bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spinal Epidural Neurostimulation for Treatment of Acute and Chronic Intractable Pain
Authors: Richardson Robert R. , Siqueira Edir B. , Cerullo Leonard J. 
Published: May 2010

Abstract
Spinal epidural neurostimulation, which evolved from dorsal column stimulation, has been found to be effective in the treatment of acute and chronic intractable pain. Urban and Nashold have shown that it is a safe, simplified alternative to dorsal column stimulation, especially because laminectomy is not required if the electrodes are inserted percutaneously. Percutaneous epidural neurostimulation is also advantageous because there can be a diagnostic trial period before permanent internalization and implantation. This diagnostic and therapeutic modality has been used in 36 patients during the past 3 years at Northwestern Memorial Hospital. Eleven of these patients had acute intractable pain, which was defined as pain of less than 1 year in duration. Initial postimplantation results from the 36 patients indicate that spinal epidural neurostimulation is most effective in treating the intractable pain of diabetes, arachnoiditis, and post-traumatic and postamputation neuroma. Long term follow-up, varying from 1 year to 3 years postimplantation in the 20 initially responding patients, indicates that the neurostimulation continues to provide significant pain relief (50% or greater) in a majority of the patients who experienced initial significant pain relief.
Risk of Intracranial Aneurysm Surgery in the Good Grade Patient
Authors: Samson Duke S. , Hodosh Richard M. , Reid William R. , Beyer Chester W. , Clark William Kemp 
Published: May 2010

Abstract
To evaluate the risk of definitive intracranial microsurgical aneurysm obliteration as a function of the timing of the operative intervention, we retrospectively reviewed 106 consecutive patients in good clinical condition who underwent such surgery. The patients who were operated upon within the first 8 days of their most recent subarachnoid hemorrhage formed the “early” group; the patients operated upon between the 9th and 31st day were considered to have undergone “late” surgery. On the basis of their clinical outcome the patients were allocated to one of four outcome categories (“good,” “fair,” “poor,” “death”) both at the time of their hospital discharge and at their most recent clinical re-evaluation, a minimum of 6 months after discharge from the hospital. There was no significant difference in the operative mortality in each group (early surgery, 5%; late surgery, 4%); additionally, no significant difference was noted in the incidence of either intraoperative complications or postoperative morbidity. A suggestive but statistically insignificant increase in the incidence of postoperative cerebral ischemic events was seen in the “early” surgery group (8% vs. 4% for the “late” surgery group). The potential significance of these findings for the timing of intracranial aneurysm surgery is discussed.
Acquired Middle Cranial Fossa Fistulas
Authors: Kaufman Benjamin , Yonas Howard , White Robert J. , Miller Clinton F. 
Published: May 2010

Abstract
To the accepted classification of three types of normal pressure, nontraumatic cerebrospinal fluid (CSF) fistulas, we would add “acquired.” This type of CSF fistula tends to occur from the middle cranial fossa because of the enlargement of “pitholes” that are normally present in its anterior medial aspect. The enlargement of these bony defects is due to normal intracranial pressure variations that, not uncommonly, create meningoceles and meningoencephaloceles. A portion of the floor of this area is aerated in up to 10% of the normal population by the lateral recess of the sphenoid sinus, the pterygoid recess. Thus, this area has the potential to act as a pathway between the middle fossa and the paranasal sinuses, allowing cerebrospinal fluid to pass into the sinuses. Isotope and computerized tomographic studies are helpful in the localization of such a CSF leak. Tomography of the base of the skull, however, is essential for the ideal definition of possible routes of fistulization. If there is any question of the presence of a middle fossa fistula, these studies can show whether the floor of this area is pneumatized and whether there are any defects in the floor. The treatment of such a fistula should include generalized reinforcement of the floor of the anterior middle fossa by a middle fossa approach. If any doubt exists as to the site of leakage (anterior or middle fossa), the minimal surgical procedure should include exploration of both areas via a frontotemporal craniotomy.
Meningiomas of the Pineal Region and Third Ventricle
Authors: Rozario Rodney , Adelman Lester , Prager Robert J. , Stein Bennett M. 
Published: May 2010

Abstract
The clinical presentation, radiological findings, and surgical management of two cases of meningioma arising from the velum interpositum without dural attachment are described. The true nature of these tumors was not suspected despite extensive preoperative diagnostic evaluation. A total removal was effected in both cases with the use of the operating microscope and a posterior fossa approach to the pineal region. A review of similar cases from the English literature is presented.
Metastasis of a Rectal Carcinoid to the Posterior Fossa
Authors: Bouldin Thomas W. , Killebrew Kate , Boone Stephen C. , Gay Robert M. 
Published: May 2010

Abstract
We report the metastasis of a rectal carcinoid to the dura mater of the posterior fossa. The clinical presentation was unusual because of a 10-year latent period between resection of the primary rectal tumor and symptoms and signs of the posterior fossa metastasis; the radiological findings were atypical of a metastasis. Gastrointestinal carcinoids, apudomas, and the concept of the APUD endocrine cell family are reviewed.
Extradural Hematoma Associated with Traumatic Middle Meningeal Artery Pseudoaneurysm
Authors: Garza-Mercado Román , Rangel Ricardo A. 
Published: May 2010

Abstract
Two new cases of extradural hematoma associated with traumatic middle meningeal artery pseudoaneurysm are presented. Sixteen such cases have previously been reported in the literature. A 22-year-old man and a 17-year-old woman each developed marked neurological deficits after head injury. In each case percutaneous common carotid angiography demonstrated a conspicuous aneurysmatic sac on the middle meningeal artery, as well as displacement of major intracranial vessels and a surrounding avascular area. At operation the extradural clot was removed and the middle meningeal artery sac was verified. Both patients recovered uneventfully. Histological analysis of one of the specimens was performed.
Increased Intraventricular Pressure without Ventriculomegaly in Children with Shunts
Authors: Engel Murray , Carmel Peter W. , Chutorian Abe M. 
Published: May 2010

Abstract
Five patients with shunt-dependent hydrocephalus were observed to have apparently normal ventricular size despite marked increases in ventricular pressure after shunt malfunction. Elastance (dP/dV) was determined in four of these patients by removing increments of cerebrospinal fluid and measuring the resulting pressure. These patients without ventricular enlargement and with markedly increased ventricular pressure had high elastance. This group of patients with “normal volume” hydrocephalus had distal shunt occlusions, in contrast to previously reported patients with cephalic shunt obstructions after ventricular decompression. Initial shunting in early infancy, prolonged shunt dependency, and lack of recent shunt revision were common factors in these patients. Markedly elevated pressure with normal volume is a threatening clinical entity, requiring prompt surgical intervention.
Cushing's Disease with Cyclic Hormonogenesis and Diabetes Insipidus
Authors: Oates Thomas W. , McCourt Jerome P. , Friedman William A. , Agee O. Frank , Rhoton Albert L. , Thomas William C. 
Published: May 2010

Abstract
A cyclic excess of cortisol secretion was detected in a patient with diabetes insipidus and diabetes mellitus. The cycles of hypercortisolism were of 7 days' duration, but during the nadir of these cycles urinary excretion of corticosteroids and 17-ketosteroids was within the normal range. The radiological appearance of the sella turcica was normal; however, computerized axial tomography of the head revealed a small tumor immediately superior to the sella turcica. At operation a small chromophobe adenoma superior to the diaphragma sellae and involving the hypophysial stalk was partially resected. Postoperatively, the patient continued to have 7-day cycles of increased corticosteroid excretion, but the amounts excreted were less than they had been preoperatively. Other patients have been described in whom Cushing's disease has been due to cyclic hypercortisolism. These cycles have been remarkably regular in individual patients, but of variable duration in different patients. Furthermore, cyclic hormonogenesis probably occurs in a variety of endocrinopathies.
Extraparenchymal Sarcoid Mass
Authors: Lax Fredric , Tabaddor Kamran 
Published: May 2010

Abstract
Sarcoidosis frequently involves the nervous system, but intracranial sarcoid mass lesions are rare. A case of a subfrontal extraparenchymal sarcoid mass mimicking a meningioma is presented. Previously reported cases of intracranial sarcoid mass lesions are reviewed.
Spinal Subdural Hematoma
Authors: Guthikonda Murali , Schmidek Henry H. , Wallman Lester J. , Snyder Thomas M. 
Published: May 2010

Abstract
A case of lumbar spinal subdural hematoma in a patient who had been on anticoagulant therapy is reported. Thus far 19 cases of spinal subdural hematoma have been reported in the literature, the majority in patients with a bleeding diathesis and after a lumbar puncture. Our case is the third reported to be in association with anticoagulant therapy. The hematoma was lumbosacral, in contrast to the usual location in the dorsal-lumbar area. A possible mechanism for the production of spinal subdural hematoma after a lumbar puncture is discussed. An early decompressive laminectomy and evacuation of the hematoma is the recommended treatment to obtain the best possible recovery of neurological function.
Delayed Traumatic Intracerebral Hematomas after Surgical Decompression
Authors: Hirsh Leonard F. 
Published: May 2010

Abstract
Delayed traumatic intracerebral hematomas found after an initially unrevealing computerized tomographic scan have been reported occasionally. Such hemorrhage may occur in an area of brain contusion with cerebral vessel injury. Four cases of intracerebral hematoma appearing after evacuation of a different traumatic intracranial mass lesion are reported. This suggests that an intracranial mass lesion may tamponade cerebral venous oozing in an area of brain contusion and delay the accumulation of intracerebral blood, accounting for the late discovery of a parenchymal hematoma.
Cardiac Arrhythmias Associated with Subarachnoid Hemorrhage
Authors: Vidal Bruno Estañol , Dergal Elias Badui , Cesarman Eduardo , San Martin Oscar Marin , Loyo Mauro , Lugo Bartolome Vargas , Ortega Roberto Perez 
Published: May 2010

Abstract
This is a prospective study of cardiac arrhythmias in patients with acute subarachnoid hemorrhage (SAH) secondary to ruptured aneurysm. Twenty per cent of the patients had serious, life-threatening arrhythmias. However, 100% of the patients had some kind of cardiac arrhythmia. The arrhythmias occurred during the first 48 hours after SAH. Such arrhythmias occur in patients without overt, pre-existing heart disease, hypoxemia, or electrolyte imbalance. A prolonged Q-T interval is frequently observed in patients with SAH who develop serious ventricular arrhythmias.
Mechanisms of Hyperventilation in Head Injury
Authors: Leitch A.G. , McLennan J.E. , Balkenhol S. , Loudon R.G. , McLaurin R.L. 
Published: May 2010

Abstract
We report the case of a head-injured patient with spontaneous hyperventilation who had recurrent episodes of relative hypoventilation associated with increases in intracranial pressure. Detailed ventilatory studies were performed during the 2nd week after injury. Our findings in this patient prompted us to review the possible mechanisms underlying the observed changes. We suggest that spontaneous hyperventilation in head injury is secondary to a decrease in cortical inhibitory influences on respiratory control mechanisms and that the transient episodes of relative hypoventilation observed in our patient may reflect modified ventilatory responses dependent on the altered state of consciousness.
Pneumocephalus after Ventriculoatrial Shunt
Authors: Steinberger Abe , Antunes John L. , Michelsen W. Jost 
Published: May 2010

Abstract
Pneumocephalus developing after a ventriculoatrial shunting procedure is described. This was found to be caused by a defect in the posterior wall of the frontal sinus, possibly secondary to chronically increased intracranial pressure. A review of the pertinent literature revealed only two other similar cases.
Invasive Pituitary Adenoma with Abscess Formation
Authors: Zorub David S. , Martinez A. Julio , Nelson Paul B. , Lam Man-Tai 
Published: May 2010

Abstract
A case is presented and 10 cases are reviewed in which abscess formation developed in an intrasellar tumor. The diagnosis was made preoperatively or before autopsy in only 1 patient. The mortality rate was greater than 50%. The most common presentation was headache, fever, and visual disturbances with an abnormal sella and sterile cerebrospinal fluid (CSF). Nonconstant findings included meningeal signs and leukocytosis of the CSF. Trans-sphenoidal removal of the tumor and drainage of the abscess with appropriate antibiotic therapy is recommended.
Value of Sequential Computed Tomography in the Multimodality Treatment of Glioblastoma Multiforme
Authors: Salcman Michael , Levine Harvey , Rao Krishna 
Published: May 2010

Abstract
Previous assessments of the value of sequential computed tomographic (CT) scanning in brain tumor patients have suffered from the heterogeneous nature of the study populations in regard to (a) pathology, (b) treatment plan, and (c) time of scanning. This report is based on the first 21 of 30 consecutive cases of glioblastoma multiforme entered into a cumulative high dose chemotherapy study. Each patient received a maximal surgical resection, 5800 to 6300 rads of radiation therapy, and BCNU (1,3-bis(2-chloroethyl)-1-nitrosourea) chemotherapy (beginning at 100 mg/m2/day × 3 days) every 8 to 10 weeks for the life of the patient. CT scans were obtained pre- and postoperatively and at each admission for chemotherapy; the scan at the time of the first BCNU course served as the postradiotherapy scan. Edema was present on 94% of the initial scans, and 94% of the tumors demonstrated contrast enhancement. In 70 instances it was possible to compare clinical status and an enhanced scan at the time of an adjuvant treatment. When the scan was improved or unchanged so was the patient (46 of 46), but worsening of the scan was accompanied by worsening of the patient only 62% of the time (15 of 24). Sequential CT scanning proved useful in (a) detecting the positive effect of a treatment plan in clinically stable patients; (b) detecting non-tumor related causes of clinical deterioration; (c) detecting early treatment failure as a prelude to reoperation and/or a change in drug protocol before clinical deterioration; and (d) detecting asymptomatic complications of the treatment plan (i.e., a 20% incidence of ventricular enlargement).
Multiple Primary Brain Tumors of Different Cell Types
Authors: Deen Gordon H. , Laws Edward R. 
Published: May 2010

Abstract
Eighteen cases of multiple primary brain tumors of different histological types were found in a review of Mayo Clinic records from 1950 to 1978. The predisposing factors, clinical presentation, location, and type of tumor are discussed. The clinical significance and etiology of these multiple tumors are considered.
Central Nervous System Metastases in Malignant Melanoma
Authors: Bullard D. E. , Cox E. B. , Seigler H. F. 
Published: May 2010

Abstract
In a series of 1341 patients with histologically proven malignant melanoma seen at Duke University Medical Center from 1968 to 1978, 107 patients developed central nervous system (CNS) metastases. These patients were evaluated on the basis of which factors were associated with the development of CNS metastases. Male patients, patients with invasive primary lesions as measured by Clark's system, and patients with primary lesions of the head/neck or oral mucosa had higher incidences of CNS metastasis. Age and race were not significant factors. Clinically, single CNS metastases were seen in 48.8% of the patients; multiple cerebral lesions were seen in 37.2% of the patients. In 22% of the patients there was CNS metastasis alone, in 41% a second organ was involved, and in 20% three organs were involved.
Osteoid Osteomas and Osteoblastomas of the Spine
Authors: Janin Yves , Epstein Joseph , Carras Robert , Khan Arfa 
Published: May 2010

Abstract
Benign osteoblastic lesions are rare bone tumors and they are usually divided into osteoid osteomas and benign osteoblastomas based on their biological behavior. Both lesions are prevalent in the spine, with the lamina and pedicle being involved frequently. Long diagnostic delays are frequent. Pain, the most prominent symptom, is often nocturnal and is relieved by aspirin in 30 to 40% of patients. Radicular pain occurs in 50% of the patients. The most common physical finding is tenderness in the vicinity of the lesion. Neurological abnormalities are more frequent in patients with osteoblastomas, which frequently extend into the neural canal. Tomograms are invaluable in most patients in whom plain films are normal. The bone scan is one of the most important diagnostic studies and provides an excellent means of following patients postoperatively. Myelograms do not always demonstrate the epidural extensions. Computed tomography accurately demonstrates the location and extent of the tumor. Permanent relief of pain and neurological recovery is dependent primarily on total removal of the lesion.
Diverse Clinical Applications of Percutaneous Lumboperitoneal Shunts
Authors: James H. E. , Tibbs P. A. 
Published: May 2010

Abstract
A population of 28 patients underwent the percutaneous placement of a shunt in the lumbar region with a single tube, the other end of which was placed in the peritoneal cavity by laparotomy. The clinical indications for the procedure were: communicating hydrocephalus (16 patients), pseudotumor cerebri (3 patients), cranial cerebrospinal fluid fistula (4 patients), and a bulging postcraniotomy site (2 patients). An additional 3 patients were treated by lumbar subcutaneousperitoneal shunt for a cerebrospinal fluid (CSF)-subcutaneous fistula after the removal of a leptomyelolipoma. The mean time of follow-up was 18.8 ± 7.8 months. All patients with pseudotumor cerebri and subcutaneous lumbar CSF fistula and all but 1 of the patients with a cranial CSF fistula improved without further therapy. Twelve of the 16 patients with communicating hydrocephalus improved and did not require other shunt procedures. There was one shunt infection, one wound dehiscence that led to shunt removal, and one shunt migration into the spinal canal. Shunt obstruction that led to revision of the shunt occurred on three occasions in 2 patients. The shunt functioned in only 1 of 4 infants under 4 months of age.
Von Hippel-Lindau Disease with Multiple Manifestations
Authors: Hubschmann Otakar R. , Vijayanathan T. , Countee Roger W. 
Published: May 2010

Abstract
The association of a recurrent cerebellar hemangioblastoma, retinal angioma, pheochromocytoma, renal carcinoma, and multiple renal and pancreatic cysts in one patient is reported, and the pertinent diagnostic studies are discussed briefly. Awareness of the possibility of late manifestations of various components of this syndrome in patients treated successfully for cerebellar hemangioblastoma will lead to their early identification and successful surgical treatment. Genetic counseling for patients affected by this syndrome and their families is recommended.
Intracranial Hemorrhage Associated with Meningioma
Authors: Lazaro Reynaldo P. , Messer Henry D. , Brinker Ray A. 
Published: May 2010

Abstract
Intracranial hemorrhage developed in two patients with meningioma without other apparent risk factors predisposing to hemorrhage. Bleeding has been reported to be associated with meningiomas regardless of the sex or age of the patient or the location or histological nature of the tumor. It can occur acutely without antecedent symptoms, often masking the tumor. The mechanism of hemorrhage is not clear. The complication has not been emphasized in the neurological literature and, although rare, should be considered in the differential diagnosis of intracranial hemorrhage.
Benign Traumatic Intracerebellar Hematoma
Authors: Pozzati Eugenio , Piazza Giancarlo , Padovani Roberto , Gaist Giulio 
Published: May 2010

Abstract
Prompt surgical intervention is thought to be necessary in patients with traumatic intracerebellar hematoma. The case reported here ran a benign course without operation. Pertinent serial computed tomographic scans are presented. It is concluded that not all traumatic hematomas of the cerebellum require operation.
Ventral Spinal Tumor
Authors: Memon Muhammed Yacob , Schneck Lawrence 
Published: May 2010

Abstract
We are reporting a case of a ventrally placed intradural meningioma at the C-7, T-1 level that was shown clearly on a computed tomographic scan without the use of metrizamide. This greatly facilitated the planning of our posterolateral approach, which permitted a complete removal of the tumor with minimal manipulation of the spinal cord.
Microsurgery of the Third Ventricle: Part 2
Authors: Rhoton Albert L. , Yamamoto Isao , Peace David A. 
Published: May 2010

Abstract
The operative approaches to the 3rd ventricle are divided on the basis of whether they are suitable for reaching the anterior or posterior part of the 3rd ventricle. The approaches suitable for lesions within or compressing the anterior portion of the 3rd ventricle are the trans-sphenoidal, subfrontal, frontotemporal, subtemporal, anterior transcallosal, and anterior transventricular. The approaches suitable for reaching the posterior portion of the 3rd ventricle are the posterior transcallosal, posterior transventricular, occipital transtentcrial, and infratentorial supracerebellar. Considerations important in selecting one of these approaches are reviewed.
Technique for C-1, C-2, and C-3 Fixation in Cases of Odontoid Fracture
Authors: Six Eric , Kelly David L. 
Published: May 2010

Abstract
A technique for fixation of C-1, C-2, and C-3 for odontoid fractures is described. Fixation wires between the laminae of the atlas and the spinous process of the axis maintain the atlantoaxial alignment. Kirschner wire pins through the spinous processes of C-2 and C-3 act as reinforcing bars for a methyl methacrylate fusion. (Neurosurgery 8:374-377, 1981)
Cerebellar Infarction with Associated Acute Hydrocephalus Due to Vertebral Artery Occlusion in a Child
Authors: Bergen Barry J. , Batnitzky Solomon , Morantz Robert A. , Price Hilton I. 
Published: May 2010

Abstract
Vertebral artery occlusion due to spontaneous rotation of the head with resultant cerebellar infarction and acute hydrocephalus occurred in a 9½-month-old child. The clinical and radiological findings are described, and a brief review of the literature is given.
Klüver-Bucy Syndrome and Herpes Encephalitis
Authors: Chutorian Abe M. , Antunes Lobo J. 
Published: May 2010

Abstract
A case of Klüver-Bucy syndrome that developed after biopsy-proven herpes encephalitis is presented. The pathophysiology of the syndrome is discussed. The evolution of the disease in our case suggests that the syndrome, as in the animal model, may in some cases be transient.