bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sterile Abscesses in Glioma Patients Treated by Intraparenchymal Injection of Lymphokine-Activated Killer Cells and Recombinant Interleukin-2: Case Reports
Authors: Atkinson Lynn L. , Merchant Randall E. , Ghatak Nitya R. , Young Harold F. 
Published: April 2011

Abstract
Earlier, we conducted Phase I clinical trials to determine any acute toxicity of adoptive immunotherapy with intralesional injections of autologous lymphocytes expressing lymphokine-activated killer (LAK) activity and recombinant interleukin-2 (rIL-2) in patients with malignant glioma. Within six weeks of craniotomy and intralesional injection of autologous LAK cells plus rIL-2, 3 of 29 patients demonstrated a decline in clinical status and evidence on computed tomographic and magnetic resonance imaging scans of edema and mass of unknown character at the site of previous surgery and immunotherapy. Craniotomy was performed to remove the tissue and reduce intracranial pressure. Microscopic examination of the excised material indicated no new tumor growth within the resected mass, but rather that the tissue had the histological characteristics of a chronic sterile abscess including necrosis, fibrosis, and influx of inflammatory cells. Factors that may have contributed to this reaction in the 3 patients were age, Karnofsky score, the extent of tumor excision, and immune status. All 3 had also been treated with greater than average numbers of rIL-2 activated lymphocytes that demonstrated significant in vitro LAK activity. The results suggest that in patients whose clinical status is good and who are not immunosuppressed by corticosteroids, the dose-limiting toxicity of intraparenchymal immunotherapy with LAK cells plus rIL-2 for glioma may be related to the total, absolute number of activated cells injected, and this toxicity develops over time and is manifested by development of a sterile abscess.
Metastatic Small Cell Carcinoma to the Pineal Body: Case
Authors: Kashiwagi Shiro , Hatano Mitsunori , Yokoyama Tatsunori 
Published: April 2011

Abstract
A case of metastatic small cell carcinoma to the pineal body is reported and the clinical and radiological features of this rare tumor are discussed. A 66-year-old man presented with progressive dementia, gait disturbance, vertical gaze palsy. and convergence retraction nystagmus. Computed tomographic scan revealed a 2 × 3-cm high-density mass in the pineal region, which showed strong contrast enhancement. The tumor was resected through a right occipital transtentorial approach. The pathological diagnosis of the surgical specimens was small cell carcinoma. A systemic workup for the primary lesion subsequently revealed small cell carcinoma of the lung. Although occurring rarely, metastatic tumor should be considered in the differential diagnosis of pineal tumor in elderly patients.
A Modification of the Brown-Roberts-Wells Stereotactic Frame for Implantation of Ventricular Access Reservoirs
Authors: Frank Edmund , Kohler Erik , Hein Larry 
Published: April 2011

Abstract
A ventricular catheter and connected subcutaneous reservoir (ventricular access reservoir) allows easy, repeated access to the cerebrospinal fluid for a multitude of purposes. In situations in which the ventricles are small or displaced, insertion of a ventricular catheter may be difficult. Multiple passes to cannulate the ventricle may damage the brain and manipulation of the catheter and reservoir may cause migration of the catheter, possibly compromising its function. A stereotactic method for insertion of ventricular access reservoirs using a device that attaches to the Brown-Roberts-Wells stereotactic system has been developed. With this device the catheter and reservoir are guided into place as a single unit, utilizing a guide attached to the Brown-Roberts-Wells frame. This technique has been useful in inserting ventricular access reservoirs into patients with small ventricles or in whom there is some abnormality of the brain or skull that renders classical landmarks for ventricular cannulation useless.
Synchronous Vertebral Decompression and Posterior Stabilization in the Treatment of Spinal Malignancy
Authors: Johnston Francis G. , Uttley David , Marsh Henry T. 
Published: April 2011

Abstract
Thirty-four patients with metastatic tumors of the spinal column exhibiting vertebral collapse and posterior element disease were treated by a single-stage operation combining decompression of the vertebral body with posterior spinal instrumentation. Attention is drawn to the use of computed tomographic scanning in planning the operative approach. The indications for surgery were neurological deficit in 32 patients and pain in 2; 14 patients received preoperative radiotherapy. Of the 21 patients who were nonambulant preoperatively, 67% walked again, 21% regained sphincter control, and 68% had less pain. The surgical mortality was 12%; wound infection and dehiscence occurred in 15%. These results indicate that a single-stage decompression and posterior stabilization may improve neurological function dramatically in patients with malignant cord compression. The operative morbidity and mortality is comparable to that of laminectomy.
Reduced Size of a Hormonally Silent Pituitary Adenoma during Treatment with CV 205-502, a New Dopamine Agonist Mainly Stimulating D2 Receptors
Authors: Hedner Pavo , Valdemarsson Stig 
Published: April 2011

Abstract
A 39-year-old woman with secondary amenorrhea and visual field defects underwent craniotomy for a large pituitary tumor that was hormonally silent according to measurement of plasma hormone levels and immunohistochemical analysis. During the preoperative investigation, bromocriptine was administered for 1 month, but there was no change in the tumor size as seen on computed tomographic scans. One month after surgery, visual field defects recurred, and a tumor mass comparable to the preoperative state was found on computed tomographic scan. The tumor size gradually diminished during treatment with CV 205-502, a tricyclic benzoquinoline which stimulates mainly D2receptors and is better tolerated than bromocriptine. The visual fields were completely normalized after 3 months of treatment with the drug, and surgical management of the tumor mass was no longer considered to be necessary. Thus, as in many similar cases, the hormonally silent pituitary tumor in this patient proved unresponsive to bromocriptine treatment. In contrast. the tumor was reduced by therapy with CV 205-502, a drug that is better tolerated and might permit a more intense stimulation of D2receptors.
Transoral Stereotactic Biopsy of the Second Cervical Vertebral Body: Case Report with Technical Note
Authors: Patil Angelo A. 
Published: April 2011

Abstract
Although the transoral approach to the atlantoaxial region is generally an open surgical procedure, in patients in whom only tissue diagnosis is required, a needle biopsy can be done. In this paper a patient with a metastatic lesion in the second cervical vertebral body is presented, and the technique for needle biopsy of the second cervical body using stereotactic methods is described.
Craniocervical Stabilization Using Luque&sol;Hartshill Rectangles
Authors: MacKenzie Alasdair I. , Uttley David , Marsh Henry T. , Bell B. A. 
Published: April 2011

Abstract

Unteated craniocervical instability is associated with a high morbidity and a significant mortality. Existing methods using bone grafts, interlaminar wires, or acrylic eventually produce stability but require prolonged periods of immobility and have a high failure rate. The ideal method of fixation should provide for permanent correction of deformity and relief of symptoms, with immediate stabilization, at a single procedure. Posterior fixation of the occiput to a stable part of the cervical spine with a molded metal rectangle held in place by interlaminar wires was used to accomplish this. We report 20 patients treated consecutively who have undergone craniocervical fusion by this method using Luque/Hartshill rectangles. Fourteen patients had preexisting atlantoaxial instability and 6 had cord compression, but would become unstable after decompression. All operations were performed under general anesthesia; 9 patients (40%) were awake for intubation/positioning, and 7 patients had a simultaneous decompression. Sixteen patients made an uncomplicated recovery and became mobile 3 days postoperatively. Symptomatic and neurological improvement occurred in 70% of all patients. Neurological complications occurred in 4 patients (20%), reflecting the serious nature of the condition; 2 patients (10%) showed no change. Scrutiny of their presentations and operations failed to identify avoidable risk factors, except faulty wiring techniques. In all patients, permanent stabilization was achieved immediately, facilitating early mobilization with a real chance of improvement, which indicates that the method merits wider application. (Neurosurgery 26:32-36, 1990)
Combined Use of Subdural and Intracerebral Electrodes in Preoperative Evaluation of Epilepsy
Authors: van Veelen C. W. M. , Debets R. M. Chr. , van Huffelen A. C. , van Emde Boas W. , Binnie C. D. , van Leeuwen Storm W. , Velis D. N. , van Dieren A. 
Published: April 2011

Abstract

For intracranial recording of partial seizures considered to originate from one of the temporal or frontal lobes, the team in the Utrecht Academic Hospital has used subdural, multicontact, flexible electrodes since 1972. These are introduced through bilateral, frontocentral trephine holes and are manipulated under fluoroscopy to cover most of the cerebral convexity. It became evident that in many patients, additional placements to record from intracerebral structures were indispensable. Therefore, using the same trephine holes, an additional 2 to 4 depth electrodes were stereotactically implanted in the mesial temporal and/or frontal structures, as appropriate. An extensive intra- and extracerebral spatial representation of the epileptogenic zone was thus obtained. We report here the methods for manufacturing and applying these electrodes and our clinical experience with 28 patients. The results obtained so far stress the value of combining subdural and depth electroencephalographic monitoring in the presurgical selection of patients suffering from medically refractory complex partial seizures. By miniaturizing the electrodes, extensive areas of the brain can be investigated without craniotomy or multiple burr holes. (Neurosurgery 26:93-101, 1990)
Intraventricular Neurocytoma: A Report of Two Cases
Authors: Patil Angelo A. , McComb R. D. , Gelber B. , McConnell J. , Sasse S. 
Published: April 2011

Abstract

Intraventricular neurocytoma is a rare clincopathological entity that has been recently recognized. Previous reports have not described the magnetic resonance imaging findings of this tumor. This paper describes two patients with neurocytoma in which serpiginous flow voids and isointensity with cortex were distinctive features on the magnetic resonance imaging scan. Immunohistochemical studies showed reactivity for neuron-specific enolase, Leu-7, and S-100 protein. (Neurosurgery 26:140-144, 1990)
Middle Fossa Arachnoid Cyst Eroding into the Middle Ear: Case Report
Authors: Haworth Charles S. , Pobereskin Louis H. 
Published: April 2011

Abstract

We describe an unusual presentation of a large middle fossa cyst which eroded through the anterior petrous ridge into the middle ear. The significance of this and considerations related to its treatment are discussed. (Neurosurgery 26:154-155, 1990)
A Study of the Reactivity of Feeding Vessels to Arteriovenous Malformations: Correlation with Clinical Outcome
Authors: Muraszko Karin , Wang Hsueh Hwa , Pelton Gregory , Stein Bennett M. 
Published: April 2011

Abstract
Isolated segments from the feeding arteries to arteriovenous malformations (AVMs) from 24 patients were studied in vitro. In a perfusion chamber, isometric contraction of these arterial rings to various vasoactive substances was recorded and correlated with the following: spontaneous activity, spasm as seen in the operating room; radiographic evidence of ectasia preoperatively and postoperatively; and postoperative course. Of the 24 patients studied, four patients had nonreactive AVM nutrient vessels upon in vitro testing. In addition, these vessel segments displayed no spontaneous activity although all of the other vessels tested developed spontaneous activity while in the perfusion chamber. The patients with “unreactive vessels” had an increased incidence of postoperative edema and hemorrhage in the surrounding brain, consistent with the symptoms of normal perfusion pressure breakthrough. Thus, our study utilizes an in vitro technique to evaluate a specific segment of the AVM complex, the feeding vessel, which permitted us to assess abnormalities of reactivity in these vessel segments. This method may be useful for future evaluations of the pathophysiology of AVMs.
Transcranial Doppler Ultrasound as a Guide to Graded Therapeutic Occlusion of the Carotid Artery
Authors: Giller Cole A. , Steig Phillip , Batjer Hunt H. , Samson Duke , Purdy Phillip 
Published: April 2011

Abstract
Although gradual carotid artery occlusion is an accepted and effective treatment for some surgically inaccessible intracranial aneurysms, there are no specific guidelines to determine the optimal amount of carotid artery narrowing at each adjustment. The technique of transcranial Doppler ultrasound, however, allows continuous measurement of blood velocity in the middle cerebral artery as the carotid artery is narrowed, so that hemodynamic effects and development of collateral flow can be immediately assessed at the bedside at each adjustment of the carotid artery diameter. This case report describes the use of transcranial Doppler to guide the rate of carotid occlusion in a patient with an unclippable giant aneurysm of the carotid artery. Sudden carotid occlusion and gradual occlusion at the usual rate were not tolerated by the patient. but repeatedly tightening the clamp until the first signs of attenuation of the Doppler signal allowed an expedient occlusion without complication. Transcranial Doppler ultrasound can provide a useful dynamic guide to gradual therapeutic carotid occlusion.
Ruptured Aneurysm at the Origin of the Accessory Middle Cerebral Artery: Case Report
Authors: Kuwabara Satoshi , Naitoh Hiroki 
Published: April 2011

Abstract
The accessory middle cerebral artery is a rare vascular anomaly of the brain. We describe a case of a ruptured aneurysm at the junction of the accessory middle cerebral artery and the horizontal portion of the anterior cerebral artery. The lesion was demonstrated by angiography and confirmed at surgery. No perforating arteries arising from this accessory artery were found. There have been only four previous reports of aneurysms located at the origin of the accessory middle cerebral artery. The relevant literature is briefly reviewed.
Arterial Graft Reconstruction in an Aneurysm of the Middle Cerebral Artery
Authors: Ramina Ricardo , Arruda Walter O. , Prestes Antonio C. F. , Parolin Monica K. F. , Teive Helio G. , Meneses Murilo S. 
Published: April 2011

Abstract
A case of a large aneurysm of the middle cerebral artery that was treated by resection of the aneurysm sac and reconstruction of the vessel is presented. The middle cerebral artery was reconstructed using a graft from the superficial temporal artery (STA). Cerebral vessel reconstructions are usually carried out with veins as grafts. This paper shows the possibility of using the STA as a graft. When a vessel reconstruction is contemplated, the skin flap should be planned in order to save the STA.
Adrenal Medulla Transplantation into the Putamen in Parkinson's Disease
Authors: Takeuchi Juji , Takebe Yoshihiro , Sakakura Tadashi , Hara Yasushi , Yasuda Takanari , Imai Terukuni 
Published: April 2011

Abstract
Autologous adrenal medulla was transplanted into the putamen of a patient with severe Parkinson's disease. After the operation, the patient's akinesia and rigidity decreased and the duration of action of L-dopa treatment was prolonged. The effect lasted for only 6 months, however, following which the patient's condition gradually began to deteriorate again, returning to the preoperative state by 12 months after surgery. This paper discusses possible reasons why the effect was only temporary.
Diffuse Idiopathic Skeletal Hyperostosis Causing Acute Thoracic Myelopathy: A Case Report and Discussion
Authors: Reisner Andrew , Stiles Richard G. , Tindall Suzie C. 
Published: April 2011

Abstract
A case of diffuse idiopathic skeletal hyperostosis presenting as acute thoracic myelopathy is reported. Diffuse idiopathic skeletal hyperostosis has long been regarded as a radiological entity with an innocuous clinical course. The manifestations of this disease are reviewed. There is mounting evidence that it is neither a clinically infrequent nor, as this case report illustrates, an exclusively benign condition.
Pseudopsychopathic Syndrome in Hydrocephalus: A Case Report and Review
Authors: Bowen Matthew , Verma Arun , Bajwa Saeed , Kusmirek Leslie 
Published: April 2011

Abstract
A 24-year-old man with a head injury developed a communicating hydrocephalus and underwent ventriculoperitoneal shunting. A revision was required, and the patient emerged from coma with severe behavior outbursts, which persisted for more than 1 year. Computed tomographic scans indicated a recurrence of low-pressure communicating hydrocephalus and a shunt revision was performed. The patient's severe behavior outbursts immediately decreased dramatically, The improvement continued long term and extended beyond the acute rehabilitation program.
Decompression of Lumbar Spinal Stenosis and Stabilization with Knodt Rods in the Elderly Patient
Authors: Conley Frances K. , Cady Carol T. , Lieberson Robert E. 
Published: April 2011

Abstract
We present a series of 25 elderly patients who exhibited signs and symptoms of neurogenic claudication and who were found to have one or two levels of spinal stenosis. At the time of decompressive surgery, excessive movement was found at the stenotic levels, so a simple stabilization procedure was performed using Knodt rods and a facet fusion. The expectation was that spine fixation would decrease the amount of postoperative back pain, which can be a result of continued abnormal mobility. All of the patients have been followed for 2 or more years. This elderly group of individuals tolerated surgery well, and long-term results were good.
Magnetic Resonance Imaging of a Fat Embolism of the Brain: Case Report
Authors: Saito Atsushi , Meguro Kotoo , Matsumura Akira , Komatsu Yoji , Oohashi Noriyoshi 
Published: April 2011

Abstract
A 22-year-old man developed fat embolism syndrome. Although a computed tomographic (CT) scan of the brain showed nothing abnormal, a magnetic resonance imaging scan detected scattered spotty areas of low intensity on T1-weighted images and of high intensity on T2-weighted images. Magnetic resonance imaging is thought to be more sensitive than computed tomography in detecting cerebral fat embolism syndrome and correlates well with the clinical course.
Treatment of Carotid-Cavernous Fistulas Associated with Ehlers-Danlos Syndrome
Authors: Halbach Van V. , Higashida Randall T. , Dowd Christopher F. , Barnwell Stanley L. , Hieshima Grant B. 
Published: April 2011

Abstract
Four patients with Ehlers-Danlos syndrome presented spontaneously with symptomatic direct carotid-cavernous fistulas. Two had previously (2 and 15 years, respectively) had contralateral carotid-cavernous fistulas that were treated with carotid occlusion procedures. The patients' ages at presentation ranged from 19 to 49 years, with a mean of 32 years. All four patients underwent attempted embolization procedures. Two patients had transarterial embolization, one with balloons and liquid adhesives, one with platinum coils and a balloon; the carotid artery was preserved in one and sacrificed in one other. In one patient, who underwent direct puncture of the carotid artery, a massive hematoma causing airway compromise required intubation and emergent surgical repair, The fistula spontaneously closed during this event. In the fourth patient, two transvenous embolizations resulted in markedly decreased flow, but diversion of residual flow to cortical veins produced a fatal pontine hemorrhage. The vascular fragility associated with Ehlers-Danlos syndrome can produce spontaneous direct carotid-cavernous fistulas and makes both diagnostic and therapeutic procedures more difficult.
Tumors of the Lateral Ventricular Wall, Especially the Septum Pellucidum: Clinical Presentation and Variations in Pathological Features
Authors: Nishio Shunji , Fujiwara Shigeru , Tashima Takatoshi , Takeshita Iwao , Fujii Kiyotaka , Fukui Masashi 
Published: April 2011

Abstract
The clinical and histopathological features of 19 patients with tumors involving the septum pellucidum are presented. These tumors predominantly affected young adults, and the clinical manifestations were usually the results of raised intracranial pressure related to obstructive hydrocephalus, mental abnormality, epileptic seizures, or a combination of these. Seventeen of the tumors grew mainly in the lateral and third ventricles, and the other 2 grew both into the lateral ventricle and the cerebral parenchyma. The direction of cellular differentiation of the tumor cells varied from patient to patient and consisted of 8 neurocytomas, 1 mature neuronal tumor with ganglionic and small round neuronal cells, 3 subependymomas, 3 subependymal giant cell astrocytomas, 2 pilocytic astrocytomas, 1 malignant astrocytoma, and 1 teratoma with embryonal carcinoma. These tumors were considered to have arisen from the multipotential cells in the subependymal plate or germ cell rests in the lateral ventricular wall, especially in the septum pellucidum. Because of the relatively inert biological behavior and histological features of most of these tumors, we favor the malformative theory of their origin. Either total or an extensive excision of the tumors in this series, which had developed mainly in the ventricular system, provided long-term survival in many cases.
Epidural Abscess after Spinal Anesthesia: A Favorable Outcome
Authors: Abdel-Magid Roshdy A. , Kotb Hassan I. M. 
Published: April 2011

Abstract
A case of lumbar epidural abscess after spinal anesthesia with sciatica and sphincteric disturbance is presented. The case was investigated by myelography and diagnosed after exploration, resulting in dramatic improvement.
Symptomatic Pineal Cyst: Case Report
Authors: Maurer Paul Kurt , Ecklund James , Parisi Joseph E. , Ondra Stephen 
Published: April 2011

Abstract
Pineal cysts are being described with increasing frequency since the advent of magnetic resonance imaging. Although pineal cysts are incidental findings in as many as 4% of magnetic resonance imaging studies, symptomatic pineal cysts are quite rare. We present a case of pineal cyst causing aqueductal obstruction with symptomatic hydrocephalus and resultant headache and syncope, which was treated by surgical resection. A review of the relevant literature and discussion follow.
Cranial Vault and Gigantic Intracranial Hydatid Cyst in a Young Woman
Authors: Negovetic Lucijan , Lupret Velimir , Smiljanic Danko , Arsenic Boris 
Published: April 2011

Abstract
The case of a young woman (20 years) with a gigantic intracranial hydatid cyst (110 × 90 × 65 mm) is presented. The first manifestation was a grand mal seizure followed by symptoms of raised intracranial pressure. The origin of the cyst was in the diploe of the right check frontal, temporal, and parietal bones. An osteoplastic craniotomy was performed, and more than 100 fertile daughter cysts were removed, together with the wall of the cyst. A modification in the standard operative procedure is proposed for gigantic cysts that emerge from the diploe of the cranial vault and extend intracranially. Therapy with dexamethasone and phenobarbital was instituted preoperatively and continued postoperatively. The 3-month follow-up showed no relapse.