bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Paralysis Associated with Myelomeningocele: Clinical and Experimental Data Implicating a Preventable Spinal Cord Injury
Authors: Heffez Dan S. , Aryanpur John , Hutchins Grover M. , Freeman John M. 
Published: April 2011

Abstract
Paralysis seen in children with myelomeningocele has been attributed to congenital myelodysplasia. We suspected that paralysis may be due in part to a spinal cord injury caused by exposure of the neural tube to the amniotic fluid. This hypothesis was tested using a fetal rat model of surgically created dysraphism. Each pup from the experimental group of rats in which the spinal cord was intentionally exposed to the amniotic fluid was born with severe deformity and weakness of the hind limbs and tail. Control fetal rats, subjected to the same procedure without directly exposing the spinal cord to the intrauterine environment, were normal at birth. Histological studies of the exposed spinal cord revealed extensive erosion and necrosis, findings similar to those described in children with myelomeningocele. We therefore propose a “two-hit” hypothesis to explain the paralysis seen in children with myelomeningocele: congenital myelodysplasia complicated by an intrauterine spinal cord injury. Intrauterine protection of the exposed spinal cord might prevent some or all of the paralysis. The possible implications of these findings for the future treatment of myelomeningocele are discussed.
Intraoperative Localization of a Cervicomedullary Glioma from the Killed End Potential: Illustrative Case
Authors: Morioka Takato , Fujii Kiyotaka , Mitani Masamitsu , Fukui Masashi 
Published: April 2011

Abstract
We recorded the intraoperative somatosensory evoked potentials directly from the upper cervical cord and medulla in a patient with an intrinsic tumor at the region of the cervicomedullary junction. The killed end potential, a large positive potential, was obtained at the caudal end of the tumor. This type of potential occurs when an impulse approaches but never passes beyond the recording electrode. Myelotomy guided by the killed end potential enabled appropriate spinal and medullary dissection and led to early encounter with the cervicomedullary tumor.
Ganglioglioma of the Optic Chiasm: Case Report and Review of the Literature
Authors: Chilton Jonathan , Caughron Michael R. , Kepes John J. 
Published: April 2011

Abstract
We describe a case of ganglioglioma of the optic chiasm and tract in a 33-year-old man. Review of the literature discloses only seven cases of tumors of the anterior visual pathway that meet the histological criteria for such neoplasms. A detailed histological description of our case and a review of the literature is provided.
Symptomatic Arachnoid Cyst at the Clivus Drained Stereotactically through the Vertex
Authors: Iacono Robert P. , Labadie Enrique L. , Johnstone Sharon J. , Bendt Teresa K. 
Published: April 2011

Abstract
A 40-year-old man had an acute ischemic event affecting the pons. He had no cardiac illness or vasculitis and was not diabetic or hypertensive. The contrast-enhanced computed tomographic scan disclosed nothing abnormal, and a vertebral angiogram showed an avascular mass markedly displacing the basilar artery and pons posteriorly and toward the right. A magnetic resonance image clearly delineated a homogeneous arachnoid cyst containing cerebrospinal fluid. To avoid manipulating posterior fossa arteries, after the recent pontine stroke, this arachnoid cyst with unusually favorable anatomical landmarks was approached stereotactically through the vertex. Fenestration and drainage of the cyst was accomplished under local anesthesia and benzodiazepine sedation with low morbidity. The procedure was well tolerated, and the patient returned to gainful employment shortly afterward. He remains asymptomatic at 3 years' follow-up. The successful outcome of this case suggests that in carefully selected symptomatic arachnoid cysts, stereotactic interventions could become a useful surgical alternative. Stereotaxis may also be helpful in other cumbersome surgical cases in which a second port for contrast injection or simple manipulation would be advantageous.
Malignant Teratoma of the Cerebellopontine Angle: Case Report
Authors: İplikçioğlú Celal A. , Özer Fahir , Benli Kemal , Bertan Vural , Ruacan Şevket 
Published: April 2011

Abstract
A case of malignant teratoma of the cerebellopontine angle is presented. Preoperative findings suggested an acoustic neurinoma or a meningioma. Particularly in adulthood, malignant teratomas arising in unusual locations can simulate common intracranial tumors.
Primary T-Cell Lymphoma with Myelopathy Associated with HTLV-1
Authors: Inoue Masaru , Kawaguchi Tsutomu , Yokoyama Hiroaki , Shimada Masahiko 
Published: April 2011

Abstract
The case of a patient who had myelopathy associated with human T-cell lymphotropic virus Type 1 (HTLV-1) for 10 years and developed a T-cell lymphoma in the cerebellum is reported. The relationship between myelopathy associated with HTLV-1 and primary T-cell lymphoma is discussed.
Effect of Nimodipine on Cerebrovascular Response to CO2 in Asymptomatic Individuals and Patients with Subarachnoid Hemorrhage: A Transcranial Doppler Ultrasound Study
Authors: Seiler Rolf W. , Nirkko Arto C. 
Published: April 2011

Abstract
The cerebrovascular response to CO2was evaluated by measuring relative changes in blood flow velocity within the middle cerebral artery by transcranial Doppler ultrasonography during normo-, hypo-, and hypercapnia. In seven patients without subarachnoid hemorrhage (five with unruptured arteriovenous malformations and two with aneurysms), the CO2vasoreactivity was tested on the side of the middle cerebral artery with normal flow velocities opposite the lesion. A baseline CO2reactivity test was obtained in each patient and then repeated under constant intravenous infusion of nimodipine, 2 mg/hr. Nine patients with ruptured aneurysms who were rated at Hunt and Hess Grades 1 or 2 were operated on within 1 to 3 days after the hemorrhage and treated with nimodipine, 2 mg/hr, given intravenously. In these patients. CO2vasoreactivity was tested during the second week after the hemorrhage, when the middle cerebral artery velocity was increased by at least 50% of the initial value or more. Nimodipine was then discontinued and, 48 hours later, when the middle cerebral artery velocity was still in the same range, CO2vasoreactivity was tested again. Two months later, after full recovery from the subarachnoid hemorrhage and normalization of the velocities, a third measurement of CO2reactivity was obtained as a baseline control. No significant effect of nimodipine on CO2vasoreactivity could be demonstrated in any of the test periods. In the second week after a subarachnoid hemorrhage, a significant reduction of the cerebrovascular response to CO2was found (P &lt; 0.005).
Stereotactic Guiding Tube for Open-System Endoscopy: A New Approach for the Stereotactic Endoscopic Resection of Intra-Axial Brain Tumors
Authors: Otsuki Taisuke , Jokura Hidefumi , Yoshimoto Takashi 
Published: April 2011

Abstract
Stereotactic endoscopic resection of intra-axial brain tumors using a newly developed endoscopic system consisting of a stereotactic guiding tube and a fine endoscope is reported. The stereotactically inserted guiding tube acts in the place of brain retractors to expose deep-seated pathological lesions, which are then visualized by means of a fine endoscope. The lesions may then be treated by various microsurgical techniques such as laser vaporization. Fifteen intra-axial lesions were operated on by this method using a guiding tube of 8 mm in outer diameter without significant complications. Seven small lesions measuring 3 to 26 mm in maximal diameter were resected totally. Eight large lesions. including two highly vascularized tumors, were examined by biopsy and resected partially through a burr hole with complete hemostasis under direct vision. This system is particularly useful for removing small intra-axial tumors in deep or eloquent areas difficult to resect using ordinary surgical techniques. It will also be applicable for other stereotactic operations that require accuracy and minimum invasiveness with complete hemostasis under direct visualization.
Thickness of Carotid Artery Atherosclerotic Plaque and Ischemic Risk
Authors: Dempsey Robert J. , Diana Louise A. , Moore Robert W. 
Published: April 2011

Abstract
Noninvasive duplex scanning of carotid artery atherosclerotic plaque was performed in 286 consecutive patients referred to a cerebrovascular diagnostic laboratory. The presence and thickness of such plaque in the region of the carotid bifurcation were examined for association with the degree of vessel stenosis, age, sex, smoking history, history of prior transient ischemic attack or stroke, and systemic manifestations of atherosclerotic disease. Atherosclerotic plaque thickness was positively correlated with degree of vessel stenosis (P&lt; 0.0001). Both parameters were independent predictors of cerebrovascular events but plaque thickness was a better predictor of prior transient ischemic attacks (P&lt;0.05), and vessel stenosis was a better predictor of prior stroke (P&lt;0.005). Patient age (P&lt;0.001) and pack-years of cigarette use (P&lt;0.001) were independent positive predictors of carotid atherosclerotic plaque thickness. The greatest effect of smoking and atherosclerotic plaque thickness was seen in heavy smokers younger than age 55. Both carotid artery plaque thickness and pack-years of smoking were significant independent predictors of other systemic manifestations of atherosclerotic disease (P&lt;0.05). Such noninvasive scanning of carotid artery atherosclerotic plaque demonstrates the significant role of age and smoking in the progression of disease. It also suggests a significant role for carotid atherosclerotic artery plaque in the pathophysiology of cerebrovascular events, especially transient ischemic attacks, even prior to the production of a flow-limiting stenosis. Finally, noninvasive screening of carotid artery plaque may provide a useful marker for the patient at risk for systemic atherosclerotic disease and identify the patient for whom maximal atherosclerotic risk factor modification is needed.
In Vivo Biological Effects of Stereotactic Radiosurgery: A Primate Model
Authors: Lunsford L. Dade , Altschuler Eric M. , Flickinger John C. , Wu Andrew , Martinez Julio A. 
Published: April 2011

Abstract
Single-fraction, closed skull, small-volume irradiation (radiosurgery) of intact intracranial structures requires accurate knowledge of radiation tolerance. We have developed a baboon model to assess the in vivo destructive radiobiological effects of stereotactic radiosurgery. Three baboons received a single-fraction, 150-Gy lesion of the caudate nucleus, the thalamus, or the pons using the 8-mm diameter collimator of the gamma unit. Serial standard neurodiagnostic tests (neurological examination, computed tomographic scan, magnetic resonance imaging, stable xenon-enhanced computed tomographic scan of cerebral blood flow, somatosensory and brain stem evoked potentials, and myelin basic protein levels of cerebrospinal fluid) were compared with preoperative studies. Magnetic resonance imaging revealed the development of a lesion at the target site between 45 and 60 days after irradiation. Deterioration of the brain stem evoked potentials preceded imaging changes when the lesion encroached on auditory pathways. Myelin basic protein levels increased subsequent to imaging changes. Postmortem neuropathological examination confirmed a well-demarcated radionecrosis of the target volume. The baboon model appears to be an excellent method to study the in vivo biological effects of radiosurgery.
Cyst of the Choroid Plexus in the Lateral Ventricle: Case Report and Review of the Literature
Authors: Odake Genya , Tenjin Hiroshi , Murakami Nobukuni 
Published: April 2011

Abstract
We report an intraventricular cyst in a 2-year-old boy who had myoclonic jerks of the extremities. The cyst had no communication with the ventricular system or subarachnoid space. Total removal of the cyst adhering to the choroid plexus was accomplished. The glial cyst wall was lined in part by flattened or cuboidal epithelium. The preoperative and postoperative computed tomographic scans and magnetic resonance images are presented, and congenital benign cysts in the lateral ventricle are reviewed and discussed.
Radical Osteoclastic Craniectomy in Sagittal Synostosis
Authors: Hassler Werner , Zentner Josef 
Published: April 2011

Abstract
We report our experience in the surgical treatment of sagittal synostosis using radical osteoclastic craniectomy in 60 consecutive patients. After surgery in children aged 6 months or younger (Group I), reossification usually started 2 weeks postoperatively and was complete within 6 months, resulting in an optimal skull contour. In children aged 7 to 12 months (Group II), reossification was prolonged and lasted for 12 months or longer. The skull contour normalized in its biparietal width and improved in sagittal diameter, remaining, however, slightly abnormal. In children older than 12 months (Group III), the skull contour partly improved in the biparietal diameter but did not change in the sagittal direction. Reossification was incomplete with persistent pseudosutures. Enlarged frontal subarachnoid spaces were reversible or improved in all patients independent of age at the time of surgery. We encountered no complications in our series. In our opinion, radical osteoclastic craniectomy is the simplest, most efficient, and most physiologically sound method for the treatment of sagittal synostosis in patients up to 6 months of age. This procedure allows the rapidly growing brain to form its skull vault, thus providing optimal cosmetic results. In older children, osteoplastic morcellation procedures should be the treatment of choice.
Distribution of Angiographic Vasospasm after Subarachnoid Hemorrhage: Implications for Diagnosis by Transcranial Doppler Ultrasonography
Authors: Newell David W. , Grady Sean M. , Eskridge Joseph M. , Winn Richard H. 
Published: April 2011

Abstract
A study was undertaken to determine how frequently angiographic vasospasm occurs outside the normal access range of transcranial Doppler ultrasound in patients who have suffered a subarachnoid hemorrhage. Vasospasm located in the basal vessels is readily identifiable using transcranial Doppler ultrasound whereas spasm affecting the more distal, vertically oriented arteries is outside the standard detection range. It is therefore speculated that the sensitivity of the technique would be adversely affected by a high incidence of distal vasospasm. A total of 136 angiograms performed on 68 patients after a subarachnoid hemorrhage from anterior circulation aneurysms were reviewed to determine the typical distribution of vasospasm. Of the 40 cases that showed &gt;25% vessel narrowing, 50.0% had spasm restricted to the basal vessels, 42.5% had spasm involving both basal and distal segments, and 7.5% had spasm of the distal segments only. None of the patients with distal vasospasm alone developed delayed ischemic deficits. It is concluded that most patients with anterior circulation aneurysms who develop vasospasm will have involvement of the basal vessels, but a small number of patients may develop vasospasm only in distal vessels.
Clinicopathological Experience with Pineocytomas: Report of Five Surgically Treated Cases
Authors: Vaquero Jesús , Ramiro Josefa , Martínez Roberto , Coca Santiago , Bravo Gonzalo 
Published: April 2011

Abstract
The clinicopathological experience associated with five cases of pineocytoma is presented. All patients were treated by surgical removal without postoperative radiotherapy. In three individuals, 2000 cGy was administered to the tumor as a presurgical diagnostic test, with no evidence of response. All cases demonstrated histological features of pineocytoma, according to the criteria of Borit et al., and of the so-called “pineocytoma with neuronal differentiation,” according to the criteria of Rubinstein. The experience obtained from the present series reveals that these tumors can occur in the initial decades of life, that a cystic appearance and the presence of calcifications are distinctive features of their radiological evaluation, and that they have a good prognosis after surgical removal, even when the histological data indicate local invasion. The convenience of reserving the term “pineocytoma” for these tumors, and of including the so-called “pineocytomas without further differentiation” within the group of pineoblastomas, is suggested in order to achieve a practical clinicopathological assessment of parenchymatous pineal tumors.
Pituitary Hemorrhage into a Rathke's Cleft Cyst
Authors: Onesti Stephen T. , Wisniewski Thomas , Post Kalmon D. 
Published: April 2011

Abstract
This report describes a case of symptomatic pituitary hemorrhage into a Rathke's cleft cyst in a 25-year-old woman. The literature on pituitary hemorrhage in nonadenomatous sellar tumors is reviewed.
Surgical Outcome in 435 Patients Who Sustained Missile Head Wounds during the Iran-Iraq War
Authors: Aarabi Bizhan 
Published: April 2011

Abstract
Variables important in predicting the final postsurgical outcome of 435 patients who sustained missile head wounds during the Iran-Iraq War were evaluated over a 99-month period. The type of projectile, site of injury, and presence or absence of foreign material did not seem to have a significant effect on the final outcome. Of the patients with a perforating type of injury, 48.8% had a poor surgical outcome as compared with 19.9% with a penetrating type and 15.6% with a tangential type. This difference is statistically significant (x2 = 14.7 and 17.1, respectively; p &lt; 0.001). The most important factor in predicting overall outcome was the Glasgow Coma Scale (GCS) score at the time of admission. Mortality and morbidity contributing to a poor surgical outcome were noted in only 6% of patients with a GCS score at admission of 13 to 15, in 24.6% of those with a GCS score of 9 to 12, in 57% of those with a GCS score of 6 to 8, and in 65% of those with a GCS score of 3 to 5. Of the 71 patients who died, 75% had a score of 3 to 8. Perforating projectiles or those traversing two or more dural compartments were statistically significant in contributing to mortality and moribidity (x2 = 17.2; p &lt; 0.001). The incidence of focal neurological deficit was 100, 90.6, 88, and 52.2% in patients with GCS scores of 3 to 5, 6 to 8, 9 to 12, and 13 to 15, respectively, The two best predictors of mortality in this group of patients were a low GCS score and infection.
Spinal Hemangioblastoma, Syrinx, and Hydrocephalus in a Two-Year-Old Child
Authors: Mock Antonio , Levi Allan , Drake James M. 
Published: April 2011

Abstract
A two-year-old child presented with an acute inability to bear weight. Radiological investigation revealed a large cervicothoracolumbar syrinx of no known cause. During investigation, acute communicating hydrocephalus developed, which required a shunt. At surgery, a small thoracic spinal cord hemangioblastoma was discovered and excised. Complete recovery with collapse of the syrinx followed. The clinical features of this rare childhood tumor and its associated effects are discussed.
Carotid-Cavernous Sinus Fistula Associated with a Primitive Trigeminal Artery
Authors: Cheng Wan-Chun , Wang Alexander Dah-Jium 
Published: April 2011

Abstract
Carotid-cavernous sinus fistulas are not rare, but they have never been reported in association with persistent primitive trigeminal artery. We recently encountered such a case. The Jaeger-Hamby procedure was employed, with mandatory occlusion of the primitive trigeminal artery.
Spinal Cord Blood Flow in the Rat under Normal Physiological Conditions
Authors: Rubinstein Avraham , Arbit Ehud 
Published: April 2011

Abstract
Regional spinal cord blood flow (SCBF) was measured in a group of rats under conditions of normothermia, normocarbia, normoxia, and normal blood pressure, using the hydrogen clearance technique. Regional SCBF in the cervical white matter was 26.8 ± 1 (SE) ml/100 g/min and in the cervical gray matter 53.6 ± 2.5; in the thoracic white matter it was 22.2 ± 2.4 ml/100 g/min and in the thoracic gray matter 41.2 ± 12/6 ml/100 g/min; and in the lumbar gray matter it was 52.3 ± 1.9 ml/100 g/min. The effect of changes in blood pressure on SCBF (autoregulation) was investigated in nine rats. We have observed that SCBF remains relatively constant in the blood pressure range of 45 to 165 mm Hg and assumes a passive flow below or above this range.
Neurinoma in the Cavernous Sinus: Report of Two Cases
Authors: Inoue Tooru , Fukui Masashi , Matsushima Toshio , Hasuo Kanehiro , Matsunaga Masayuki 
Published: April 2011

Abstract
Two cases of trigeminal neurinoma located solely in the cavernous sinus are reported. Preoperatively, magnetic resonance imaging provided the accurate localization of the lesions, allowing precise planning of the surgical approach, that is, a subtemporal lateral approach and a pterional superior approach, respectively. The neurinomas inside the cavernous sinus were removed successfully, and the patients developed no new neurological deficits except for anesthesia in the 1st division of the trigeminal nerve. The characteristic magnetic resonance imaging findings of trigeminal neurinoma in the cavernous sinus are presented, and the different surgical approaches are discussed.
Delayed Hearing Loss after Neurovascular Decompression
Authors: McDonnell Dennis E. , Jabbari Bahman , Spinella Giovana , Mueller Gustave H. , Klara Peter M. 
Published: April 2011

Abstract
We report two unusual cases of delayed hearing loss after neurovascular decompression of structures within the cerebellopontine angle. In the first case, the patient noted a unilateral hearing loss 3 weeks after undergoing vascular decompression of the trigeminal nerve for tic douloureux. This gradually improved over an 18-month period. In the second case, the patient awoke on the 4th day after vascular decompression of the facial nerve for hemifacial spasm with a bilateral hearing loss that has remained unchanged after the onset. These are examples of delayed acoustic dysfunction occurring with a shift in surgically freed vessels and may have been induced by newly directed neurovascular compression or distortion.
Elevation of the Petrous Bone Caused by Hyperplasia of the Occipital Bone Presenting as Hemifacial Spasm: Diagnostic Values of Magnetic Resonance Imaging and Three-Dimensional Computed Tomographic Images in a Bone Anomaly
Authors: Tanaka Akira , Tanaka Tatsuroh , Irie Yutaka , Yoshinaga Shinya , Tomonaga Masamichi 
Published: April 2011

Abstract
A case of elevation of the petrous bone due to hyperplasia of the occipital bone presenting as hemifacial spasm is reported. A 44-year-old man sought treatment for twitching of the buccal muscles on the right side that progressed rapidly in severity within 2 weeks of the onset. The anatomical details of the petrous and occipital bones were delineated clearly by computed tomographic scans of a bone window level. Details of the brain stem were shown by magnetic resonance images. The bone anomaly was displayed more realistically by three-dimensional computed tomographic reconstructions. The faithful representation of structures with these radiological studies should be mandatory, to prepare the surgical planning of such a complicated bone anomaly.