone David G. , Naidich Thomas P. 
Published: May 2010

Abstract
The value of laser resection was assessed in the last 50 of 128 consecutive cases of pediatric spinal lipoma. In this series, there was no mortality. No patient suffered increase in neurological or urological deficit. Postoperatively, 8 of 20 patients with prior motor deficit (40%) had substantially improved motor function. Two of 17 previously incontinent patients became continent of urine (12%). Use of the CO2 laser reduced the length of operation, the intraoperative blood loss, and the degree of manipulation of the spinal cord and nerve roots. Most of the fat could be removed successfully from the liponeural junction, permitting more nearly anatomical removal of the intramedullary component of the lesion and greater ease in replacing the cord into a reconstructed arachnoid-dural canal. In the authors' opinions, proper management of the patient with spinal lipoma now requires early prophylactic resection of the lipoma and untethering of the spinal cord.
Isolated Central Nervous System Metastasis from Transitional Cell Carcinoma of the Bladder: Report of a Case and Review of the Literature
Authors: Davis Raphael P. , Spigelman Melvin K. , Zappulla Rosario A. , Sacher Michael , Strauchen James A. 
Published: May 2010

Abstract
Although systemic metastases from transitional cell carcinoma of the bladder occur frequently, involvement of the central nervous system is uncommon. We describe a patient with an isolated cerebral metastasis who had previously undergone resection of a Grade III, Stage B2 carcinoma of the bladder. We have been able to find only one previous case report of a solitary intracerebral metastasis from transitional cell carcinoma of the bladder without evidence of primary recurrence or additional sites of spread. Central nervous system metastasis from bladder carcinoma must be considered in the differential diagnosis of solitary intracerebral lesions.
Vancomycin Penetration of a Brain Abscess: Case Report and Review of the Literature
Authors: Levy Robert M. , Gutin Philip H. , Baskin David S. , Pons Vincent G. 
Published: May 2010

Abstract
A 56-year-old man developed an abscess within a right parietal cystic anaplastic astrocytoma 3 days after removal of iodine-125 sources placed 9 days earlier for interstitial radiation therapy. After treatment with cephalosporin antibioties proved unsuccessful, the patient was treated with intravenous vancomycin and intermittent percutaneous drainage of the abscess. Vancomycin levels obtained from the brain abscess fluid, both before and during later operative removal of the abscess, were 15 and 18 μg/ml, respectively; the serum vancomycin level was 21 μg/ml. This is the first report of the excellent penetration of vancomycin into brain abscess fluid.
Fenestration of Intraventricular Cysts Using a Flexible, Steerable Endoscope and the Argon Laser
Authors: Powers Stephen K. 
Published: May 2010

Abstract
Two infants with hydrocephalus and compartmentalization of the lateral ventricles due to cerebrospinal fluid infection were treated by fenestration of the ventricular cysts using the argon laser through a steerable flexible endoscope. Both children had undergone failed multiple shunting procedures that attempted to drain the lateral ventricular cysts. One child had chronic granulomatous disease and persistent Candida ventriculitis and meningitis. His infection resolved after removal of multiple shunt systems was made possible by endoscopic laser fenestration to convert a multilocular to a unilocular hydrocephalus. Postoperative computed tomographic scans and head circumference measurements showed arrested hydrocephalus in both cases, and both children remain symptom-free 6 months after operation. The argon laser was used to coagulate and incise the ventricular septae in both cases. The steerable flexible endoscope enabled excellent visualization of the ventricular system without manipulation of the endoscope at the corticotomy site. Necessary improvements in the design of the flexible endoscope and the delivery system for the argon laser are discussed.
Surgical Management of Arteriovenous Malformations That Follow the Tentorial Ring
Authors: Solomon Robert A. , Stein Bennett M. 
Published: May 2010

Abstract
In a series of 200 intracranial arteriovenous malformations (AVMs) treated surgically, 33 malformations were situated very close to the tentorial incisura. All but one of these AVMs were totally removed. Four operative approaches were utilized in this group of patients: (a) an interhemispheric approach for lesions of the medial hemispheres, splenium of the corpus callosum, and posterior 3rd ventricle; (b) a subtemporal approach to the inferior and medial temporal lobe; (c) a supracerebellar-infratentorial approach to anterodorsal cerebellum and quadrigeminal regions; and (d) a subtemporal transtentorial exposure to the dorsolateral mesencephalon. There were no surgical deaths. Three patients had unsatisfactory outcomes. Our experience with this series indicates that deep cerebral AVMs in the region of the tentorial incisura may be safely removed if there is proper selection of operative approach and attention to surgical technique.
Successful Laser-assisted Excision of a Metastatic Midbrain Tumor
Authors: Tobler William D. , Sawaya Raymond , Tew John M. 
Published: May 2010

Abstract
Metastatic lesions to the midbrain are rare. They are found in 1 to 3% of autopsy series of solitary brain metastases. The consensus of opinion in the current literature is that they are inoperable lesions and should be treated by radiation therapy alone. This is the first case report of a completely excised metastatic adenocarcinoma to the midbrain. The patient's clinical course has been stable, and there is no computed tomographic evidence of recurrence at 18 months follow-up. (18:795-797, 1986)
Intracranial Extension of Orbital Pseudotumor: A Case Report
Authors: Noble Susan Cline , Chandler William F. , Lloyd Ricardo V. 
Published: May 2010

Abstract
A patient with intracranial extension of an orbital pseudotumor is reported. This rare consequence of an unusual inflammatory process has been reported on only two previous occasions. Our patient initially presented with unilateral loss of vision and a mass in the sphenoid sinus. Transsphenoidal biopsy revealed inflammatory tissue with a predominance of plasma cells. Over 2 years later, computed tomographic scanning demonstrated involvement of the ipsilateral frontal lobe, and craniotomy revealed invasion of both the dura mater and the cortex by this inflammatory process. Immunohistochemical staining for B and T cells was done to rule out lymphoma, and extensive cultures and staining were performed to identify any infectious process. Because this progressive lesion did not respond to steroid treatment, radiation therapy to the affected area was carried out. Orbital pseudotumor should be considered when an inflammatory process is identified in the meninges and cortex of the anterior fossa. (18:798–801, 1986)
Syringomyelia in a Man with Sarcoidosis
Authors: Rawlings Charles E. , Saris Stephen C. , Muraki Alan , Friedman Allan 
Published: May 2010

Abstract
Sarcoidosis, generally a systemic ailment, uncommonly affects the central nervous system. It only rarely affects the spinal cord alone or in combination with other areas. Syringomyelia has never been associated with sarcoidosis. We report the case of a 32-year-old man with sarcoidosis who presented with surgically verified syringomyelia. The pertinent literature is reviewed. The mechanisms by which sarcoidosis could cause a syrinx are discussed. (18:805–807, 1986)
Intraoperative Ultrasonography with a Cystoscope for the Biopsy of a Deep-seated Brain Lesion: Case Study
Authors: Greenberg I. M. 
Published: May 2010

Abstract
An intraoperative technique for deep brain biopsy is described. It features the use of an integrated surgical support system for the instruments and a rod that provides external topographical maintenance of the coordinates established ultrasonographically. A cystoscope, when supported mechanically by this system, permits multiple entries of the biopsy forceps to the lesion without further disturbance of the brain, as well as irrigation, coagulation, and visualization, if desired. When used in conjunction with real time intraoperative ultrasonography, the surgeon may view the entire procedure and be certain that the biopsy sample has been obtained from the lesion, major deep blood vessels have been avoided, and the biopsy site is stable after the procedure. The advantages of this technique include simplicity, low cost, accuracy, stability, and availability to every neurosurgeon in every hospital.
Somatosensory Evoked Potential Monitoring of Spinal Cord Ischemia during Aortic Operations
Authors: Kaplan Barry J. , Friedman William A. , Alexander James A. , Hampson Scott R. 
Published: May 2010

Abstract
Somatosensory evoked potentials were monitored in 22 consecutive patients undergoing surgical correction of an aortic coarctation. Induction of spinal cord ischemia by cross clamping of the aorta elicited a change in the evoked potential in 9 patients (41%). These alterations occurred within 5 minutes of aortic clamping in 3 cases and after 18 to 21 minutes in the remaining 6 cases. Loss of the somatosensory evoked potential for more than 14 minutes was associated with postoperative neurological deficit. Alteration of the evoked potential within 5 minutes of aortic cross clamping was significantly related to poor collateral circulation shown on the preoperative aortogram. The pathophysiology of evoked potential changes in spinal ischemia is discussed in detail.
Surgical Correction of Lesions Affecting the Second Portion of the Vertebral Artery
Authors: Diaz Fernando G. , Ausman James I. , Shrontz Carl , Pearce Jeffrey , Gehring Randy , Mehta Bharat , Dujovny Manuel 
Published: May 2010

Abstract
Substantial controversy has surrounded the diagnosis and management of vertebrobasilar ischemic events, with no consensus on the value of medical or surgical treatment of patients symptomatic with brain stem ischemia who have angiographically proven vertebral artery lesions. This report presents our experience with the surgical treatment of 12 of 88 patients with angiographically verifield lesions in the vertebral artery who were symptomatic for 1 to 12 months before their evaluation. None experienced symptomatic relief with antiplatelet agents, nor did the administration of anticoagulants in 4 of the patients provide any benefit. The lesions included bilateral vertebral artery occlusion with distal reconstitution through muscular collaterals in 6 patients, unilateral vertebral artery hypoplasia with contralateral long-tailed lesions from the vertebral artery origin to C-5 in 3 patients, and severe bilateral vertebral artery origin lesions extending beyond the C-5 level in 3 patients. A vertebral endarterectomy and vertebral-carotid transposition in the second portion of the artery were successfully used to reestablish flow and obtain symptomatic relief in 10 of the 12 cases; 1 of these procedures had to be redone because of a persistent stenosis at C-4. Another patient had a saphenous vein graft from the common carotid to the vertebral artery at C-5. The remaining patient had an anastomosis of the distal external carotid to the vertebral artery at C-3, but this failed and an anastomosis of the occipital artery to the anterior inferior cerebellar artery had to be completed to reestablish flow. We think that operation offers a possible means to reestablish flow and to obtain symptomatic relief for patients with symptoms of brain stem ischemia who have severe angiographic lesions in the first two portions of the vertebral artery.
Optochiasmatic Arachnoiditis with Treatment by Surgical Lysis of Adhesions, Corticosteroids, and Cyclophosphamide: Report of a Case
Authors: Marcus Alan O. , Demakas John J. , Ross H. Arlene , Duick Daniel S. , Crowell Robert M. 
Published: May 2010

Abstract
A 24-year-old woman presented with progressive optochiasmatic arachnoiditis causing progressively worsening visual loss associated with headache and amenorrhea. Treatment with the standard initial therapy of dexamethasone, warfarin, and dipyridamole was unsuccessful at halting her disease process. Surgical lysis of adhesions led to a temporary improvement and then deterioration. A course of therapy with cyclophosphamide was initiated and her response to this therapy resulted in resolution of her headaches, return of her vision to normal, and resumption of her normal menstrual cycles.
Pneumocephalus Secondary to Tension Pneumothorax Associated with Comminuted Fracture of the Thoracic Spine
Authors: McCall Charles S. , Nguyen Tai Q. , Vines Frederick S. , Bremer Alfonso M. 
Published: May 2010

Abstract
We present an unusual case of pneumocephalus secondary to a tension pneumothorax associated with fracture of the thoracic spine. Air from a pneumothorax entered the thoracic intraspinal compartment and the intracranial cavity through a comminuted fracture of the spine. The pneumocephalus and the pneumothorax resolved after aspiration of the intrathoracic air via an intercostal catheter. Diagnosis, therapeutic modalities, and potential complications of a pneumocephalus and of a communication between the thoracic cavity and the spinal dural space are discussed.
Primary Pontine Hematoma Presenting as a Cerebellopontine Angle Mass
Authors: Russell Brian , Rengachary Setti S. , McGregor Douglas 
Published: May 2010

Abstract
A case of hemipontine hematoma from the rupture of a cryptic vascular malformation presenting as a cerebellopontine angle tumor is reported. The clinical features of and surgical approaches to partial pontine hematomas are briefly reviewed.
Fibrous Xanthoma in the Gasserian Ganglion: Case Report
Authors: Morimura Tatsuo , Tani Eiichi , Yamaura Ikuya , Kochi Nobuo 
Published: May 2010

Abstract
Occurrence of fibrous xanthoma has been reported increasingly in the skull and the central nervous system, but is extremely rare in the gasserian ganglion. We report on the clinical presentation, radiological appearance, surgical treatment, and histological makeup of a fibrous xanthoma arising from the left gasserian ganglion.
Use of Intraoperative Ultrasound in Decision Making during Spinal Operations
Authors: Theodotou Basil C. , Powers Stephen K. 
Published: May 2010

Abstract
The use of intraoperative spinal ultrasonography in 14 cases and its effect on decision making during laminectomy procedures is discussed. The advantages of the technique in operations for syringomyelia, trauma, spondylosis, intramedullary tumors, and neuroablative procedures of the spinal cord are elaborated.
Surgically Treated Cerebral Arterial Ectasia with So-Called Moyamoya Vessels
Authors: Hanakita Junya , Miyake Hidenori , Nagayasu Shinji , Nishi Shyogo , Suzuki Takanori 
Published: May 2010

Abstract
The case of a 43-year-old woman with multiple intracranial arterial ectasia was reported. The arterial ectasia was accompanied by stenosis of the middle cerebral artery and so-called moyamoya vessels. After extracranial to intracranial bypass surgery, the size and contour of the arterial ectasia decreased. Because the arterial ectasia decreased in size after the extracranial to intracranial bypass surgery, this operation might be useful for space-occupying lesions due to arterial ectasia.
Aneurysmal Bone Cyst of the Cervicothoracic Spine: Computed Tomographic Evaluation of the Value of Preoperative Embolization
Authors: Disch Steven P. , Grubb Robert L. , Gado Mokhtar H. , Strecker William B. , Marbarger John P. 
Published: May 2010

Abstract
In this report, the management of an aneurysmal bone cyst in the cervicothoracic region of an 8-year-old girl is described. Aneurysmal bone cyst is a histologically benign lesion that is often extremely vascular. In the spine, it can cause extensive bone destruction and compress neural structures. Because this lesion may involve all parts of a vertebra, full delineation of the lesion before its excision is important in planning the surgical approach. The value of preoperative embolization to reduce tumor vascularity, allowing total excision, and the improved radiological evaluation of this lesion with computed tomographic scanning are demonstrated.