bluuebunny/crossref_metadata_2025_split huggingface dataset:
Degenerative Spondylolisthesis with an Intact Neural Arch: A Review of 60 Cases with an Analysis of Clinical Findings and the Development of Surgical Management
Authors: Epstein Nancy E. , Epstein Joseph A. , Carras Robert , Lavine Leroy S. 
Published: May 2010

Abstract
The treatment over the past 12 years of 60 patients with degenerative spondylolisthesis with an intact neural arch is reviewed. The patients averaged 65 years of age, with women outnumbering men by a ratio of 2:1. Symptoms in the lower extremities had been present for 3 months to 10 years, although varying back pain had existed for longer periods. Two-thirds showed signs of motor dysfunction. Sensory alterations and a positive Lasėgue's sign could be demonstrated in only one-half of the patients studied. Four of 5 patients developed intermittent neurogenic claudication, with varying evidence of painful radiculopathy. The marked disability caused by claudication contrasted sharply with the lesser neurological changes, and these patients required early surgical decompression. Diagnostic studies included electro-myography, plain x-ray films, tomography, computed tomographic scanning, and myelography. The latter outlined a relative stenosis caused by olisthesis as well as arthrotic and spondylotic changes that determined the extent of decompressive operation required. The L-4, L-5 interspace was involved in 56 patients, L-3, L-4 was involved in 2, and L-5, S-1 was involved in 2. The ideal operation with L-4, L-5 olisthesis included complete laminectomy of L-4 and L-5 with unroofing of the lateral recesses and foraminotomy. This more extensive procedure was justified because of the failures encountered in previous patients in whom inadequate decompression had been performed. Among failures, obesity, diabetes, hyperlordosis, and extensive long-standing dysfunction were prominent. The relief of symptoms of intermittent neurogenic claudication was the most gratifying response observed. There was no unusual morbidity.
Do We Need to Cross Match Blood for Elective Laminectomy?
Authors: Sarma Deba P. 
Published: May 2010

Abstract
Elective laminectomy cases do not need a routine order for typing and cross matching of blood. Data from the literature and from personal experience in the blood bank of a 580-bed general hospital are presented to support this conclusion. An ABO-Rh type and an antibody screen can safely substitute for routine cross matches for such cases. The use of type and screen rather than cross match allows the blood bank to distribute limited blood resources more efficiently without jeopardizing the patients.
Bilateral Parietal Arteriovenous Malformations: Report of a Case
Authors: Stone James L. , Crowell Robert M. , Lisner Blaine M. , Naseem Mohammad , Oldershaw John B. 
Published: May 2010

Abstract
A patient with bilateral parietal arteriovenous malformations (AVMs) is reported. The clinical presentation included seizures, coma, and signs of tentorial herniation. After the evacuation of a large left intraparietal hematoma, cerebral angiography identified a small left parietal AVM, which was excised. Mass effect and increased intracranial pressure were present at the time of the initial angiography, and the presence of a right parietal AVM was not appreciated. Postoperative cerebral angiography to document excision of the left parietal AVM then disclosed the small right parietal AVM, which was later excised. The patient has recovered very well. The natural history of AVMs and the occurrence of multiple AVMs are discussed.
Intracerebral Hemorrhage Remote from the Site of the Initial Neurosurgical Procedure
Authors: Waga Shiro , Shimosaka Shinichi , Sakakura Makoto 
Published: May 2010

Abstract
Four cases of intracerebral hemorrhage remote from the site of the initial neurosurgical procedure are presented. Two of the four patients had preoperative hypertension. Possible mechanisms are discussed, and labile hypertension and unstable blood pressure during the perisurgical period may be contributory. Clinical awareness of this rare but potential complication is essential to early diagnosis and treatment. Difficulty in awakening from anesthesia and the development of new neurological deficits not attributable to the operative site are the most important keys to early diagnosis. Computed tomography is the diagnostic method of choice.
Moderate Grade Astrocytoma Presenting in a 4-Month-Old Child with a Family History of von Recklinghausen's Neurofibromatosis Spanning Four Generations: A Case Report
Authors: Epstein Nancy E. , Rosenthal Alan D. , Selman Jay , Osipoff Michael , Hyman Roger A. 
Published: May 2010

Abstract
Intracranial gliomas are found in association with von Recklinghausen's neurofibromatosis. However, few truly neonatal lesions have been identified and studied. This case report concerns a 4-month-old child who was found to have a massive thalamic glioma of moderate grade. Four paternal generations had suffered from different manifestations of this transmissible autosomal-dominant (Ad) phakomatosis.
Current Status of Carotid Endarterectomy for Atheromatous Disease
Authors: Loftus Christopher M. , Quest Donald O. 
Published: May 2010

Abstract
The authors discuss the indications for both elective and emergency carotid endarterectomy. Reports on the surgical treatment of asymptomatic bruit and contralateral carotid stenosis are reviewed. The results of endarterectomy for symptomatic carotid disease, including transient ischemic attacks, acute neurological deficit, and complete carotid occlusion, are discussed. The complications and risks of carotid surgery are also presented.
Spontaneous Arterial Subdural Hematoma
Authors: McDermott Michael , Fleming Ross J. F. , Vanderlinden Graham R. , Tucker William S. 
Published: May 2010

Abstract
The occurrence of spontaneous arterial subdural hematomas is very rare. We report five patients who presented with sudden severe headache and who developed progressive neurological deficits, two becoming comatose. None had a history of trauma. A diagnosis of subarachnoid hemorrhage was suspected in all patients, but all proved to have subdural hematomas caused by “spontaneous” rupture of a cortical artery. Nineteen similar cases have been reported in the English literature. The source of bleeding was identified as a cortical artery located near the sylvian region in four of our five patients and in most of the reported cases. There are several possible anatomical situations that may predispose a cortical artery to “spontaneous” rupture: (a) spontaneous rupture of a cortical artery at the point of origin of a fragile arterial twig, especially a right-angled branch, a point of potential weakness; (b) rupture of a small artery traversing the subdural space and connecting a cortical artery to the dura mater (a “bridging” artery); (c) adhesions between a cortical artery and arachnoid or dura mater; (d) a knuckle of cortical artery protruding through the arachnoid and adherent to the dura mater. In each situation, the artery is probably torn by a sudden movement of the brain during a vigorous head movement, not severe enough to be considered trauma.
Iohexol versus Metrizamide for Lumbar Myelography: Preliminary Report of Double-Blind Trial
Authors: Gebarski Stephen S. , Gabrielsen Trygve O. , Knake James E. , Latack Joseph T. , Hoff Julian T. 
Published: May 2010

Abstract
Lumbar myelography was performed in 38 patients; 19 received iohexol (an investigational aqueous contrast agent) and 19 received metrizamide. Iohexol is stable in solution, which is not the case with metrizamide. There was no other significant difference in diagnostic utility or quality between the two media. However, there was considerable postmyelography morbidity in the metrizamide group, but no postmyelography morbidity in the iohexol group. Preliminary clinical evidence suggests that iohexol is significantly superior to metrizamide as a contrast agent for lumbar myelography.
Quantitative Determination of Plasma Fibrinolytic Activity in Patients with Ruptured Intracranial Aneurysms Who Are Receiving ϵ-Aminocaproic Acid: Relationship of Possible Complications of Therapy to the Degree of Fibrinolytic Inhibition
Authors: Burchiel Kim J. , Hoffman John M. , Bakay Roy A. E. 
Published: May 2010

Abstract
Fifty-two patients were each given a constant infusion of 1.5 g of ϵ-aminocaproic acid (EACA) per hour after subarachnoid hemorrhage (SAH) from an intracranial aneurysm. Each patient's available plasminogen activity (APA), a measure of plasma fibrinolytic activity, was determined by fluorometric assay before and during EACA treatment. Five categories of potential EACA complications were identified: rebleeding, cerebral vasospasm, hydrocephalus, thrombosis, and miscellaneous (bleeding time prolongation, thrombocytopenia). The APA of the 37 patients with complications was significantly higher than that of the 15 without complications. Four patients suffered rebleeding episodes and had significantly higher APA levels during EACA therapy when compared to all other patients, i.e., those with and without other complications. Patients with vasospasm, hydrocephalus, and thrombotic complications also had significantly higher APA levels during EACA therapy compared to patients without complications. The latter may be simply a reflection of the activation of fibrinolytic activity that occurs after SAH. It is apparent from these studies that, after the initiation of EACA treatment, a maximal steady state inhibition of fibrinolytic activity is not achieved for 2 days and, after the cessation of EACA therapy, normal fibrinolytic activity is not restored for a period of 3 to 4 days. In addition, patients with thrombotic events may show persistently low serum plasminogen activity after discontinuance of EACA therapy, probably due to continuing thrombosis and consumption of plasminogen. These results indicate that patients with recurrent preoperative aneurysmal hemorrhage while on EACA therapy may have inadequate fibrinolytic inactivation, and this may be an important factor contributing to rebleeding episodes. The authors conclude that further studies of patients with SAH from ruptured intracranial aneurysms who are receiving EACA should be done to correlate serum fibrinolytic activity, rebleeding episodes, and other putative complications of antifibrinolytic therapy.
Neurosurgical Treatment of Nonmalignant Intractable Rectal Pain: Microsurgical Commissural Myelotomy with the Carbon Dioxide Laser
Authors: Fink Robert A. 
Published: May 2010

Abstract
Spinal cord neuroablative procedures for intractable midline pain have been limited in application because of frequent side effects and disabilities caused by manipulation of adjacent normal structures during the operation. The carbon dioxide laser, with its ability to execute microneurosurgical procedures without such manipulation, presents an opportunity to minimize adverse effects while still interrupting the desired pain-conducting fibers. Commissural myelotomy with the carbon dioxide laser in a patient suffering from pain due to nonmalignant disease and with a preoperatively intact spinal cord is described.
“Conjoined” Nerve Roots: A Requirement for Computed Tomographic and Myelographic Correlation for Diagnosis
Authors: Gebarski Stephen S. , McGillicuddy John E. 
Published: May 2010

Abstract
In a case of “conjoined” nerve roots with herniated nucleus pulposus, the computed tomographic findings were inconclusive, if not misleading. Myelography alone was also not definitive. Correlation of these two studies allowed a successful surgical approach.
Defective Cerebrovascular Autoregulation in Regions Proximal to Arteriovenous Malformations of the Brain: A Case Report and Topic Review
Authors: Solomon Robert A. , Michelsen Jost W. 
Published: May 2010

Abstract
We report the case of a patient with a large left subfrontal arteriovenous malformation (AVM) that was supplied by the right internal carotid artery. The anomalous blood supply developed because of complete occlusion of the left internal carotid artery. When the AVM was removed, the patient experienced a hemorrhage into the right basal ganglia. The possibility that this hemorrhage was related to a defect of autoregulation in blood vessels that lie proximal to a large AVM is discussed. Even though this is a unique case, the pathophysiological events that are documented are relevent to the preoperative preparation and surgical management of all patients with AVMs.
Tuberous Sclerosis: A Review for the Neurosurgeon
Authors: Nagib Mahmoud G. , Haines Stephen J. , Erickson Donald L. , Mastri Angeline R. 
Published: May 2010

Abstract
The clinical. radiological, and pathological characteristics of tuberous sclerosis are reviewed. Neurosurgical intervention in the syndrome is discussed in light of two recently treated cases and a literature review.
Method of Computed Tomography-based Stereotactic Biopsy with Arteriographic Control
Authors: Kelly Patrick J. , Alker George J. , Kall Bruce A. , Goerss Stephan 
Published: May 2010

Abstract
A method for computed tomography (CT)-based stereotactic biopsy of intracranial neoplasms with arteriographic control is described. Stereotactic CT and digitized stereotactic arteriographic data are input to a three-dimensional computer matrix that corresponds to the coordinate system of a stereotactic frame located in the operating room. A site for biopsy is selected by cursor from the CT display screen. The computer calculates and outputs the mechanical adjustments of the stereotactic frame necessary to place the target point into the focal point of the frame. Horizontal and vertical approach angles are determined from the digitized arteriogram and are displayed as settings on the stereotactic frame that represent an avascular trajectory along which the lesion may be biopsied safely. This procedure has been used successfully in 86 patients, with no morbidity or mortality.
Clinical Utility of Allogeneic Skull Discs in Human Craniotomy
Authors: Prolo Donald J. , Gutierrez Robert V. , DeVine Jeffrey S. , Oklund Sally A. 
Published: May 2010

Abstract
One hundred fifteen burr hole defects were filled with sterilized human cadaver skull in 45 patients ranging in age between 10 and 88 years. One to 6 allogeneic skull discs per patient were placed in all areas of the calvaria. The length of postoperative observation ranges between 6 months and 5 years. No instances of infection, resorption, or rejection have occurred. Discs became incorporated and were osteoconductive, with new bone formed by “creeping substitution.” In contrast to frozen autogeneic skull, these allogeneic discs were not resorbed. Allogeneic skull may be used safely and effectively to fill small discontinuity defects in the human calvaria.
Myxopapillary Ependymoma of the Filum Terminale and Cauda Equina in Childhood: Report of Seven Cases and Review of the Literature
Authors: Chan Helen S. L. , Becker Laurence E. , Hoffman Harold J. , Humphreys Robin P. , Hendrick Bruce E. , Fitz Charles R. , Chuang Sylvester H. 
Published: May 2010

Abstract
Seven of fourteen children with spinal cord ependymoma had myxopapillary tumors of the filum terminale. These tumors made up 15.9% of all primary spinal neuroectodermal tumors in children (44 cases) seen during a 62-year period (1919 to 1981). Their clinical presentation, radiological features, pathological findings, treatment, and outcome are reported. Six of the seven patients were known to be alive at the time of writing. The seventh patient was lost to follow-up after 3 years without tumor recurrence. Of 5 patients whose primary mode of treatment was operation alone, 3 had intraspinal or intracranial recurrences. Despite tumor recurrences, 2 patients were long term survivors after further operation and irradiation, whereas the third patient recently received craniospinal irradiation for intracranial tumor recurrence. The 2 patients who did not have tumor recurrence after operation alone had been followed for 3 and 7 years, respectively. Two children with subtotal tumor resection and spinal irradiation had no recurrences at 1 and 17 years, respectively. Our data suggest that this unusual subtype of spinal ependymoma is not uncommon during childhood and has a good prognosis. All patients with this tumor require prolonged follow-up for tumor recurrence after operation and irradiation.
Cerebral Abscess: Loss of Computed Tomographic Enhancement with Steroids
Authors: Black Keith L. , Farhat Saeed M. 
Published: May 2010

Abstract
A case of cerebral abscess with decreased computed tomography enhancement and clinical improvement after steroid therapy alone is reported. When the steroids were discontinued, the computed tomography enhancement increased and the patient's clinical condition deteriorated. The abscess subsequently ruptured with the development of ventriculitis. The infection was not eradicated with penicillin or chloramphenicol, but was effectively treated with metronidazole.
Neurosyphilis Presenting as a Focal Mass Lesion: A Case Report
Authors: Kulla Lawrence , Russell James A. , Smith Thomas W. , Zito Joseph L. , Davidson Robin 
Published: May 2010

Abstract
A patient with subacute aphasia and hemiparesis was found to have a low density white matter lesion with mass effect on the computed tomographic (CT) scan. Serological examination and biopsy established the diagnosis of paretic neurosyphilis. This CT appearance has not previously been described in cases of neurosyphilis. Neurosyphilis should be considered as a potentially treatable cause of a cerebral mass lesion.
Extreme Lateral Disc Herniation: Diagnosis by Computed Tomographic Scanning
Authors: Godersky John C. , Erickson Donald L. , Seljeskog Edward L. 
Published: May 2010

Abstract
Extreme lateral disc herniation with compression of the nerve root as it exits through the foramen has been a recognized entity for a number of years. Until recently, this diagnosis was made infrequently except at the time of operation. Reported here are 12 cases of root compression from disc herniation at the level of the pedicle or farther laterally in the foramen (extreme lateral disc herniation). Diagnosis and localization of the root compression were determined preoperatively in 11 of 12 cases based on the computed tomographic (CT) scan appearance of the lesion. Myelography was performed in 9 cases and was interpreted as normal in 6 and abnormal in 3 instances. In each of the 3 abnormal studies, the actual abnormality was at a different level than that predicted by the myelogram. The clinical presentations in these patients were not distinct except that a positive straight leg raising test was present in only 7 of 12. Preoperative knowledge of the site of nerve root compression as delineated by CT scanning was essential in planning the operative procedure. It prevented unnecessary exploration of uninvolved levels and directed the surgeon to the far lateral site of the herniation. Illustrative examples are presented.
Connatal Brain Tumors in Patients with Tuberous Sclerosis
Authors: Painter Michael J. , Pang Dachling , Ahdab-Barmada Mamdouha , Bergman Ira 
Published: May 2010

Abstract
Two neonates with tuberous sclerosis and giant cell astrocytomas diagnosed soon after birth are described. During attempted surgical resection of their tumors, both infants developed refractory intraoperative cardiac arrhythmias and died. At autopsy, both patients had multiple cardiac rhabdomyomas. Subependymal giant cell astrocytomas rarely present in the neonate, but genetic implications and associated cardiac hamartomas warrant special consideration of these connatal tumors. Surgical considerations suggest that an operative approach to these tumors should be delayed beyond the neonatal period.
Low Grade Glioma Presenting as Subarachnoid Hemorrhage
Authors: Memon Muhammed Yacob , Neal A. , Imami R. , Villareal N. 
Published: May 2010

Abstract
During the last 2 years, we treated three cases of brain tumor that presented with intracranial hemorrhage. Two of the three tumors were metastatic. They presented with hemorrhage into the tumor, but no blood in the cerebrospinal fluid. One tumor was a low grade astrocytoma that presented as subarachnoid and intraventricular hemorrhage in a 15-year-old child. It was removed with no neurological sequelae.
Subdural Hemorrhage Secondary to Extramedullary Hematopoiesis in Postpolycythemic Myeloid Metaplasia
Authors: Brown Jeffrey A. , Gomez-Leon Guillermo 
Published: May 2010

Abstract
A 64-year-old woman with a 20-year history of polycythemia vera and a 2-month history of postpolycythemic myeloid metaplasia (PPMM) became comatose because of bilateral subdural hematomas. Biopsy of the dura mater at operation demonstrated extramedullary hematopoiesis (EMH). The subdural hemorrhage was secondary to dural invasion by hematopoietic tissue and vascular dilation with a predisposing element of thrombocytopenia. This is the second case of central nervous system (CNS) EMH in a case of polycythemia vera. Only 8 cases of symptomatic CNS EMH and 16 cases overall have been reported, and these were primarily due to agnogenic myeloid metaplasia. Symptoms were secondary to the mass effect of dural tumor-like hematopoietic tissue or to an elevated cerebrospinal fluid protein content. The survival after a diagnosis of PPMM with CNS EMH has been less than 6 months in all cases. CNS EMH is an unusual and a potentially critical complication of polycythemia vera that should be considered in the evaluation of the patient with polycythemia vera and myeloid metaplasia.
Penetrating Injury of the Tuberculum Sellae
Authors: Nath F. P. , Teasdale E. , Mendelow A.D. 
Published: May 2010

Abstract
An unusual case of perforation of the tuberculum sellae and right ethmoid bone by a 10-in, serrated bread knife is described. The patient survived with no neurological or endocrine deficit. The importance of preoperative angiography and control of the proximal and distal vasculature is stressed.
Squamous Cell Carcinoma and Meningomyelocele
Authors: Chadduck William M. , Uthman Edward O. 
Published: May 2010

Abstract
A case of invasive squamous cell carcinoma arising in the skin overlying a large lumbar meningomyelocele is reported. This case is unique in that a chronic neurocutaneous fistula was not present. It is proposed that chronic irritation of the meningomyelocele was the primary factor in the pathogenesis of the cancer.
Intramedullary Subependymoma of the Cervical Spinal Cord: Case Report
Authors: Salcman Michael , Mayer Richard 
Published: May 2010

Abstract
The third case of intramedullary subependymoma of the cervical spinal cord is reported. This is the first such case for which intraoperative views are available. It was possible to remove most of this lesion with the aid of the operating microscope, the carbon dioxide laser, and the use of somatosensory evoked potentials. The diagnosis was clouded by the coexistence of Holmes-Adie pupils and absent reflexes in the lower extremities. All three reported intramedullary subependymomas have been found in the cervical spinal cord of middle-aged patients. Tumors in this clinical setting should not be assumed to be unresectable astrocytomas without careful histopathological and intraoperative evaluation.