bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monitoring of Cortical Somatosensory Evoked Potentials to Determine the Safety of Sacrificing the Anterior Cerebral Artery
Authors: Grundy Betty L. , Nelson Paul B. , Lina Agnes , Heros Roberto C. 
Published: May 2010

Abstract
Cortical somatosensory evoked potentials (SSEPs) reflect the functional integrity of somatosensory pathways from the site of stimulation to the primary somatosensory cortex. We used intraoperative monitoring of cortical SSEPs to determine whether the right anterior cerebral artery (RACA), the major feeding vessel of a large arteriovenous malformation (AVM), could be sacrificed without compromising sensorimotor function in the left lower extremity. The SSEPs recorded after test occlusion of the RACA showed preservation of the initial cortical positivity, and the RACA was divided. The AVM was excised completely, and the patient suffered no neurological deficit.
Overall Management of Vascular Lesions Considered Treatable with Extracranial-Intracranial Bypass: Part 1
Authors: Heilbrun Peter M. 
Published: May 2010

Abstract
From 1973 to 1979, 49 patients with internal carotid occlusion were evaluated and treated. Eighteen of 49 (37%) presented with transient ischemic attack/prolonged reversible ischemic neurological deficit, 14 of 49 (29%) presented with mild completed stroke, 13 of 49 (27%) presented with severe completed stroke, and 4 of 49 (8%) were asymptomatic. Surgical treatment consisting of extracranial-intracranial (EC-IC) bypass, internal carotid stump reconstruction and endarterectomy to open the occlusion, contralateral endarterectomy for carotid stenosis opposite the occlusion, and iatrogenic carotid occlusion with EC-IC bypass was carried out on 22 (45%) patients considered at risk for ischemia based on angiographic evidence of poor collateral circulation and potential sources of emboli. Medical treatment consisting of anticoagulants or anti-platelet aggregation agents was used in 27 (55%) patients with good collateral circulation. By 6 weeks after the initiation of treatment, 10 of 49 (20%) reached end points of new strokes and death. By an average of 3 years after treatment began, 30 of 49 (61%) reached the same end points. The results suggest that new ischemic events in the distribution of the occluded carotid artery occur infrequently if the angiographic study shows adequate collateral circulation to the ischemic territory at risk. Surgical revascularization should be reserved for patients with (a) recurrent ischemic events after the diagnosis of carotid occlusion or (b) poor collateral circulation.
Cutaneous Implantation Metastasis Complicating a Superficial Temporal-Middle Cerebral Artery Anastomosis
Authors: Salzman Richard S. , Bennett Richard G. , Fleischer Alan S. 
Published: May 2010

Abstract
A 52-year-old patient who underwent a superficial temporal-middle cerebral artery anastomosis subsequently developed an unusual squamous cell carcinoma in the skin overlying the anastomosis. The pathological picture and course of events suggest that this tumor was implanted into deeper tissues at the time of operation. Systematic microscopically controlled operation (Mohs' chemosurgical technique) was required to preserve the anastomosis while completely extirpating the tumor.
Giant Serpentine Aneurysm of the Posterior Cerebral Artery
Authors: Fukamachi Akira , Hirato Masabumi , Wakao Tetsuo , Kawafuchi Jun-ichi 
Published: May 2010

Abstract
We are reporting an unusual case of a giant serpentine aneurysm of the posterior cerebral artery (PCA). We were unable to find a report in the literature of a similar aneurysm. The microsurgical pterional approach was used for temporary clipping of the P-2 segment of the PCA, and the aneurysm was trapped successfully and excised. The discussion includes the operative approach to the giant serpentine aneurysm.
Technical note: Flow Sheet for the Neurosurgical Intensive Care Unit
Authors: Clifton Guy L. , Grossman Robert G. 
Published: May 2010

Abstract
With the rapid expansion of knowledge and techniques for the care of critically ill patients, the organization and recording of data have become increasingly complex and increasingly important for patient care. A flow sheet for the Neurosurgical Intensive Care Unit has been developed in a series of pilot studies with input from general and cardiovascular surgeons and nurses specializing in critical care medicine.
Treatment of Ischemic Deficits from Vasospasm with Intravascular Volume Expansion and Induced Arterial Hypertension
Authors: Kassell Neal F. , Peerless Sydney J. , Durward Quentin J. , Beck David W. , Drake Charles G. , Adams Harold P. 
Published: May 2010

Abstract
In 58 patients with progressive neurological deterioration from angiographically confirmed cerebral vasospasm after spontaneous subarachnoid hemorrhage, arterial hypertension was induced in an attempt to improve their deficits. The most effective regimen consisted of intravascular volume expansion, blockade of the vagal depressor response, and the administration of antidiuretics and vasopressor agents. With this protocol, arterial blood pressure could be sustained at high levels for prolonged periods. Neurological deterioration was reversed in 47 patients, transiently in 4: permanent improvement occurred in 43. Complications experienced during therapy included pulmonary edema, dilutional hyponatremia, aneurysmal rebleeding, coagulopathy, hemothorax, and myocardial infarction. Elevating systemic arterial pressure in states of cerebrovascular insufficiency resulting from vasospasm is safe if meticulous attention is paid to physiological, biochemical, and hematological parameters, with the exception that it may be hazardous in the presence of an untreated ruptured or intact aneurysm. Intravascular volume expansion and induced hypertension are effective in reversing ischemic deficits from vasospasm provided that treatment commences before cerebral infarction and that adequate pressures are maintained for a sufficient period. The production of a hypervolemic state by the use of colloid and crystalloid infusion accompanied by atropine blockade of the vagal depressor response and blunting of the diuresis with vasopressin enables arterial pressure to be elevated for longer than 1 week.
Spontaneous Cerebrospinal Fluid Otorrhea in Association with a Congenital Defect of the Cochlear Aqueduct and Mondini Dysplasia
Authors: Park Tae Sung , Hoffman Harold J. , Humphreys Robin P. , Chuang Sylvester H. 
Published: May 2010

Abstract
Unrecognized spontaneous cerebrospinal fluid (CSF) otorrhea led to recurrent bacterial meningitis in three children. The underlying cause of the spontaneous CSF otorrhea was proved to be a congenital cystic dilatation of the cochlear aqueduct and Mondini dysplasia of the temporal bone. The CSF leak recurred in all patients after an initial surgical attempt to close the defects through a tympanotomy. A suboccipital approach was used successfully to obliterate the CSF fistulas in two children; a translabyrinthine approach was used in the other. A search of the literature revealed that Mondini dysplasia is a congenital anomaly that can commonly cause spontaneous CSF otorrhea in children. The authors discuss the management of this uncommon entity on the basis of a literature review and their own experience.
Intracranial Epidural Suppuration: The Occult Empyema
Authors: Davidson Robin I. 
Published: May 2010

Abstract
Four patients with intracranial epidural empyema are discussed, illustrating the variety of clinical presentations of this process. A review of the ear, nose, and throat and neurosurgical literature is provided. The common incidental clinical presentation of this lesion is emphasized. Its symptoms are overshadowed almost invariably by concomitant disease processes, which include acute sinusitis, osteomyelitis, subgaleal empyema, subdural empyema, and subcortical intrapa-renchymal abscess. The diagnosis and treatment of intracranial epidural empyema are still dependent upon a high index of clinical suspicion.
Closure of Myelorachischisis Defects with Reverse Latissimus Dorsi Myocutaneous Flaps
Authors: Clark Dorothy H. , Walsh John W. , Luce Edward A. 
Published: May 2010

Abstract
The closure of myelorachischisis defects has been difficult and at times complicated. Over the past 2 decades, the use of rotational advancement flaps has been increasingly popular, but can be attended by instances of skin ischemia and necrosis. The development of the myocutaneous and muscle flap concept has aided reconstructive surgery. Extensive experience with the useful latissimus dorsi flap with and without overlying skin has been obtained for the reconstruction of a variety of truncal defects. We describe the use of bilateral “reverse” latissimus dorsi muscle flaps based on the paraspinal perforators for the closure of myelorachischisis defects in two patients. Coverage was uneventful in both instances. A 2-year follow-up revealed no compromise of upper extremity function due to sacrifice of the latissimus dorsi muscles. We offer an approach to the problem of closure of large myelorachischisis defects: bilateral reverse latissimus dorsi muscle flaps and delayed skin coverage. This approach seems to offer a good muscle layer over the dural closure and to provide long-standing durable coverage without apparent compromise of upper extremity function.
Spontaneous Cerebellar Hematoma in Children: Report of Two Cases and Review of the Literature
Authors: Ammirati Mario , Tomita Tadanori 
Published: May 2010

Abstract
Two children with hydrocephalus due to a spontaneous intracerebellar hematoma secondary to blood dyscrasia were treated successfully with a ventriculoperitoneal shunt. They represent the first documented cases of spontaneous intracerebellar hemorrhage in children treated successfully without posterior fossa operation. The size of the hematoma. the severity of the hydrocephalus, and the patient's neurological and physical condition are important factors in choosing the mode of treatment.
Tension Pneumocephalus after Trans-sphenoidal Hypophysectomy: Case Report
Authors: Shields Christopher B. , Valdes-Rodriguez Antonio G. 
Published: May 2010

Abstract
Tension pneumocephalus may occur spontaneously or may complicate a compound basal skull fracture or a cranial operation. We report a unique case of tension pneumocephalus after trans-sphenoidal hypophysectomy that may have developed because of the presence of an external lumbar subarachnoid drain.
Neuroradiological Detection of Small and Intracanalicular Acoustic Tumors: An Emphasis on CO2 Contrast-enhanced Computed Tomographic Cisternography
Authors: Clark W. Craig , Acker James D. , Robertson Jon H. , Gardner Gale , Dusseau John J. , Moretz William 
Published: May 2010

Abstract
Seventy patients suspected clinically of having an acoustic tumor were evaluated using the computed tomographic (CT) scan as the initial neuroradiological procedure, followed by CO2 contrast CT cisternography in cases where the intravenous contrast-enhanced scan did not reveal any lesion. Forty-eight gas CT cisternograms revealed 10 small acoustic tumors, 2 of which were totally intracanalicular. The authors present a review of the basic CT anatomy of the temporal bone as it relates to acoustic tumors. Based upon the ease of performance of the procedure, the low postexamination morbidity, and the excellent diagnostic results, CO2 CT cisternography is recommended as the procedure of choice in the diagnosis of small and intracanalicular acoustic tumors.
Pressure-mounted Cottonoids: Technical Note
Authors: Arbit Ehud 
Published: May 2010

Abstract
A newly designed cottonoid is fixed to the tip of the suction device by the negative pressure. It is especially useful during microsurgical procedures in areas crowded with neurovascular elements. The advantage of pressure-mounted cottonoids lies in the protection provided to the brain and neurovascular elements during suction, even in the face of high aspiration pressure, and in the simplicity of their use.
Spinal Meningioma: An Unusual Radiological and Clinical Case
Authors: Fontana M. , Carapella C. M. , Caroli F. , Riccio A. 
Published: May 2010

Abstract
The authors report a case of extra-intradural meningioma with an unusual myelographic appearance and a long clinical history. Some interesting radiological and clinical aspects of the lesion and possible pathogenetic mechanisms causing the erosion of the L-2 vertebra are discussed.
High Grade Astrocytoma with Spontaneous Meningeal and Cranial Invasion
Authors: Tognetti Francesco , Piazza Giancarlo , Morrone Bernardino 
Published: May 2010

Abstract
Unusual features of a Grade IV cerebral astrocytoma (glioblastoma) are presented; infiltration of the dura mater and destruction of the overlying calvarium. The meningeal fibroblastic reaction and the blood supply recruitment of the tumor from the external carotid system are also described. The literature dealing with biologically “aggressive” tumors of the glial series displaying direct invasion of the cranial extraneural structures is summarized.
Changes of the Auditory System after Cerebellopontine Angle Manipulations
Authors: Sekiya Tetsuji , Iwabuchi Takashi , Andoh Akira , Kamata Shigeki 
Published: May 2010

Abstract
The current tendency in acoustic neuroma surgery to attempt the preservation of hearing function and the problem of accidental hearing loss caused by microsurgical neurovascular decompression operations for hemifacial spasm or trigeminal neuralgia prompted us to study the exact surgical vulnerability of the auditory system. The surgical procedures for operation on the cerebellopontine angle of dogs were carried out according to the sequence of the posterior fossa transmeatal operation for acoustic neuroma. The operation was tentatively divided into three stages: (a) craniectomy and dural opening, (b) cerebellar retraction, and (c) identification of the cochlear nerve in the unroofed internal auditory canal (IAC). The postoperative behavior of the auditory system was evaluated electrocochleographically (EcochG) and histologically. Overzealous retraction of the cerebellar hemisphere caused transient disturbance of the EcochG pattern. Mechanical stretching of both the cochlear nerve and the internal auditory artery may cause a disturbance in the synchronized discharge of the cochlear neurons. Various manipulations at the porus acusticus internus or the IAC (such as pinching the nerve with forceps or electrocoagulation) produced thoroughly distorted EcochG patterns. From the histological findings, the main causative factor for these labyrinthine damages was considered to be vascular insufficiency The current need for neurosurgical operations to preserve hearing is discussed in the light of these findings.
Carbon Dioxide Laser Vaporization of Brain Tumors
Authors: Gongbai Chen , Qiwu Xu 
Published: May 2010

Abstract
Since 1977, we have used a 170-W CO2 laser manufactured in Shanghai. In animal studies we found less temperature increase in neighboring cerebral tissue after laser vaporization (0.8°C) than after bipolar coagulation (1.4°C) or monopolar coagulation (8°C). Some factors affecting the reaction of cerebral tissue to CO2 laser irradiation are discussed. This laser was also used in 30 craniotomies: 20 for gliomas, 5 for meningiomas, 4 for metastases, and 1 for a vascular malformation. No obvious cerebral or systemic adverse effects were seen, but the length of follow-up is insufficient to demonstrate an increased survival rate.
Intraventricular Cysticercosis
Authors: Ignacio Madrazo N. , GarcÍa-RenterÍa José A. , Miguel Sandoval B. , López Vega Francisco J. 
Published: May 2010

Abstract
The authors review their experience with 21 cases of intraventricular cysticercosis, which corresponded to 28% of all cases of neurocysticercosis in their department during an 18-month period. The surgical approach depends on the cyst's location; one uses the transcortical microsurgical approach to reach the lateral ventricles, the transcortical or transcallosal approach to reach the 3rd ventricle, and direct exploration to reach the 4th ventricle. Cysticercus cysts should be removed because they may produce acute or chronic hydrocephalus and, if the parasite dies within the ventricles, it will generate an inflammatory reaction with local and generalized ventriculitis, which produces irreversible neurological damage.
Gastric Secretory and Mucosal Injury Response to Severe Head Trauma
Authors: Gudeman Steven K. , Wheeler C. B. , Miller Douglas J. , Halloran Gregg L. , Becker Donald P. 
Published: May 2010

Abstract
The problem of gastric secretory and mucosal injury response was evaluated in 19 patients who had suffered a severe head injury. Fifteen of 19 patients had some evidence of gastrointestinal hemorrhage. In 7 cases, this was marked. The mean volume of gastric secretions ranged from 36.4 ml/hour on Day 1 to 47.6 ml/hour on Day 6. The mean value of titratable acidity ranged from 3.4 meq/hour on Day 1 to 3.9 meq/hour on Day 6. Possible risk factors were analyzed as a means of predicting specific subgroups of severely injured patients who would be more prone to have gastrointestinal complications. During the first 6 days after injury, there was no significant association (correlation coefficient not significant at the 0.05 level of significance) of the presence of an intracranial mass lesion, elevated intracranial pressure, brain stem dysfunction or prior episodes of hypotension or hypoxia, sepsis, shock, or the requirement for pressor agents with elevated gastric acid output, mucosal erosion, or hemorrhage. Because no specific risk factor or factors could be identified, all severely braininjured patients should be on some form of therapy for the prevention of gastrointestinal complications.
Hydatid Cyst of the Posterior Fossa: Case Report
Authors: Villarejo F. , Blazquez M. G. , Arcas J. , Pascual-Castroviejo I. , Esteban F. 
Published: May 2010

Abstract
A new case of a posterior fossa hydatid cyst is reported. The frequency, symptoms, diagnosis, and treatment of these cysts are discussed.
Compressive Neuropathy as a Complication of Anticoagulant Therapy
Authors: Hoyt Thomas E. , Tiwari Rajendra , Kusske John A. 
Published: May 2010

Abstract
Three cases of compressive neuropathy after anticoagulant therapy are reported. The first known description of ulnar and radial nerve involvement in this syndrome is provided. A review of the literature along with a discussion of some of the clinical features, the diagnosis, and the management of this entity are presented.
Use of the Carbon Dioxide Laser for Acoustic Tumor Surgery
Authors: Robertson John H. , Clark Craig W. , Robertson James T. , Gardner Gale L. , Shea Coyle M. 
Published: May 2010

Abstract
The carbon dioxide laser has been used clinically in both otorhinolaryngology and neurological surgery for approximately 10 years. Only recently, however, have technical modifications allowed its use with the operating microscope, providing the increased precision and control necessary for intracranial surgery. This paper reports the authors' experience with the carbon dioxide laser in the removal of acoustic tumors, details the surgical technique involved, and describes the advantages that may accompany the use of the laser in the removal of these difficult lesions.
Supratentorial Capillary Hemangioblastoma Presenting with Fatal Spontaneous Intracerebral Hemorrhage
Authors: Adegbite Andrew B. , Rozdilsky Bohdan , Varughese George 
Published: May 2010

Abstract
Spontaneous intracerebral hemorrhage from a supratentorial capillary hemangioblastoma resulting in the death of a 26-year-old woman is reported. We suggest that the presence of glial fibrillary acidic protein containing stromal cells in the tumor tissue may serve as a point distinguishing hemangioblastoma from angioblastic meningioma.
Ewing's Sarcoma Arising Primarily in the Spinal Epidural Space: Fifth Case Report
Authors: Spaziante Renato , de Divitiis Enrico , Giamundo Arcangelo , Gambardella Arturo , Di Prisco Bartolo 
Published: May 2010

Abstract
Ewing's sarcoma is found exceptionally as a primary epidural tumor of the spine. Four cases have been described in the literature. We describe the fifth case: a 10-year-old boy who underwent operation followed by radiotherapy and chemotherapy. For 1 year he then had a complete remission with no local recurrence and his neurological condition was satisfactory, although metastases developed later. Comparison with the cases described previously shows all five to possess interesting features in common.
Subclavian Catheterization for the Placement of a Ventriculovenous Shunt
Authors: Lehman Ralph A.W. , Hart James C. 
Published: May 2010

Abstract
Repeated nonfunction of the distal end of a ventriculoperitoneal shunt led to an unsuccessful attempt to introduce the distal catheter into the vena cava through the jugular vein. Subclavian catheterization utilizing a cardiac pacemaker introducer set proved to be a simple and effective means of establishing a ventriculovenous shunt.
Disturbances of Cerebrospinal Fluid Circulation during the Acute Stage of Subarachnoid Hemorrhage
Authors: Dóczi Thomas , Nemessányi Zoltán , Szegváry Zsuzsa , Huszka Endre 
Published: May 2010

Abstract
Radioisotope cisternography was performed and the erythrocyte and hemoglobin contents of the cerebrospinal fluid (CSF) were determined within the first 4 days after subarachnoid hemorrhage in 42 patients. The clinical condition of the patients was related to the severity of the CSF circulation disturbances. Thirty-five patients had some degree of disturbance of CSF flow, and only 2 of the 42 patients had normal flow. In 5 cases the cisternograms were inconclusive. The severity of CSF circulation disturbances correlated well with clinical condition. No relationship was found between the number of erythrocytes in the CSF and the development of CSF circulation disturbances. The CSF erythrocyte content did not correlate with the clinical condition. It is suggested that flow disturbances of the CSF during the acute stage of subarachnoid hemorrhage might play an important role in the pathomechanism of the disease.
Congenital Subgaleal (Epidermoid) Inclusion Cyst of the Anterior Fontanel in a Mexican Female Child: Case Report
Authors: Garza-Mercado Román , Tamez-Montes Dagoberto 
Published: May 2010

Abstract
A 30-month-old Mexican girl with an inclusion subgaleal cyst located over the anterior fontanel is described. This is the first such case ever diagnosed at our institution and, we believe, the first reported from Mexico. Radical excision of the lesion was accomplished. The internal table of the skull was eroded, but no intracranial extension was noticed. As the cyst contained no hair follicles nor any sebaceous or sweat glands, it was histologically classified as an epidermoid cyst. This is another example of such a lesion in an infant of non-African descent.
Osteogenic Sarcoma of the Skull Complicating Paget's Disease: Case Report
Authors: Young Henry A. , Hardy David G. , Ashleigh Raymond 
Published: May 2010

Abstract
A case of osteogenic sarcoma of the skull in a patient with long-standing Paget's disease is reported. Osteogenic sarcoma arising within the skull is rare in Paget's disease, although the recent literature emphasizes that it is more common than was realized previously. Intraparenchymal brain invasion, which is rare and present usually only as a preterminal event, was found in this patient who presented initially with minimal neurological findings. Rapid neurological deterioration in this patient was due to macroscopic hemorrhage into tumor. Although microscopic hemorrhage is characteristic of this tumor, gross hemorrhage into osteosarcoma of the skull as a cause of sudden neurological deterioration has not been reported previously. Radical resection is the treatment of choice, although the prognosis for this tumor remains dismal.