bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microsurgical Endarterectomy of the Intracranial Vertebral Artery for Vertebrobasilar Transient Ischemic Attacks
Authors: Allen George S. , Cohen Ronald J. , Preziosi Thomas J. 
Published: May 2010

Abstract
Two patients who had typical vertebrobasilar transient ischemic attacks (TIAs) that were refractory to anticoagulation with dicumarol and to antiplatelet therapy with aspirin and/or dipyridamole are described. Angiography revealed in both patients a stenotic atherosclerotic plaque of the intracranial vertebral artery between the posterior and anterior inferior cerebellar arteries. At operation, the first patient had an atherosclerotic plaque extending into the basilar artery, and no endarterectomy was attempted. The second patient had a 1-cm localized plaque that was removed successfully from the vertebral artery. Neither patient sustained a neurological deficit as a result of the operation. The patient whose plaque was not removed at operation continues to have vertebrobasilar TIAs and suffered a brain stem stroke 2 weeks after operation. The patient whose plaque was removed at operation continues to be free of TIAs 8 months later, and angiography performed 3 months after operation showed a widely patent vertebral artery. A portion of the intracranial vertebral artery has now been shown to be accessible to endarterectomy using the operating microscope. Angiography is helpful in determining this accessibility preoperatively.
Intraneural Ganglion
Authors: Scherman Brian M. , Bilbao Juan M. , Hudson Alan R. , Briggs Sandra J. 
Published: May 2010

Abstract
We report a case of common peroneal mononeuropathy caused by an intraneural ganglion in a 9-year-old boy. The mass and the contiguous nerve fascicles were excised under the operating microscope. Histologically, the cyst wall was composed of layers of elongated cells merging with fascicles that exhibited changes suggestive of a pressure-ischemia effect. Electron microscopy showed that the cells forming the cyst wall were myofibroblasts, similar to the cells found in ganglia arising from joints elsewhere in the body. A review of the English literature on intraneural ganglia discloses 44 additional cases, of which 86% involved the common peroneal nerve. The most common clinical feature was motor dysfunction (followed by pain, sensory loss, and the presence of a palpable mass), and a significant male predominance is noted. The pathogenesis of this nerve lesion is discussed in light of our findings.
Primary Meningeal Myxochondrosarcoma Presenting as a Cerebellar Mass
Authors: Smith Thomas W. , Davidson Robin I. 
Published: May 2010

Abstract
This report describes a malignant cartilagenous tumor that originated from the dura at the base of the skull near the foramen magnum and presented as an intracerebellar mass in a 12-year-old boy. The histopathology of the tumor was confusing because of its prominent myxoid stroma and lack of well-defined cartilage. The presence of sulfated mucopolysaccharides in the matrix and the ultrastructural characteristics of the tumor cells established the cartilagenous nature of the neoplasm.
Craniopharyngioma
Authors: Lipper Maurice H. , Kishore Pulla R. S. , Ward John D. 
Published: May 2010

abstract
Craniopharyngioma usually presents on a computed tomographic (CT) scan as a hypodense or isodense lesion, with calcification, in the suprasellar region. A case with atypical CT findings of a huge, homogeneous, high density, apparently solid, lobulated suprasellar mass is presented. An explanation for the appearance of the tumor is discussed based upon clinical analysis of the tumor contents.
Overall Management of Ruptured Aneurysm
Authors: Kassell Neal F. , Boarini David J. , Adams Harold P. , Sahs Adolph L. , Graf Carl J. , Torner James C. , Gerk Mary K. 
Published: May 2010

Abstract
The overall management results with 61 consecutive patients admitted within 3 days of subarachnoid hemorrhage from a ruptured intracranial aneurysm were analyzed. During the course of this study, the preferred method of management shifted from late surgery (planned at least 7 days after the last hemorrhage) to early surgery (within 4 days of the last hemorrhage). Ten moribund patients were excluded from analysis, leaving 24 in the late group and 27 in the early group. Both groups had comparable patient demographic characteristics and neurological conditions, and their care was supervised by one neurosurgeon (N.F.K.). A microsurgical intracranial operation was performed on all patients who survived long enough to have surgery, The intraoperative conditions and complications were similar for the two groups. The average length of follow-up was 11 months in the late and 9 months in the early group. The overall management results for the late group showed a 42% favorable outcome, a 17% unfavorable outcome, and a 42% mortality. The early group had an 81% favorable outcome, a 7% unfavorable outcome, and an 11% mortality. Patients in both good and poor conditions fared better in the early group. Seven late group patients rebled, compared to none in the early group. The number of medical complications, the length of hospitalization, and the occurrence of symptomatic vasospasm were all greater in the late group. Vasospasm in the early group occurred only postoperatively and, with the aneurysms secured, was treated more aggressively and successfully with hypertensive/hypervolemic therapy than the predominantly preoperative vasospasm in the late group.
Cerebellar Hemorrhage Complicating Cervical Laminectomy
Authors: Chadduck William M. 
Published: May 2010

Abstract
A case of cerebellar hemorrhage complicating the postoperative course of a patient who had undergone a cervical laminectomy in the sitting position is presented. The drop in cerebrospinal fluid pressure accompanying the procedure is thought to have had some role in the development of the hemorrhage.
Primary Osteogenic Sarcoma of the Skull
Authors: Wang Y. C. , Shih C. J. , Leu F. J. , Tu Y. C. 
Published: May 2010

Abstract
A young man suffered from a tumor mass in the skull, which proved to be a rare case of primary osteogenic sarcoma. The histological findings obtained at autopsy showed metastatic lesions in the lungs, left diaphragm, and other areas. The diagnosis, treatment, and autopsy findings of this case are presented.
Microsurgical Treatment of Intractable Hemifacial Spasm
Authors: Yeh Hwa-Shain , Tew John M. , Ramirez Rafael M. 
Published: May 2010

Abstract
Ten patients with intractable hemifacial spasm were treated by posterior fossa exploration and microsurgical technique. These patients have been followed 1 to 5 years. The spasmodic motor disorder was related to compression of the 7th nerve or its exit zone at the brain stem by a dolichoectatic anterior inferior cerebellar artery in eight patients and to kinking and ectasia of the basilar or vertebral artery in two patients. In five patients. There were prominent arachnoidal adhesions in the cerebellopontinc angle, and an arachnoid cyst was a component of the lesion in another patient. Additional conditions associated with hemifacial spasm in cluded geniculate neuraligia, facial paresis, vertigo, hearing loss, and trigeminal neuralgia. The surgical morbidity and postoperative results are discussed
New Options for the Microsurgeon
Authors: Greenberg I. M. 
Published: May 2010

Abstract
Using the Greenberg universal retraction system, a single surgeon can control four or more microinstruments simultaneously in a single microsurgical field. By decreasing the number of hand movements heretofore required and by increasing the surgeon' biotechnological options, the entire microsurgical procedure becomes more efficient and more economical, maximizing the surgeon' capabilities and performance.
Odontoid Fracture
Authors: Ekong Chris E. U. , Schwartz Michael L. , Tator Charles H. , Rowed David W. , Edmonds Virginia E. 
Published: May 2010

Abstract
Twenty-two patients with C-2 fractures involving the odontoid process were treated by immobilization in a halo device. Six had associated spinal cord injury (1 complete and 5 incomplete), and 16 had no spinal cord injury. The age of the patients ranged from 20 to 86 years, with a mean age of 53. There were 15 cases in which the fracture line went through the base of the odontoid process only (Type 2), 1 case with a Type 2 odontoid fracture associated with a Jefferson fracture, 4 in which the fracture line involved the body of C-2 (Type 3), and 2 cases with a Type 3 odontoid fracture associated with a Jefferson fracture. Eighteen of the patients were followed for at least 6 months (the mean follow-up period was approximately 2/12; years) to determine the results of bony fusion and neurological improvement. Three patients died early: 1 had no spinal cord injury and died of an associated head injury; 2 had spinal cord injuries and died of respiratory failure. One was lost to follow-up. Successful bony healing and stability at the fracture site as indicated by flexion and extension roentgenograms of the cervical spine were achieved in 10 (59%) of 17 patients treated with the halo ring and vest only. Early fusion was required in 1 patient, and late fusion was required in 5 patients. The remaining 2 patients refused operation. Improvement in neurological status was noted in all four surviving patients with spinal cord injury. and none of the patients without spinal cord injury developed a neurological deficit during the course of the halo treatment. The average duration of hospitalization was 27 days for those without spinal cord injury and 70 days for those with spinal cord injury. Complications related directly to the halo devices were few and minor and included scalp infection, pressure sores, loosening of the halo pins, and 1 case of osteomyelitis of the skull. We found that the halo device is useful for immobilizing the cervical spine even in the presence of diminished sensation over the trunk. Except for the presence of certain types of coexisting head injury, an absolute contraindication to its use has not been encountered. The major advantage of the halo vest is that it allows external maneuvering of bony injuries in all three planes followed by fixation when acceptable reduction is attained without the need for early operation in patients who may already be very ill. The halo vest also allows early mobilization of patients and early discharge from the hospital.
Treatment of Trigeminal Neuralgia and Other Facial Pains by Retrogasserian Injection of Glycerol
Authors: Sweet William H. , Polelti Charles K. , Maeon James B. 
Published: May 2010

Abstract
Håkanson's treatment of trigeminal neuralgia by injecting 0.2 to 0.4 ml of glycerol into the cerebrospinal fluid in Meckel's cave was carried out in 27 patients with trigeminal neuralgia, 3 with atypical facial neuralgia, and 1 with post-traumatic facial neuralgia. Minor modifications of his technique are described based on our finding of a greater pain and sensory loss upon injection than he noted. We present evidence that glycerol is more toxic than its cryoprotectant effect would intimate and that it selectively eliminates those components of the compound action potential in the trigeminal rootlets customarily associated with pain. We conclude that the method is probably going to be an improvement over radiofrequency heating for the treatment of trigeminal neuralgia in many situations.
Photoradiation Therapy in the Treatment of Malignant Brain Tumors
Authors: Laws Edward R. , Cortese Dennis A. , Kinsey James H. , Lagan Robert T. , Anderson Robert L. 
Published: May 2010

Abstract
Hematoporphyrin derivative accumulates in malignant brain tumors and, when activated by light, can produce a cytotoxic reaction. A system for utilizing this concept in the treatment of human malignant brain tumors has been developed and tested in a small series of patients. No significant adverse reactions have occurred, and further development and research are planned.
Sacral Fracture
Authors: Weaver Edgar N. , England George D. , Richardson Donald E. 
Published: May 2010

Abstract
Sacral fractures are either transverse or longitudinal (vertical). Transverse fractures may be isolated and can be subdivided into two types. Upper transverse fractures occur in younger people and result from severe traumatic flexion of the upper body on the fixed pelvis. Lower transverse fractures result from a hard blow to the coccyx, as in a fall. Vertical fractures are essentially never isolated, always being associated with an anterior break in the pelvic ring. These result from extreme forces transmitted through the ilium. Any of these fractures can cause injury to neural elements, and surgical decompression may be indicated in certain of the transverse types.
Occipital Artery to Posterior Inferior Cerebellar Artery Bypass for Vertebrobasilar Ischemia
Authors: Roski Richard A. , Spetzler Robert F. , Hopkins Leo N. 
Published: May 2010

Abstract
Fourteen patients who underwent occipital to posterior inferior cerebellar arterial bypass are reviewed. All of the patients were treated for severe vertebrobasilar ischemia secondary to lesions of the distal vertebral artery. There was no operative death or permanent postoperative morbidity. On follow-up evaluation (averaging 13 months after operation), there has been 100% graft patency and a noticeable improvement in the neurological function in all patients. Operating with the patient in the prone position and avoiding intraoperative hypotension help to minimize the operative morbidity from this procedure.
Intraventricular Cerebrospinal Fluid Antibiotic Concentrations in Patients with Intraventricular Infections
Authors: James H. E. , Wilson H. D. , Connor J. D. , Walsh J. W. 
Published: May 2010

Abstract
The antibiotic concentration of the fluid from either lateral ventricle was determined 104 times in 37 patients through direct ventricular puncture, external ventricular drainage (EVD). or cerebrospinal fluid shunt sampling. The patients were 1 month to 12 years old. When the patients were receiving maximal intravenous antibiotic therapy alone, the concentrations for the most part were below 5 μg/ml. whereas patients receiving an antibiotic through direct ventricular puncture, EVD. or a shunt reservoir usually had concentrations over 5 μ/ml. However, wide variations from patient to patient were found with all forms of treatment despite similar dosages. Clustering of the concentration tended to occur in each individual patient. The authors conclude that, to obtain a high concentration of an antibiotic in the ventricular fluid, one should administer it directly into the ventricle.
Aneurysmal Bone Cyst of the Cervical Spine
Authors: Bret Philippe , Confavreux Christian , Thouard Hervé , Pialat Jean 
Published: May 2010

Abstract
The authors report the case of a 62-year-old woman with an aneurysmal bone cyst of the cervical spine. The patient presented with a progressive tetraparesis. Cervical computed tomographic scanning revealed a mass involving three contiguous vertebral bodies. The patient underwent two consecutive surgical procedures: (a) laminectomy and metallic plate osteosynthesis and (b) an anterior approach for curettage of the cyst and autologous grafting. Twelve months after operation, the patient was given a course of radiation therapy in the cervical area. She was found to be asymptomatic at the 20-month follow-up examination. The authors discuss the etiological, anatomical, and radiological features of vertebral aneurysmal bone cysts and evaluate treatment methods.
Extraneural Metastasis of Cerebellar Glioblastoma Multiforme
Authors: Pang Dachling , Ashmead Josephine W. 
Published: May 2010

Abstract
The first case of glioblastoma multiforme of the cerebellum with extraneural metastasis is presented, and the literature on the postoperative extraneural spread of neuroectodermal tumors is reviewed. It is thought that an open dura mater at the operative site increases the contact of tumor cells with extrameningeal tissues, where lymphatic and vascular invasion can take place. Every effort should be made to close the posterior fossa dura mater after resection of a malignant neoplasm.
Computed Tomography in Pott's Disease
Authors: Gropper Gary R. , Acker James D. , Robertson Jon H. 
Published: May 2010

Abstract
Computed tomography (CT) has become increasingly useful in diagnosing various disorders of the spine. However, the value of CT in infectious disease of the spine must be defined. A case of Pott's disease with CT demonstration of associated bony and soft tissue changes is presented.
Reversible Panhypopituitarism Caused by a Suprasellar Aneurysm
Authors: Verbalis Joseph G. , Nelson Paul B. , Robinson Alan G. 
Published: May 2010

Abstract
A case of panhypopituitarism and hyperprolactinemia caused by a giant intracranial aneurysm is presented. The case is unique because both the pattern of the pituitary dysfunction and the complete normalization of all pituitary function after decompression of the aneurysm demonstrate the importance of pure compressive effects of mass lesions on pituitary function. The literature regarding return of pituitary function after resection of sellar and suprasellar masses is reviewed, and a schema for classification of pituitary dysfunction caused by mass lesions is proposed.
Familial Primary Nervous System Neoplasms in Three Generations
Authors: Wald Steven L. , Liwnicz Boleslaw H. , Truman Thomas A. , Khodadad Ghahreman 
Published: May 2010

Abstract
A familial cluster of primary nervous system tumors is described. Four members of the same family in three generations developed central nervous system tumors: two glioblastomas, a craniopharyngioma, and a spinal cord tumor.
Post-traumatic Spinal Epidural Hematoma
Authors: Foo Dominic , Rossier Alain B. 
Published: May 2010

Abstract
Five patients with vertebral fracture and spinal epidural hematoma (SEH) are described. Another 58-year-old man developed a post-traumatic SEH without bony damage. From the literature, 38 patients (31 male, 4 female, and 3 unknown) were collected. Ankylosing spondylitis or rheumatoid arthritis was noted in 9 of 12 subjects between 50 and 75 years of age. Two groups of patients were identified: Group 1—16 patients with spinal fracture (aged 23 to 63 years), and Group 2—22 patients without spinal fracture (the age was less than 18 years in 12 subjects). In Group 2, a coagulation defect or spinal epidural vascular malformation resulted in a SEH in 6 patients. The preoperative myelopathy was complete in 3 patients each from Group 1 (23.1%) and Group 2 (16.7%). Of the 31 patients operated upon, 9 of the 13 from Group 1 (69.3%) and 6 of the 18 from Group 2 (33.3%) underwent laminectomy within I week after the onset of symptoms. Postoperative neurological return was observed in 38.5% (5 of 13) and 88.9% (16 of 18) of these two groups of patients, respectively. Post-traumatic SEHs, predominant in the male population, are often associated with vertebral disease in elderly patients. In the very young patient, there is usually no fracture/dislocation of the spine. A predisposing lesion may be present when spinal fracture is not evident. The prognosis after surgical intervention is better in patients without spinal fracture than in those with vertebral damage, probably because of less contusion to the spinal cord and the presence of very young subjects in the former group of patients.
Central Nervous System Involvement in the Nevoid Basal Cell Carcinoma Syndrome: Case Report and Review of the Literature
Authors: Naguib Mahmoud G. , Sung Joo Ho , Erickson Donald L. , Gold Lawrence H. A. , Seljeskog Edward L. 
Published: May 2010

Abstract
The characteristic features of central nervous system involvement in the nevoid basal cell carcinoma syndrome are reviewed. Emphasis is given to the frequent association of medulloblastoma with the syndrome.
Solitary Cerebral Metastasis: The Effect of Craniotomy on the Quality and the Duration of Survival
Authors: Chan Richard C. , Steinbok Paul 
Published: May 2010

Abstract
The authors report 57 patients in whom craniotomies for solitary intracranial metastatic tumor were performed in Vancouver General Hospital between 1970 and 1980. The median survival after craniotomy varied between 3.5 and 10 months depending upon the types of primary tumors. Patients with metastatic central nervous system (CNS) tumor from breast, kidney, or an unknown primary site had longer periods of survival than those with bronchogenic carcinoma. The outcome for metastatic melanoma was poor. Eighty-two per cent of the patients were able to enjoy home life and were self-dependent at the time of discharge from the hospital. A long latent interval between the primary tumor diagnosis and secondary CNS metastasis favored longer survival for patients with bronchogenic carcinoma, but not for those with melanoma. The presence of systemic metastases was an adverse factor. There was no significant difference in the duration of survival between patients with right- or left-sided cerebral lesions, but those with right hemispheric involvement had a better quality of survival. The use of computed tomographic scanning improved both the duration and the quality of postoperative survival.
Chondromyxoid Fibroma of the Cervical Spine—a Case Report with a Review of the Literature and a Description of an Operative Approach to the Lower Anterior Cervical Spine
Authors: Standefer Michael , Hardy Russell W. , Marks Kenneth , Cosgrove D. M. 
Published: May 2010

Abstract
A case of chondromyxoid fibroma arising from the C-7 vertebral body and involving the epidural space and paraspinal soft tissues is presented. The surgical treatment of this tumor is described, and the pertinent literature is reviewed.
Recurrence of Cerebral Aneurysm after Initial Neck Clipping
Authors: Ebina Kunihiko , Suzuki Mikio , Andoh Akira , Saitoh Kazuko , Iwabuchi Takashi 
Published: May 2010

Abstract
Neck clipping has generally been believed to be among the most reliable of the operative modalities for cerebral aneurysm. However, recurrences with catastrophic outcome have been known to occur. We recently treated two patients who each had a new aneurysm at the site of the initial clipping. In both cases, the recurrence was found several years after the aneurysm neck had been closed successfully with a silver clip, which had been confirmed by intraoperative inspection and by postoperative angiographic studies demonstrating disappearance of the aneurysm. Histological examination of the recurrent aneurysm showed that the arterial wall had apparently been damaged by the clip edge, which resulted in thinning and disruption of both the muscle layer and the internal elastic lamina. Therefore, local fragility of the arterial wall adjacent to the aneurysm seems to have been the cause of the formation of a new aneurysm. The need to reinforce the thin-walled parent artery and the usefulness of high resolution computed tomography for the early detection of recurrent aneurysms are emphasized.
Spontaneous Regression of Arteriovenous Malformations
Authors: Nehls Daniel G. , Pittman Hal W. 
Published: May 2010

Abstract
Spontaneous regression of an arteriovenous malformation (AVM) is quite rare. When a regression does occur, there is usually an associated factor, such as intracranial hemorrhage, operation, radiation therapy, or new neurological deficit. Twenty-one cases of AVM regression identified in the literature are reviewed. An additional case in which the resolution was totally spontaneous is presented. Regressions occurred over intervals ranging from 7 months to 21 years. Several mechanisms for regression are discussed.
Traumatic Ophthalmic Fistula Simulating Carotid-Cavernous Fistula
Authors: Freitas Miguel A. L. , Filho Cyro A.B. , Lima Ranulfo , Marchiori Edson 
Published: May 2010

Abstract
In a patient with a penetrating lesion of the right orbit with proptosis and a bruit in this region, carotid angiography revealed an ophthalmic fistula between the ophthalmic artery and the superior ophthalmic vein. Three days after admission, the symptoms disappeared, and repeat angiography showed the spontaneous thrombosis of the fistula.