bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spinal Meningiomas: Review of 174 Operated Cases
Authors: Solero Carlo L. , Fornari Maurizio , Giombini Sergio , Lasio Giovanni , Oliveri Giuseppe , Cimino Carlo , Pluchino Franco 
Published: April 2011

Abstract
The long-term results obtained in a series of 174 patients operated on for spinal meningiomas are critically analyzed. This series was similar to those of other authors with regard to age, sex, location of the tumors, and clinical presentation. Before surgery, about 70% of the patients were included in Groups I and II (mild neurological impairment), and about 30% of the patients were classified in Groups III and IV (significant to severe neurological impairment, up to paraplegia). Complete tumor removal was achieved in 96.5% of the patients, and surgical mortality was about 1%. Microsurgical technique, which was adopted in the last 29 cases, proved to be very effective in reducing undue damage to the spinal cord and in minimizing the postoperative neurological deficits. Of the 174 patients who underwent surgery, 156 underwent late follow-up study for an average of 15 years (2 patients died in the immediate postoperative period, and 16 patients were lost to follow-up). Twenty-nine patients died of causes unrelated to the spinal meningioma; of the remaining 126 patients, 92% were categorized in Groups I and II, and only 8% in Groups III and IV. The rate of recurrence was 6% (9 patients) among the 150 patients who had complete tumor removal, and the rate of regrowth was 17% (1 patient with anaplastic meningioma) among the 6 patients treated by subtotal removal. The early diagnosis of the disease and the use of microsurgical technique appeared as the most relevant factors for further improvement of the surgical results.
Using a National Health Care Data Base To Determine Surgical Complications in Community Hospitals: Lumbar Discectomy as an Example
Authors: Ramirez Lincoln F. , Thisted Ronald 
Published: April 2011

Abstract
To determine the incidence of acute complications of an operation in a large cross-section of U.S. community hospitals, we developed a method that combines the screening of discharge abstracts with the sampling of medical records. Our target patients were those who underwent discectomy for routine lumbar discogenic radiculopathy. We assembled 39,389 discharge abstracts of patients who underwent lumbar discectomy in the U.S. in 1980. This population contained some nontarget patients with a) errors in principal diagnosis or procedure, b) operations exceeding two levels, c) fusion, d) previous laminectomy, or e) problems of the lumbar spine in excess of routine disc disease. Screening of discharge abstracts allowed us to exclude some of these patients. Those remaining were then divided by the reported hospitalization into three groups: 1) death, 2) nonfatal complication, and 3) normal hospitalization. A sample of patients from each group was selected for detailed study, and questionnaires were mailed to hospital medical records departments to confirm the hospitalization and to obtain other medical information unavailable in the abstract. With this information, we 1) removed the remaining nontarget patients a through e above); 2) categorized reported complications as erroneous, preexistent, trivial or major; 3) calculated the incidence of major complications; and 4) assessed the reliability of the discharge abstract data. Principal diagnosis and procedure were reliably coded in 96.5% of abstracts. No deaths were reported in error and none were excluded in error. Among patients who had complications, 4% of the abstracts incorrectly indicated complications, and 11% omitted one complication while correctly reporting others. Among the abstracts reporting a normal hospitalization, 0.7% omitted a complication. The abstract data had a 62% sensitivity and a 99% specificity for complications. Based on a final clean population of 28,395 patients, the incidence of death (per 10,000) was 5.9, and that of serious complication was 157.
Cerebellar Astrocytomas in Elderly Patients with Very Long Preoperative Histories: Report of Three Cases
Authors: Kepes John J. , Whittaker Keith C. , Watson Kenneth , Morantz Robert A. , Millett Ruth , Clough Charles A. , Oxley Dwight K. 
Published: April 2011

Abstract
Three patients, ages 69, 67, and 74 years, respectively, underwent surgical removal of cystic cerebellar astrocytomas. All three had past histories pointing to the existence of a cerebellar lesion for many decades prior to surgery: Patient 1 had had nystagmus on lateral gaze on the side of the tumor since early childhood; Patient 2 had had sensorineural hearing loss on the side of her neoplasm for 38 years preceding the operation; and Patient 3 was diagnosed as having a brain tumor 51 years before the operation. (He has been blind because of pressure hydrocephalus for half a century, but otherwise managed to live a productive farming and family life until he sustained a head injury in a car accident, which forced him to undergo removal of his cerebellar tumor.) The neoplasms in all three instances were found by histological examination to be low-grade astrocytomas. These cases indicate that low-grade cerebellar astrocytomas, which are well known for their characteristically long postoperative courses, may at times manifest a slow growth potential with an exceptionally long preoperative course.
Myeloradiculopathy Secondary to Pseudogout in the Cervical Ligamentum Flavum: Case Report
Authors: Gomez Heldo , Chou Samuel M. 
Published: April 2011

Abstract
A case of cervical myeloradiculopathy secondary to deposits of calcium pyrophosphate dihydrate (Ca2P2O7 2H2O) (CPPD) crystals in the degenerating ligamentum flavum, with marked granulomatous inflammation, is presented. This uncommon clinical presentation of pseudogout (CPPD deposition disease) was confirmed after surgical removal of a compressive cervical ligamentum flavum. The diagnosis of CPPD crystal deposition was determined by polarized light microscopy and energy-dispersive x-ray microanalysis in frozen sections of the biopsy specimen. A review of seven previously reported cases along with the present case failed to reveal trauma as a causative factor.
Mechanical Aspiration of Hematomas in an in Vitro Model
Authors: Kaufman Howard H. , Herschberger Joyce E. , Maroon Joseph C. , Wilberger Jack E. , Onik Gary M. 
Published: April 2011

Abstract
A modified Nucleotome (Surgical Dynamics, San Leandro, California) was used to aspirate blood clot in an in vitro model of intracerebral hematoma. This machine was successful in removing the clot at a reasonably rapid rate. It aspirates normal rat brain far more slowly. It therefore shows promise for being effective and safe in removing intracerebral hematomas in humans.
Titanium Mesh and Acrylic Cranioplasty
Authors: Malis Leonard I. 
Published: April 2011

Abstract
Since June 1985 100 cranioplasties have been carried out using titanium mesh and acrylic. There have been no complications and no infections. Titanium mesh is virtually radiolucent. Titanium is nonmagnetic and is the most biocompatible metal known.
Titanium Wire Internal Fixation for Stabilization of Injury of the Cervical Spine: Clinical Results and Postoperative Magnetic Resonance Imaging of the Spinal Cord
Authors: Geisler Fred H. , Sutton Leslie N. , Mirvis Stuart E. , Zrebeet Hafez , Joslyn John N. 
Published: April 2011

Abstract
Nine patients with dislocation of the cervical spinal with posterior ligamentous damage were treated with posterior internal fixation using a twisted pair of 22-gauge titanium wires and iliac crest bone fusion. Fixation using the titanium wire was compared with fixation using stainless steel wire for differences in surgical insertion, long term stability of bony fusion, and postoperative magnetic resonance imaging (MRI) artifacts near the implanted wire. MRI of the cervical spine is valuable for diagnosing the acute and chronic consequences of traumatic cervical spinal injury by providing anatomic evaluation of both the spinal cord and the supporting bony/ligamentous structures in the neck. Because MRI is an accurate and sensitive noninvasive test, it is especially useful for the long-term serial assessment of the region near the cervical dislocation site to detect the sequelae of spinal cord injury, including syrinx, arachnoid cyst, cord tethering, and persistent mechanical impingement on the spinal cord or spinal roots. Previous attempts at our institution to obtain useful MRI scans of the cervical region adjacent to stainless steel wires after posterior wire fixation have failed due to marked imaging artifacts arising from the ferromagnetic properties of these wires. Our substitution of biocompatible titanium wire (Titanium 6 A1-4V ELI alloy, Specialty Steel and Forge, Leonia, New Jersey) for stainless steel wire produced identical immediate stabilization and ultimate bony fusion of the fracture and yielded minimal MRI artifacts overlying the immediately adjacent spinal cord and neural canal; however, the installation was technically more difficult, because of the titanium wire's greater stiffness. We believe that the implantation of a permancent fixation device in these patients should be made of an MRI-compatible material, such as titanium wire, to allow serial imaging with MRI in their lifelong medical care.
Stereotactic Craniotomy: Methods and Results Using the Brown-Roberts-Wells Stereotactic Frame
Authors: Moore Matthew R. , Black Peter McL. , Ellenbogen Richard , Gall Clifford M. , Eldredge Elizabeth 
Published: April 2011

Abstract
Combining the power of stereotactic precision with open craniotomy in a stereotactic craniotomy technique decreases surgical time, morbidity, and postoperative hospitalization. Indications for its use are deep intrinsic masses 3.5 cm or less in diameter; small, superficial lesions otherwise difficult to localize; and lesions associated with motor, visual, or speech areas. Using the standard Brown-Roberts-Wells system allows a) precisely planned cortical entries, b) gross total lesion excisions under direct vision, c) use of probe-guided resection margins, d) small craniotomies through linear incisions, and e) use of local anesthetic alone for resections. The method and results of this universally available and relatively inexpensive technique are discussed in reference to 20 patients.
Laser-Assisted Reconstruction of the Oculomotor Nerve: Experimental Study on the Feasibility of Cranial Nerve Repair
Authors: Seifert Volker , Stolke Dietmar 
Published: April 2011

Abstract
In this experimental study the feasibility of microsurgical laser-assisted repair of the oculomotor nerve in the cat was investigated. The 3rd cranial nerve was explored after a temporobasal craniectomy from its exit at the brain stem to its entrance into the cavernous sinus and transected. The cut nerve ends were loosely reapproximated and welded together with a CO2milliwatt laser using a power setting of 80 to 90 mW and a spot size of 150 M. Regeneration of the oculomotor nerve within an observation period of 12 months as assessed by weekly examination of the pupil diameter was excellent in 4 animals and satisfactory in 2. In the two control groups consisting of 6 animals in which the nerve reconstruction had been performed with fibrin glue or by simple nerve reapproximation minimal nerve regeneration could be observed only in one animal. The histomorphological examinations revealed good regeneration across the laser anastomosis including new formation of a perineural sheath without any significant scarring effect or constriction at the anastomotic site. It is concluded that the CO2milliwatt laser might be a useful tool for the microsurgical repair of cranial nerves and should possibly be incorporated into the neurosurgical armamentarium of reconstructive cranial nerve surgery.
Microvascular End-to-Side Arterial Anastomosis Using the Nd: YAG Laser
Authors: Shapiro Scott , Sartorius Carl , Sanders Steven , Clark Steve 
Published: April 2011

Abstract
End-to-side, laser-assisted vascular anastomosis (LAVA) using a Nd:YAG laser was successfully performed on rat carotid arteries. A midline neck incision allowed isolation and approximation of both carotid arteries in an end-to-side fashion using four 10-0 nylon stay sutures. The laser parameters used for vessel fusion were 0.3-second 5-W pulses at a spot size of 600 Mm. Anastomoses were analyzed at various time intervals from 1 day to 6 months by angiogram and histological examination. The anastomotic patency was 86%. Aneurysm formation occurred in 23%. Histological examination revealed an acute/subacute transmural injury both at the anastomotic site and several hundred microns away, with delayed re-endothelialization and some attempt at muscular and elastic regeneration. Histological assessment of the aneurysms demonstrated a total loss of the internal elastic lamina and muscularis. A brief discussion comparing Nd:YAG LAVA to other LAVA techniques follows.
Brain Metastasis from Nonseminomatous Germ Cell Tumors of the Testis: Case Report and Review of the Role of Surgery
Authors: Jelsma Richard K. , Carroll Michael 
Published: April 2011

Abstract
The prognosis for patients with nonseminomatous germ cell tumor of the testis is good, even when extensive metastatic disease is present, because this tumor is very sensitive to chemotherapy with cisplatin, vinblastine, and bleomycin (PVB). If a metastasis occurs in the brain, however, the prognosis is poor because the blood-brain barrier limits the entrance of these drugs into the brain and creates a sanctuary for tumor. The current treatment for a brain metastasis is either standard PVB chemotherapy plus whole brain radiation therapy or a rigorous chemotheraputic regimen that penetrates the blood-brain barrier better than PVB. Surgery is seldom used for brain metastasis, largely because of the poor results with surgical debulking in noncentral nervous system disease. This is the report of a patient with disseminated nonseminomatous germ cell tumor and multiple large brain metastases, who was treated with surgery, PVB, and whole brain radiation therapy and cured. Evidence is presented to support a role for surgical debulking in patients with large brain metastasis.
Causes of Morbidity and Mortality from Surgery of Aneurysms of the Distal Basilar Artery
Authors: Batjer Hunt H. , Samson Duke S. 
Published: April 2011

Abstract
Despite modern neurosurgical technology and neuroanesthetic care, treatment of aneurysms of the distal basilar artery remains fraught with complications. Between 1982 and 1988, 126 patients with aneurysms of the distal basilar artery who had been treated by 2 surgeons were retrospectively analyzed to determine the causes of morbidity and mortality from this disease and its treatment. Ten patients (8%) died, and 14 patients (11%) suffered permanent neurological disability after treatment. The causes of failed management could be grouped into the following categories: 1) direct effects of hemorrhage; 2) errors in surgical timing; 3) conceptual errors; 4) technical errors; 5) morbidity from delayed cerebral ischemia; and 6) complications of hypertensive/hypervolemic therapy for symptomatic vasospasm; a small group of patients who died despite having received what we consider excellent management were grouped under a seventh category, “bad luck.” Frequently, patients who did poorly suffered from multiple complications, each of which contributed to their overall morbidity. It is our hope that increased awareness of these potential pitfalls and the further evolution of intravascular technique in selected cases will, in time, improve the outlook for patients suffering from these dangerous lesions.
The Calmodulin Antagonist Trifluoperazine Provides Mild Prophylactic protection against Cerebral Vasospasm after Subarachnoid Hemorrhage, but No Therapeutic Value
Authors: Peterson John W. , Candia Guillermo , Spanos Athanasios J. , Zervas Nicholas T. 
Published: April 2011

Abstract
In vitro studies of the canine basilar artery have demonstrated that calmodulin antagonism can effectively inhibit cerebral arterial smooth muscle contractility. The prophylactic and therapeutic effectiveness of a potent calmodulin antagonist. the phenothiazine compound tnfluoperazine (TFP). was investigated in vivo over a wide range of doses in the well-documented “double-subarachnoid hemorrhage” canine model of cerebral vasospasm. The compound is perhaps more well-known under its trade name. Stelazine. as a classic antipsychotic drug. The drug demonstrated no therapeutic relief of preexisting chronic cerebral vasospasm at any time during 2 days of systemic administration at any practical dose. At doses far in excess of the normally accepted therapeutic range in humans. a prophylactic regimen reduced the severity of chronic cerebral vasospasm after subarachnoid hemorrhage by approximately 35% compared to untreated dogs.
Fatal Phenytoin-Related Toxic Epidermal Necrolysis: Case Report
Authors: Kelly Daniel F. , Hope Donald G. 
Published: April 2011

Abstract
Toxic epidermal necrolysis is a rare but often fatal hypersensitivity reaction to numerous agents, including most anticonvulsants. The authors present a case of fatal phenytoin-related toxic epidermal necrolysis in a patient who was given prophylactic anticonvulsant therapy after he sustained a moderately severe closed head injury. The typical course and current management of toxic epidermal necrolysis are reviewed, as are the indications for the prophylaxis of posttraumatic epilepsy.
Balo's Concentric Sclerosis: A Variant of Multiple Sclerosis Associated with Oligodendroglioma
Authors: Shankar Susarla K. , Rao Tirupattur Vasudev , Srivastav Vinod K. , Narula S. , Asha Thota , Das Sarala 
Published: April 2011

Abstract
We report a case of Balo's concentric sclerosis, a rare and acute variant of multiple sclerosis, which coexisted with an oligodendroglioma. The demyelinating lesion was clinically silent and was detected at necropsy. The pathogenesis of concentric sclerosis and the relationship of the demyelinating lesion to the evolution of the glial neoplasm is briefly discussed.
Implantation of a Reservoir for Recurrent Subdural Hematoma Drainage
Authors: Laumer Rudolf , Schramm Johannes , Leykauf Karin 
Published: April 2011

Abstract
In a prospective study 144 adult patients with chronic subdural hematomas were randomly divided into three treatment groups after burr-hole evacuation. The two commonly used procedures (external closed system drainage and aspiration and irrigation without any drainage) were compared to a modified technique: permanent subdural drain with subcutaneous reservoir. After the hematoma was washed out with saline solution, a silicon catheter with multiple perforations was introduced into the subdural cavity and connected to a Rickham reservoir, fixed in the frontoparietal burr hole. In patients who showed secondary deterioration or enlargement of the residual hematoma as proven by computed tomographic scan, the reservoir was punctured and the subdural fluid aspirated. The great advantage of this method is that it is practicable at the bedside as well as in the outpatient department, thus making it possible to reduce the number of additional operations. The incidence of symptomatic residual or recurrent hematoma was similar in all three groups. The reoperation rate was 4-fold greater in the groups treated with conventional therapy, when compared to the group with the implanted system. At the same time there was no indication that the implantation of the drain was less safe, as judged by the incidence of seizures and infections.
Cavernous Hemangioma in the Cavernous Sinus: Case Report
Authors: Sawamura Yutaka , de Tribolet Nicolas 
Published: April 2011

Abstract

The case of a middle-aged woman with a cavernous hemangioma of the right cavernous sinus who showed ipsilateral hemianopsia associated with contralateral blindness caused by left retrobulbar optic neuritis is presented. Total removal of the tumor was followed by recovery of the visual function of the right eye. (Neurosurgery 26:126-128, 1990)
Leptomeningeal Cyst Resulting from Adulthood Trauma: Case Report
Authors: Halliday Andrea L. , Chapman Paul H. , Heros Roberto C. 
Published: April 2011

Abstract

The authors report a rare sequelae of a skull fracture in an adult, a leptomeningeal cyst. A unique method for repairing this defect is described as well. (Neurosurgery 26:150-153, 1990)
Somatosensory and Auditory Brain Stem Conduction after Head Injury: A Comparison with Clinical Features in Prediction of Outcome
Authors: Lindsay Kenneth , Pasaoglu Aydin , Hirst David , Allardyce Gwen , Kennedy Ian , Teasdale Graham 
Published: April 2011

Abstract
Evoked potential conduction times in brain stem auditory (BCT) and central somatosensory pathways (CCT) were recorded from 23 normal subjects and 101 patients with severe head injury. Abnormalities in the CCT and the BCT findings correlated with the clinical indices of brain damage (coma score, motor response, pupil response, and spontaneous and reflex eye movements) in the head-injured patients and each correlated with outcome at 6 months from the injury. The CCT in the “best” hemisphere produced the strongest correlation with outcome (P&lt;0.001). The correlation of the CCT with outcome was stronger in the 47 patients examined 2 to 3 days after the injury (P&lt;0.001) compared to the 34 patients examined within 24 hours after the injury (P&lt;0.02). No such difference was noted for the BCT. Serial studies within the first 2 weeks of injury did not show a consistent pattern and repetition of the investigation over this period did not provide any additional information. We used an INDEP-SELECT discriminant analysis program to determine whether information from the evoked potential data could improve prediction of outcome based on clinical data alone. With the addition of the CCT, the predictive accuracy (expressed as the correct classification probability) increased only slightly from 77 to 80%, and the difference was not significant. We conclude that central somatosensory and auditory brain stem conduction times provide useful prognostic information in paralyzed or sedated patients, but when neurological examination is feasible the benefits of evoked potential analysis do not justify the effort involved in data collection.
Treatment of a Giant Aneurysm of the Cavernous Internal Carotid Artery Associated with a Persistent Primitive Trigeminal Artery: Case Report
Authors: Miyatake Shin-ichi , Kikuchi Haruhiko , Kondoh Soh-ichirou , Higashi Toshio , Yamagata Sen , Nagata Izumi 
Published: April 2011

Abstract
A case of an unruptured giant aneurysm of the cavernous portion of the left internal carotid artery associated with a persistent primitive trigeminal artery (PTA) is presented. The usual surgical approach to giant aneurysms at this site. including ligation of the ipsilateral internal carotid artery (ICA) and an extracranial-intracranial (EC-IC) bypass, was inadequate because of continued blood supply to the aneurysm via the PTA from the vertebrobasilar system. The patient was successfully treated with a combination of EC-IC bypass surgery, ICA ligation, and simultaneous intravascular balloon obliteration of the ICA just distal to the junction of the PTA and immediately proximal to the aneurysmal neck. Follow-up radiological investigations showed thrombosis of the aneurysm.
Hyperprolactinemia in a Patient with a Pituitary and an Ovarian Dermoid Tumor: Case Report
Authors: Klonoff David C. , Kahn Douglas G. , Rosenzweig William , Wilson Charles B. 
Published: April 2011

Abstract
A patient with galactorrhea. amenorrhea, and hyperprolactinemia caused by a dermoid tumor of the pituitary gland is presented. The patient had a prior history of an ovarian dermoid tumor. The pathology of dermoid tumors is discussed along with the management of pituitary tumor-associated hyperprolactinemia. This is the first reported case of an intracranial and an ovarian dermoid tumor occurring in the same patient.