bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of Cefotaxime in Gram-negative Meningitis
Authors: LeFrock Jack L. , Molavi Abdolghader , Smith Bruce , Black Perry , Rosenberg Manuel , Rolston Kenneth , Brodner Robert , Chandrasekar Pranatharthi , Henao Libia , Kannangara Don W. 
Published: May 2010

Abstract
We treated 12 adult patients who had gram-negative bacillary meningitis with cefotaxime administered intravenously at a dose of 2 g every 4 hours. The etiological organisms included Haemophilus influenzae (3 cases), Serratia marcescens (3 cases), Klebsiella pneumoniae (3 cases), Escherichia coli (2 cases), and Enterobacter (1 case). The infection followed a neurosurgical procedure in 6 cases. The mean inhibitory and bactericidal concentrations of cefotaxime for the isolates ranged from 0.125 to 0.25 ug/ml. The cerebrospinal fluid (CSF) concentrations of cefotaxime ranged from 5.0 to 15.2 ug/ml, and the CSF bactericidal titers were 1:64 to 1:128. The CSF in all patients was sterilized within 96 hours. All 12 patients recovered, and there were no relapses.
A Comparison of Pressure-Volume Models in Hydrocephalus
Authors: Simon Richard H. , Lehman Ralph A. W. , O'Connor Sean J. 
Published: May 2010

Abstract
Traditional descriptions of the pressure-volume properties of the craniospinal axis have expressed pressure as a function of volume. This study develops a theoretical and practical rationale for expressing volume as a function of pressure. We tested the rationale by comparing the two functions using pressure and volume data collected from 37 hydrocephalic patients during ventricular fluid removal. Two equivalent expressions were evaluated, one expressing pressure as an exponential function of volume and one relating volume as an exponential function of pressure. Each expression had three parameters, adjustable to the specific case. We used a nonlinear curve-fitting algorithm to determine the best estimate of the parameters. We could fit three-parameter exponential functions of either type to the data in all cases. We found a superior goodness-of-fit to aggregated data when expressing volume as a three-parameter exponential function of pressure changes. This finding is discussed in the context of the preferable number of parameters in a model and the interpretation of the terms in the models. This “reversed” volume-pressure relationship has importance in the development of more complicated models involving these same relationships.
Traumatic Aneurysm of the Supraclinoid Internal Carotid Artery: Report of a Case
Authors: Enomoto Hitomi , Shibata Takayuki , Ito Akio , Harada Tsutomu 
Published: May 2010

Abstract
A case of traumatic aneurysm of the supraclinoid internal carotid artery is presented. Formation of the aneurysm was thought to be due to a direct injury to the wall of the internal carotid artery from a basal skull fracture of the anterior cranial fossa.
Total Removal of a Falcotentorial Junction Meningioma by Biparietooccipital Craniotomy in the Sea Lion Position: A Case Report
Authors: Suzuki Mikio , Sobata Eiji , Hatanaka Mitsuaki , Suzuki Shigeharu , Iwabuchi Takashi , Makiguchi Kohichi 
Published: May 2010

Abstract
The successful total removal of a huge falcotentorial junction meningioma in a 59-year-old woman by biparietooccipital craniotomy with the patient in the sea lion position (prone with a hyperextended neck and with 20° elevation of the upper and lower halves of the body) is reported, with some comments on the advantages of this approach and position. Taking advantage of the exposure of the dural sinus, the confluens sinuum pressure was measured by direct catheterization with the patient in various positions. The pressure was 3.6 cm H2O in the sea lion position, 2.4 cm H2O in the reverse jackknife position (supine with 20° elevation of the upper and lower halves of the body), and - 12 cm H2O in the sitting position.
Intracranial Space-occupying Lesions in Acquired Immune Deficiency Syndrome Patients
Authors: Snow Robert B. , Lavyne Michael H. 
Published: May 2010

Abstract
The recent description of the acquired immune deficiency syndrome (AIDS) followed the observation of an increased incidence of unusual neoplasms and opportunistic infections in previously healthy homosexual men, intravenous drug abusers, Haitians, hemophiliacs, and certain infants. Active research efforts on this group of patients established a defect in cellular immunity. Six patients with AIDS who underwent neurosurgical procedures for intracranial space-occupying lesions are presented. Two of the patients had toxoplasmosis brain abscesses, one had primary central nervous system lymphoma, one had cytomegalovirus encephalitis, one had progressive multifocal leukoencephalopathy, and one patient remained undiagnosed despite pathological examination of the brain tissue specimen. We recommend brain biopsy in AIDS patients with space-occupying lesions because the regimen for the various conditions differs. Although the central nervous system diseases found in AIDS patients are associated with a high mortality rate, four of the six patients responded favorably to specific treatment.
External Stereotactic Irradiation by Linear Accelerator
Authors: Colombo Federico , Benedetti Antonio , Pozza Franco , Avanzo Renzo Carlo , Marchetti Cristina , Chierego Giorgio , Zanardo Agostino 
Published: May 2010

Abstract
Stereotactic radiotherapy has two advantages: (a) the possibility of giving high radiation doses to small but spatially well-defined target volumes and (b) the presence of a stepped dose gradient between the target volume and the surrounding healthy tissues. To utilize these advantages, the authors built a new stereotactic head frame by which the intracranial target is fixed to the rotational isocenter of a 4-MV linear accelerator. The collimator openings are selected according to the volume and the three-dimensional configuration of the target, and the radiation dose is based on the radiosensitivity of the lesion. After the patient is fixed to the frame, the radiation source and the patient are rotated so that the target is irradiated through infinite portals distributed over the convexity of the skull. It is thereby possible to obtain very high radiation doses centered into the target with a stepped dose gradient. The preliminary radiodosimetric tests and the operative technique are described. The advantages of this technique compared to interstitial radiotherapy and Leksell's radiosurgery are emphasized. This noninvasive procedure has been used to treat a series of intracranial tumors.
Chronic Subdural Hematomas: To Drain or Not to Drain?
Authors: Markwalder Thomas Marc , Seiler Rolf W. 
Published: May 2010

Abstract
A consecutive series of 21 adult patients with chronic subdural hematoma was studied in respect to postoperative resolution of subdural collections and clinical improvement after burr hole evacuation without subdural drainage. This series was compared to a previously studied series of patients with chronic subdural hematoma in whom postoperative closed system drainage had been installed. Using the identical protocol for treatment and postoperative follow-up, we obtained identical results with respect to time-related neurological improvement and persistence of subdural collections in the undrained and drained series, except that the steadily progressive clinical improvement during the early postoperative phase (24 hours) in all cases of the drained series was not universal in the undrained cases. Our study suggests that, to avoid the possibility of early postoperative clinical deterioration, burr hole craniostomy and closed system drainage is advisable. We think that subdural drainage is not necessary when the installation of the drainage system seems to be technically difficult, as it may be in cases with considerable perioperative cortical expansion.
Control of Spasticity by Implantable Continuous Flow Morphine Pump
Authors: Erickson D.L. , Blacklock J.B. , Michaelson M. , Sperling K.B. , Lo J.N. 
Published: May 2010

Abstract
Continuous flow pumps are being used for the delivery of morphine sulfate to the intrathecal and epidural spaces for control of pain. We have encountered several patients who had a combination of pain and spasticity or who had spasticity so intense that it was the source of pain. One to two milligrams of intrathecal morphine dramatically relieved their spasticity and pain. Three such patients have subsequently undergone pump implantation with prolonged control of their spasticity. This has initiated a formal clinical investigation directed at determining the physiological mechanism of this phenomenon, as well as its long term efficacy.
Giant Posttraumatic Aneurysm of the Intracranial Carotid Artery: Evolution and Regression Documented by Computed Tomography
Authors: Saleman Michael , Botero Ernesto , Bellis Edwin 
Published: May 2010

Abstract
Posttraumatic aneurysms of the proximal intracranial internal carotid artery are rare, A case is presented in which the evolution and regression of such an aneurysm is documented by computed tomography as well as by arteriography. The coexistence of a proximal dissection of the cervical carotid artery probably contributed to the growth of the aneurysm.
Bilateral Mycotic Aneurysms of the Intracavernous Carotid Artery
Authors: Abbassioun Kazem , Amirjamshidi Abbass , Rahmat Hamid 
Published: May 2010

Abstract
A rare case of bilateral intracavernous internal carotid artery aneurysms is presented. The clinical and laboratory data strongly suggested the mycotic nature of the aneurysms. Internal carotid artery ligation was performed because of clinical evidence of progressive enlargement of the right-sided aneurysm. The left-sided aneurysm was managed medically. It remained asymptomatic and, 14 months later, a control angiogram showed no significant change in its size and configuration.
Occipital Interhemispheric Acute Subdural Hematoma Treated by Lambdoid Suture Tap
Authors: Brill Charles B. , Jarath Veena , Black Perry 
Published: May 2010

Abstract
We present the case of a 6-week-old infant with acute subdural hematoma secondary to hemorrhagic disease of the newborn. Computed tomographic scan localization of the collection in the posterior portion of the supratentorial compartment allowed for its removal by lambdoid suture taps. The procedure is described.
Malignant Change in an Intradiploic Epidermoid: Report of a Case and Review of the Literature
Authors: Yanai Yoshimi , Tsuji Reizoh , Ohmori Shigehiro , Tatara Naoto , Kubota Satoru , Nagashima Chikao 
Published: May 2010

Abstract
An unusual case of intradiploic epidermoid tumor is reported. In this case, a soft mass located over the parietal bone was noted shortly after birth. The mass gradually enlarged. The tumor underwent malignant change after several excisions and repeated inflammations. The patient was successfully treated with extensive excision, radiotherapy, and chemotherapy. Compiling a summary of reported cases with a tabulation of pertinent information, we discuss the incidence, pathogenesis, prognosis, and therapy of malignant intradiploic epidermoid.
Real Time Ultrasound Diagnosis of Hemorrhagic Pathological Conditions in the Posterior Fossa of Preterm Infants
Authors: Bejar Raul , Coen Ronald W. , Ekpoudia Ikpe , James Hector E. , Gluck Louis 
Published: May 2010

Abstract
Real time echoencephalography (RTE) was used to diagnose and serially follow intracranial pathological conditions in the posterior fossa of infants with a gestational age of &lt;34 weeks. The posterior fossa was studied in four planes (coronal, modified coronal, sagittal, and parasagittal) with a sector scanner equipped with a high frequency transducer that was placed on the fontanelles and the sutures. Hemorrhagic complications were easily differentiated from normal anatomy. RTE diagnosis was confirmed with computed tomographic scans (5 patients) and postmortem examination of the brain (18 infants). RTE is a precise and noninvasive technique to visualize hemorrhagic and other forms of abnormalities in the infratentorial compartment.
Microsurgical Excision of Paraventricular Arteriovenous Malformations
Authors: Hoi Sang U 
Published: May 2010

Abstract
Periventricular arteriovenous malformations (AVMs) have often been deemed inoperable because of their location in critical structures. Furthermore, the excision of large lesions may be complicated by the potential for serious brain swelling and hemorrhage due to “autoregulation breakthrough.” Nonetheless, the unfavorable natural history of the untreated disease in a symptomatic young patient has induced us to approach these lesions using staged microsurgical excision combined with elective barbiturate coma for maximal cerebral protection. Between 1979 and 1983, six patients (four female, aged 12 to 60 years, and 2 male, aged 14 and 29) who harbored large AVMs in the basal ganglia, thalamic, and hypothalamic areas presented with subarachnoid hemorrhage (2 cases), progressive neural deficits (3 cases), and intractable headache (1 case). Nineteen staged operations were performed for the complete excision of these lesions. Among the first three patients, there was one death due to “autoregulation breakthrough” hemorrhage into the lateral ventricle during the excision of a lesion approached through the sylvian fissure using standard anesthesia techniques. This led to the adoption of the transventricular surgical approach and elective barbiturate coma to facilitate exposure of the lesion and to protect the adjacent vital structures from potential ischemia. Three patients were treated in this fashion uneventfully. Of the five successfully treated patients, two have returned to their preoperative status and one has completely recovered from global hemispheric ischemia and hemiplegia. The hemiparesis in one patient worsened as a result of postoperative hypertensive intraventricular hemorrhage, and one patient developed mild dysphasia and hemiparesis. This experience suggests that this approach offers a valid therapeutic regimen for the treatment of this disease. During the same period, three patients-one man (age 23) and two women (aged 29 and 22)-harboring four intraventricular AVMs presented with intraventricular hemorrhage. After the acute effects of chemical ventriculitis and hydrocephalus were overcome with cerebrospinal fluid diversion, all four lesions were excised microsurgically using the transtemporal approach. One patient demonstrated significant and progressive improvement of her preoperative memory deficit. The remaining two patients have both returned to their preoperative employment. Homonymous visual defects in two patients were transient, and seizure activity developing after operation was easily controlled medically. This experience confirms that intraventricular AVMs can be excised with minimal morbidity and should be treated aggressively in the symptomatic young patient.
Developments in the Treatment and Prognosis of Multiple Cerebral Abscesses
Authors: Rousseaux Marc , Lesoin Francis , Destee Alain , Jomin Michel , Petit Henri 
Published: May 2010

Abstract
Multiple cerebral abscesses have been recognized with increasing frequency because of the use of computed tomography and have been the subject of various therapeutic proposals. Their prognosis has been considerably improved thanks to high does antibiotic therapy. However, diagnostic and therapeutic problems persist.
General Metabolism in Patients with Acute Paraplegia and Quadriplegia
Authors: Kaufman Howard H. , Rowlands Brian J. , Stein Debra K. , Kopaniky Dennis R. , Gildenberg Philip L. 
Published: May 2010

Abstract
This study measured the nutritional status of eight spine-injured patients during their first 10 to 14 days in the hospital. Initial and follow-up nutritional assessment showed that their nutritional status deteriorated at least partly due to an inadequate supply of protein and calories. Infective complications and prolonged respiratory support were common and may have been caused in part by impaired nutrition. This suggests that a prospective study of aggressive nutritional support for patients with spinal cord transection should be initiated to determine whether this acquired malnutrition and its associated complications can be prevented.
Microsurgical Removal of Suprasellar Meningiomas
Authors: Al-Mefty Ossama , Holoubi Abdulmoti , Rifai Ayman , Fox John L. 
Published: May 2010

Abstract
The authors report 17 cases of large suprasellar meningiomas operated on during the 2-year period from February 1982 through March 1984. The tumors ranged from 4 to 9 cm in diameter. These patients presented with severe visual loss (4 were blind) and optic atrophy or papilledema. These tumors were noteworthy in their encroachment against and around the carotid arteries and optic nerves laterally, as well as against the hypothalamus with extension into the interpeduncular cistern and frontal foss. Advanced microsurgical technique assisted in total removal of all tumor tissue with preservation of vital sturctures. There were three deaths: two from pulmonary embolism and one from gastrointestinal hemorrhage. The surgical technique for the total removal of these very large tumors is described.
Surgical Resection of a Pineal Tumor Containing Elements of Germinoma and Astrocytoma
Authors: Neuwelt Edward A. , Buchan Colin , Blank Nathan K. , Lewy Alfred J. 
Published: May 2010

Abstract
A 15-year-old boy presented with hydrocephalus due to a pineal tumor presumed to be a germinoma. After a shunting procedure, gross total tumor resection was carried out via an occipital transtentorial approach. Histopathological examination of the tissue demonstrated that, in addition to the expected germinoma, the tumor also contained areas of astrocytoma and areas that, taken in isolation as in a needle biopsy, could have been diagnosed as pineocytoma. The diagnosis and therapy of a pineal tumor of mixed histological types such as this lesion would be seriously compromised by “conventional” empiric radiation and even a stereotactic needle biopsy may not have provided an adequate tissue sample.
Hemangiomatous Anomaly of Bone in Crouzon's Syndrome: Case Report
Authors: Alpers Charles E. , Edwards Michael S.B. 
Published: May 2010

Abstract
A striking and diffuse hemangiomatous architecture was identified by microscopic examination of bone specimens obtained at cranial synostectomy and from the craniofacial area of a young boy with Kleeblättschadel deformity and Crouzon's syndrome. A retrospective review of the histopathological appearance of bone specimens from other patients with Crouzon's syndrome treated on our service and a review of the literature on craniosynostosis suggest that the hemangiomatous pattern seen in this patient is rare if not unique. The unusual pathological findings provide evidence that the underlying pathophysiology of this disorder may be heterogeneous.
Microvascular Decompression in Hemifacial Spasm: Intraoperative Electrophysiological Observations
Authors: Møller Aage R. , Jannetta Peter J. 
Published: May 2010

Abstract
Facial muscle responses in patients with hemifacial spasm undergoing microvascular decompression operations were recorded. Two peripheral branches of the facial nerve were stimulated and the electrical responses of muscles innervated by these branches were studied to see how the lateral spread of activity that is known to be present in these patients was affected by decompressing the facial nerve. In some of the patients the hemifacial spasm ceased when the dura mater was opened, in some it ceased when the arachnoid was opened, and in others the spasm persisted until the offending vessel was dissected away from the nerve. The lateral spread of activity elicited by antidromic stimulation of a branch of the facial nerve was less affected by opening of the dura mater or arachnoid: it usually persisted until the blood vessel that had been compressing the facial nerve was removed and reappeared when the vessel that had been compressing the facial nerve was allowed to slip back onto the nerve. This seems to indicate that microvascular decompression of the facial nerve is effective in alleviating hemifacial spasm because it removes the actual cause of the disorder rather than simply causing local injury to the nerve as a result of the procedure.
Spinal Vascular Tumors: Dilemmas in Diagnosis and Management
Authors: Cawthon David F. , Cacayorin Edwin D. , Modesti Luciano M. , Lin Luke , King Robert B. 
Published: May 2010

Abstract
Three case reports of spinal vascular tumors illustrate the need for well-organized and thorough neuroradiological and neurosurgical planning to achieve an initial cure without delay and to avoid inadequate operative procedures.
Late Stenosis of a Superficial Temporal-Middle Cerebral Artery Bypass: Angiographic and Histological Findings
Authors: Gumerlock M.K. , Coull B.M. , Howieson J. , Buchan C. , Neuwelt E.A. 
Published: May 2010

Abstract
The course of a patient with an initially widely patent superficial temporal artery-middle cerebral artery (STA-MCA) bypass and an enlarged donor vessel is presented. Over 17 months, the STA became markedly stenotic. Serial angiography is correlated with autopsy histological findings showing severe atherosclerotic changes throughout the donor vessel. The potential causative factors, both medical and surgical, are discussed and the appropriate literature is reviewed. Parallels are drawn from the cardiac bypass experience. The bypass itself may have precipitated or accelerated intimal hyperplasia, which stenosed (and may have eventually occluded) the vessel. Is this phenomenon more frequent than we realize?
Bifrontal Epidural Hematoma after Transsphenoidal Operation: Report of a Case with a Rare Complication
Authors: Saitoh Youichi , Mori Shintaro , Nii Yasuo , Abekura Makoto , Arita Norio , Hayakawa Toru , Moriwaki Kaname , Mogami Heitaro 
Published: May 2010

Abstract
We report a patient with a growth hormone-secreting adenoma who developed bifrontal epidural hematomas after a transsphenoidal operation. To our knowledge, this is the first report of such a complication.
Arteriovenous Malformation in the Territory of the Occluded Middle Cerebral Artery with Massive Intraoperative Brain Swelling: Case Report
Authors: Aoki Nobuhiko , Mizutani Hiroshi 
Published: May 2010

Abstract
We present an extremely rare case of an arteriovenous malformation (AVM) in the territory of the middle cerebral artery, the main trunk of which was occluded asymptomatically. Immediately after an uneventful excision of the entire AVM, massive brain swelling occurred unexpectedly and was treated successfully with high dose barbiturate therapy associated with other standard measures of controlling increased intracranial pressure. The underlying pathophysiological mechanisms leading to the massive intraoperative brain swelling in this case are discussed.
Left Atrial Myxoma with Cerebral Emboli
Authors: Branch Charles L. , Laster D. Wayne , Kelly David L. 
Published: May 2010

Abstract
Infarction of the central nervous system secondary to embolism from left atrial myxoma is a recognized phenomenon. However, myxoma as the source of an embolus may be overlooked if an index of suspicion is not present during the evaluation of the patient with a stroke without a known cause. We present a case report that illustrates some of the pitfalls and characteristic findings present in the evaluation of these patients. The magnetic resonance image of multiple cerebral aneurysms and infarction associated with this condition is presented along with a unique, arteriographically proven resolution of a fusiform cerebral aneurysm after the removal of the cardiac tumor. A review of published case reports suggests that, if the cardiac tumor is recognized and treated quickly, the ultimate prognosis, while uncertain, is usually good. However, because the potential exists for recurrence of the cardiac tumor, for enlargement of the cerebral lesions, or for late development of cerebral lesions, long term follow-up is mandatory and a vigorous work-up must be pursued if the patient again becomes symptomatic or develops central nervous system manifestations for the first time.