bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiation-associated Gliomas: A Report of Four Cases and Analysis of Postradiation Tumors of the Central Nervous System
Authors: Liwnicz Boleslaw H. , Berger Thomas S. , Liwnicz Regina G. , Aron Bernard S. 
Published: May 2010

Abstract
Four cases of radiation-associated gliomas are described. All patients were white men, irradiated in childhood for craniopharyngioma, anaplastic ependymoma, retinoblastoma of the orbit, and Burkitt's lymphoma, respectively. The dose ranged from 1800 to 5900 rads, and the latency period was 5 to 25 years. All primary and secondary tumors were verified histologically, and no evidence of persistence of the primary tumors was found. All secondary tumors arose in the fields of irradiation. Ninety-six cases of radiation-induced tumors of the central nervous system have been reported in the literature to date. Twenty-four were gliomas and occurred mainly in young men.
Visual Recovery after Transsphenoidal Removal of Pituitary Adenomas
Authors: Cohen Alan R. , Cooper Paul R. , Kupersmith Mark J. , Flamm Eugene S. , Ransohoff Joseph 
Published: May 2010

Abstract
We reviewed the records of 100 consecutive patients with histologically verified pituitary adenomas who underwent transsphenoidal decompression of the optic nerves and chiasm. The patients' ages ranged from 18 to 80 years, with a median of 52 years. Preoperatively, all patients had objective signs of visual acuity or field defects. Postoperatively, visual acuity was normal or improved in 79% of the eyes and the visual fields were normal or improved in 74%. The visual outcome (for both acuity and fields) was better in younger patients and those with a shorter duration of symptoms. Patients with lesser degrees of preoperative visual acuity compromise had better postoperative visual acuity outcome. However, the severity of preoperative visual field defects did not seem to predict postoperative field outcome, and even patients with severe preoperative field defects often had striking postoperative improvement. Patients who had undergone prior operation were less likely to have either visual acuity or visual field improvement after reoperation. Postoperative deterioration in visual acuity was noted in only 5 patients (6 eyes). Complications were few. There were 4 instances of cerebrospinal fluid rhinorrhea, but only 2 patients needed operative repair. There was no instance of permanent diabetes insipidus, although 17 patients developed transient diabetes insipidus. In most cases, visual improvement was sustained. The average duration of follow-up was 26 months. Three patients required a subsequent operation to correct visual loss in the immediate postoperative period, but only 1 patient has undergone late operation for recurrence of tumor. There was no operative mortality.
Reconstruction of the Pituitary Fossa in Transsphenoidal Surgery: An Experience of 140 Cases
Authors: Spaziante Renato , de Divitiis Enrico , Cappabianca Paolo 
Published: May 2010

Abstract
Even though the main problems of transsphenoidal surgery are encountered during the intra- and suprasellar portions of the operation, proper reconstruction of the sella turcica plays an important role in the overall results, greatly influencing the final outcome. Improper measures may bring about a complicated postoperative course, whereas a wise and precise method allows one to control any surgical condition, preventing the more dangerous consequences of the transsphenoidal approach (i.e., empty sella, cerebrospinal fluid leakage, hemorrhage, infection, etc.). The authors review the different methods of sellar plugging and, on the basis of their own experience, indicate the most suitable one for each of the more usual situations. A good result is achievable if only natural materials are used and one avoids synthetic prostheses. Extradural packing is the technique of choice whenever a hermetic closure and a particularly effective intrasellar plug are required.
Bilateral Spontaneous Carotid-Cavernous Fistulas Treated by the Detachable Balloon Technique: Case Report
Authors: Yamamoto Isao , Watabe Tsuneya , Shinoda Masaki , Hasegawa Yohko , Sato Osamu 
Published: May 2010

Abstract
This report describes the case of a 39-year-old woman with bilateral spontaneous carotid-cavernous fistulas that were treated successfully by the detachable balloon technique. The clinical features and management are reviewed.
Use of the Extracranial-Intracranial Arterial Bypass in the Management of Refractory Vasospasm: A Case Report
Authors: Rosenstein Jacob , Batjer Hunt H. , Samson Duke S. 
Published: May 2010

Abstract
Cerebral arterial vasospasm after aneurysmal subarachnoid hemorrhage remains one of the major causes of morbidity and mortality in patients surviving the initial hemorrhage. Once established, no known method has been shown to reverse this process in humans. Although intravascular volume expansion and induced arterial hypertension have been shown to be effective in the reversal of neurological deficits secondary to vasospasm, a large proportion of patients remain refractory to these methods. We report one such case successfully managed by the estalishment of an extracranial-intracranial anastomosis in an attempt to augment collateral flow.
Discrepancy between Computed Tomography and Magnetic Resonance Imaging in a Case of Medulloblastoma
Authors: Heafner Michael D. , Schut Luis , Packer Roger J. , Bruce Derek A. , Bilaniuk Larissa T. , Sutton Leslie N. 
Published: May 2010

Abstract
In a 2-year-old girl with signs and symptoms of a posterior fossa tumor, the computed tomographic scan showed what appeared to be a brain stem glioma. However, magnetic resonance imaging (MRI) demonstrated the lesion to be extrinsic to the brain stem. Posterior fossa exploration disclosed a medulloblastoma filling the 4th ventricle. This discrepancy in imaging techniques points out the usefulness of MRI in the evaluation and treatment of posterior fossa lesions.
One-Stage Reduction Cranioplasty for Macrocephaly Associated with Advanced Hydrocephalus
Authors: Park T. S. , Grady M.Sean , Persing John A. , Delashaw Johnny B. 
Published: May 2010

Abstract
A reduction cranioplasty in one stage was performed on a child with massive enlargement of the head secondary to advanced hydrocephalus. The authors discuss the techniques and advantages of a modified head position and a cross bar craniotomy for reduction cranioplasty.
Computed Tomographic Grading with Hounsfield Number Related to Delayed Vasospasm in Cases of Reptured Cerebral Aneurysm
Authors: Fujita Shigekiyo 
Published: May 2010

Abstract
The relationship between cisternal high density calculated by Hounsfield number (HN) in computed tomography and the subsequent development of cerebral infarction due to delayed vasospasm was studied retrospectively in 36 cases of ruptured cerebral aneurysm. All patients were hospitalized within 24 hours and underwent operation within 48 hours after subarachnoid hemorrhage. Extensive removal of cisternal blood clots was carried out after obliteration of the aneurysm. The patients were divided into two groups according to the occurrence of vasospasm. In the group without vasospasm, the average HN was 65.7 preoperatively; after operation, the HN declined significantly to 62.2. In the group with vasospasm, the average HN was 77.6 preoperatively and 77.5 postoperatively. The relation between HN in postoperative computed tomography and vasospasm was as follows. When HN was 68 or less, vasospasm did not occur in any case. When HN ranged from 68 to 73, the incidence of vasospasm was 50%. When HN was 73 or more, vasospasm occurred in all cases. We propose a new system using HN to predict the incidence of vasospasm. This system is useful in deciding the timing of operation and determining the amount and location of clots to be removed.
Central Herniation Revealed by Focal Decrease in Blood Flow without Elevation of Intracranial Pressure: A Case Report
Authors: Wozney Paul , Yonas Howard , Latchaw Richard E. , Gur David , Good Walter 
Published: May 2010

Abstract
Until recently, in standard hospital settings the tissue blood supply could be inferred only from indirect measures such as assessment of the clinical signs and intracranial pressure (ICP) monitoring. This critical parameter can now be imaged directly with stable xenon-enhanced computed tomographic (CT) imaging. The procedure requires only an additional 10 minutes after a standard head study, yet it provides potentially vital information about tissue perfusion. We describe here a patient in whom a frontal lobe hematoma produced a direct mass effect, causing an element of central herniation with relative sparing of lateral and posterior cortical regions. Although the ICP recordings remained unchanged, symptoms of brain stem compression became apparent. Xenon/CT cerebral blood flow (CBF) mapping demonstrated a flow decrease mainly within the left frontal lobe and throughout central ganglionic structures. After removal of the left frontal hematoma, both clinical status and local and central flow improved. Because the xenon/CT method combines direct anatomical information with blood flow information in one examination, it may be a valuable clinical tool in providing a better understanding of pathophysiology in patients with head injuries and other mass lesions.
Symptomatic Rathke's Cleft Cyst with Pituitary Adenoma: Case Report
Authors: Swanson Steven E. , Chandler William F. , Latack Joseph , Zis Katerina 
Published: May 2010

Abstract
A rare case of a pituitary adenoma found in association with a symptomatic Rathke's cleft cyst in a 34-year-old woman presenting with headaches, visual symptoms, and amenorrhea is described. The diagnostic evaluation and operative treatment of these coincident lesions are discussed.
Anesthesia and Surgery in the Seated Position: Analysis of 554 Cases
Authors: Matjasko Jane , Petrozza Patricia , Cohen Melvin , Steinberg Polly 
Published: May 2010

Abstract
Because controversy exists regarding continued use of the seated position for neurosurgical procedures, this prospective (1981-1983) and retrospective (1972-1981) analysis of 554 seated patients was done to establish the incidence and severity of venous air embolism (VAE) related to type of surgical procedure and anesthetic technique; to examine the impact of specific monitoring practices on detection, morbidity, and mortality; and to establish the incidence of other complications related to the seated position (hypotension, quadriplegia, and arterial air embolism (AAE)). The overall morbidity and mortality related to the seated position was 1% (2 VAE, 1 AAE, 2 hypotension, 1 myocardial infarction) and 0.9% (1 VAE, 1 AAE, 2 hypotension, 1 quadriplegia), respectively. There has been no mortality since 1975. N2O did not seem to increase the incidence or severity of VAE. The seated position is safe in experienced hands if appropriate surgical and anesthetic skills are exercised in patient selection and management. Caution is advised in patients with atherosclerotic cardiovascular disease, severe hypertension, cervical stenosis, and right to left intracardiac shunts.
Microsurgical Anatomy of the Superficial Veins of the Cerebrum
Authors: Oka Kazunari , Rhoton Albert L. , Barry Margaret , Rodriguez Roland 
Published: May 2010

Abstract
The microsurgical anatomy of the superficial cortical veins was examined in 20 cerebral hemispheres. The superficial cortical veins are divided into three groups based on whether they drain the lateral, medical, or inferior surface of the hemisphere. The veins on the three surfaces are further subdivided on the basis of the lobe and cortical area that they drain. The superficial cerebral veins collect into four groups of bridging veins: a superior sagittal group, which drains into the superior sagittal sinus; a sphenoidal group, which drains into the sphenoparietal and cavernous sinuses on the inner surface of the sphenoid bone; a tentorial group, which converges on the sinuses in the tentorium; and a falcine group, which empties into the inferior sagittal or straight sinus or their tributaries. The superior sagittal group drains the superior part of the medial and lateral surfaces of the frontal, parietal, and occipital lobes and the anterior part of the basal surface of the frontal lobe. The sphenoidal group drains the parts of the frontal, temporal, and parietal lobes adjoining the sylvian fissure. The tentorial group drains the lateral surface of the temporal lobe and the basal surface of the temporal and occipital lobes. The falcine group drains an area that includes the cingulate and parahippocampal gyri and approximates the cortical parts of the limbic lobe of the brain. The relationship of these veins to the venous lacunae was also examined.
Tuberous Sclerosis and Multiple Intracranial Aneurysms: Case Report
Authors: Blumenkopf Bennett , Huggins Michael J. 
Published: May 2010

Abstract
A 6-year-old girl with tuberous sclerosis was found to have multiple intracranial fusiform arterial aneurysms. This represents the fifth reported case of this association. The concepts of an arterial dysplasia being present in cases of tuberous sclerosis and of developmental defects being the cause of some intracranial aneurysms are discussed. The need for a prospective study to assess the prevalence of intracranial aneurysms in patients with tuberous sclerosis is suggested.
Traumatic Aneurysm of the Anterior Cerebral Artery Associated with a Contralateral Carotid-Cavernous Fistula: A Case Report
Authors: Noterman J. , Flament-Durand J. , Hermanus N. , Brotchi J. 
Published: May 2010

Abstract
An unusual case of traumatic aneurysm of the A-1 part of the anterior cerebral artery associated with a contralateral carotid-cavernous fistula is presented. Trapping of the fistula was carried out, and an attempt to repair the vessel wall was made. Thrombosis of the vessel occurred, but remained asymptomatic. Causes, physiopathology, and treatment of traumatic aneurysms are discussed.
Dangerous Rises in Blood Pressure upon Heating of Trigeminal Rootlets; Increased Bleeding Times in Patients with Trigeminal Neuralgia
Authors: Sweet William H. , Poletti Charles E. , Roberts James T. 
Published: May 2010

Abstract
During radiofrequency (RF) heating of trigeminal rootlets, we regularly measured blood pressure rises to 250 to 300 mm Hg, confirming two previous reports. We also found abnormally increased bleeding times in 12% of 127 patients awaiting operation for trigeminal neuralgia. These two facts probably explain 6 fatalities and 2 lasting hemiplegias from intracranial bleeding unrelated to vascular puncture by the needle electrode during RF procedures for trigeminal neuralgia. We recommend correction of the abnormal bleeding time and control of the blood pressure rises by i.v. sodium nitroprusside.
Contrasting Actions of Naloxone in Experimental Spinal Cord Trauma and Cerebral Ischemia: A Review
Authors: Hamilton Allan J. , Black Peter McL. , Carr Daniel B. 
Published: May 2010

Abstract
Endorphins have been implicated in the pathophysiology of both spinal cord injury and cerebral ischemia. This review examines the nature of the experimental evidence to support this hypothesis. Present studies suggest that naloxone administration improves neurological function and outcome in the setting of the spinal cord trauma by centrally inhibiting an opiate receptor-mediated diminution of spinal cord flow. In the setting of spinal shock, naloxone administration is associated with improvement in vital sign and cardiovascular parameters as measured by mean arterial pressure, cardiac output, body temperature, and ventilation. Experiments using a variety of animal stroke models similarly support the notion that naloxone improves neurological function in the setting of cerebral ischemia by a stereospecific opiate receptor-mediated effect, but this improvement does not seem to be accompanied by augmentation of blood flow to affected areas of the brain or by any improvement in vital signs or cardiovascular parameters as seen in spinal cord trauma. A variety of mechanisms are discussed to explain these observations. The therapeutic implications of administering opiate agonists and antagonists in the setting of neurological deficits are outlined for the neurosurgeon.
Pathophysiology of Nonneoplastic Obstruction of the Foramen of Monro and Progressive Unilateral Hydrocephalus
Authors: Shizuo Oi , Matsumoto Satoshi 
Published: May 2010

Abstract
Our experience with progressive unilateral hydrocephalus in children and the pathophysiology of nonneoplastic obstruction of the foramen of Monro has been analyzed. The status of the foramen of Monro in either congenital or acquired progressive unilateral hydrocephalus was classified into the following four categories: Category 1, atresia of the foramen; Category 2, morphological obstuction; Category 3, functional obstruction; and Category 4, patent foramen. Illustrative cases including hydrodynamic studies and intracranial pressure monitoring are discussed.
Brain Tumors during the First Twenty-four Months of Life
Authors: Tomita Tadanori , McLone David G. 
Published: May 2010

Abstract
One hundred patients with brain tumors were diagnosed and treated during the first 24 months of life. They represent 16% of 608 children with brain tumors treated from 1952 through 1984. The most common histological type of brain tumors during the first 24 months are benign astrocytoma, medulloblastoma, and choroid plexus papilloma. The tumor location is distributed relatively evenly among the cerebellum and the 4th ventricle, the cerebral hemisphere (including the lateral ventricle), and the suprasellar region and 3rd ventricle. The chief presenting signs and symptoms are a full fontanelle, macrocephaly, changes of behavior, and delayed developmental milestones. Localizing signs are infrequent. Ninety-two patients underwent craniotomy with a one-month surgical mortality rate of 12%. The surgical mortality rate was 5.6% among 36 recent patients diagnosed by computed tomography. The 5-year survival rate is 41% in the patients younger than 12 months and 74% in patients diagnosed during the 2nd year of life. This study indicates the validity of Collins' rule for medulloblastomas during the first 24 months of life, but not for benign or malignant astrocytomas.
Basal Arterial Occlusive Disease
Authors: Quest Donald O. , Correll James W. 
Published: May 2010

Abstract
Seventeen patients with basal occlusive disease have been seen over the past 4 years. Nine of these had a classical moyamoya appearance on angiography. Of these nine, seven were adults and two were children. Eight had ischemic episodes, and one had a hemorrhage. One had neurofibromatosis with a chiasmal glioma and had received radiotherapy. Eight patients underwent superficial temporal-middle cerebral artery (STA-MCA) bypass, and one refused operation. Six patients improved, one had a stroke on the opposite side, and one died. Eight patients had unilateral basal arterial occlusive disease. Of these, three had ischemic episodes, four had hemorrhages, and one had only headaches. Four were adults, and four were children. Five underwent STA-MCA bypass with improvement, one with headaches had an aneurysm treated, and two were not operated upon. Considerations regarding the cause, therapeutic options, and disease course in these patients are discussed.
Delayed Chiasmal Decompression after Transsphenoidal Operation for a Pituitary Adenoma
Authors: Goldman James A. , Hedges Thomas R. , Shucart William , Molitch Mark E. 
Published: May 2010

Abstract
A patient with a large pituitary adenoma and visual field loss showed no significant change 6 weeks after transsphenoidal operation, but marked and abrupt improvement occurred at 10 weeks. The implications of this delayed improvement are discussed
Diaphragm Pacing by Electrical Stimulation of the Phrenic Nerve
Authors: Glenn William W. L. , Phelps Mildred L. 
Published: May 2010

Abstract
Sophisticated techniques for electrical stimulation of excitable tissue to treat neuromuscular disorders rationally have been developed over the past 3 decades. A historical review shows that electricity has been applied to the phrenic nerves to activate the diaphragm for some 200 years. Of the contemporary methods for stimulating the phrenic nerve in cases of ventilatory insufficiency, the authors prefer stimulation of the phrenic nerve in the thorax using a platinum ribbon electrode placed behind the nerve and an attached subcutancously implanted radiofrequency (RF) receiver inductively coupled to an external RF transmitter. Instructions are given for implanting the electrode-receiver assembly, emphasizing atraumatic handling of the phrenic nerve and strict aseptic techniques. Diaphragm pacing is conducted with low frequency electrical stimulation at a slow repetition (respiratory) rate to condition the diaphragm muscle against fatigue and maintain it fatigue-free. Candidates for diaphragm pacing are those with ventilatory insufficiency due to malfunction of the respiratory control center or interruption of the upper motor neurons of the phrenic nerve. In the Yale series, there were 77 patients treated by diaphragm pacing; 63 (82%) started before 1981 and thus were available for follow-up for at least 5 years; 33 (52%) were paced for 5 to 10 years, and 15 (24%) were paced for 10 to 16. Long term stimulation of the phrenic nerves to pace the diaphragm is an effective method of ventilatory support in selected cases
Hydrocephalus and Vasospasm after Subarachnoid Hemorrhage from Ruptured Intracranial Aneurysms
Authors: Black Peter McL. 
Published: May 2010

Abstract
The incidence of hydrocephalus and vasospasm and the relationship between them were analyzed retrospectively in 87 patients with subarachnoid hemorrhage from ruptured intracranial aneurysms. Sixty-seven per cent of the patients showed ventricular enlargement on a computed tomographic scan done within 30 days of the hemorrhage; in patients whose first scan was done within 3 days of the hemorrhage, 63% seemed to have ventricular enlargement by a neuroradiologist's interpretation. Shunts were required in 14% of the patients because of delayed neurological deterioration or enlarging ventricles; 3% required ventriculostomy shortly after admission. Seventy-four per cent of the patients had angiographic spasm on an angiogram done within the first 30 days after hemorrhage. Sixty-two per cent of the patients had both hydrocephalus and vasospasm: 22% had neither. Five per cent had hydrocephalus, but no spasm; 11% had spasm. but no hydrocephalus. Hydrocephalus and vasospasm were significantly associated (P &lt; 0.01, x2). These data document a high incidence of mild ventricular enlargement and angiographic vasospasm after subarachnoid hemorrhage. They also emphasize that these two sequelae of subarachnoid hemorrhage are closely linked, probably by the presence of blood in the basal cisterns obstructing cerebrospinal fluid flow and surrounding arteries there.