bluuebunny/crossref_metadata_2025_split huggingface dataset:
Flow-regulated Continuous Spinal Drainage
Authors: Swanson Steven E. , Kocan Mary Jo , Chandler William F. 
Published: May 2010

Abstract
A new method for continuous external drainage of cerebrospinal fluid (CSF) for the treatment of CSF fistulas is described. In this system, CSF is withdrawn continuously from the lumbar subarachnoid space at a controlled flow rate calculated to be slightly less than the natural absorption rate of CSF. Controlled spinal drainage can be achieved using equipment readily available in most intensive care units. This system was developed to prevent pneumocephalus during CSF drainage, as illustrated in the case presentation.
Transcranial Enucleation for Optic Nerve Tumor
Authors: Sacks Joel G. , McLennan James E 
Published: May 2010

Abstract
Tumors involving both the eye and the optic nerve present a special surgical problem. Conventional enucleation techniques neither permit the surgical exploration of the optic nerve nor assure the complete removal of tumor within the orbit, and they often involve transection through tumor-containing tissue. Transcranial enucleation permits the inspection of the tumor from the back of the globe to the chiasm and its en bloc removal.
Flaccidity after Head Injury
Authors: Butterworth John F. , Selhorst John B. , Greenberg Richard P. , Miller Douglas , Gudeman Steven K. 
Published: May 2010

Abstract
Upon admission, 17 of 223 (8%) consecutive patients with severe head injury exhibited a flaccid, wholly unresponsive motor examination. In this study alcoholic intoxication neither caused depressed motor responsiveness in head-injured patients with high serum ethanol levels nor accounted for the motor examination in those exhibiting the flaccid state. Flaccidity was attributed principally to impaired ventilation in 4 patients, a major intracranial mass in 12. and a spinal cord injury in 1. Compared to the larger group of head-injured patients, the flaccid patients had a significantly greater incidence of hypercapnia (P &lt; 0.001), acidosis (P &lt; 0.01), and both elevated and uncontrollable intracranial pressure (ICP) (P&lt; 0.001). These findings and the high mortality rate (76%) in this study suggest that the magnitude of respiratory complications and the severity of mechanical brain injury are greater in flaccid patients. The flaccid patients undergoing surgical decompression for major intracranial mass lesions (11 cases) have all died and. although still small in number, this group may represent an important subset with a poor prognosis. Nonetheless, a protocol that encourages rapid radiological and electrophysiological assessment and vigorous surgical and ICP management until the probable cause of flaccidity is identified and treated has benefit. The flaccid state was reversed and a good recovery was attained after the restoration of blood pressure and/or ventilation in 2 patients who appeared to have sustained a very grave head injury. In another patient, absent somatosensory evoked potentials greatly facilitated the diagnosis of a spinal subdural hematoma. This program of prompt diagnosis and intense therapy did not result in a protracted course or undue numbers of severely braindamaged survivors.
Spinal Epidural Abscess in Children
Authors: Fischer Edwin G. , Greene Clarence S. , Winston Ken R. 
Published: May 2010

Abstract
This is a report of three children with spinal epidural abscess. The literature is reviewed and the features of this condition in children are noted. Because of the nonspecificity of presenting symptoms in children, the diagnosis may be delayed. resulting in a worse outcome, especially in children under I year of age. The extensive laminectomy advised for the treatment of spinal epidural abscesses in adults is undesirable in children because of the risk of spinal deformity and in most cases is probably not necessary.
Delayed Complication of Matson Operation for Hydrocephalus
Authors: Friedman Phillip , Cass Harvey H. 
Published: May 2010

Abstract
A 26-year-old woman had had a lumbar subarachnoid-ureteral shunt established at the age of 10 weeks for hydrocephalus, She developed normally and had no trouble until meningitis developed because of reflux from a urinary tract infection. The meningitis responded to antibiotic treatment, and the shunt was removed from the subarachnoid space. Subsequently. the patient deteriorated clinically, with ictal episodes of altered consciousness, headache, and signs of midbrain dysfunction. Despite normal size ventricles on serial computed tomographic scans, her intracranial pressure was markedly elevated. which was shown by spinal puncture pressure. A diversionary lumboperitoneal shunt was inserted. An immediate, sustained recovery followed. The recognition of increased intracranial pressure in the absence of ventriculomegaly led to management that averted a disastrous outcome.
Traumatic Intracranial Aneurysm in an Infant
Authors: Laurent John P. , Cheek William R. , Mims Thomas , McCluggage Charles W. 
Published: May 2010

Abstract
Nonpenetrating head injury causing an intracranial aneurysm in an infant is rare. A case of this type is presented and the pertinent literature is reviewed. Because of the high mortality and morbidity associated with traumatic aneurysms, infants with severe head injury require cognizance that late deterioration may be due to an intracranial aneurysm.
Intracerebral Metastasis of Esophageal Carcinoma
Authors: Chalif David , Epstein Nancy , Flamm Eugene S. , Whelan Margaret , Budzilovich Gleb 
Published: May 2010

Abstract
Esophageal carcinoma is a rare but recognized source of intracerebral metastatic tumors. The case of a 62-year-old man with an isolated intracerebral metastasis from this primary focus is presented and discussed, Total excision was followed by complete resolution of the patient's neurological deficit.
Hyperthermia for Brain Tumors
Authors: Salcman Michael , Samaras George M. 
Published: May 2010

Abstract
Hyperthermia has great potential as an antineoplastic agent because: (a) it is effective against relatively radioresistant hypoxic cells and cells in S phase: (b) unlike most chemotherapeutic agents. it is effective against poorly vascularized and metabolically quiescent tissues; (c) as a physical agent, its biological effect is related to the duration and intensity of its application; (d) it seems to have no cumulative toxicity; and (e) it potentiates the effects of both chemotherapy and ionizing radiation at the cellular level. The use of hyperthermia for malignant brain tumors is constrained by a relatively narrow therapeutic index and the considerable thermal sensitivity of normal neural tissue. Glioblastoma multiforme, by virtue of its low growth fraction and heterogeneous cell populations, seems to be an ideal candidate for hyperthermia administered as part of a combined modality treatment program. Focal hyperthermia can be produced by a number of energy sources, including those utilizing ultrasound, microwave, and radiofrequency generators. The clinical safety and feasibility of a miniature microwave radiator/sensor system for direct implantation have been demonstrated. In comparison to normal feline brain, malignant brain tumors in humans are unable to dissipate heat efficiently.
Diagnosis of Acoustic Neurinoma
Authors: Harner Stephen G. , Laws Edward R. 
Published: May 2010

Abstract
Seventy-six patients underwent the primary removal of an acoustic neurinoma at the Mayo Clinic from 1978 through 1980. Hearing loss was present in 97% of the patients, and tinnitus and dysequilibrium occurred in 70% of the patients. The most common signs were a decreased corneal reflex. nystagmus. and facial hypesthesia. In these patients, pure tone and speech audiometry are used to define the hearing loss. When hearing is still present, the speech discrimination is often disproportionately low. Acoustic reflex testing and brain stem evoked response are used to determine whether the hearing loss is cochlear or retrocochlear. When these tests could be performed in this series of patients. they were accurate in 85 to 95%. The vestibular response to caloric testing is expected to be decreased or absent in about 90% of patients, and this was so in 86% of our patients. Radiographic studies are the most important tests currently used for the diagnosis of acoustic neurinoma. Tomography of the internal aduitory canal shows abnormalities in 80% of patients. Computed tomography with contrast enhancement demonstrates abnormalities in 90% of patients. The computed tomographic (CT) scan may reveal the location. the size, and often the consistency of the tumor. In cases still questionable after CT scanning. positive contrast rhjombencephalography is used for clarification. In this series, no single symptom. sign. abnormal audiometric test result. or abnormal radiographic finding was present in all patients; therfore, the most important factor in diagnosis is an alert physician.
Circulatory Changes Caused by a Closed, Negative Pressure Drainage System after Craniotomy
Authors: McCulloch G. A.J. , Pattison W. J. 
Published: May 2010

Abstract
Adverse circulatory responses such as cardiac arrhythmias, hypotension. and even cardiac arrest can be brought about by the suddeb lowering of intracranial pressure. This paper describes two cases of bradycardia and hypotension and one of hypotension alone caused by the application of closed, negative pressure drainage to a craniotomy wound.
Nonsurgical Management of Spontaneous Intracerebral Hematoma
Authors: Duff Thomas A. , Ayeni Sylovanius , Levin Allan B. , Javid Manucher 
Published: May 2010

Abstract
This report describes our experience with the use of osmotic diruetics, governed by continuous monitoring of intracranial pressure (ICP), as the primary treatment for 12 consecutive patients suffering from an acute, supratemtorial intracerebral hematoma. In all cases the hematoma, as shown by computed tomographic scan, had a long axis of &gt;4.0 cm. ICP and cerebral perfusion pressure were successfully maintained within the assigned limits in all patients, and in none was surgical evacuation required. There was one death during the 6-month follow-up period. With appropriate weighting to differences in admission status, statistical comparison of the patient outcome in the present series with that reported by McKissock et al. suggests that ICP monitoring can improve the outcome of conservatively (and perhaps surgically) treated patients.
High Dose E-Aminocaproic Acid Prolongs the Bleeding Time and Increases Rebleeding and Intraoperative Hemorrhage in Patients with Subarachnoid Hemorrhage
Authors: Glikc Roberta , Green David , Ts'ao Chung-hsin , Witt Wendy A. , Yu Amy T.W. , Raimondi Anthony J. 
Published: May 2010

Abstract
E-Aminocaproic acid (EACA) has been used to prevent rebleeding in patients with intracranial aneurysms becuase it crosses the blood-brain barrier and is an inhibitor of fibrinolysis. Recommended doses have ranged from 24 to 48 g/day. We now describe an inhibitory effect on platelet function at the higher dose range. In vitro, a dose-dependent inhibition of adenosine diphosphate-and collagen-induced platelet aggregation was observed with concentrations of EACA beginning at 7.6 mM. In vivo. Prolongation of the template bleeding time was observed in all eight patients receiving 48 g/day (&gt;20 minutes in four), in all five on 36 g/day (&gt;20 minutes in three), and in none of seven on smaller doses. More importantly, rebleeding and excessive intraoperative bleeding (requiring more than I litre of bllod replacement) occurred predominantly in patients receiving the larger doses of EACA. Within 48 hours of the discontinuation of EACA, the bleeding times returned to normal values in all but one patient. We conclude that EACA exerts a dose-dependent inhibitory effect on platelet function and that patients receiveing doses in excess of 24 g/day may be at risk of serious bleeding. Patients receiving EACA should be monitored with serial bleeding time tests.
Absorbale or Nonabsorbable Suture Materials for Closure of the Dura Mater?
Authors: Vãllfors Bertil , Hansson Hans-Arne , Svensson Joel 
Published: May 2010

Abstract
This study was undertaken to determine which suture material would give the best results for closure of the dura mater. Because there is no need for the suture to remain longer than until healing has occurred and as remaining foreign material will predispose to foreign body reactions and infection. it was consideered important to test new absorbable materials like polyglactin 910 (Vicryl) and polyglycolic acid (Dexon) for closure of the dura mater. The reactions from these materials were compared to those of silk and polyester (Ethibond) in doge 60 days after the suture of dural incisions. The quality of healing with respect to the smoothness of the subdural surface, the presence of adhesions between sutures and the brain surface, the degree of absorption of the material, and reactions around the sutures were evaluated. Vicryl gave the best results. Providing a smooth subdural surface without adhesions. It was almost totally absorbed when healing was completed, in contrast to Dexon and the other materials. The cellular reaction around Vicryl was slight. Silk, Ethibond, and Dexon protruded from the subdural surface and adhesions to the arachnoid were common. When the dura mater was removed. these adhesions tore off the leptomeninges with their vascular supply to the cortex. The results of these experiments seem to justify the recommendation of Vicryl for suturing of the dura mater. Such an absorbable material decreases the risk of foreign body reactions, and infections will be more easily combated because of the absence of foreign material. The lack of subdural adhesions is an advantage if reoperation in necessary.
Craniocerebral Injuries from Dog Bite in an Infant
Authors: Wilberger James E. , Pang Dachling 
Published: May 2010

Abstract
Aniamal bite is a common cause of craniofacial injuries in children. Whereas scalp lacerations from animal bites are often extensive and severe. only four instances of compound depressed skull fractures from animal bites have been reported. A case of a dog bite to the head of an infant is presented to point out the potential for such an insult to produce cranial perforation and underlying brain damage. The associated roentgenographic and computed tomographic features are shown.
Oculomotor Palsy Caused by Aneurysm Clip
Authors: Wakai Susumu , Eguchi Tsuneyoshi , Asano Takao , Takakura Kintomo 
Published: May 2010

Abstract
Two cases of oculomotor palsy caused by the Sugita aneurysm clip are presented. In both patients, the palsy completely disappeared about 2 and 3 months. respectively. after reclipping the aneurysm of the internal carotid artery with another type of clip. Whenever 3rd nerve palsy develops postoperatively and is suspected of being caused by the aneurysm clip. reapplication of the clip should be performed promptly.
Redundant Nerve Roots of the Cauda Equina
Authors: Naguib Mahmoud G. , Latchaw Richard E. , Erickson Donald L. , Seljeskog Edward L. 
Published: May 2010

Abstract
Two cases of the syndrome of redundant nerve roots of the cauda equina are reported. Both cases were treated surgically, A review of the clinical picture, management. and etiology is presented. In each case, preoperative and postoperative myelography was performed: in one patient myelography demonstrated a complete resolution of the characteristic serpentine filling defects.
Preoperative Prognostic Factors for Rebleeding and Survival in Aneurysm Patients Receiving Antifibrinolytic Therapy
Authors: Tomer James C. , Kassell Neal F. , Wallace Robert B. , Adams Harold P. 
Published: May 2010

Abstract
Prognostic factors for mortality and recurrent hemorrhage in the preoperative, 2-week period were determined in 1114 patients who participated in the antifibrinolytic therapy investigations of the Cooperative Aneurysm Study between 1970 and 1977. Factors significantly related to mortality were admission neurological status, diastolic blood pressure, interval to treatment, degree of vasospasm, and medical condition. Factors associated with the likelihood of recurrent hemorrhage were interval to treatment, patient' sex, and admission neurological status. These factors need to be considered in the analysis of clinical data in the management of ruptured intracranial aneurysms.
Importance of Monitoring the Circulating Blood Volume in Patients with Cerebral Vasospasm after Subarachnoid Hemorrhage
Authors: Kudo Tadashi , Suzuki Shigeharu , Iwabuehi Takashi 
Published: May 2010

Abstract
We used the isotope dilution technique to monitor circulating blood volume (CBV) in three patients with ruptured cerebral aneurysms who developed pre- or postoperative ischemic symptoms that responded well to intravascular volume expansion therapy with blood transfusion and plasma expanders. In the first and second cases, predeterioration CBVs were obtained. Both of these patients showed hypovolemia and a decreased red blood cell volume at the time of neurological deterioration. A predeterioration CBV was not available for the third patient for comparison, but his red cell volume was also markedly decreased. Postrecovery CBVs were obtained in the second and third cases. Our data suggested that a depleted red blood cell volume was more responsible for neurological deterioration than was a lowered plasma volume. To prevent the occurrence of hypovolemia and anemia in aneurysm patients, we should monitor CBV not only at the time of neurological deterioration, but also at the time of admission and during the immediate postoperative period.
Monitoring of Activated Clotting Time during Carotid Endarterectomy
Authors: Rosenwasser Robert H. , Garrido Eddy , Freed Michael H. , Shupak Robert C. 
Published: May 2010

Abstract
The activated clotting time was monitored in 10 patients undergoing carotid endarterectomy. This measure accurately tells the surgeon the level of anticoagulation and permits him to calculate the exact amount of protamine needed for heparin reversal. This technique can be done easily and, in our opinion, enhances the safety of carotid endarterectomy.
Neurosurgical Aspects of the Parietal Boss in Patients with Chronic Subdural Hematomas
Authors: Iwabuchi Takashi , Sekiya Tetsuji , Sekiya Tetsuji 
Published: May 2010

Abstract
There are many modes of trephination for the treatment of chronic subdural hematoma. Angiographic and computed tomographic (CT) analysis of 60 consecutive patients with chronic subdural hematoma indicated that the parietal boss, which is likely to be overlooked by routine CT scanning, is one of the most suitable places for opening a burr hole. Our patients responded satisfactorily to irrigation therapy via a single burr hole in the parietal boss.
Extraneural Metastatic Medulloblastoma during Childhood
Authors: McComb Gordon J. , Davis Richard L. , Isaacs Hart 
Published: May 2010

Abstract
From 1960 to 1977, 59 patients with histologically confirmed medulloblastoma were initially treated at Childrens Hospital of Los Angeles. Of this group, 49 have died and, of these, 34 were autopsied. Among the autopsied cases, 2 infants had neck masses that proved to be medulloblastoma that had spread from the cerebellar vermis before any surgical intervention. Four additional patients who had undergone a posterior fossa craniectomy without either the pre- or postoperative placement of a cerebrospinal fluid-diverting shunt were found to have extraneural metastatic medulloblastoma at autopsy. The extraneural metastatic medulloblastoma rate in the autopsied cases was 17.6% (6 of 34). Our series shows that the incidence of the extraneural spread of medulloblastoma is associated with being young, being male, and having diffuse tumor involvement of the subarachnoid space.
Extracranial-Intracranial Bypass Grafting in the Surgical Treatment of Bacterial Aneurysms
Authors: Day Arthur L. 
Published: May 2010

Abstract
The use of an extracranial-intracranial arterial anastomosis in the treatment of two cases of bacterial aneurysm is reported. Utilization of this procedure may expand the indications for surgical treatment of bacterial aneurysms to include those affecting proximal and critically located arteries.
Midbrain Lesions
Authors: Rosenblum William I. , Greenberg Richard P. , Seelig John M. , Becker Donald P. 
Published: May 2010

Abstract
Midbrain lesions were found in 23 of 35 autopsied, head-injured people. These lesions were interpreted as “primary” that is. occurring at the time of impact. This interpretation was concordant with the clinical data, although the difficulty in establishing the precise moment at which the lesions were initiated in any individual case was recognized. Correlative clinicopathological data in head-injured people showed that midbrain damage could be determined by evoked potentials (EPs). In a total of 165 head-injured patients, the early presence or absence of evidence for midbrain lesions on EP examination was a powerful prognostic indicator of death or recovery. respectively. Autopsy and HP data showed that midbrain damage almost always occurred in the presence of hemispheric injury, but this fact should not obscure either the high frequency of midbrain lesions in those dying of head injury or the great prognostic value of their presence or absence.
Traumatic Subdural Hygroma in Adults
Authors: St. John James N. , Dila Carl 
Published: May 2010

Abstract
The authors review 25 cases of post-traumatic subdural hygroma in adults and report the findings of computer tomography in 4 cases. There was marked diversity in the severity of injury and in chronicity. The site of the lesion was consistently delineated by angiography, but preoperative differentiation from subdural hematoma was possible only with computed tomography. The mortality was 28%. Good recovery occurred in 48%. The prognosis was best among younger patients with subacute or chronic lesions.
Intracranial Pressure Monitoring in Severe Pediatric Near-Drowning
Authors: Dean Michael J. , McComb Gordon J. 
Published: May 2010

Abstract
Between April 1979 and April 1981, 20 near-drowned children admitted to Childrens Hospital of Los Angeles with a Glasgow coma score of 3 underwent intracranial pressure (ICP) monitoring and brain resuscitative therapy. By the 3rd hospital day, 14 patients had developed ICP elevation above 20 torr. and 11 of these had sustained intracranial hypertension above 30 torr. Ten of these children died, and 4 remain in a persistent vegetative state. Of 6 patients whose ICP never exceeded 20 torr. 3 recovered completely, 1 died, and 2 remain without any cognitive function. The salvage rate for patients with normal ICP after near-drowning accidents is significantly better than that for patients in whom the ICP is elevated (P = 0.017). Intracranial hypertension is associated with a uniformly bad outcome and is frequent in patients who die or suffer permanent, severe central nervous system damage after near-drowning.
Trigeminal Neuralgia Treated by the Injection of Glycerol into the Trigeminal Cistern
Authors: Håkanson Sten 
Published: May 2010

Abstract
Seventy-five patients with trigeminal neuralgia were treated by the injection of 0.2 to 0.4 ml of glycerol by the anterior percutaneous route into the trigeminal cistern, which was visualized by the aid of contrast medium (metrizamide). Eighty-six per cent of the patients were completely free from pain after the treatment, which produced only minimal disturbance of facial sensitivity. No complications have been observed. It is suggested that glycerol acts mainly on partly demyelinated nerve fibers, which are assumed to be involved in the trigger mechanism.