bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subarachnoid Hemorrhage from a Peripheral Intracranial Aneurysm Associated with Malignant Glioma: Report of a Case
Authors: Andrews Brian T. , Raffel Corey , Rosegay Harold 
Published: May 2010

Abstract
The case of a patient who initially presented with a subarachnoid hemorrhage from an aneurysm of the distal left middle cerebral artery is reported. The aneurysm was later found to have occurred within a malignant glioma. Histological analysis showed tumor infiltrating the wall of the aneurysm. A causal relationship between growth of the tumor and development and rupture of the aneurysm is postulated.
Traumatic Subarachnoid-Pleural Fistula
Authors: Lovaas M. Edward , Castillo Reynaldo G. , Deutschman Clifford S. 
Published: May 2010

Abstract
Subarachnoid-pleural fistula is a rare condition; only 18 cases have been reported. The 19th case of subarachnoid-pleural fistula. which followed a small caliber gunshot wound, is reported. Diagnosis was made via radionuclide scan, and primary operative repair was necessitated by the failure of conservative management. A review of the literature reveals several means of diagnosing this disorder, as well as a number of management alternatives.
Subacute Diencephalic Necrosis and Dural Arteriovenous Malformation
Authors: Nakada Tsutomu , Kwee Ingrid L. , Ellis William G. , St. John James N. 
Published: May 2010

Abstract
We report a case of congestive venous necrosis involving the diencephalon symmetrically, presumably precipitated by a dural arteriovenous malformation (AVM). The patient presented with a 1-month history of intermittent confusion and gait ataxia. The initial radiological work-up revealed a dural AVM. The patient's subsequent deterioration was accompanied by computed tomographic findings of diencephalic congestion. Pathological examination showed subacute necrosis of the diencephalon. We discuss the pathogenesis of this case of subacute diencephalic necorsis and its possible relationship to the entity of subacute diencephalic angioencephalopathy.
The Cerebral Venous System
Authors: Schmidek Henry H. , Auer Ludwig M. , Kapp John P. 
Published: May 2010

Abstract
The authors discuss the gross and microscopic anatomy and the physiology of the cerebral venous system. Cerebral veins under pathological circumstances (hypercapnia, arterial hypertension, and increased intracranial pressure), pharmacological observations, the venous blood-brain barrier, and traumatic involvement are reviewed. Neoplastic involvement and radiological aspects are included. Surgical reconstruction of venous sinuses (including the Donaghy technique), tumor removal, sinus thrombectomy, and extraanatomical bypass of the transverse sinus are discussed.
Cranial Chordomas: Clinical Presentation and Results of Operative and Radiation Therapy in Twenty-six Patients
Authors: Raffel Corey , Wright Donald C. , Gutin Philip H. , Wilson Charles B. 
Published: May 2010

Abstract
The clinical presentation and the results of operative and radiation therapy in a series of 26 patients with cranial chordomas seen at the University of California, San Francisco, between 1940 and 1984 are reviewed. There were 14 men and 12 women, with a mean age of 39.6 years. Six patients had chondroid chordomas. The most common presenting symptoms were headache and diplopia, and the most common presenting sign was extraocular palsy. Fifty-three operations directed at removal of the tumor were performed. Twenty-three patients received various forms of radiation therapy postoperatively, including conventional external beam therapy, heavy charged particles, and interstitial implants. The average length of follow-up is 5.6 years. Eleven of 26 patients have died; the mean duration of survival in this group, excluding 1 perioperative death, was 4 years and 2 months. Although the average survival time of 6 years and 4 months was the same in patients with typical chordomas (excluding the perioperative death and 1 patient lost to follow-up) and in those with the chondroid variant, all of the latter are still alive, whereas more than half of the patients with typical chordoma have died.
Psychological Factors and Outcome of Electrode Implantation for Chronic Pain
Authors: Daniel Michael S. , Long Charles , Hutcherson W. L. , Hunter Samuel 
Published: May 2010

Abstract
The utility of using psychological assessments as a basis for predicting pain relief after electrode implantation is examined. Two raters independently reviewed the functional pain protocols of chronic pain patients who were candidates for deep brain (n = 13) or spinal cord (n = 17) electrode implants and predicted whether each would have a good or poor treatment response. At follow-up, five deep brain (39%) and four spinal cord (24%) patients were classified as having good responses to treatment. Predictions of outcome based on psychological data were accurate for 80% of the patients. These results suggest that functional pain assessment is useful as a part of preimplantation screening and emphasize the importance of psychological factors in the outcome of treatment for chronic pain.
Malignant Carcinoid Causing Spinal Cord Compression
Authors: Gowitt Gerald T. , Mirra Suzanne S. 
Published: May 2010

Abstract
Neurological complications of malignant carcinoid are infrequent, Only 11 cases of central nervous system metastasis are documented, and neurological symptoms may be the initial or only manifestation of this tumor. We describe the case of a 60-year-old man with no known primary tumor who presented with spinal cord compression by a thoracic epidural tumor. After laminectomy, the diagnosis of carcinoid was made by light and electron microscopic demonstration of neurosecretory granules in tumor cells. Urine 5-hydroxyindole acetic acid and plasma serotonin levels were subsequently found to be elevated. Carcinoid tumors should be considered in the differential diagnosis of lesions metastatic to the spinal cord and brain.
Combined Occipital Transtentorial and Infratentorial Supracerebellar Approach in the Concorde Position for the Treatment of an Arteriovenous Malformation in the Upper Vermis: Case Report
Authors: Aoki Nobuhiko 
Published: May 2010

Abstract
With a patient in the concorde position, lying prone with the head flexed and tilted laterally, higher than the heart, it is possible to use both the occipital transtentorial and infratentorial supracerebellar approaches without changing the patient's position. We report the successful treatment with this combined approach of an arteriovenous malformation in the upper vermis supplied by the superior cerebellar artery.
Bilateral Internuclear Ophthalmoplegia Due to Hydrocephalus: A Case Report
Authors: Nishizaki Tomoyuki , Tamaki Norihiko , Nishida Yoshimitsu , Matsumoto Satoshi 
Published: May 2010

Abstract
We report a case of bilateral internuclear ophthalmoplegia due to hydrocephalus associated with Arnold-Chiari malformation. The bilateral internuclear ophthalmoplegia in this case was probably caused by brain stem displacement due to hydrocephalus. This patient was considered to have “arrested” hydrocephalus on the basis of the clinical and computed tomographic findings and the results of the continuous intraventricular pressure monitoring. However, the bilateral internuclear ophthalmoplegia gradually improved after ventriculoperitoneal shunting.
Late Epilepsy after Aneurysm Operations
Authors: Keränen Tapani , Tapaninaho Antti , Hernesniemi Juha , Vapalahti Matti 
Published: May 2010

Abstract
The risk of late epilepsy was analyzed in a consecutive series of 177 patients operated on for supratentorial aneurysms. Late seizures occurred in 25 patients (14%); the seizures were recurrent in 21 patients (12%). Most seizures were partial, secondary generalized, or generalized tonic-clonic (72%). The mean latency between the operation and seizures was 8.4 months (range, 1 to 24 months), and in only 2 patients was the interval more than 12 months. The most important risk factors were preoperative and postoperative complications. Only 2.5% of the 81 Grade I patients developed epilepsy, compared to 33% of the 42 Grade III-IV patients. Other risk factors were location of the aneurysm in the middle cerebral artery, the presence of a large intracerebral hematoma, postoperative spasm with late ischemic infarction, and shunt-dependent hydrocephalus. The timing of operation or intraventricular intracranial pressure monitoring did not change the risk of late epilepsy. The fact that only 2 patients had early epilepsy may have been due to routine treatment with prophylactic anticonvulsants. The value of prophylaxis in late epilepsy is unproven, but prophylactic treatment could be useful in patients with a high risk of epileptic seizures.
Prevention of Rebleeding after Operation for Subarachnoid Hemorrhage of Unknown Cause
Authors: Sakai Noboru , Yamada Hiromu , Ando Takashi , Nishimura Yasuaki 
Published: May 2010

Abstract
This study is presented to promote prophylactic operation to prevent rebleeding after subarachnoid hemorrhage (SAH) of unknown cause. Twenty-two cases of nontraumatic SAH of unknown cause of a total of 254 cases of SAH treated during a 5-year period (1980-1984) were available for this study. A follow-up study (4 to 61 months after treatment; median, 43 months) revealed a 4.5% mortality rate. Four patients chosen from among the 22 SAH cases underwent prophylactic operation. The decision to operate was based on repeated angiography showing regional cerebral vasospasm corresponding to a limited hyperdense area on the computed tomographic scan at the time of the onset of SAH. Microsurgery revealed a minute protrusion (less than 2 mm in diameter) or thinning of the arterial wall with old hematoma of the surrounding brain in all 4 cases, and treatment required only coating of the abnormal site. All 4 patients are now fully recovered. Frequently, abnormal changes of such cerebral arteries as the anterior communicating artery, the internal carotid artery (C-1 and C-2), and the middle cerebral artery (M-1) may occur. Therefore, the authors emphasize the necessity of surgical treatment for specific cases of SAH with an unknown cause.
Sudden Loss of Pain Control with Morphine Pump Due to Catheter Migration
Authors: Hirsh Leonard F. , Thanki Ashokkumar , Nowak Thomas 
Published: May 2010

Abstract
The use of implantable morphine pumps for the treatment of cancer pain is increasing. A sudden loss of previously adequate pain control should suggest pump malfunction. Pump revision should be considered, rather than automatically increasing oral analgesics. This case report details a rapid loss of pain control due to intraspinal catheter migration into the abdominal subcutaneous space
Completely Thrombosed Giant Aneurysm of the Basilar Artery Trunk: A Case Report
Authors: Spincemaille G. H. J. J. , Slooff J. L. , Hogenhuis L. A. H. , Lodder J. 
Published: May 2010

Abstract
A patient with a completely thrombosed giant aneurysm arising from the trunk of the basilar artery is described. Although it is difficult to differentiate this anomaly from a posterior fossa tumor, negative angiographic findings combined with certain computed tomographic (CT) signs may point to the correct diagnosis. Our case demonstrates that one of these CT signs (viz. ringlike contrast enhancement) can be explained by the presence of vasa vasorum in the aneurysm wall
External Pneumatic Calf Compression Reduces Deep Venous Thrombosis in Patients with Ruptured Intracranial Aneurysms
Authors: Black Peter McL. , Crowell Robert M. , Abbott William M. 
Published: May 2010

Abstract
We evaluated the ability of intermittent external pneumatic calf compression to prevent deep venous thrombosis after subarachnoid hemorrhage from ruptured intracranical aneurysms. Fifty-six subarachnoid hemorrhage patients not given external pneumatic calf compression were compared with 90 patients who had calf compression after their subarachnoid hemorrhages. Both groups of patients were on strict bedrest for 7 to 21 days after aneurysm rupture, and both received e-aminocaproic acid, 30 to 36 g/day intravenously, until operation. The risk factors in the two groups were similar, and the nursing and medical care did not seem to differ. Of patients without external pneumatic compression, 18% had venographically proven deep venous thrombi, which contrasts with 6% of patients receiving calf compression. This was a significant difference (p &lt; 0.05; x2). These retrospective data suggest that external pneumatic calf compression helps to prevent deep venous thrombosis in patients with subarachnoid hemorrhage when delayed operation, bedrest, and antifibrinolytic agents are used.
Brain Necrosis after Radiotherapy for Primary Intracerebral Tumor
Authors: Hohwieler Marcia L. , Lo Theodore C. M. , Silverman Mark L. , Freidberg Stephen R. 
Published: May 2010

Abstract
Radiotherapy is a standard postoperative treatment for cerebral glioma. We have observed the onset of symptoms related to brain necrosis, as opposed to recurrent tumor, in surviving patients. This has been manifest as dementia with a computed tomographic pattern of low density in the frontal lobe uninvolved with tumor, but within the field of radiotherapy. Two patients presented with mass lesions also unrelated to recurrent tumor. We question the necessity of full brain irradiation and suggest that radiotherapy techniques be altered to target the tumor and not encompass the entire brain.
Reversal of Visual Impairment after Interstitial Irradiation of Pituitary Tumor
Authors: Kumar P. P. , Good R. R. , Cox T. A. , Leibrock L. G. , Skultety F. M. 
Published: May 2010

Abstract
Bilateral blindness secondary to a recurrent hemangiopericytoma of the pituitary fossa in a 22-year-old man was corrected by the transsphenoidal implantation of a single high activity iodine-125 seed.
Dysphagia and Dysphonia Secondary to Anterior Cervical Osteophytes
Authors: Brandenberg Greg , Leibrock Lyal G. 
Published: May 2010

Abstract
A 77-year-old man presented with a 4-year history of progressive dysphagia to the point that he could no longer swallow solid foods. During the past several months, he had developed dysphonia. Cervical spine x-ray films demonstrated massive anterior degenerative osteophytic spurs between C-3 and C-7. Evaluation with barium swallow and cervical computed tomography demonstrated esophageal and laryngeal compression. Resection of the anterior osteophytes resolved the dysphagia and dysphonia.
Expanding Intracerebellar Hematoma: A Possible Clinicopathological Entity
Authors: Aoki Nobuhiko , Mizuguchi Kunio 
Published: May 2010

Abstract
An adult case of intracerebellar hematoma with a definite capsule is presented. The hematoma is thought to have been enlarged by repeated hemorrhages inside the capsule, with consequent progressive neurological symptoms. Intracerebellar hematoma does not always disappear by absorption. On the contrary, it may expand, and symptoms and signs similar to those of cerebellar tumor may subsequently develop. The authors propose that the expanding intracerebellar hematoma is a possible clinicopathological entity with a definite capsule comparable to that of chronic subdural hematoma.
Spontaneous Migration of a Bullet in the Spinal Subarachnoid Space Causing Delayed Radicular Symptoms
Authors: Karim Najmaldin O. , Nabors Michael W. , Golocovsky Mario , Cooney Donald F. 
Published: May 2010

Abstract
The authors report a case of a gunshot wound to the left lower quadrant of the abdomen in a patient who initially was neurologically intact. The bullet had lodged at the T-11, T-12 level in the spinal canal. After an exploratory laparotomy, the patient developed severe low back pain radiating to his left lower extremity and an incomplete footdrop. Repeat x-ray films and a myelogram showed that the bullet had migrated to the L-4, L-5 level on the left. Bullet emboli and delayed sequelae of gunshot wounds to the spine are discussed.
Use of the Philadelphia Collar as an Alternative to the Halo Vest in Patients with C-2, C-3 Fractures
Authors: Sean M. Grady , Matthew A. Howard , John A. Jane , John A. Persing 
Published: May 2010

Abstract
We analyzed retrospectively 27 individuals with C-2, C-3 fractures, 8 of whom were treated with a Philadelphia collar rather than the more commonly used halo vest. Successful fusion without neurological deficit occurred in all cases whether treatment was by Philadelphia collar (n = 8), halo apparatus (n = 16), or prolonged bed rest (n = 3). There was an increase in subluxation in 3 patients in both the Philadelphia collar group and the halo apparatus group. However, 1 of the 3 in the collar group was uncooperative and discarded his collar during treatment. If he is excluded, the subluxation rate in the Philadelphia collar group is 27%: the rate in the halo group is 19%. The Philadelphia collar seems to be an acceptable means of stabilizing the neck in C-2, C-3 fractures, but one must consider the degree of cervical movement in the collar (as detected by dynamic x-ray films), patient reliability, and patient age. The presence of subluxation did not preclude successful fusion in either the Philadelphia collar or the halo vest groups.
Chronic Vermal Herniation in a Case of Osteosarcoma of the Occipital Bone
Authors: Challa Venkata R. , Crone Kerry R. , Ferree Carolyn R. , Moody Dixon M. , Kelly David L. 
Published: May 2010

Abstract
Upward projection of the cerebellar vermis through the tentorial hiatus is called upward vermal herniation (UVH). UVH is less common in clinical practice than uncal herniation. Even more uncommon is chronic vermal herniation and impaction in the tentorial hiatus. To illustrate this phenomenon, we present the clinical, radiological, and morphological features of vermal impaction in a patient with a postradiation osteosarcoma of the occipital bone. In spite of nearly total excision of the tumor pushing the cerebellum upward, his postoperative course was complicated by respiratory problems and an altered level of consciousness, finally resulting in death. His clinical status paralleled the computed tomographic (CT) demonstration of persistent obliteration of the supramesencephalic cistern. CT makes more reliable the detection and management of UVH, but a high index of suspicion is necessary for prevention of this complication.
Pure Word Deafness: A Possible Explanation of Transient Deteriorations after Extracranial-Intracranial Bypass Grafting
Authors: Kanter Steven L. , Day Arthur L. , Heilman Kenneth M. , Gonzalez-Rothi Leslie J. 
Published: May 2010

Abstract
Pure word deafness is a rare behavioral disorder in which the comprehension of spoken language is grossly disturbed. but the abilities to speak, read, write, and process nonverbal auditory stimuli remain intact. This disorder is caused by superior temporal gyrus lesions in the dominant hemisphere that isolate Wernicke's area from incoming auditory information. This involved area is supplied by cortical middle and posterior temporal end-artery branches of the middle cerebral artery. Among approximately 100 extracranial-intracranial bypass procedures performed at our institution in the past 5 years, three patients developed the syndrome of pure word deafness. A cortical or posterior temporal branch of the middle cerebral artery was utilized as the recipient artery in each instance. In all cases, the deficit was transient, delayed (i.e. the patient did not awaken from anesthesia with the deficit), and unrelated to the preoperative deficit. The syndrome of pure word deafness may be more common after bypass than is currently recognized. Localized arterial spasm, dysautoregulation secondary to operative manipulation, or focal brain swelling may be operative mechanisms in the development of this and other delayed, reversible deficits related to bypass surgery.
Forme Fruste of von Recklinghausen's Disease: Unilateral Association of an Orbital Neurofibroma, a Trigeminal Neurinoma, and an Acoustic Neurinoma
Authors: Kasuya Hidetoshi , Kadowaki Hirotaka , Yato Seiji , Kubo Osami , Kagawa Mizuo , Kitamura Koichi 
Published: May 2010

Abstract
A patient who presented with a tumor of the left ambient cistern, a left cerebellopontine angle tumor, and a left orbital tumor causing left hearing loss and left exophthalmos without café au lait spots or cutaneous neurofibromas is described. There was no family history of von Recklinghausen's disease. A cerebellopontine angle tumor removed by a suboccipital craniectomy was an acoustic neurinoma. An ambient cistern tumor was approached through a subtemporal route. A tumor arising from the trigeminal nerve was also a neurinoma. An orbital neurofibroma was excised by a frontal craniotomy with removal of the orbital roof. This rare unilateral association of neurinomas and a neurofibroma on the left side was thought to be a forme fruste of von Recklinghausen's disease, and it could be considered a presentation of a mosaic of von Recklinghausen's disease.
Neuroradiological and Electroencephalographic Features in a Case of Temporal Lobe Status Epilepticus
Authors: Stone James L. , Hughes John R. , Barr Arlene , Tan Walter , Russell Eric , Crowell Robert M. 
Published: May 2010

Abstract
A patient with medically intractable status epilepticus of temporal lobe origin is presented. A computed tomogram showed a low density area adjacent to the midbrain, possibly related to atrophy of the medial temporal lobe. Cerebral angiography revealed early filling veins and an anterior temporal blush. Magnetic resonance (MR) scanning (T2 weighted images) showed increased signal intensity in the region of the amygdala and anterolateral left temporal lobe. Ictal activity was recorded from scalp electrodes over the left temporal area, and many paroxysms were recorded from cortical surface electrodes. An anterior temporal lobectomy revealed only gliosis. The cerebral blood flow changes accompanying status epilepticus of focal origin are reviewed, and a possible relation of electroencephalographic, angiographic, and MR findings is discussed.
Intrathecal Morphine during Lumbar Spine Operation for Postoperative Pain Control
Authors: Blacklock J. Bob , Rea Gary L. , Maxwell Robert E. 
Published: May 2010

Abstract
The analgesic requirements and bladder function of 5 patients who received 1 mg of intrathecal morphine during lumbar spine operation are compared to those of 10 control patients. No analgesics were used by the treatment group for the first 24 hours postoperatively. The test group subsequently required twice the amount of analgesics during the 2nd through 5th days after operation compared to controls. All 5 patients who received intrathecal morphine developed urinary retention for 24 to 36 hours. The brief duration of analgesia, the increased narcotic use after the effects of the morphine dissipated, and urinary retention after a single intraoperative dose of intrathecal morphine suggest caution in using this technique.
Myiatic Scalp and Skull Infection with Diptera Sarcophaga: Case Report
Authors: Arbit Ehud , Varon Rose E. , Brem Steven S. 
Published: May 2010

Abstract
The authors describe an unusual infestation of an ulcerative squamous cell carcinoma of the scalp and skull with Diptera Sarcophaga larvae. Human myiasis is rare in temperate zones and presents a rather unique neurosurgical challenge. The clinical presentation and treatment of human myiasis are briefly discussed.