bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous Lateral Pontine Hemorrhage with Associated Trigeminal Nerve Root Hematoma
Authors: Veerapen Richard 
Published: April 2011

Abstract
Spontaneous hemorrhage into the lateral part of the pons with sequelae compatible with survival has been documented previously. The author describes an unusual case with spontaneous hemorrhage into the lateral pons, with intraneural extension into the right trigeminal nerve root. Radiological features were of an expanding mass of the cerebellopontine angle. The patient was treated surgically with success.
Management of Hydromyelia
Authors: Wisoff Jeffrey H. , Epstein Fred 
Published: April 2011

Abstract
The authors review their experience in the management of 22 patients with hydromyelia over a 26-month period. Ten children had Chiari I malformations and hydromyelia; 4 children had myelomeningoceles (3 with large thoracic spinal cord cavitations and 1 with cervical hydromyelia); 6 children had distal hydromyelia associated with tethered cords and occult dysraphism; and 2 patients had cavitation subsequent to arachnoiditis. All patients were investigated preoperatively with MRI and intraoperatively with ultrasound. These neurodiagnostic examinations dictated the type of surgical intervention. Patients with Chiari I or Chiari II malformations, cervical hydromyelia, or basal arachnoiditis underwent decompression of the hindbrain malformations, myelotomy with drainage of the cyst, and placement of a stent. When the area of hydromyelia extended to the obex, as demonstrated by intraoperative ultrasound, the obex was plugged. Cyst-pleural shunts were placed in the children who had myelomeningoceles and thoracic hydromyelia. Patients with distal hydromyelia underwent modified terminal ventriculostomy. The classical presentation of brachial amyotrophy and dissociated sensory loss was present in only 3 patients. Progressive scoliosis without neurological deficit, pain, and Lhermitte's phenomenon were common presentations. The patients with tethered cords were generally asymptomatic from their cysts. The authors discuss operative technique, utilization of intraoperative ultrasound, and surgical outcome.
Evidence of Redistribution of Cerebral Blood Flow during Treatment for an Intracranial Arteriovenous Malformation
Authors: Batjer Hunt H. , Purdy Phillip D. , Giller Cole A. , Samson Duke S. 
Published: April 2011

Abstract
The presence of an intracranial arteriovenous malformation has a dramatic impact on local circulatory dynamics. Treatment of some arteriovenous malformations can result in disastrous hyperemic states caused by redistribution of previously shunted blood. This report describes serial hemodynamic measurements of both cerebral blood flow and flow velocity in 3 patients during treatment for arteriovenous malformations. Measurements of cerebral blood flow were made by computed tomographic scan employing the stable xenon inhalation technique; flow velocity, including autoregulatory characteristics, was measured by transcranial Doppler ultrasonogram. Substantial hyperemia developed in one patient (Case 1) after resection and in another (Case 3) after embolization. Embolization resulted in restoration of normal regional cerebral blood flow in a patient who demonstrated hypoperfusion before treatment (Case 2). In Patient 1, postoperative hyperemia was associated with persistently elevated flow velocities, and may have been accompanied by hemispheric neurological deficits. Sequential hemodynamic measurements may predict patients at risk of perioperative complications, and may become useful clinical guidelines for the extent and timing of embolization and for the timing of surgery after intracranial hemorrhage or preoperative embolization procedures.
Corpus Callosotomy for Refractory Seizures in a Patient with Cortical Heterotopia: Case Report
Authors: Stearns Michael , Wolf Aizik L. , Barry Elizabeth , Bergey Gregory , Gellad Fouad 
Published: April 2011

Abstract
Heterotopia of the cerebral cortex, a disorder of neuronal migration, may be associated with medically intractable seizures. We report on a patient with bihemispheric cortical heterotopia who had medically intractable atonic seizures that were successfully treated by corpus callosotomy. The clinical and radiographic aspects of cortical heterotopia and the surgical management of seizures associated with heterotopia are discussed.
Radiation-Induced Osteosarcoma of the Sphenoid Bone
Authors: Tanaka Shigeya , Nishio Shunji , Morioka Takato , Fukui Masashi , Kitamura Katsutoshi , Hikita Koutaro 
Published: April 2011

Abstract
The case of a patient who developed osteosarcoma in the sphenoid bone 15 years after radiation therapy for a craniopharyngioma is reported. Radiation-induced osteosarcoma of the sphenoid bone has not been reported previously. Reported cases of radiation-induced osteosarcomas are reviewed.
Giant Invasive Intracerebral Dermoid Tumor with Subependymoma-like Reaction: Case Report
Authors: Fenstermaker Robert A. , Ganz Edward , Roessmann Uros 
Published: April 2011

Abstract
A large, completely intracerebral, dermoid tumor with extensive outgrowth of appendages into brain tissue caused prominent reactive changes in the surrounding white matter, similar to those seen in a typical subependymoma. This case lends support to the notion that some subependymomas are reactive in etiology.
Transcranial Doppler Sonographic Identification of a Subgroup of Patients with Normal Pressure Hydrocephalus with Coexistent Vascular Disease and Treatment Failure
Authors: Fritz Wolfram , Kalbarczyk Henry k , Schmidt Klaus 
Published: April 2011

Abstract
We report on transcranial Doppler sonography with carbogen reactivity testing of flow velocity as applied to patients with normal pressure hydrocephalus. A subgroup can be differentiated that shows coexistent cerebrovascular disease, The surgical prognosis in these patients is bad. A flow chart demonstrating the proposed clinical examination is presented.
Brain Mapping Techniques to Maximize Resection, Safety, and Seizure Control in Children with Brain Tumors
Authors: Berger Mitchel S. , Kincaid Joseph , Ojemann George A. , Lettich Ettore 
Published: April 2011

Abstract
Intraoperative brain mapping techniques were used to localize language cortex, sensorimotor pathways, and seizure foci in children with supratentorial brain tumors. The methods of direct cortical and subcortical stimulation, in addition to electrocorticography, enabled us to maximize tumor resection, minimize morbidity, and eradicate epileptogenic zones which were always adjacent to, but not involving, the tumor nidus. Language localization was found to be quite variable in the children tested and anatomically unpredictable based on the preoperative neurological or radiological examination. Physiological mapping techniques, therefore, appear to be safe, reliable, and very useful for operations on tumors located within or adjacent to eloquent brain regions in the pediatric population.
Independent Evaluation of a Multidisciplinary Rehabilitation Program for Chronic Low Back Pain
Authors: Cassisi Jeffrey E. , Sypert George W. , Salamon Anita , Kapel Larry 
Published: April 2011

Abstract
Severe chronic low back pain was diagnosed in 236 patients by one physician and they were referred to the University of Miami Comprehensive Pain and Rehabilitation Center (UMCPRC) over a 5-year period for an intensive 4-week inpatient treatment program. Of these 143 (61%) were able to be contacted by telephone and given a structured interview designed for the study. The average time elapsed at follow-up from referral for all patients was 22.5 months. Outcome was measured in the following terms: current levels of pain, percent decrease in pain, subsequent health care utilization, activities of daily living, and attitudes toward treatment. After completion of the interview, the McGill Pain Questionnaire and the Oswestry Low Back Pain Disability Questionnaire were sent to the patients. The patients fell into five groupings: Group 1—participants in the UMCPRC program (n = 39); Group 2—those whose participation was not approved by insurance (n = 30); Group 3—those who declined participation (n = 46); Group 4—participants in other programs (n = 14); Group 5—dropouts (n = 14). The five groups were not meaningfully different with regard to prereferral demographics. Interestingly, Group 1 patients exhibited significantly greater prereferral pain and unemployment levels. Despite this, at follow-up significantly more Group 1 members were employed and they exhibited a greater percent decrease in pain as compared to the nonparticipant groups. Returned McGill and Oswestry Questionnaires mirrored these findings. Group 1 members also demonstrated significantly lower rates of subsequent health care utilization, i.e., physician visits, hospitalizations, and surgery than the nonparticipant groups. In conclusion, independent evaluation suggests that the type of program given at UMCPRC is effective for the treatment of chronic intractable low back pain. Future directions are briefly discussed.
Epidermoid Tumors of Meckel's Cave: Case Report and Review of the Literature
Authors: Miyazawa Nobuhiko , Yamazaki Hiromichi , Wakao Tetsuo , Nukui Hideaki 
Published: April 2011

Abstract
Lesions of Meckel's cave are extremely uncommon and difficult to diagnose. The symptoms and signs are variable, and the lesion may not appear on routine roentgenographic or computed tomographic examination. A patient with a small epidermoid tumor of Meckel's cave that was diagnosed by magnetic resonance imaging is herein reported. The epidermoid appeared as a low-intensity mass on the T1-weighted image and as a high-intensity mass on the T2-weighted image. Coronal sections defined the anatomic relationship to the trigeminal nerve. Preoperative recordings of the trigeminal sensory evoked response may be predictive of postoperative recovery of neurological deficits. Furthermore, intraoperative recording was extremely useful in avoiding inadvertent neurological injury. Review of the literature confirms the rarity of this lesion and the usefulness of magnetic resonance imaging in diagnosing it, although based on a limited number of cases.
Traumatic Trochlear Nerve Palsy Diagnosed by Magnetic Resonance Imaging: Case Report and Review of the Literature
Authors: Burgerman Robert S. , Wolf Aizik L. , Kelman Shalom E. , Elsner Henry , Mirvis Stuart , Sestokas Anthony K. 
Published: April 2011

Abstract
Although head trauma is the leading cause of acquired trochlear nerve dysfunction, it receives little attention in the neurosurgical literature. A case is reported of closed head injury that resulted in a right superior oblique palsy in association with incoordination on the left side. Diagnostic imaging revealed a normal cranial computed tomographic scan and a left dorsal midbrain lesion on magnetic resonance imaging scan. The relevant anatomy is reviewed, as well as the action of the superior oblique muscle, its agonists and antagonists, and the clinical manifestations of superior oblique dysfunction. This case is one of the few we are aware of in which a relatively isolated trochlear nerve palsy is the result of a lesion that can be documented by diagnostic imaging, and the first in which the imaging modality is magnetic resonance imaging scan.
Laser-Assisted Microsurgical Extirpation of a Brain Stem Cavernoma: Case Report
Authors: Seifert Volker , Gaab Michael R. 
Published: April 2011

Abstract
A 43-year-old woman presented with progressing signs of a space-occupying brain stem lesion. A computed tomographic scan revealed a hyperdense process located in the pons. Magnetic resonance imaging confirmed the lesion, which had a reticulated core of increased and decreased signal intensity. Vertebral angiography did not show any vascular supply of the process. The patient was operated upon in the lateral park bench position. The lesion, being located close to the exit zone of the trigeminal nerve, could be removed totally with incision of the brain stem and atraumatic vaporization of the tumor tissue with the CO2laser. Despite the fact that the histopathological examination revealed a cavernous angioma the application of laser energy was judged to be extremely valuable for the surgical procedure. It was concluded that with proper selection of application mode and wattage the CO2laser may be used for extirpation of vascularized lesions also especially when situated in or close to deep lying vital structures of the brain.
Aneurysms of the Intracavernous Carotid Artery: Clinical Presentation, Radiographic Features, and Pathogenesis
Authors: Linskey Mark E. , Sekhar Laligam N. , Hirsch William , Yonas Howard , Horton Joseph A. 
Published: April 2011

Abstract

Thirty-seven patients with 44 intracavernous carotid artery aneurysms (ICCAAns) were seen at one institution from 1976 through 1988. Fifteen patients had multiple intracranial aneurysms and 7 had bilateral ICCAAns. Age at diagnosis ranged from 15 to 80 (median 61). Thirty patients were women. Sixteen had a history of hypertension. In 34% of patients the ICCAAns were asymptomatic at diagnosis. 36% were associated with headache, and 57% had associated signs or symptoms of mass effect including sixth nerve paresis (43%). trigeminal pain or sensory loss (32%), third nerve paresis (20%), decreased vision or visual field cut (18%), fourth nerve paresis (16%), and Horner's syndrome (7%). In 4 patients the ICCAAns ruptured, leading to subarachnoid hemorrhage in 3 and epistaxis in 1. Two patients with ICCAAns were seen with spontaneous thrombosis of the ipsilateral internal carotid artery leading to distal ischemic symptoms in 1. More than 90% of the ICCAAns were saccular. Thirty-four percent were small (&lt;1 cm), 48% were large (1 to 2.5 cm), and 16% were giant (&gt;2.5 cm). The majority arose from the anterior genu of the intracavernous internal carotid artery, followed in frequency by the horizontal segment, and then the posterior genu. Magnetic resonance imaging is superior to computed tomography for diagnosing ICCAAns and is the screening procedure of choice. Angiography remains the “gold standard” for diagnosis and determining specific anatomic details necessary to plan therapy. Analyzing the radiographic anatomy of 44 ICCAAns, we conclude that theories attributing the origin of aneurysms to arterial bifurcations may be inadequate to explain the point of origin and direction of take off of up to one-fourth of ICCAAns. (Neurosurgery 26:71-79, 1990)
Combined Frontotemporal-Orbitozygomatic Approach for Tumors of the Sphenoid Wing and Orbit
Authors: McDermott Michael W. , Durity Felix A. , Rootman Jack , Woodhurst W. B. 
Published: April 2011

Abstract

An extension of a combined frontotemporal and orbitozygomatic exposure was developed to remove 8 hyperostosing invasive sphenoid wing meningiomas (Group 1) and 11 complicated intraorbital tumors with and without intracranial extension (Group 2). Two separate bone flaps were created: a free frontotemporal-sphenoidal (pterional) bone flap and en bloc removal of the superior and lateral orbital margins with attached zygomatic arch. Cranio-orbital reconstruction was performed using the inner table of the pterional bone flap. Complete tumor removal was achieved in 14 patients and near total removal in 5. There was no mortality and in those patients who did not require orbital exenteration excellent to good cosmetic results were achieved in all but one case. This approach affords a wide exposure of the orbit and anterior and middle skull base, so that large tumors of the orbit and tumors involving the orbital apex, sphenoid wing, and infratemporal and pterygopalatine fossae can be removed. (Neurosurgery 26:107-116, 1990)
Extensive Dural Sinus Thrombosis Treated by Surgical Removal and Local Streptokinase Infusion
Authors: Persson Lennart , Lilja Anders 
Published: April 2011

Abstract

This article describes the clinical course, including measurements of intracranial pressure (ICP), radiological findings, and treatment, of a gravely ill patient with extensive thrombosis involving the superior sagittal and both transverse sinuses, and the galenic venous system. When “conventional” therapy including anticoagulants and neuro-intensive care failed to reverse the progressive neurological deterioration or to control the ICP, the condition was approached surgically and thrombotic material was removed from the dural sinuses without much difficulty. The effect on the ICP was dramatic, although short-lived. A second operation, combined with local infusion of streptokinase in the sagittal sinus, had a permanent effect as judged from the ICP measurements, radiological findings, and clinical improvement. The combination of direct operative removal of thrombotic material and local infusion of a thrombolytic agent (streptokinase) proved to be an effective treatment of severe dural sinus thrombosis in this patient. (Neurosurgery 26:117-121, 1990)
Primary Neuroendocrine (Merkel Cell) Carcinoma Presenting in the Calvarium: Case Report
Authors: Wojak Joan C. , Murali Raj 
Published: April 2011

Abstract

A case of a primary neuroendocrine carcinoma arising in the calvarium and involving the bone, dura, and underlying brain is presented. The histopathology and immunohistochemical staining characteristics of tumor were consistent with those of Merkel cell tumor. The natural history and histopathology of this tumor are discussed, along with the possible explanation for the origin of this tumor in the calvarium. (Neurosurgery 26:137-139, 1990)
Progressive Necrosis of the Conus Medullaris: Magnetic Resonance Imaging and Surgical Findings
Authors: de Toffol B. , Cotty P. , Gaymard B. , Velut S. 
Published: April 2011

Abstract

A 67-year-old man with non-insulin-dependent diabetes mellitus progressively developed, over a 2-year period, lower extremity sensory and motor defects associated with impaired bladder function and perineal and perianal sensation related to a disease of the conus medullaris extending from T12 to S5. The magnetic resonance imaging scan suggested myelomalacia and the diagnosis of progressive necrotic myelopathy was confirmed by surgical intervention. (Neurosurgery 26:147-149, 1990)
Neurosurgical Applications of Fibrin Glue: Augmentation of Dural Closure in 134 Patients
Authors: Shaffrey Christopher I. , Spotnitz William D. , Shaffrey Mark E. , Jane John A. 
Published: April 2011

Abstract
In a wide variety of neurosurgical procedures performed on 134 patients over a 3-year period. fibrin glue has been applied as an adjunct to dural closure. Overall success at preventing cerebrospinal fluid (CSF) leakage was 90% (121 of 134, 90% effective). In patients considered to be at high risk for CSF leakage intraoperatively but without pre-established fistulae (Group 1), the success rate was higher (111 of 119, 93% effective). In patients with pre-established CSF fistulae (Group 2), the success rate was lower (10 of 15, 67% effective). As single donor sources of concentrated fibrinogen are now available with reduced risks of blood-borne disease transmission, fibrin glue may be a valuable clinical tool for the neurosurgeon. (Neurosurgery 26:207-210, 1990)
Magnetic Resonance Imaging and Cervical Spondylotic Myelopathy
Authors: Mehalic Thomas F. , Pezzuti Roger T. , Applebaum Brett I. 
Published: April 2011

Abstract
Nineteen patients were examined for cervical spondylotic myelopathy with magnetic resonance imaging. Pre- and postoperative magnetic resonance scans were obtained in most cases. Surgical confirmation of the pathological condition was obtained for all 19 patients. On the T2-weighted scans, there was increased signal intensity within the spinal cord at the point of maximal compression. The exact cause of the increased signal intensity on the T2-weighted images is not known, but is suspected to represent edema, inflammation, vascular ischemia, myelomalacia, or gliosis. The increased signal intensity diminished postoperatively in the patients who improved clinically, and remained the same or increased in those whose conditions remained unchanged or worsened after decompression. The authors suggest that these T2-weighted images carry prognostic significance.
Percutaneous Automated Biopsy in the Diagnosis of Primary Infectious Spondylitis
Authors: Onik Gary , Shang Yulin , Maroon Joseph , Eichenblat Mario , Mercer David , Bailes Julian E. 
Published: April 2011

Abstract
Three cases of primary infectious spondylitis, two caused by Staphylococcus aureus and one by tuberculosis, were diagnosed using the method previously described for automated percutaneous discectomy. All three patients, in whom biopsy using fine needle techniques previously was unsuccessful, had positive cultures from specimens obtained using the automated method. The method combines the advantages of local anesthesia and minimal morbidity with the obtaining of adequate material for culture and pathological examination.
Selective Uptake of Hematoporphyrin Derivative into Human Cerebral Glioma
Authors: Hill John S. , Kaye Andrew H. , Sawyer William H. , Morstyn George , Megison Phillip D. , Stylli Stanley S. 
Published: April 2011

Abstract
The uptake of hematoporphyrin derivative (HpD) into human cerebral glioma was measured using a porphyrin extraction technique. Patients with cerebral glioma were injected with HpD at a dose of 5 mg/kg body weight 24 hours before surgery and photoradiation therapy (PRT). Biopsies of tumor, and where possible, adjacent brain and normal brain were taken for analysis of HpD uptake. HpD was selectively localized into all grades of glioma, and there was a direct correlation between the grade of glioma and HpD level in the tumor. The levels were highest in glioblastoma multiforme (mean uptake of 5.9 mg of HpD/g of tumor wet weight) and lower in the intermediate-grade anaplastic astrocytoma (mean uptake of 2.4 mg/g of tumor) and the low-grade astrocytoma (1.6 mg/g of tumor), Uptake into normal brain tissue taken from HpD-sensitized patients was 0.2 mg/g. HpD was also localized into the “brain adjacent to tumor” region. The selective uptake into the low-grade glioma suggests that PRT may be of use as an adjuvant therapy in these tumors and the detection of HpD in this region indicates that PRT may control the spread of tumor infiltrating into the adjacent normal brain.
Cerebral Gliosarcomas: Correlation of Computed Tomographic Findings, Surgical Aspect, Pathological Features, and Prognosis
Authors: Maiuri Francesco , Stella Lucio , Benvenuti Dino , Giamundo Arcangelo , Pettinato Guido 
Published: April 2011

Abstract
The cases of 5 patients with cerebral gliosarcomas examined by computed tomography are reported and the correlations among the computed tomographic (CT) findings, the surgical and histological aspects, and the prognosis are discussed. In some patients, these tumors appear on CT scan as intracerebral lesions, with large necrotic areas and peripheral contrast enhancement; this CT aspect, similar to that of glioblastomas, corresponds to a diffusely infiltrating growth of the tumor and the prevalence of a gliomatous component. In other patients, the tumor appears on the CT scan as a hyperdense mass with well-defined margins and homogenous contrast enhancement;; this CT finding, which may mimic that of a meningioma, corresponds to a rather well-demarcated surgical aspect and the prevalence of sarcomatous component. In our series, we have also noticed a more prolonged survival in a patient with a CT aspect that suggested a meningioma and prevalence of the sarcomatous component.