bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brain Tumors Occurring before 1 Year of Age: A Retrospective Review of 22 Cases in an 11-Year Period (1977-1987)
Authors: Haddad Souheil F. , Menezes Arnold H. , Bell William E. , Godersky John C. , Afifi Adel K. , Bale James F. 
Published: April 2011

Abstract
Congenital brain tumors have been reported infrequently and their management remains ill defined. An 11-year review (1977-1987) of all children with brain tumors with the onset of symptoms before 1 year of age was completed. Twenty-two children with the following histological diagnoses were treated: astrocytoma (7 patients), primitive neuroectodermal tumor (6 patients), papilloma or carcinoma of the choroid plexus (3 patients), malignant teratoma (2 patients), dermoid tumor (2 patients), embryonal rhabdomyosarcoma (1 patient), and chloroma (1 patient). Fifteen tumors were supratentorial in location, and 7 were infratentorial. Initial symptoms were hydrocephalus (32%), focal neurological deficit (23%), asymptomatic increase in head circumference (18%), failure to thrive (14%), and seizures (4.5%). The goal of treatment was a radical excision when possible, with primary chemotherapy in the last 6 years of the review period. Radiation therapy was the adjunct to surgery in the initial 5-year period. All patients with papillomas of the choroid plexus and dermoid lesions underwent a total resection with no recurrence. All 7 astrocytomas were supratentorial, with 6 occurring in the diencephalon. Five of the seven patients with astrocytomas survived more than 5 years. The 6 primitive neuroectodermal tumors were located equally between the supra- and infratentorial spaces. Four of the 6 infants with these tumors received chemotherapy (2 received chemotherapy alone; 2 received chemotherapy and radiation therapy) and are tumor free 2 to 9 years later. A fifth child received radiation therapy alone early in the series and survived only 4 months. The family of the other child refused adjunctive treatment. A radical resection with chemotherapy appears to be the rational approach, keeping additional operations and radiation therapy as options for recurrent disease while avoiding the effects of irradiation on the developing brain.
Sufentanil Citrate and Morphine/Bupivacaine as Alternative Agents in Chronic Epidural Infusions for Intractable Non-Cancer Pain
Authors: Hassenbusch Samuel J. , Stanton-Hicks Michael D. , Soukup James , Covington Edward C. , Boland Mary Beth 
Published: April 2011

Abstract
Intraspinal narcotic (usually intrathecal morphine) infusions with implanted pumps are increasingly used in patients with intractable chronic pain not caused by cancer. In some patients, pain control is difficult with infusions of morphine. Seven patients with diagnoses of arachnoiditis, epidural scarring, and/or vertebral body compression fracture were treated with alternative solutions in an epidural route. For maximal flexibility, Medtronic implanted programmable infusion pumps with catheters to T6-T10 were used, and pain was monitored by verbal pain scales. In three patients, epidural infusions of morphine in 0.5% bupivacaine (MS-MARC) resulted in little or no pain relief without significant side effects (e.g., headache, nausea, or vomiting). In these same patients, epidural infusions of sufentanil citrate resulted in pain scale reductions of 92%, 82%, and 40%, respectively, with no side effects. Four other patients found more effective pain relief when switched from initial sufentanil citrate infusions to MS-MARC. Pain scale reductions (with no side effects) were 92%, 76%, 59%, and 47% in these patients. Pain relief and minimal side effects with sufentanil citrate is theorized to result from its higher lipophilicity promoting local transdural diffusion to spinal cord and limiting upward diffusion to the brain stem. Sufentanil citrate is also advantageous for programmable pumps because it is 100 times more potent than morphine and therefore allows longer pump refill times and higher infusion doses. Although this study was done on a limited number of patients, sufentanil citrate and MS-MARC in epidural infusions using programmable infusion pumps for non-cancer patients provide significant alternative drug combinations and routes. (Neurosurgery 29:76-82, 1991)
Cervicocranial Arterial Dissection
Authors: Anson John , Crowell Robert M. 
Published: April 2011

Abstract
Dissection of the cervicocranial arteries is becoming more frequently recognized as a cause of neurological disorders. Typical clinical features seen with dissection include unilateral headache, oculosympathetic palsy, amaurosis fugax, and symptoms of focal brain ischemia. The diagnosis of carotid or intracranial dissection is usually best confirmed by angiography, although magnetic resonance imaging and computed tomography have been shown to visualize intimal dissection. The prognosis in cases of spontaneous dissection is generally benign unless the initial manifestation involves infarction with substantial deficit. The best approach to treatment appears to be the administration of the anticoagulant, heparin, followed by warfarin or antiplatelet therapy. Surgical intervention is reserved for cases of progressive or recurrent ischemic complication that occurs despite the administration of adequate doses of anticoagulants. (Neurosurgery 29:89-96, 1991)
Deafness after Bilateral Midbrain Contusion: A Correlation of Magnetic Resonance Imaging with Auditory Brain Stem Evoked Responses
Authors: Jani Niranjan N. , Laureno Robert , Mark Alexander S. , Brewer Carmen C. 
Published: April 2011

Abstract
A 46-year-old woman became deaf after a closed head injury. When a computed tomographic scan failed to disclose the cause, conversion disorder was suspected. Magnetic resonance imaging, however, showed bilateral contusions of the inferior colliculi, providing objective evidence for an organic cause of hearing loss. Auditory brain stem evoked responses and stapedial reflexes also provided objective evidence of brain stem injury. This case illustrates the phenomenon of dorsal midbrain injury after head trauma. It indicates the sensitivity of magnetic resonance imaging for small focal lesions after head trauma, and it demonstrates some difficulties in the diagnosis of “hysterical” deafness. (Neurosurgery 29:106-109, 1991)
Meningioma: The Role of a Foreign Body and Irradiation in Tumor Formation
Authors: Saleh Jamshid , Silberstein Howard J. , Salner Andrew L. , Uphoff Dean F. 
Published: April 2011

Abstract
A case of meningioma is reported. At the age of 18 years, the patient had undergone insertion of a Torkildsen shunt through a posteroparietal burr hole for obstructive hydrocephalus secondary to a tumor of the pineal region, of which no biopsy had been made. After the hydrocephalus was relieved, he underwent irradiation of the tumor. Thirty years later, he was treated for an intracranial meningioma wrapped around the shunt. The tumor followed the shunt in all of its intracranial course. Microscopy disclosed pieces of the shunt tube within the meningioma. The role of a foreign body and irradiation in the induction of meningiomas is discussed, and a comprehensive review of the literature is presented. (Neurosurgery 29:113-119, 1991)
Anterior Decompression in Cervical Spine Trauma: Does the Timing of Surgery Affect the Outcome?
Authors: Levi Lion , Wolf Aizik , Rigamonti Daniele , Ragheb John , Mirvis Stuart , Robinson Walker L. 
Published: April 2011

Abstract
To clarify the ideal timing of anterior decompression and stabilization for all patients with cervical spine trauma as well as its efficacy for patients with complete deficits, we reviewed the records of 103 consecutive patients with cervical spine trauma (50 incomplete deficits, Group A; 53 complete deficits, Group B) who underwent this procedure during a 5-year period at the Shock Trauma Center. We subdivided each group according to time of surgery: early and delayed (&lt;24 and &gt;24 hours past injury, respectively). In Group A, 10 patients underwent early surgery and 40 patients underwent delayed surgery (range, 2 to 77 days past injury; mean, 13 days). One patient (2.5%) in the delayed group died. The following data refer to the early and delayed subgroups, respectively: average acute hospitalization, 20 and 22 days; patient motor score improvement (at discharge), 37.2 and 45.0%; functional grade improvement (at discharge), 5 (50.0%) and 9 (22.5%) patients. At 1-year follow-up, every patient who had had a deficit had progressed to a higher functional grade. In Group B, 35 patients underwent early surgery and 18 underwent delayed surgery (range, 2 to 45 days past injury; mean, 13 days). One patient (2.9%) in the early group died. The following data refer to the early and delayed subgroups, respectively: average acute hospitalization, 38.7 and 45.2 days (P &lt; 0.05); respiratory care (number of daily suction procedures), 6.0 and 9.86 (P &lt; 0.05); patient motor score improvement (at discharge), 3.9 and 4.5%; functional grade improvement (at discharge), 4 (11.4%) and 1 (5.6%) patients. At 1-year follow-up, 16 (45.7%) and 7 (38.9%) patients, respectively, had progressed to a higher functional grade (mean motor score improvement, 15.0 and 16.7%, respectively). Only 5 patients (14.3%) did not gain the function of at lease one more segment. Although our study demonstrated no statistically significant difference in outcome between early surgery and delayed surgery subgroups, we feel early anterior decompression and stabilization is appropriate for selected patients because this process has a comparable adverse sequelae rate to that of delayed surgery; it provides superior ease of patient care, it facilitates earlier transfer to rehabilitation (an important parameter in decreasing medical expenses), and it may benefit even patients with complete deficits diagnosed on the first day.
Reversal of a Dense, Persistent, Holohemispheric Neurological Deficit after an Endarterectomy of the Carotid Artery: Case Report
Authors: McKenzie Rickey L. , Awad Issam A. , Sila Cathy A. 
Published: April 2011

Abstract
The role and timing of a carotid endarterectomy in the setting of an acute ischemic stroke-in-evolution remain controversial. Although computed tomographic (CT) scans typically show no abnormalities in the acute stage, it is generally agreed that a dense neurological deficit (hemiplegia) and/or multiple modality neurological disturbance (involving motor, sensory, gaze, and visual field impairment) represent contraindications to surgical intervention. We present a case of an acute right holohemispheric neurological deficit including dense hemiplegia, hemisensory loss, gaze disturbance, hemineglect, and impaired level of consciousness. This persisted for 4 days while serial CT scans showed no evidence of infarction. Angiography revealed pre-occlusive stenosis of the right internal carotid artery with sluggish antegrade flow. The anterior collaterals of the circle of Willis were impaired, and the right middle cerebral artery territory filled via the posterior communicating artery. Despite the dense neurological deficit persisting for 4 days, a carotid endarterectomy was performed. Gradual neurological improvement was noted within hours of the operation, and all neurological deficits resolved within the subsequent 3 days. This case is consistent with prolonged holohemispheric hemodynamic compromise below the threshold of neurological dysfunction, but above the threshold of tissue infarction (“idling neurons”). Features assisting in the recognition of this unusual scenario and the indications and risks of revascularization in this setting are discussed.
Hemorrhagic Venous Infarction after Excision of an Arteriovenous Malformation: Case Report
Authors: Miyasaka Yoshio , Yada Kenzoh , Ohwada Takashi , Kurata Akira , Tokiwa Kaiti , Suwa Tomoya , Yamada Masaru , Oka Hidehiro 
Published: April 2011

Abstract
A case of arteriovenous malformation (AVM) in which postoperative hemorrhagic infarction developed, probably because of occlusion of the former draining veins, is reported. The hemorrhage developed in the temporal lobe 3 days after the initial operation and was located in the immediate vicinity of the site of the AVM. The following findings suggest that the postsurgical hemorrhage probably resulted from a venous thrombosis: 1) no evidence of residual AVM; 2) delayed onset of the hemorrhage, inconsistent with the time course of a hemorrhage developing according to the breakthrough theory or with insufficient hemostasis with a high-pressure afterload; 3) good correlation between the location of the hemorrhage and the occlusion of the draining veins; and 4) multifocal hemorrhage affecting both the gray matter and the subcortical white matter. Postoperative hemorrhagic infarction caused by thrombosis in the draining veins is rare, but it should be considered as a distinct postoperative complication after removal of an AVM.
Sarcoidosis Presenting as an Isolated Intramedullary Tumor
Authors: Levivier Marc , Brotchi Jacques , Balériaux Danielle , Pirotte Benoit , Flament-Durand Jacqueline 
Published: April 2011

Abstract
We report a case of isolated intramedullary sarcoidosis. The patient developed progressive signs that indicated a spinal tumor, which were investigated with contrast-enhanced magnetic resonance imaging scans. Magnetic resonance imaging clearly revealed an intramedullary lesion, but the diagnosis of sarcoidosis was made on the pathological analysis of the surgical specimen. Magnetic resonance imaging with contrast enhancement is reported in a histologically proven case of intramedullary sarcoidosis. Only 12 other cases of isolated intramedullary sarcoidosis have been reported. We review and discuss these cases according to their clinical presentation, the segmental location of the granulomas in the spinal cord, preoperative and operative diagnoses, and signs for systemic sarcoidosis. In none of the cases was the diagnosis of intramedullary sarcoidosis made before surgery. We think that surgical therapy for intramedullary lesions is the best way to diagnose rare instances of benign lesions like sarcoidosis and to treat them in an appropriate manner.
Prominent Meningeal “Tail Sign” in a Patient with a Metastatic Tumor
Authors: Senegor Moris 
Published: April 2011

Abstract
A prominent enhancement of the dura adjacent to meningiomas has been described as being pathognomonic of these tumors. We describe a case where a classic meningeal “tail sign” was associated with an extra-axial metastatic tumor attached to the tentorium. There was no tumor invasion of the dura. We conclude that this sign is nonspecific and can be seen with dural-based tumors other than meningiomas.
Posterior Fossa Epithelial Cyst of Ectodermal Origin
Authors: Fleming Hilari , Murayama Shiego , Dacey Ralph G. 
Published: April 2011

Abstract
The case of a large ventral cyst of the posterior fossa of probable ectodermal origin in a 33-year-old patient is presented. Intracranial epithelial cysts are rare, and their histogenesis is a subject of controversy. Previous reports have hypothesized either a neuroepithelial or endodermal origin for the majority of these cysts. This case is unusual because it is the first case, to our knowledge, where melanocytes and melanin have been demonstrated within the cyst wall. These findings suggest an ectodermal origin for this cyst.
Spinal Invasion of Pulmonary Hydatidosis: Computed Tomographic Demonstration
Authors: Iplikçioğlu Celal A. , Kökes Fatih , Bayar Akif , Doğanay Saffet , Buharali Zeki 
Published: April 2011

Abstract
A case of pulmonary hydatidosis in which cysts caused spinal cord compression is presented. To our knowledge, spinal invasion after pulmonary hydatidosis has not been demonstrated previously.
Intradural Cervical Lipoma in a Neurologically Intact Patient: Case Report
Authors: Heary Robert F. , Bhandari Yashwant 
Published: April 2011

Abstract
The authors report an unusual intradural subpial lipoma of the cervical spinal cord in a neurologically intact adolescent. The patient sought treatment for neck pain and had a history of previous trauma. Magnetic resonance imaging revealed the lesion. There are no reported cases of a subpial lipoma detected in the absence of any neurological deficits. A subtotal excision was performed, and pathological studies confirmed the diagnosis. Postoperatively, the patient remained neurologically intact.
Multisegmental Cervical Spondylosis: Treatment by Spondylectomy, Microsurgical Decompression, and Osteosynthesis
Authors: Seifert Volker , Stolke Dietmar 
Published: April 2011

Abstract
Vertebral body replacement after spondylectomy, combined with microsurgical decompression and anterior plating, was performed in 22 patients as an aggressive therapeutic approach to multisegmental cervical spondylosis. The patients were 13 men and 9 women, ranging in age from 32 to 74 years. In 19 patients, the typical signs of cervical myelopathy were present. In three patients, pain was the major symptom, accompanied by moderate spastic paresis and hyperreflexia. Apart from cervical myelography and computed tomographic scanning, which was performed in 10 patients, magnetic resonance imaging was the radiological procedure of choice in 12 patients. During spondylectomy, one vertebra was removed in 14 patients, two vertebrae in seven patients, and three vertebrae in one patient. The time of postoperative follow-up ranged from 8 to 46 months, with an average interval of 21 months. In all 22 patients, satisfactory bony fusion was achieved as demonstrated by radiological control examinations. Seventeen patients (77%) were symptom free or had only minor residual symptoms. Three (14%) patients had intermittent nuchal or cervicobrachial pain, which responded well to analgesic medication or the application of a soft collar. Two (9%) patients still had myelopathic but not incapacitating symptoms. Of 15 patients who were employed before surgery, 13 returned to a full-time job. The only severe complication of surgery was a prevertebral abscess that healed without sequelae. It is concluded that aggressive surgical therapy of multisegmental cervical spondylosis by a combination of vertebrectomy, decompression (using the surgical microscope), bone grafting, and osteosynthesis is a straightforward and promising procedure for the treatment of this debilitating disease.
Trigeminal Cisternal Injection of Glycerol for Treatment of Chronic Intractable Cluster Headaches
Authors: Hassenbusch Samuel J. , Kunkel Robert S. , Kosmorsky Gregory S. , Covington Edward C. , Pillay Prem K. 
Published: April 2011

Abstract
Medical treatment of chronic cluster headaches (cluster headaches that occur frequently without remission) can be very difficult. In many patients, the pain remains severe despite all medication trials. For these patients, previous reports recommend radiofrequency trigeminal rhizotomy, which risks corneal anesthesia and subsequent corneal decompensation. As a safer, yet effective, treatment, retro-Gasserian injections of glycerol were given to eight patients having intractable chronic cluster headaches. Needle penetration into the trigeminal cistern, glycerol amount (0.55 ml), and length of patient elevation after the procedure (80-90 degrees upright for 10 h) were modified for maximal exposure of the V 1 division. Three patients required one additional injection, and one patient required two additional injections. Verbal pain scales (means ± 1 standard error of the mean) were: 9.1 ± 0.30 (preoperative), 2.6 ± 1.10(1 mo postoperative), and 2.1 ± 0.64 (1 yr postoperative). Daily headache frequency decreased from 6.0 ± 2.0 (preoperative) to 0.2 ± 0.09 (i.e., one headache every 5 days) (1 yr postoperative). Three of the eight patients had no headaches after 1 year. There were no instances of corneal or facial anesthesia. One year postoperatively, five patients required no medication, and three remained on low doses of medication for headache treatment. In contrast to previous limited reports of glycerol injections for cluster headaches, results with these patients having chronic cluster headaches support the use of glycerol injections as a viable treatment alternative, with significant pain relief and corneal safety.
Imprints, Smears, and Frozen Sections of Brain Tumors
Authors: Reyes Marc G. , Homsi Fayez M. , McDonald Larry W. , Glick Roberta P. 
Published: April 2011

Abstract
In this study, we compared the suitability and accuracy of imprints, smears, and frozen sections of suspected brain and spinal cord tumors of 150 patients. Eighty-six percent of the imprints, 91% of the smears, and 99% of the frozen sections were suitable for interpretation. Among the suitable preparations, 82% of the imprints, 92% of the smears, and 99% of the frozen sections agreed with our diagnosis on paraffin sections. Although frozen sections were clearly more accurate than imprints and smears, the latter two provided diagnoses in patients with acquired immunodeficiency syndrome where frozen sections were not done to avoid contaminating our cryostat and in a patient with an epidermoid cyst of the middle fossa that could not be adequately frozen sectioned. Our study shows that imprints and smears complement frozen sections in the intraoperative diagnosis of tumors of the central nervous system.
Sudden Appearance of a Mycotic Aneurysm of the Intracavernous Carotid Artery after Symptoms Resembling Cluster Headache: Case Report
Authors: Todo Tomoki , Inoya Hiroshi 
Published: April 2011

Abstract
Acute cavernous sinus syndrome developed in a 44-year-old man after he had experienced symptoms resembling cluster headache for 3 weeks. The cause was determined to be the sudden appearance of a large saccular aneurysm of the intracavernous portion of the left carotid artery secondary to an acute inflammation of the left cavernous sinus. The absence of this aneurysm before the onset of the ophthalmoplegia was confirmed by a computed tomographic scan and angiogram performed only 1 week earlier. The patient was treated with antibiotics in combination with a short regimen of steroids, which resulted in a slowly developing thrombosis of the aneurysm, although the cavernous sinus syndrome remained. This case suggests several important aspects regarding the pathogenesis of mycotic intracavernous carotid aneurysms, the mechanism of an acute manifestation of the cavernous sinus syndrome by an intracavernous carotid aneurysm, and the relation of the intracavernous portion of the carotid artery to cluster headache. (Neurosurgery 29:594-599, 1991)
Neonatal Cavernous Hemangioma of the Dura Mater: Case Report
Authors: Saldana Cristobal J. , Zimman Horacio , Alonso Pedro , Mata Pedro R. 
Published: April 2011

Abstract
A case of dural cavernous hemangioma, diagnosed prenatally as an intracranial mass by ultrasonography and surgically treated after elective delivery, is presented. The clinical and pathological features of this unusual type of congenital vascular malformation are reported, and the relevant literature is reviewed.
Inflammatory Lesion Mimicking a Metastatic Ependymoma
Authors: Friedman Henry S. , Tuori Susan L. , Tuori Susan L. , Hatten Paul H. , Hockenberger Beverly , Vandersteenhoven Jacob J. , Oakes Jerry W. 
Published: April 2011

Abstract
A 2.5-year-old child who had undergone nearly total resection of an infratentorial ependymoma demonstrated a new enhancing lesion on the undersurface of the right cerebellar hemisphere 7 weeks after the initiation of adjuvant chemotherapy. The residual primary tumor demonstrated continued regression during chemotherapy, and magnetic resonance imaging of the spine and cytopathological examination of the cerebrospinal fluid showed no evidence for other sites of metastatic tumor. Because of the unusual anatomic and temporal characteristics of this lesion and despite radiographic criteria highly suspicious for a metastatic lesion, a biopsy was performed, revealing histological evidence of an inflammatory process.