bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the Postoperative Course of Excised Brain Abscess by Computerized Tomography
Authors: Feely Michael P. , Dempsey Peter J. 
Published: May 2010

abstract
We present two patients with brain abscess who underwent complete excision with a satisfactory clinical outcome although serial computerized tomography (CT) scans in the early postoperative period seemed to indicate a large residual abscess in each case. We recommend treatment based on the clinical course rather than the CT scan appearance, indicate that earlier reports on this topic may be misleading, and suggest an explanation for these findings.
Bilateral Interhemispheric Subdural Hematomas
Authors: Major David L. Kasdon , Magruder Michael R. , Stevens Edwin A. , Paullus Wayne S. 
Published: May 2010

abstract
Interhemispheric subdural hematomas are rare. Bilateral interhemispheric subdural hematomas in a patient with a ventriculoperitoneal shunt for hydrocephalus were diagnosed by computerized tomographic (CT) scan after mild head trauma. The value of CT scanning, the clinical presentation and treatment, and a review of the literature are presented.
Cervical Dermal Sinus and Intramedullary Spinal Cord Abscess
Authors: Bean James R. , Walsh John W. , Blacker Martin H. 
Published: May 2010

abstract
Congenital dermal sinuses in the cervical region are rare. A case report is presented in which the persistent anomaly led to formation of an intramedullary spinal cord abscess. The clinical presentation, radiological diagnosis, and surgical management are discussed.
Fracture and Complete Dislocation of the Thoracic or Lumbosacral Spine
Authors: Jackson Richard H. , Quisling Ronald G. , Day Arthur L. 
Published: May 2010

Abstract
Severe fracture/dislocation of the thoracic (T) or lumbar (L) spine is usually associated with complete neurological dysfunction below the level of injury. Three cases of severe spinal fracture/dislocation are presented in this report. Two of these patients suffered only partial neurological deficit, which improved after open reduction, internal fixation, and bone fusion. Severe fracture/dislocation of the T or L spine may be quite obvious on lateral roentgenograms. Occasionally, however, the fracture site may be obscured by the overlying shoulders, hips, or soft tissues. If no lateral displacement is evident on anteroposterior (AP) films, a false impression of normal alignment may be given, as was the case in two of our patients. A careful interpretation of the AP view will provide the diagnosis in such cases. The subtle AP radiographic changes suggesting fracture/dislocation of the T or L spine are detailed. The mode of injury, physical findings, prognosis, and surgical treatment of such severe injuries are also briefly reviewed.
Planned Intracranial Revascularization before Proximal Ligation for Traumatic Aneurysm
Authors: Fein Jack M. , Flamm Eugene 
Published: May 2010

Abstract
Proximal internal carotid artery aneurysm may be treated successfully with internal carotid artery ligation. If this is not tolerated because of ischemic insufficiency, an alternative strategy is possible. This consists of extracranial-intracranial bypass to increase the collateral circulation and perfusion pressure in the ipsilateral cerebral hemisphere before ligation. Experience with two cases is presented to show that such an approach is feasible.
Carcinoma Associated with Lipomeningocele
Authors: Marini Giovanni , Bollati Angelo , Galli Giuseppe , Gandolfini Massimo 
Published: May 2010

Abstract
We report the case of a 41-year-old man with an epidermoid carcinoma that had developed on a meningocele with a fistulous tract that chronically drained cerebrospinal fluid. After a review of the literature, we discuss the cause of this rare occurrence. We think that the recurrent discharge of spinal fluid (never complicated by meningitis) may have caused a chronic irritation of the tissues and then the delayed development of a carcinoma, which is similar to a case found in the literature. In our case there was a “flow” of carcinomatous cells along the fistula, which entered the meningocele, invading the subdural space as far as the peduncle. Our patient, who had a benign lesion (meningocele), came under neurosurgical care only after the lesion had degenerated. The malignant degeneration of such a benign lesion emphasizes the need for surgical treatment as soon as possible.
Bilateral Acute Subdural Hematomas Undiagnosed by Computerized Tomography
Authors: Gudeman Steven K. , Young Harold F. , Miller Douglas J. , Becker Donald P. 
Published: May 2010

Abstract
The authors describe a case of bilateral acute subdural hematomas undiagnosed by computerized tomography of the brain. The role of cerebral angiography in the management of the head-injured patient is discussed.
The Genesis and Significance of Delayed Traumatic Intracerebral Hematoma
Authors: Gudeman Steven K. , Kishore P. R. S. , Miller Douglas , Girevendulis Alex K. , Lipper Maurice H. , Becker Donald P. 
Published: May 2010

Abstract
During a 34-month period, 12 cases of delayed traumatic intracerebral hematoma (DTICH) were diagnosed among 162 consecutive prospectively studied patients admitted to the Medical College of Virginia with severe closed head injuries. All patients were unresponsive to command and unable to utter formed words at the time of admission. The interval from injury to diagnosis of DTICH by computerized tomography (CT) was within 48 hours in 11 of the 12 cases. Six patients had no decompressive surgery before the development of the lesion. Four patients had undergone decompressive surgery and then developed DTICH on the contralateral side. Two patients developed lesions in the vicinity of the operative site that were thought not to be the result of operation. The development of DTICH was not heralded by neurological deterioration nor by elevation of intracranial pressure. Eleven of the 12 patients had suffered a secondary hypoxic insult soon after the head injury. We suggest that the CT appearance of DTICH is likely to represent hemorrhage into an existing traumatized area and is an epiphenomenon rather than a cause of severe primary and secondary brain damage.
Hysteresis in the Relationship between Cerebrospinal Fluid Absorption Minus Formation and Cerebrospinal Fluid Pressure in the Dog
Authors: Chandler William F. , Zwetnow Nicolaus N. , LÖfgren Jan 
Published: May 2010

Abstract
In this study the difference between cerebrospinal fluid (CSF) absorption and formation (A - F) was measured as a function of CSF pressure in the living and dead dog. We determined this relationship between A - F and CSF pressure during both increasing and decreasing CSF pressures. A hysteresis effect was identified in 78% of living animals, but was not seen in the dead animals. This suggests that the mechanism of CSF absorption in the living dog is nonpassive and pressure-sensitive.
Tension Pneumocephalus of the Cranial Subdural Space
Authors: Black Peter McL. , Davis James M. , Kjellberg Raymond N. , Davis Kenneth R. 
Published: May 2010

Abstract
A case of subdural tension pneumocephalus is presented. Computerized cranial tomography permitted rapid diagnosis including localization of the air, thus facilitating prompt treatment. Tension pneumocephalus should be considered in a patient with a cerebrospinal fluid drainage device who deteriorates after craniotomy.
Cervical Spondylotic Radiculopathy Producing Motor Manifestations Mimicking Primary Muscular Atrophy
Authors: Dorsen Michael , Ehni George 
Published: May 2010

Abstract
Cervical radiculopathy unaccompanied by pain or sensory disorder but manifested only by paresis, atrophy, fasciculation, and reflex loss is unusual. Three such cases are presented. Considerable diagnostic difficulty may arise in distinguishing patients presenting with these features from those who have primary motor neuron disease. Two additional case reports demonstrate that this distinction is not always possible. Diagnosis, management, and prognosis are discussed. Differentiation between motor neuron disease and spondylosis will avert needless surgery in the former group and will result in beneficial, sometimes curative surgery in the latter group.
Acute Hyperesthesia after Spinal Trauma
Authors: Mullen John B. 
Published: May 2010

Abstract
Four cases of acute hyperesthesia after spinal trauma are presented. An attempt is made to characterize the natural history of this syndrome. In the three cases with truncal sensory aberration, hyperesthetic zones developed only anteriorly. All four patients demonstrated spontaneous relief of pain within 2 weeks after injury. The pain was modified by transcutaneous stimulation in one case and by l-dopa in another case. It is suggested that the “lesion” responsible for the hyperesthetic response is partial damage to dorsal root fibers at a point medial to the dorsal root ganglion.
Intraventricular Fiberscopic Observations in Adult Hydrocephalic Patients
Authors: Takei Yoshio , Pearl Gary S. , Fresh Babson C. , Fleischer Alan S. , Payne Nettleton S. , Tindall George T. 
Published: May 2010

Abstract
A flexible ventriculofiberscope was used to diagnose intraventricular pathological conditions in eight adult hydrocephalic patients. In each case the entire procedure was recorded on videotape for documentation, review, and teaching. Four representative cases are presented to illustrate the use and value of this technique.
Temporary Microvascular Clips
Authors: Dujovny Manuel , Kossovsky Nir , Laha Ranjit K. , Leff Louis , Wackenhut Norman , Perlin Alfred 
Published: May 2010

Abstract
Selected commercially designated temporary clips (Acland, Biemer, Kleinert-Kutz, Variangle, and Yasargil) were applied for 1 hour to rat common carotid arteries. Scanning electron and light microscopic studies revealed varying degrees of endothelial damage. The authors believe that further improvements are needed in the design of temporary clips.
Traumatic False Aneurysm and Carotid-Cavernous Fistula
Authors: Lister Richard J. , Yonas Howard , Sypert George W. 
Published: May 2010

Abstract
Severe head injury with resultant basilar skull fracture is the most common etiology for traumatic false aneurysm of the cavernous carotid artery and for traumatic carotid-cavernous fistula. We present a case of false aneurysm and fistula that occurred as a complication of sphenoidotomy, fortunately a rare etiology of these two serious problems. Because of the current resurgence of trans-sphenoidal surgery, it is of utmost importance that all neurosurgeons possess an accurate and detailed knowledge of the anatomy of the carotid artery and its intracavernous route.
Use of Metrizamide Computerized Tomographic Cisternography in the Evaluation of Patients with Malignant Glioma for Immunotherapy
Authors: Neuwelt Edward A. , Diehl Jan T. , Hill Suellen A. , Maravilla Kenneth R. 
Published: May 2010

Abstract
The communication between the subarachnoid space and the surgically created tumor cavity in glioma patients was evaluated by metrizamide cisternography. It was necessary to know the presence or absence of such a communication to determine the route of administration of autologous lymphocytes as a form of immunotherapy. The contrast injections were made either into the spinal subarachnoid space or directly into the tumor cavity. The presence of communication was demonstrated and followed by computerized tomographic (CT) scanning. The results were also corroborated by comparing the white cell counts in the fluid from the tumor cavity and the spinal subarachnoid space 24 hours after autologous lymphoid cell infusion. In only two of seven patients was a communication present. In the five patients without a communication, the blocks were at the tentorial hiatus (one patient), due to a nonpatent subarachnoid space over the cerebral convexity (two patients), and the result of adhesions at the pial margin of the tumor cavity (three patients). In addition, certain limitations in the use of computerized tomography in the evaluation of glioma patients are demonstrated. These problems include the effects of steroids on tumor size, the poor correlation between “enhancement” on CT scan and tumor recurrence, and the difficulty of differentiating metrizamide and hemorrhage by CT scan in the immediate postoperative period.
Brain Metastasis
Authors: Black Perry 
Published: May 2010

Abstract
An overview of brain metastasis with respect to the pathological, diagnostic, and therapeutic aspects is presented. Management is almost always palliative, with cure being a rare exception. Evaluation of various therapeutic modalities—radiation, chemotherapy, or surgery—has been confounded by a lack of controlled, randomized studies whereby the relative benefit of the respective modalities can be assessed objectively. Despite these limitations, some progress is being made in the identification of those patients for whom therapy is likely to be of benefit. Apart from the use of steroids to control cerebral edema, radiotherapy is currently the most commonly employed therapeutic modality for cerebral metastasis. It is the treatment of choice for multiple intracranial metastases and it affords temporary improvement in neurological symptoms in about 60% of patients. For solitary metastases, combined therapy—surgical excision followed by whole brain radiotherapy—has been shown to result in a better quality and longer duration of survival than either modality alone. Except for patients who are terminally ill, aggressive treatment seems warranted, inasmuch as therapeutic results have been improving steadily over the years. Neither chemotherapy nor immunotherapy has been shown to be of benefit in the management of cerebral metastasis. An exception is choriocarcinoma, which responds well to a combination of radiation therapy and chemotherapy. Although the prognosis for meningeal carcinomatosis is poor, improved survival may be achieved by a combination of chemotherapy and radiotherapy. These are recommended guidelines for surgical intervention, usually followed by radiotherapy: (a) In general, surgical excision is recommended only for patients with relatively superficial, solitary lesions. It is reasonable, however, to consider the excision of a metastatic lesion that is immediately life-threatening or incapacitating, even though one or more other metastatic brain lesions may be present. This may be extended to the removal of multiple metastatic brain tumors if they are surgically accessible. (b) The second consideration is whether the primary tumor can or has been treated or if the primary tumor will permit reasonably long survival. (c) There should not be metastases elsewhere in the body, although their presence should not categorically exclude the patient as a surgical candidate. (d) The patient's general condition should be satisfactory. (e) Operation is recommended if the diagnosis of the intracranial lesion is uncertain. (f) A shunt should be considered for treatment of hydrocephalus secondary to obstruction of the cerebrospinal fluid pathway by tumor or edema.
Needle Biopsy under Computerized Tomographic Control
Authors: James Hector E. , Wells Michael , Alksne John F. , Wickbom Ingmar , Siemers Paul , Brahme Folke , Rosenberg Jay 
Published: May 2010

Abstract
Thirteen patients with intracranial lesions were submitted to a twist drill needle biopsy under computerized tomographic (CT) control, with sedation and local anesthesia. (The patients' ages ranged from 12 to 81 years.) The final diagnoses were glioblastoma in 7 patients and 1 case each of anaplastic astrocytoma, low grade astrocytoma, thrombosed arteriovenous malformation, cerebral infarct, 3rd ventricular epidermoid, and degenerative disease of the brain. Definitive diagnosis was obtained in all but 2 patients with this technique. Appropriate therapy was subsequently instituted in 11 patients without further operation. Transiently increased weakness of the previously affected limbs was the only untoward effect (4 patients). Intracranial hematoma after this procedure was seen in 1 patient in this series, as detected by the postprocedure CT scan, but there was no change in the clinical course. All patients were treated with dexamethasone for 24 to 48 hours before and for several days after the procedure to avoid decompensation of intracranial dynamics because of edema. The procedure, including appropriate level CT scans of the lesion area, was performed in approximately 1 hour in all patients.
Treatment of Acute Focal Cerebral Ischemia with Intermittent, Low Dose Mannitol
Authors: Little John R. 
Published: May 2010

Abstract
The object of this investigation was to study the effects of intermittent, low dose mannitol therapy on conscious cats after acute left middle cerebral artery (MCA) occlusion. A simple implanted device was applied to the proximal left MCA of 40 adult cats using microsurgical techniques. In the acute experiments, 10 cats were untreated and 10 cats received mannitol (0.5 g/kg intravenously) immediately before occlusion and again 3, 6, and 9 hours later. They subsequently underwent intra-arterial perfusion with colloidal carbon and buffered paraformaldehyde 12 hours after occlusion. The plasma osmolality immediately before perfusion was 316 ± 2 (SD) milliosmoles in untreated cats and 331 ± 5 milliosmoles in treated cats. Gross swelling, impaired carbon filling, and breakdown of the blood-brain barrier (BBB) to fluorescein were seen in the left MCA territory of 8 untreated cats and 1 treated cat. The mean percentage of gray matter cross sectional area where severe ischemic neuronal alterations predominated was 45 ± 12% in untreated and 14 ± 16% in treated cats (p &lt; 0.01). The mean capillary luminal diameter in the left sylvian cortex was 4.5 ± 1.0 μ in untreated cats (control, 6.5 ± 1.0 μ) and 5.5 ± 1.0 μ in treated cats. In the subacute experiments, 10 cats were not treated and 10 cats received mannitol as in the acute experiments. The cats were killed with a large bolus of sodium pentobarbital 48 hours after left MCA occlusion. Gross swelling and breakdown of the BBB were less severe in treated cats. The mean cross sectional area of infarcted tissue was 55 ± 12% in untreated cats and 33 ± 21% in treated cats (p &lt; 1.0). The findings of this study indicate that intermittent, low dose mannitol therapy delays the onset of ischemic cerebral injury and may reduce the size of the eventual infarct or convert a potential infarct into a so-called “transient ischemic attack.”
Saccular Aneurysm Associated with Fenestrated Basilar Artery
Authors: Becker Dennis H. , Hamilton Richard D. 
Published: May 2010

Abstract
A case of saccular aneurysm associated with a fenestrated proximal basilar artery is presented. The aneurysm projected anteriorly, superiorly, and slightly to the left. Via a right suboccipital approach, the aneurysm was clipped with preservation of all vessels. The only postoperative deficit is a resolving dysphonia.
Rupture of Intracranial Aneurysm Causing Acute Subdural Hematoma, Intratemporal Hematoma, and Decerebration, with Survival
Authors: Ryan Edward P. 
Published: May 2010

Abstract
The author reports a case of intracerebral and subdural hematomas of acute onset secondary to rupture of an aneurysm. The patient was in a state of advanced decerebration and was breathing spontaneously although irregularly. There was a gratifying response to prompt neurosurgical intervention.
Eosinophilic Granuloma Mimicking a Pituitary Tumor
Authors: Goodman Richard H. , Post Kalmon D. , Molitch Mark E. , Adelman Lester S. , Altemus L. Reed , Johnston Hugh 
Published: May 2010

Abstract
The authors present the case report of a patient in whom hypopituitarism, diplopia, and visual field defects were due to eosinophilic granuloma. Radiographic studies were suggestive of a pituitary tumor and subsequent histological evaluation showed replacement of the anterior pituitary by histiocytic cells. Eosinophilic granuloma should be included in the differential diagnosis of an intrasellar mass.
Spinal Metastasis
Authors: Black Perry 
Published: May 2010

Abstract
An overview of the current status of various aspects of spinal metastasis, including pathology, diagnosis, and management, is presented. The cell type of the tumor, particularly with reference to its radiosensitivity, seems to be positively correlated with treatment outcome, regardless of the treatment modality. Because pretreatment neurological status also seems to influence prognosis, early identification of spinal involvement in patients at risk is important; therefore, a high index of suspicion in patients known to have cancer is necessary. The most useful warning of impending spinal cord or nerve root compression is spinal or radicular pain, which usually precedes neurological deficit by days to years. An aggressive diagnostic evaluation of pain symptoms is therefore warranted; this should include plain spine films and, in questionable cases, radioisotope bone scan. Myelography should also be considered in any cancer patient with persistent spinal or radicular pain, even in the absence of neurological deficit and certainly if there is any neurological impairment. Therapeutically, radiation and surgery continue as the mainstays of management, whereas steroids and chemotherapy serve as adjuvants. The guidelines for management recommended in this paper are to be viewed as tentative because the ideal treatment for spinal metastasis has not been established. The proposed guidelines are based on an analysis of retrospective studies that suggest that radiotherapy should be the primary mode of treatment and that surgery should be reserved for situations in which radiotherapy fails or where there is bony compression or spinal instability. Cases are presented to illustrate the application of these guidelines.
Scanning Electron Microscopic and X-ray Energy Spectrographic Analysis of the Inner Surface of Human Atherosclerotic Carotid Plaques
Authors: Dujovny Manuel , Kossovsky Nir , Loubeau Jean-Michel , Nelson Debra , McManus George 
Published: May 2010

Abstract
Forty specimens of carotid plaque from 30 patients who had suffered cerebrovascular accidents and 10 asymptomatic control patients were examined by light and scanning electron microscopy (SEM). The SEM revealed the finely detailed surface characteristics of the plaque including cell deposits, endothelial damage, and exposed subendothelium. X-ray energy spectrography scans revealed that 7 specimens had calcium deposits. Presurgical treatment with dipyridamole and aspirin inhibited or substantially reduced thrombus formation.
Spontaneous Cervical Carotid Artery Dissection
Authors: Chapleau Charles E. , Robertson James T. 
Published: May 2010

Abstract
The authors report a patient with spontaneous high cervical internal carotid artery dissection and a severe reversible ischemic deficit. Successful treatment consisted of 5 months of continuous intravenous heparin using an implantable infusion device. The details of this therapy are described, and alternative therapeutic modalities are discussed.
Tuberculous Brain Abscess
Authors: Leblanc Richard 
Published: May 2010

Abstract
A 27-year-old Vietnamese male immigrant to Canada developed a hemispheric cerebellar abscess. The patient presented at the hospital with osteomyelitis of the 5th finger of the left hand. He complained of lassitude, weight loss, and early morning headache, nausea, and vomiting, and he developed a left facial weakness. A computed tomographic scan demonstrated the distinctive appearance of an abscess of the left cerebellar hemisphere. Aspiration of the abscess afforded immediate relief of obstructive hydrocephalus and provided pus from which Mycobacterium tuberculosis was grown, thus permitting specific antituberculous chemotherapy. The cerebrospinal fluid obtained at the time of operation was sterile. The patient recovered fully. A primary site of infection was not conclusively identified.