bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Bioccipital Reticulum Cell Sarcoma: A Case Report with Emphasis on Carbon Dioxide Laser Applicatio
Authors: Habibi Mehdi , Bernstein Ronald A. , Stone James , Oldershaw John , Rhee Hwaja L. 
Published: May 2010

Abstract
A case of bilateral occipital primary reticulum cell sarcoma of the brain is reported, and the literature concerning this rare and often confusing tumor is reviewed. Gross total CO2 laser ablation of this infiltrating tumor of the right visual cortex is compared to conventional excision of the left occipital tumor in the same patient. The uniqueness of this case and the role of the CO2 laser in the total excision of such malignant tumors are emphasized.
Prevention of Air Embolism with Positive End Expiratory Pressure
Authors: Voorhies Rand M. , Fraser Richard A. R. , Van Poznak Alan 
Published: May 2010

Abstract
Pulmonary air embolism is recognized as a possible complication of neurosurgical procedures performed with the patient in the sitting position. A variety of preventive and therapeutic modalities have been proposed in the literature. We have used a consistent regimen consisting of precordial Doppler monitoring, measurement of end expiratory CO2, the semireclining position, and positive end expiratory pressure (PEEP). A right atrial catheter was not used. This approach has given good results in 81 patients: there was significant air embolism in only 1 case (1.2%). We believe that PEEP is as important in the prevention as it is in the treatment of pulmonary air embolism. By flexibly adjusting the level of PEEP, one may recreate the hemodynamic equivalent of the prone position, thereby eliminating the risk of venous air embolism and simultaneously the need for right heart catheterization.
Intracranial Extension of Nasal Dermoids
Authors: McQuown Sherry A. , Smith James D. , Gallo Anthony E. 
Published: May 2010

Abstract
Nasal dermoid cysts with intracranial extension have been thought to be a rare entity. Seven new cases of nasal dermoid cyst with intracranial involvement were treated from 1975 through 1982 by combined otolaryngological-neurosurgical management. Preoperative radiological studies were helpful in predicting intracranial extension in only three cases. The extracranial lesion was resected by the otolaryngologist using surgical hemoclips to tag the dermoid remnant entering the cranium. These hemoclips were a helpful landmark for the neurosurgeon when resecting the intracranial extension through a bifrontal craniotomy approach. In four cases, the dermoid cyst entered the cranium through a persistent foramen cecum and lay within the falx in association with a bifid crista galli. We think that this entity is more common than was previously appreciated. Patients with a diagnosis of nasal dermoid should undergo polytomography or computed tomography of the glabellar area. Even when all x-ray studies are negative, neurosurgical preoperative evaluation and operative standby should be obtained before the otolaryngologist attempts the resection of a nasal dermoid cyst.
Vasospasm of the Vertebrobasilar System in Cases of Ruptured Intracranial Aneurysm
Authors: Chui Mario , Battista Arthur F. , Kricheff Irvin I. 
Published: May 2010

Abstract
The reported incidence of vasospasm in cases of ruptured vertebrobasilar (VB) aneurysm varies considerably. The classification into local and diffuse spasm may partially explain the discrepancy. In the present small series, we found that local spasm is more common than diffuse spasm, which is rare in cases of ruptured VB aneurysm when compared with ruptured supratentorial aneurysm. It is hoped that further work may help to explain this apparent difference between the anterior and the posterior circulation and may contribute to the understanding of vasospasm.
In Vitro Secretion of Adenoma and Anterior Lobe Cells in Two Typical Cases of Cushing's Disease
Authors: Lüdecke Dieter K. , Schabet Martin , Saeger Wolfgang 
Published: May 2010

Abstract
Fragments of adrenocorticotropic hormone (ACTH) cell adenomas and anterior lobes of two patients with Cushing's disease were obtained by transnasal operation. Both patients showed the typical clinical course, with postoperative ACTH deficit and all other pituitary functions intact. Equivalent specimens of tissue were investigated by immunocytology and in a superfusion system. The majority of adenoma cells were ACTH-positive, whereas ACTH-secreting cells of the anterior lobes were mostly inactive and were reduced in number. In vitro, adenomatous tissue showed high ACTH secretion into the superfusion medium, which was increased significantly after vasopressin application. Corticoid feedback was impaired. Anterior lobe cells exhibited a significant spontaneous ACTH secretion that was reduced by cortisol, but not stimulated by vasopressin. These results support the concept of an impaired corticoid feedback at the adenoma level in the presence of suppressed ACTH secretion of the para-adenomatous anterior lobe.
Orbital Floor Fracture: An Unusual Complication of Trans-septal Trans-sphenoidal Hypophysectomy
Authors: Newmark Harris , Kant Naval , Duerksen Roger , Pribram Henry W. 
Published: May 2010

Abstract
The authors report a fracture of the orbital floor that was caused by a speculum during trans-sphenoidal hypophysectomy. There were also fractures of the medial wall of the maxillary antrum and the frontal process of the maxilla. This unusual complication has not been described previously.
Ventricular Obstruction Secondary to Vascular Malformations
Authors: Hoi Sang U. , Kerber Charles 
Published: May 2010

Abstract
Enlarged veins in two vascular malformations blocked the cerebrospinal fluid outflow pathways, causing hydrocephalus. Both patients presented not with the usual clinical picture (hemorrhage, seizure, etc.), but with signs of increased intracranial pressure. Computed tomography and angiography were necessary to understand the pathophysiology. An arteriovenous malformation was responsible for the first patient's headache, and a venous varix was the causative lesion in the second patient. Hydrocephalus caused by a venous varix has not been reported before.
Dural Plasmacytoma
Authors: Pritchard Paul B. , Martinez Robert A. , Hungerford Douglas G. , Powers James M. , Perot Phanor L. 
Published: May 2010

Abstract
Dural plasmacytoma is an unusual form of myeloma. We describe a woman with plasmacytoma of the tentorium cerebelli that was managed successfully with surgical decompression and radiotherapy. Computed tomography, not previously reported in cases of dural plasmacytoma, was useful in her management. Another unique feature was the restoration of a normal immunoglobulin G content in the blood and cerebrospinal fluid after local treatment of the neoplasm. Two previously reported cases showed similar normalization of cerebrospinal fluid immunoglobulin G after local radiotherapy. Dural plasmacytoma presents a characteristic clinical syndrome. The typical patient is a woman (92% of the reported cases) in the 5th decade of life. Clinical findings reflect intracranial hypertension, often with focal neurological signs, consistent with the usual dural or tentorial origin of the tumor. Immunoglobulin abnormalities may be found in serum or cerebrospinal fluid. The prognosis is good after surgical decompression and local radiotherapy.
Chronic Disseminated Intravascular Coagulation and Metastatic Brain Tumor: A Case Report and Review of the Literature
Authors: Sawaya Raymond , Donlon Jerome A. 
Published: May 2010

Abstract
A patient who had a primary lung carcinoma in remission but had a solitary metastatic lesion to the cerebellum was referred to the neurosurgery service. He was noted to be thrombocytopenic, and further hemostatic evaluation revealed chronic disseminated intravascular coagulation. He was treated with heparin and platelet transfusions. Although the fibrinogen levels improved, the thrombocytopenia persisted. Four weeks after admission, repeat chest x-ray films and tomograms indicated progressing metastatic nodules. A review of the literature reveals a variety of hemostatic defects associated with tumor metastatic to the brain. This current case indicates the need for careful hemostatic evaluation in all patients with brain lesions.
Effects of Therapeutic Pentobarbital Coma on Multimodality Evoked Potentials Recorded from Severely Head-injured Patients
Authors: Newlon Pauline G. , Greenberg Richard P. , Enas Gregory G. , Becker Donald P. 
Published: May 2010

Abstract
We sought to determine whether pentobarbital (PB) coma compromises the use of evoked potentials (EPs) in the assessment of brain dysfunction and of the prognosis of severely head-injured patients. Therefore, the effects of therapeutic PB on somatosensory (SEPs, BSEPs), visual (VEPs), and auditory (BAEPs) evoked potentials recorded from 20 patients early after injury were analyzed. Seventeen head-injured patients served as controls. EP studies were obtained shortly after admission (Mean Day 2, PB present) and approximately 2 weeks after injury (Mean Day 15, PB absent). The mean serum level of PB in the treatment group was 1.9 mg/100 ml. The drug effect was assessed by comparisons between the PB and the control groups. Statistical analyses were based on differences observed between two studies in the same patient. Analyses of covariance (F tests) were performed on data from all modalities. Wave form complexity was minimally affected by the drug. Middle and long latency components of the SEP were depressed by PB, and latencies of BSEP peaks and the early components of the SEP were delayed. The amplitude of some VEP peaks was reduced by PB. The BAEP was not significantly altered. All of the observed effects of PB were determined to be due to the hypothermia exhibited by PB-treated patients (mean temperature, 36.1ºC), which was not seen in the control group (mean, 37.8ºC). It is concluded that, with appropriate interpretation, EPs can be used to monitor brain function in head-injured patients when PB therapy is used.
Relationship between Contrast Enhancement on Computed Tomography and Cerebral Vasospasm in Patients with Subarachnoid Hemorrhage
Authors: Tazawa Toshiaki , Mizukami Masahiro , Kawase Takeshi , Usami Takashi , Togashi Osamu , Hyodo Akio , Eguchi Takashi 
Published: May 2010

Abstract
To elucidate the relationship between abnormal enhancement of the cisterns on computed tomography and cerebral vasospasm, we performed a systematic and prospective study in 60 patients with ruptured cerebral aneurysms. There is a significant relationship between the findings of contrast-enhanced computed tomography (CECT) within Day 3 of rupture and cerebral vasospasm. Among 37 patients undergoing CECT between Day 0 and Day 3. 17 (46%) showed prominent increases in density in the region around the circle of Willis and its branches. In 13 of 17 cases (76%), severe vasospasm with motor paralysis occurred. In the remaining 4 cases (24%) with only slight or no cerebral vasospasm, the hematoma in the subarachnoid space was removed surgically by Day 3. In 19 of 20 cases without remarkable CECT, no severe cerebral vasospasm with motor paralysis occurred. There is no significant relationship between the CECT findings after Day 3 and cerebral vasospasm. The results indicate that the prominent increase in density in the region of the circle of Willis and its branches often observed on CECT within Day 3 of subarachnoid hemorrhage is useful for prediction of the occurrence of cerebral vasospasm and also provide information on the pathogenesis of cerebral vasospasm.
Experience with Brain Biopsy for Suspected Herpes Encephalitis: A Review of Forty Consecutive Cases
Authors: Morawetz Richard B. , Whitley Richard J. , Murphy Dennis M. 
Published: May 2010

Abstract
From January 1973 through July 1981, 40 patients underwent brain biopsy for suspected herpes simplex encephalitis at the University of Alabama Medical Center. Biopsy was performed as a component of experimental antiviral studies to ensure correct diagnosis. A tentative diagnosis was made on clinical grounds, and the site of biopsy was chosen on the basis of localizing neurological signs, the electroencephalogram, and/or computed tomographic (CT) scan abnormalities. Patients ranged in age from 15 months to 73 years, with a median age of 19 years. Thirty patients were male, and 10 were female. Brain tissue from 17 of the 40 patients grew herpes simplex virus in tissue culture. There was one biopsy-related complication, a wound dehiscence requiring secondary closure. In no case was death attributable to the brain biopsy procedure. The outlook in patients with proven herpes encephalitis worsened directly with both an increasing interval between the onset of symptoms and the initiation of antiviral therapy and the age of the patient. The presence of a CT scan abnormality before the initiation of therapy was associated with a very poor prognosis. Three patients not included in this series were referred for brain biopsy to rule out herpes simplex encephalitis, but were found to have bacterial infections. Two had subdural empyemas and the third had a brain abscess with overlying subdural empyema. Current technique calls for biopsy of the anterior portion of the inferior temporal gyrus on the affected side.
Prenatal Diagnosis of Occipital Encephalocele by Ultrasound Scanning
Authors: Weinstein Philip , Weinstein Louis , Dotters Deborah , Bedrick Alan , Anderson Carolyn 
Published: May 2010

Abstract
Fetal visualization in utero can be routinely accomplished using noninvasive ultrasound techniques that do not administer ionizing radiation. Image resolution with real time sonography is sufficient to demonstrate details of possible congenital central nervous system malformations before delivery. The case reported illustrates the advantages of advance warning in an infant with occipital meningoencephalocele for determining prognosis, planning delivery by cesarean section, and preparing for immediate neurosurgical repair.
Intrasellar Abscess after Transsphenoidal Pituitary Adenomectomy
Authors: Robinson Bernard 
Published: May 2010

Abstract
Intrasellar abscess is a rare disease that is difficult to diagnose preoperatively. Few neurosurgeons who operate by the transsphenoidal route are concerned with intrasellar abscess despite its high mortality rate. We describe a case of intrasellar abscess which, to our knowledge, is only the second diagnosed or suspected preoperatively. Most cases have been diagnosed unexpectedly at operation or autopsy. This case also is the first reported intrasellar abscess arising within an intrasellar graft used to seal the sella turcica after transsphenoidal pituitary adenomectomy. The clinical suspicion of infection proved more reliable than roentgenograms and laboratory studies in leading to the proper diagnosis and successful therapy.
Neurogenic Pulmonary Edema Associated with Ruptured Spinal Cord Arteriovenous Malformation
Authors: Lee Don S. , Kobrine Arthur 
Published: May 2010

Abstract
A case of neurogenic pulmonary edema (NPE) associated with a ruptured spinal cord arteriovenous malformation (AVM) is presented. The mechanisms involved in the development of NPE are discussed briefly. The possible role of preganglionic sympathetic fibers in the spinal cord in the etiology of NPE is suggested.
Management of Plasmacytomas of the Spine
Authors: Loftus Christopher M. , Michelsen Christopher B. , Rapoport Frederick , Antunes J. Lobo 
Published: May 2010

Abstract
Epidural plasmacytoma often reflects systemic myelomatous involvement and usually has a poor prognosis. The isolated spinal plasmacytoma, however, is a lesion with the potential for long term remission or even cure in some cases. We report six patients with isolated plasmacytoma of the low thoracic or lumbar region, all of whom presented with pain and minimal neurological deficits. Our approach to such cases included a complete medical work-up and radiographic definition of the lesion with a bone scan, a skeletal survey, myelography, computed tomography, and, in some instances, spinal angiography. All of these patients underwent laminectomy and spinal fusion with autologous bone and harrington rods. There was no morbidity associated with the procedure, which was designed to prevent possible collapse during subsequent radiotherapy or chemotherapy, with its attendant potential for neurological catastrophe. Several patients have developed systemic involvement necessitating chemotherapy, but in follow-up extending now to 4 years all patients remain ambulatory and pain-free. We are encouraged by the potential for symptomatic relief and neurological improvement of patients with isolated spinal plasmacytomas who are treated with an aggressive medical and surgical approach.
Lumboatrial Shunt: Case Report
Authors: Friedman Phillip , Gass H. Harvey 
Published: May 2010

Abstract
Hydrocephalus without ventriculomegaly and pseudotumor cerebri may present special problems in its treatment. Lumboperitoneal shunting, although frequently effective, is not successful in all cases. A lumbar subarachnoid to venous shunt is described as an alternative to lumboperitoneal shunting. A case illustrating its use is reported.
Teratoid Cyst of the Spinal Cord
Authors: Padovani Roberto , Tognetti Francesco , Laudadio Silvia , Manetto Valeria 
Published: May 2010

Abstract
The authors report a rare case of intramedullary teratoid cyst, in which an arteriovenous malformation of the spinal cord was first suspected. The controversial problem of the histogenesis of teratomas is reviewed. The authors stress the benign course of these lesions after operation, even when radical surgery cannot be performed.
Sacral Plexus Nerve Sheath Tumor: Case Report
Authors: Robertson Jon H. , Gropper Gary R. , Dalrymple Sharon , Acker James D. , McClellan George A. 
Published: May 2010

Abstract
A young woman with chronic sciatica was found to have an intrapelvic sacral plexus nerve sheath tumor. Computed tomography of the pelvis was used to delineate this unusual site of tumor development. The case report and a discussion of pelvic nerve sheath tumors are presented.
Cerebral Gangliogliomas during Childhood
Authors: Sutton Leslie N. , Packer Roger J. , Rorke Lucy B. , Bruce Derek A. , Schut Luis 
Published: May 2010

Abstract
We have reviewed our experience with gangliogliomas treated in the post-computed tomography (CT) era at the Children's Hospital of Philadelphia. Of 234 newly histologically verified neoplasms seen at our institution since 1975, 10 (4.3%) were gangliogliomas of the cerebral hemispheres. The presenting complaint was seizures in 9 of 10 patients. and in 8 the seizures were poorly controlled despite increasing doses of anticonvulsant medication. At the time of diagnosis, only 2 patients had a focal neurological deficit and none had signs or symptoms of increased intracranial pressure. Learning disability and behavioral disturbances were common in this group of children. The CT appearance of these lesions was characteristic: most appeared as a cerebrospinal fluid density area that was located peripherally and often indented the skull. There was little contrast enhancement, and a few were diagnosed initially as arachnoid or porencephalic cysts. Despite the CT appearance, all but 2 of the lesions were found to be solid at operation. In one patient, the lesion appeared as an enhancing lesion of the thalamus, and this patient died. Operation resulted in symptomatic improvement. Eight of 9 children are alive, with a follow-up of 1 to 80 months (median, 19.5 months), and are free of progressive disease. Five are seizure-free while receiving anticonvulsant therapy and an additional 3 have improved seizure control as a result of operation. Two of the 3 children with intellectual difficulties preoperatively have shown improvement on testing after operation, probably the result of improved seizure control. One patient developed a disseminating malignancy and died. It is concluded that worsening seizures in the pediatric age group should warrant CT examination and that ganglioglioma should be included in the differential diagnosis of low density areas on CT.
Role of Emergency Skull X-ray Films in the Evaluation of the Head-injured Patient: A Retrospective Study
Authors: Cooper Paul R. , Ho Victor 
Published: May 2010

Abstract
Hospital admission of the patient with apparently minor head injury with a normal level of consciousness is generally unnecessary. However, a certain number of these patients will deteriorate neurologically because of the development of a post-traumatic intracranial mass lesion. Skull roentgenograms are commonly obtained in these patients in a search for a linear skull fracture on the assumption that a skull fracture predisposes the patient to the development of an intracranial mass. To determine the utility of emergency skull x-ray films. we retrospectively reviewed the records of 207 patients with known traumatic intracranial masses. We specifically sought to determine the number of patients who were neurologically intact at the time of presentation, were admitted solely because of the presence of a skull fracture, and then went on to develop signs or symptoms of an intracranial mass lesion. Of the 207 patients, 119 patients had cerebral contusions. 89 had subdural hematomas, 50 had intracerebral hematomas, and 31 had epidural hematomas (some patients had two or more lesions). Seventy-six of the 207 patients (37%) had skull fractures. One hundred ninety-one of 207 patients (92%) had an abnormal level of consciousness at the time of presentation and would have been admitted regardless of their skull film findings. Of the 16 patients who were fully alert, 10 had normal skull x-ray films: all were admitted for focal neurological deficits, nausea and vomiting, amnesia, etc., but would have been discharged had the skull x-ray films been the only determinant for admission. Six of the 16 patients who were alert had skull fractures. All but 1 of these patients had systemic injuries, focal deficit, or other reasons for admission. Only 1 patient of the entire series was completely intact neurologically, had a skull fracture, was sent out, and returned having experienced neurological deterioration. This patient had an epidural hematoma and made a good recovery after operation. We conclude that skull roentgenograms performed to identify linear skull fractures in the head-injured patient are neither cost-effective nor useful in predicting deterioration from a mass lesion and should not be used for this purpose or as a determinant for hospital admission.
Twist Drill Craniostomy and Closed System Drainage of Chronic and Subacute Subdural Hematomas
Authors: Carlton Candace K. , Saunders Richard L. 
Published: May 2010

Abstract
Based on reports in the literature on the success and low morbidity of twist drill craniostomy (TDC) and closed system drainage (CSD) for chronic subdural hematomas, a prospective study was initiated in 1981 and included all symptomatic patients presenting with a history and clinical and computed tomographic (CT) findings consistent with subacute or chronic subdural hematoma. A total of nine patients were treated with TDC and CSD as the initial procedure. An asymptomatic or progressively improving patient with greater than 50% reduction in subdural size by repeat CT scan was set as the end point of therapy. There were no complications, all patients improved with drainage, and seven were cured by this method alone. The results are compared retrospectively to surgically treated patients, and an overall decrease in morbidity and length of hospitalization are noted. The technique and CT scan correlations are described, and the rationale for use of this method is discussed in terms of our current understanding of the pathophysiology and complications of the disease.