bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dexamethasone-a Helpful Adjunct in Management after Lumbar Discectomy
Authors: King J. Stovall 
Published: May 2010

Abstract
This randomized prospective study was designated to test the hypothesis that intraoperative and postoperative administration of a potent antiinflammatory steroid (dexamethasone) would reduce patients' postoperative pain. The hypothesis is based on the concept that inflammation is associated with a lowering of the threshold for nociceptive sense organs and that the inflammatory process is responsible, at least in part, for postoperative pain. The quantity of narcotics requested by the patients during the first 72 hours of the postoperative period was used as the measure of their postoperative pain. Patients treated with steroid who underwent lumbar laminotomy and discectomy used considerably less narcotic during the postoperative period than those not treated with steroid (P value &lt; 0.01). Less difference was noted in patients who underwent laminectomy, and no statistically significant difference was noted for those who underwent anterior discectomy. It is concluded that the use of an antiinflammatory steroid during and after operation significantly reduces the immediate postoperative pain after lumbar discectomy and may be useful in the postoperative management of other surgical procedures.
Intrasellar Cavernous Hemangioma
Authors: Buonaguidi Roberto , Canapicci Raffaelle , Mimassi Nagi , Ferdeghini Marco 
Published: May 2010

Abstract
We present a very rare case of an intrasellar cavernous hemangioma mimicking, clinically and neuroradiologically, the presence of a nonfunctioning pituitary adenoma. It was possible to diagnose this benign, congenital vascular malformation only through a histological examination.
Hemangioma Calcificans in the Fourth Ventricle
Authors: Hidenori Kobayashi , Hirokazu Kawano , Haruhide Ito , Minoru Hayashi , Shinjiro Yamamoto 
Published: May 2010

Abstract
A case of hemangioma calcificans in the 4th ventricle is reported. Skull x-ray films demonstrated a dense calcification in the posterior fossa. Computed tomography disclosed a hyperdense mass in the 4th ventricle. The clinical picture was of increased intracranial pressure due to obstructive hydrocephalus. An hemangioma calcificans in the 4th ventricle was removed successfully.
Anomalous Exit of the C-6 Nerve Root via the C-6, C-7 Foramen
Authors: Rosner Michael J. , Whaley Robert 
Published: May 2010

Abstract
We report a case of the anomalous exit of the C-6 nerve root at the C-6, C-7 foramen. This caused intense radicular and cervical pain in a 25-year-old woman. At myelography, the 5th and 6th cervical roots appeared conjoined, and at operation the C-6 root and ganglion were found to turn acutely downward, lateral to the pedicle of C-6, and then to exit with the C-7 nerve root through the C-6, C-7 foramen. The ganglion of C-6 was placed nearly parallel to the dural sac and tethered at its origin on the dural sac and at the exit foramen with the C-7 root. The pedicle of C-6 was interposed between the dural sac and the ganglion of C-6, Cervical hemilaminectomy and resection of the pedicle of C-6 defined the anatomy and resulted in a clinical cure. The radiological features are described and contrasted with those of other anomalies. To our knowledge, this is the first report of such an anomalous course of exit of a cervical root.
Criteria for Cure in Acromegaly: Report of a Case Apparently Cured in Which Persisting Tumor Was Found at Autopsy
Authors: Wrightson Philip , Holdaway Ian MacM. , Synek Beth J. L. 
Published: May 2010

Abstract
A 49-year-old man with acromegaly underwent the apparently complete removal of a pituitary microadenoma by the transsphenoidal route. There was complete remission of the biochemical abnormalities for 21/2 years, with basal plasma growth hormone (GH) levels of less than 1 ng/ml and normal somatomedin levels. The patient then died after the rupture of a cerebral aneurysm. Serial sections of the pituitary fossa showed persistent tumor with a volume of about 6% of the remaining normal gland. It is concluded that current endocrine tests are limited in their ability to detect residual GH-secreting tumor. Their sensitivity is likely to depend on the mass of the tumor and on the GH secretion rate. Predictions of long term cure based on these tests are only tentative.
Acute Operation and Preventive Nimodipine Improve Outcome in Patients with Ruptured Cerebral Aneurysms
Authors: Auer Ludwig M. 
Published: May 2010

Abstract
Sixty-five patients with ruptured aneurysms were operated upon within 48 to 72 hours after subarachnoid hemorrhage (SAH) and were treated with a regimen of intra- and postoperative nimodipine for the prevention of symptomatic vasospasm. The clinical grading (Hunt and Hess) was I to III in 49 patients and IV or V in 16. The SAH was mild in 15 patients, moderate in 27, and severe in 23; 12 patients harbored an intracerebral hematoma, and 6 had intraventricular bleeding. Acute hydrocephalus was observed on preoperative computed tomography (CT) in 19 patients. On CT 3 days postoperatively (i.e., Day 3-4 after SAH), 30 of 65 patients still had subarachnoid blood; however, severe symptomatic vasospasm as the deciding threatening event during the delayed postoperative period was not encountered in this series. Transient symptoms of ischemia were noted in 2 patients (3%) and were accompanied by angiographic spasm in 1. Irreversible neurological deficit occurred in 2 patients (3%); in 1 of these, it was a complication of postoperative control angiography. Of the patients preoperatively graded I or II, 96% had an excellent to fair outcome 6 months postoperatively, and 1 patient (4%) had died because of a surgical complication. Among patients preoperatively graded III or IV, 86% had an excellent to fair outcome, and the remaining 14% had a poor outcome. Shunt-dependent hydrocephalus developed in 7% of the patients. Acute surgical repair of ruptured cerebral aneurysms and preventive topical and intravenous administration of nimodipine reduce management complications and improve outcome; above all, ischemic lesions from symptomatic vasospasm are reduced to a minimum.
Lumbar Disc Hernia Secondary to Gunshot Injury
Authors: Mariottini A. , Delfini R. , Ciappetta P. , Paolella G. 
Published: May 2010

Abstract
The authors present a case of injury to the 4th lumbar root secondary to a gunshot wound. The lesion was not directly related to the traumatic action of the projectile, but was caused by the compressive action of disc material forced into the vertebral canal as a result of the destructive effects of a 7.65 caliber bullet.
Sarcoidosis Presenting as an Intramedullary Spinal Cord Mass
Authors: Hitchon Patrick W. , Haque Anwar Ul , Olson Jeffrey J. , Jacobs Steven K. , Olson Steven P. 
Published: May 2010

Abstract
A patient with sarcoidosis of the spinal cord showing cord enlargement upon myelography is presented. The literature regarding spinal cord involvement with sarcoidosis, the indications for operation, and treatment is reviewed.
Neuroepithelial Cysts of the Posterior Fossa: Pathogenesis and Report of Two Cases
Authors: Andrews Brian T. , Halks-Miller Meredith , Berger Mitchell S. , Rosenblum Mark L. , Wilson Charles B. 
Published: May 2010

Abstract
We present two cases of simple neuroepithelial cyst-one at the cerebellopontine angle and the other in the pontine brain stem-in which a basement membrane was detected. The pathogenesis of these cysts, their diagnosis using computed tomography-metrizamide cisternography and nuclear magnetic resonance imaging, and their surgical treatment by fenestration and drainage are discussed.
Primary Dural Melanomas: Report of Two Cases and Review of the Literature
Authors: Özden Beyhan , Barlas Orhan , Hacthanefioğlu Uğur 
Published: May 2010

Abstract
Two cases of primary melanoma of the central nervous system originating from the dura mater and without involvement of the leptomeninges are described. In one case, the tumor was located extradurally with firm attachment to the dura mater and dural melanosis. In the other case, the dura was involved diffusely with multiple discrete masses of 1 to 3 mm in diameter. A literature review revealed five other cases of primary dural melanoma. A discussion of the origin of primary dural melanoma is presented.
Lower Extremity Functional Neuromuscular Stimulation in Cases of Spinal Cord Injury
Authors: Cybulski George R. , Penn Richard D. , Jaeger Robert J. 
Published: May 2010

Abstract
Functional neuromuscular stimulation (FNS) provides a mechanism for the activation of muscles paralyzed by injury to the spinal cord. Although this technique was first used to treat patients with spinal cord injury over 20 years ago, only recent advances in electronics and biomechanics have made it a promising aid for the rehabilitation of these patients. Thus far, restoration of palmar prehension and lateral prehension in quadriplegics and of standing and biped gait in paraplegics has been achieved under carefully controlled laboratory conditions. This article reviews the current status of FNS and its potential as a practical tool to aid spinal cord-injured patients. Neurosurgeons who care for these patients might be expected to be involved in the future use of FNS if implantable systems are developed and tested.
A Quantitative Assessment of the Brain Stem Auditory Evoked Response during Intraoperative Monitoring
Authors: Zappulla Rosario , Greenblatt Edward , Kaye Steven , Malis Leonard 
Published: May 2010

Abstract
The brain stem auditory evoked response (BAER) was monitored intraoperatively in 11 patients with tumors of the posterior fossa. A technique for the objective quantitative assessment of the BAER based on the variance of the phase angle between small group averages is described. The resulting component synchrony measure corroborated standard peak latency and amplitude changes of the BAER during operative manipulation. A discussion of the replication and use of the objective measure is presented.
Giant Cell Reparative Granuloma of the Cranial Vault: Exceptional Bone Lesion
Authors: Garza-Mercado Román , Cavazos Elisamaría , Hernández-Batres Francisco 
Published: May 2010

Abstract
Giant cell reparative granuloma (GCRG) is an uncommon nonneoplastic lesion of bone. It is even rarer in the bones of the skull, particularly in the calvarial bones. Originally considered to be peculiar to the jawbones, GCRG has been described in some other locations, such as the short tubular bones of the hand and foot and the facial (paranasal) bones. Only one GCRG has been found in the skull, this one in the temporal bone. The authors were unable to find a report of such a lesion in the bones of the calvarium. The etiology of GCRG is unknown, but it is believed to result from a traumatic intraosseous hemorrhage or periosteal reaction. A GCRG was diagnosed in a 31-month-old male infant who presented with a nonpainful, slow-growing, right frontal swelling, apparently related to a head contusion that had occurred 21 months earlier. The lesion was removed surgically. The main differential diagnosis is giant cell tumor.
Treatment of Tandem Lesions of the Extracranial Carotid Artery
Authors: Pritz Michael B. , Smolin Michael F. 
Published: May 2010

Abstract
The authors present a patient with bihemispheric transient ischemic attacks attributed to stenosis of the left common carotid origin and stenosis and ulceration of the left cervical internal carotid artery. Because of precarious cerebral blood supply secondary to occlusions of the right common carotid and left vertebral arteries, several measures were undertaken perioperatively to provide protection from cerebral ischemia during vessel occlusion. These included Swan-Ganz catheter monitoring to maximize cardiac output and maintain satisfactory hydration, normocarbia, satisfactory oxygenation, and moderate hypertension and barbiturate infusion. With these adjuncts, both lesions were treated together. Retrograde balloon angioplasty under fluoroscopic control of a significant stenosis of the common carotid artery origin was performed before carotid endarterectomy. Postoperative digital subtraction angiography demonstrated a satisfactory technical result. The management of tandem lesions of the extracranial carotid artery is discussed. Balloon angioplasty coupled with extracranial vascular reconstructive procedures may allow the management of lesions not treated safely or effectively by either technique alone.
Meningioma with Intracerebral Hematoma
Authors: Kohli Chander M. , Crouch Rebecca L. 
Published: May 2010

Abstract
A case of spontaneous intracranial hemorrhage associated with a meningioma is presented. Intracranial hemorrhage has been reported to be associated with meningioma in 45 cases. A comprehensive review of the subject is presented. The importance of the diagnosis of associated hemorrhage and subsequent surgical intervention is emphasized.
Giant Granular Cell Tumor of the Suprasellar Area; Immunocytochemical and Electron Microscopic Studies
Authors: Liwnicz Boleslaw H. , Liwnicz Boleslaw H. , Liwnicz Regina G. , Huff Stephen J. , McBride Bert H. , Tew John M. , Tew John M. 
Published: May 2010

Abstract
We describe a case of a granular cell tumor (GCT) of the suprasellar region with an 11-year history in a 26-year-old woman. The computed tomographic scan showed a midline, contrast-enhancing, noncalcified mass. The biopsy was diagnosed as GCT. The tumor was treated with radiation therapy. At necropsy, a large, homogeneous GCT surrounded by gliosis was found. The tumor cells were filled with granules positive for periodic acid-Schiff, diastase-resistant. The cells did not contain glial fibrillary acidic protein or S-100 protein. Electron microscopy showed tumor cells filled with innumerable lysosomal structures. No intermediate filament was found within the cytoplasm. The tumor cells were not surrounded by a basement membrane. Based on this study and on our review of the literature, the suggestion that GCT has a multicellular origin is upheld.
Cerebellopontine Angle Gumma
Authors: Eltomey Atef A. , Olin Michael S. , Roberts Melville P. 
Published: May 2010

Abstract
A rare lesion, a gumma in the cerebellopontine angle, is reported. Gumma may mimic other more commonly occurring cerebellopontine angle tumors. The computed tomographic (CT) appearance and histological characteristics are discussed. The literature of cerebral gumma is reviewed. This is the only reported case of cerebellopontine angle gumma seen on CT scan and verified histologically at operation.
Nocardial Osteomyelitis of the Spine with Epidural Spinal Cord Compression-a Case Report
Authors: Awad Issam , Bay Janet W. , Petersen John M. 
Published: May 2010

Abstract
A 53-year-old man presented with complaints of back pain and weakness in his lower extremities. Physical examination demonstrated a thoracic myelopathy with a sensory level at T-4, The diagnostic work-up revealed vertebral osteomyelitis of the thoracic spine with epidural compression at T-2-T-4 causing a nearly complete block on myelography. A decompressive laminectomy and debridement were performed, followed by anterior spinal fusion. Nocardia asteroides was cultured from the epidural space. The patient was concurrently treated with sulfonamides. No underlying malignancy or immunosuppression could be demonstrated, but a primary pulmonary nocardial infection was suspected. A satisfactory recovery was accomplished. Only four other cases of nocardial osteomyelitis of the spine have been reported in the literature. These are discussed, and possible mechanisms are proposed for the pathophysiology of this rare manifestation. Current recommendations on the specimen processing, diagnosis, and therapy of nocardial infections are briefly reviewed.
Motor Evoked Potentials from Transcranial Stimulation of the Motor Cortex in Humans
Authors: Levy Walter J. , York Donald H. , McCaffrey Michael , Tanzer Fred 
Published: May 2010

Abstract
Electrical monitoring of the motor system offers the potential for the detection of injury, the diagnosis of disease, the evaluation of treatment, and the prediction of recovery from damage. Existing evoked potentials monitor one or another sensory modality, but no generally usable motor monitor exists. We have reported a motor evoked potential using direct stimulation of the spinal cord over the motor tracts in cats and in humans. To achieve a less invasive monitor, we used transcranial stimulation over the motor cortex in the cat, thus stimulating the motor cortex. We report here the initial application of this method to humans. A plate electrode over the motor cortex on the scalp and a second electrode on the palate direct a mild current through the motor cortex which will activate the motor pathways. This signal can be recorded over the spinal cord. It can elicit contralateral peripheral nerve and electromyographic signals in the limbs or movements when the appropriate stimulation parameters are used. In clinical use to date, this has been more reliable than the somatosensory evoked potential in predicting motor function in patients where the two tests differed. It offers a number of possibilities for the development of valuable brain and spinal cord monitoring techinques, but requires further animal studies and clinical experience. Studies to date have not demonstrated adverse effects, but evaluation is continuing.
Preliminary Report: Intracranial Cholinergic Drug Infusion in Patients with Alzheimer's Disease
Authors: Harbaugh Robert E. , Roberts David W. , Coombs Dennis W. , Saunders Richard L. , Reeder Teddi M. 
Published: May 2010

Abstract
After toxicity studies in dogs, a preliminary feasibility trial of the continuous intracranial infusion of a muscarinic agonist was begun in four patients with biopsy-documented Alzheimer's disease. During the last 8 months, a totally implantable infusion system has been used to deliver bethanechol chloride into the cerebrospinal fluid of these patients at doses of 0.05 to 0.7 mg/day. Complications have been few and resolved spontaneously or were easily reversible. The subjective response to this treatment has been encouraging, with reports of improved cognitive and social function during drug infusion and a return to base line function with single-blind saline placebo infusions. Obviously, further evaluation will be necessary to demonstrate the efficacy of this treatment, and a double-blind placebo-controlled crossover trial is now being done. However, we think the preliminary results are encouraging and warrant the consideration of this approach as a potential treatment in patients with Alzheimer's disease.
Extracranial Metastasis of Cerebral Glioblastoma Multiforme: Case Report
Authors: Sadik Rasul A. , Port Robert , Garfinkel Burton , Bravo Jose 
Published: May 2010

Abstract
A patient with glioblastoma multiforme of the right cerebral hemisphere that was treated by surgical removal followed by cobalt therapy is presented. The patient's only neurological deficit at the initial presentation had been a left homonymous hemianopsia, which remained unchanged after operation. He had maintained a good functional state for about 18 months. Then, because of low backache, he was restudied thoroughly, and a bony destructive lesion was found in the body of the 4th lumbar vertebra. A computed tomographic scan-guided biopsy of this lesion revealed a histopathological picture similar to that of the primary cerebral glioma. This metastatic glioma of the spine was treated with cobalt therapy with good clinical (i.e., pain relief) response. The case represents extracranial metastasis of cerebral glioblastoma, which is rarely seen. A brief review of the literature and of the theories concerning dissemination is presented.
Familial Osteodysplasia Associated with Trigeminal Neuralgia: Case Report
Authors: Niijima Kyo Huang , Kondo Akinori , Ishikawa Jun-ichiro , Kim Choigon , Itoh Hiraji 
Published: May 2010

Abstract
A 24-year-old woman suffering from left trigeminal neuralgia presented with the familial occurrence of skeletal anomalies simulating Hajdu-Cheney syndrome. She was of a short stature and had low-set ears, protrusion of the bilateral temporal and occipital bones, platybasia, basilar impression, and dental anomaly. Vertebral angiography disclosed marked displacement to the left and dorsally of the basilar artery, which was confirmed during the operation to have compressed the left trigeminal nerve in the cerebellopontine angle narrowed by the unusually protruded bony structure. Cases of Hajdu-Cheney syndrome have occasionally been reported, a few combined with facial spasm, but Hajdu-Cheney syndrome with trigeminal neuralgia is very rate. The patient's family members were surveyed. The possible cause of the neuralgia with its relation to the osteodysplasia is briefly discussed.
Massive Preoperative Pulmonary Embolism and Suprasellar Brain Tumor: Case Report and Review of the Literature
Authors: Sawaya Raymond , Decourteen-Meyers Gabriella , Copeland Bradley 
Published: May 2010

Abstract
A 57-year-old man presented to our facility with the diagnosis of a suprasellar mass and died on the 2nd post-admission day from a massive pulmonary embolism. At autopsy, the mass was diagnosed as craniophyarngioma. This case report and review of the literature suggest an intimate relation between brain tumors and thromboembolic complications as evidenced by the high incidence of this association, the frequent occurrence of coagulopathies in patients with brain tumors, and the prevalence of tumors in the suprasellar location. The specific mechanisms that may be at play are reviewed.
How Do Vessels Proliferate in the Capsule of a Chronic Subdural Hematoma?
Authors: Yamashima Tetsumori , Yamamoto Shinjiro 
Published: May 2010

Abstract
An ultrastructural study was performed to define the mechanisms of proliferation of macrocapillaries and capillaries in the capsule of chronic subdural hematoma. Mitotic activities of endothelial cells and vascular sprouts may contribute to the vascular proliferation. Platelets may also play an important role. Endothelial cells of proliferating macrocapillaries were highly attenuated except for the nuclear portion and showed variable electron densities. The adjacent endothelial cells had less intimate cellular junctions than the proliferating capillaries. The proliferating endothelial cell sometimes contacted the opposing endothelial cell across the lumen, separating the latter into two compartments. The pericytes varied remarkably in size, shape, and electron density. Proliferating capillaries had a narrowed vascular lumen and were characterized by cuboidal or thickened endothelial cells with enlarged nuclei, numerous pinocytotic vesicles, and cytoplasmic protrusions into the vascular lumen. They occasionally had intimate cellular junctions with interdigitations and slender pericytes of high electron density. Proliferating vessels occasionally had some clear endothelial cells that contained filamentous material and a few dense bodies. These cells might represent degenerated or swollen endothelial cells. However, they showed no evidence of increased permeability. Postdegranulation platelets were sometimes trapped in the endothelial linings. These data indicate that the most important factor for the development of chronic subdural hematoma exists in the vessels of the capsules, which have a marked proliferation potential and a fragile nature. The possibility of transition from proliferating capillaries to macrocapillaries is discussed.