bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous Minidose Metrizamide Endomyelographic Computed Tomography in Syringomyelia
Authors: Blumenkopf Bennett 
Published: May 2010

Abstract
Two patients presented with syringomyelia, each unusual. After neuroradiographic diagnosis with delayed metrizamide computed tomography (CT) or magnetic resonance imaging (MRI), an interesting diagnostic question arose. A percutaneous minidose metrizamide endomyelographic CT (PMDMECT) study clarified each situation and directly affected the neurosurgical approaches. The features of each case, the technique of PMDMECT, and postoperative follow-up data are reported.
Osteoplastic Opening of the Sellar Floor in Transsphenoidal Surgery: Technical Note
Authors: de Divitiis Enrico , Spaziante Renato 
Published: May 2010

Abstract
The authors propose a technique of opening the sellar floor during a transsphenoidal approach by means of two small bone flaps hinged sideward. Both opening and reconstruction of the sellar floor may be improved by this method, which may be used when the floor is paper-like.
Magnetic Resonance Imaging of Intradural Spinal Lipoma
Authors: Lantos George , Epstein Fred , Kory Leslie A. 
Published: May 2010

Abstract
Intradural lipomas are rare tumors of the spinal canal. We report the occurrence of this neoplasm in a 19-year-old girl. Magnetic resonance accurately depicted both the exact location within the spinal canal and the precise tumor histology and was more informative than myelography. This case illustrates the value of magnetic resonance imaging in patients presenting with myelopathy. In many instances, this modality may be all that is needed in preoperative planning.
Brain Stem Abscess Managed with Computed Tomographyguided Stereotactic Aspiration
Authors: Nauta H. J. W. , Contreras F. L. , Weiner R. L. , Crofford M. J. 
Published: May 2010

Abstract
The importance of stereotactic aspiration to the successful management of three cases of brain stem abscess is discussed with special reference to the advantages offered over medical treatment alone. Stereotactic aspiration allows evacuation of pus, accurate bacteriological diagnosis, selection of an optimal antibiotic regimen, and instillation of antibiotics directly into the abscess cavity. In two of the three cases described here, the abscess reaccumulated after initial aspiration despite appropriate maximal medical therapy. A repeat aspiration was required before resolution occurred. We conclude that medical management alone is not adequate for some cases of brain stem abscess. There was no morbidity that could be attributed to the procedure, suggesting that the risk of stereotactic aspiration is probably quite low and is likely to be less than the risk of incorrect diagnosis, suboptimal choice of antibiotics, or progression of the lesion despite appropriate maximal medical therapy.
Brain Metastasis of an Invasive Thymoma
Authors: Dewes Werner , Chandler William F. , Gormanns R. , Ebhardt G. 
Published: May 2010

Abstract
A rare case of a thymoma metastatic to brain is reported. This tumor was localized intraoperatively with the use of transdural ultrasound imaging, and gross total resection was accomplished. Radiation therapy was administered to both brain and mediastinum. The growth characteristics, classification, and treatment of thymomas are discussed.
Prediction and Prevention of Delayed Ischemic Dysfunction after Aneurysmal Subarachnoid Hemorrhage and Early Operation
Authors: Messeter Kenneth , Brandt Lennart , Ljunggren Bengt , Svendgaard Niels Aage , Algotsson Lars , Romner Bertil , Ryding Erik 
Published: May 2010

Abstract
Mean hemispheric cerebral blood flow (CBF) was studied after the intravenous administration of xenon-133 in 20 anesthetized patients with aneurysmal subarachnoid hemorrhage. Before early aneurysm operation, repeated CBF measurements were made to evaluate the cerebral vascular reactivity to controlled hyperventilation. Thirteen individuals received intravenous treatment with the calcium channel blocker nimodipine, whereas the other seven patients did not receive such specific antiischemic treatment. Five of the latter patients had an impaired CO2 response, and three showed delayed ischemic deterioration (DID), whereas none of the seven nimodipine-treated patients with impaired CO2 response showed DID. One nimodipine-treated patient with a preserved CO2 response, in whom operation was complicated, developed DID. The observed findings indicate that DID after uncomplicated early aneurysm operation may be associated with an early disturbance of cerebral vasoreactivity. Treatment with nimodipine may counteract the development of DID in patients with an impaired CBF CO2 response.
Histological and Morphometric Observations on the Reticular Fibers in the Arterial Beds of Patients with Ruptured Intracranial Saccular Aneurysms
Authors: Østergaard John R. , Reske-Nielsen Edith , Oxlund Hans 
Published: May 2010

Abstract
Histological and morphometric studies on the collagenous, reticular, and elastic fibers of the tunica media were performed on the middle cerebral and brachial arteries of patients with ruptured intracranial saccular aneurysms and controls. There was no difference between aneurysm patients and controls in the amount of collagenous and elastic fibers. The amount of reticular fibers was, however, reduced about 35% in aneurysm patients within both the middle cerebral artery (P &lt; 0.01) and the brachial artery (P &lt; 0.02). The reticular fibers were irregularly distributed and often appeared shorter and coarser than normally. The observations point to a generalized abnormality of the arterial bed in some patients with rupture of saccular aneurysms.
Radiation Control in the Intensive Care Unit for High Intensity Iridium-192 Brain Implants
Authors: Sewchand Wilfred , Drzymala Robert E. , Amin Pradip P. , Salcman Michael , Salazar Omar M. 
Published: May 2010

Abstract
A bedside lead cubicle was designed to minimize the radiation exposure of intensive care unit staff during routine interstitial brain irradiation by removable, high intensity iridium-192. The cubicle shields the patient without restricting intensive care routines. The design specifications were confirmed by exposure measurements around the shield with an implanted anthropomorphic phantom simulating the patient situation. The cubicle reduces the exposure rate around an implant patient by as much as 90%, with the exposure level not exceeding 0.1 mR/hour/mg of radium-equivalent 192Ir. Evaluation of data accumulated for the past 3 years has shown that the exposure levels of individual attending nurses are 0.12 to 0.36 mR/mg of radium-equivalent 192Ir per 12-hour shift. The corresponding range for entire nursing teams varies between 0.18 and 0.26. A radiation control index (exposure per mg of radium-equivalent 192Ir per nurse-hour) is thus defined for individual nurses and nursing teams; this index is a significant guide to the planning of nurse rotations for brain implant patients with various 192Ir loads. The bedside shield reduces exposure from 192Ir implants by a factor of about 20, as expected, and the exposure from the lower energy radioisotope iodine-125 is barely detectable.
Magnetic Resonance Imaging and Intraoperative Neurosonography in Syringomyelia
Authors: Wilberger Jack E. , Maroon Joseph C. , Prostko Richard E. , Baghai Parviz , Beckman Irwin , Deeb Ziad 
Published: May 2010

Abstract
Treatment of syringomyelia remains a difficult and controversial problem. However, the recent advent of magnetic resonance imaging (MRI) and intraoperative ultrasound allows a more precise approach to the diagnosis and management of this disorder. Experience with 27 cases of syringomyelia has shown that MRI is superior to all other forms of diagnostic imaging for the exact anatomical delineation of syrinxes and other spinal cord cavities. One-third of the syrinxes demonstrated by MRI were either not adequately visualized or missed by myelography and/or computed tomographic scanning. Intraoperative ultrasound has been used to allow more precise operative approaches to the syrinx as well as to guide the exact placement of shunt tubes into syrinx cavities. A method has also been developed to allow intraoperative ultrasound of the spinal cord with patients in the sitting position.
Uptake of Indium-111-labeled Leukocytes by Brain Metastasis
Authors: Balachandran Suppiah , Husain Muhammad M. , Adametz James R. , Pallin John S. , Angtuaco Tesesita L. , Boyd Charles M. 
Published: May 2010

Abstract
Uptake of indium-labeled leukocytes was seen in two cases of histologically proven brain metastasis. In one, this led to misdiagnosis of the lesion as an abscess. On histological evaluation, a large number of white blood cells or macrophages was seen at the neoplastic sites. Reasons for leukocyte accumulation around metastatic brain neoplasms are discussed. In contrast to the current reports that indium-labeled leukocyte scans can differentiate intracranial infection from tumor, these cases demonstrate their lack of specificity in the detection of brain abscess.
Neuroschisis of the Cervical Spinal Cord in a Patient with Klippel-Feil Syndrome
Authors: Nagib Mahmoud G. , Larson David A. , Maxwell Robert E. , Chou Shelly N. 
Published: May 2010

Abstract
During the neurological work-up of a young patient with Klippel-Feil syndrome, the presence of a neuroschisis of the cervical spinal cord was detected. The patient presented with a transient and acute hemisensory loss and a Horner's syndrome of the opposite side. The unusual presentation and radiological findings in a patient with Klippel-Feil syndrome prompted this report.
Malignant Fibrous Histiocytoma of the Clivus: Case Report
Authors: Cook Bruce R. , Vries John K. , Martinez Julio A. 
Published: May 2010

Abstract
A case of malignant fibrous histiocytoma of the clivus in a 21/2;-year-old boy is reported. There are no prior reports of this tumor in this location. The child was treated with operation, radiation therapy, and chemotherapy. The tumor recurred locally 21 months later. The recurrence was palliated by operation and chemotherapy, permitting an additional 20-month survival.
Chronic Encapsulated Intracerebral Hematoma in a Young Chinese Adult: Case Report
Authors: Chan Sze-tong , Tse C. H. C. 
Published: May 2010

Abstract
Chronic encapsulated intracerebral hematoma is rare. Six cases have been reported. A case of chronic encapsulated intracerebral hematoma in a young Chinese adult is presented. The possible pathoetiology underlying these cases is discussed.
Aneurysms of the Distal Anterior Cerebral Artery and Associated Vascular Anomalies
Authors: Wisoff Jeffrey H. , Flamm Eugene S. 
Published: May 2010

Abstract
Between July 1975 and July 1985, 20 patients with 24 congenital distal anterior cerebral artery (DACA) aneurysms were admitted to our institution and underwent microsurgical clipping of their aneurysms. This group composes 4% of the 588 aneurysms managed surgically during this period. The clinical presentations included subarachnoid hemorrhage, transient ischemic attacks, headaches, and seizures. Fourteen patients had additional vascular anomalies documented by angiography: multiple aneurysms, bilateral DACA aneurysms, arteriovenous malformation distal to incidental DACA aneurysms, and azygous DACA. Computed tomography was performed in 19 patients and was valuable in preoperative planning and prognosis: intracerebral hematoma and intraventricular hemorrhage were associated with poor preoperative grade and the development of vasospasm. Operative management, case morbidity/mortality, and the high incidence of multiple aneurysms and other vascular anomalies associated with DACA aneurysms are discussed. Because of the devastating effects of subarachnoid hemorrhage from these aneurysms, they should be carefully searched for and treated before hemorrhage occurs.
Successful Resection of Choroid Plexus Papillomas Diagnosed at Birth: Report of Two Cases
Authors: Tomita Tadanori , Naidich Thomas P. 
Published: May 2010

Abstract
The authors report two cases of large, vascular choroid plexus papillomas that were detected at birth and surgically excised shortly thereafter. Both patients made excellent recovery and demonstrate normal psychomotor development. Experience suggests that it is proper to be aggressive in managing these benign neonatal tumors.
Metastases of a Spinal Glioblastoma Multiforme into an Intracranial Arachnoid Cyst
Authors: Kendrick Donovan F. , Bonnin Jose M. , Garcia Julio H. 
Published: May 2010

Abstract
Spread of spinal cord glioblastoma multiforme to the intracranial compartment is uncommon. This report documents a case of metastatic spread of glioblastoma multiforme from the spinal cord to an intracranial arachnoid cyst. Seeding of the cyst cavity could have occurred by direct permeation of the cyst wall by the neoplastic glial cells spreading via the cerebrospinal fluid or by direct access of the cells through a defect in the arachnoid cyst wall and their subsequent entrapment by a ball valve type mechanism, leading to multiple implants.
Lymphocytic Adenohypophysitis of Pregnancy with Complete Recovery
Authors: McGrail Kevin M. , Beyerl Brian D. , Black Peter McL. , Klibanski Anne , Zervas Nicholas T. 
Published: May 2010

Abstract
A case of lymphocytic adenohypophysitis in a postpartum woman who became symptomatic during her 8th month of pregnancy is presented. The clinical presentation, endocrine findings, pathological findings, and operative management are discussed. Transient hypopituitarism is documented. Unlike most previously published cases, this woman had complete recovery of anterior pituitary function.
Communicating Fourth Ventricular Hydrocephalus: Case Report
Authors: Aoki Nobuhiko 
Published: May 2010

Abstract
The case of an infant with hydrocephalic enlargement of the 4th ventricle and dilatation of the basal cisterns is presented. Although the lateral ventricular shunt was proved to be functioning, the patient developed supratentorial hypertension marked by a tense fontanelle. Placement of a 4th ventricle-peritoneum shunt was followed by shrinkage of the 4th ventricle and resolution of the supratentorial hypertension. Work-up, including computed tomographic ventriculography and cisternography, demonstrated occlusion of the aqueduct of Sylvius and of subarachnoid spaces. This unique pathological process, differentiated from an isolated 4th ventricle, could be referred to as communicating 4th ventricular hydrocephalus.
Normal Pressure Hydrocephalus in Children and Young Adults
Authors: Barnett Gene H. , Hahn Joseph F. , Palmer Joann 
Published: May 2010

Abstract
Normal pressure hydrocephalus (NPH) is generally considered to be a disorder of adult and geriatric patients. We report four patients who are children or young adults with chronic neurological disorders, recent deterioration of their levels of function, normal cerebrospinal fluid (CSF) pressures, and ventricular enlargement. All four patients improved after the placement or revision of a ventriculoperitoneal shunt. Frequent symptoms and signs included irritability (three patients), vomiting (three patients), and abnormal limb posturing (two patients). Correct diagnosis was hampered by two factors: (a) Multiple or prolonged recordings of CSF pressures were invariably well within the normal ranges with respect to age, and (b) the patients had chronic neurological deficits. After ventriculoperitoneal shunting, subjective and objective improvement was seen in all cases. Young patients with large ventricles may benefit from shunting procedures despite low CSF pressures. These patients may be clinically identified by symptoms of new neurological dysfunction in cases of previously static neurological disease or acceleration of slowly progressive neurological dysfunction. Some of these underlying neurological disorders may predispose children and young adults to NPH.
Balloon Compression Rhizolysis in the Surgical Management of Trigeminal Neuralgia
Authors: Belber Carl J. , Rak Richard A. 
Published: May 2010

Abstract
To overcome some of the disadvantages of the current percutaneous surgical approaches to trigeminal neuralgia, we offer balloon compression rhizolysis (BCR) as an alternative. Guided by fluoroscopy, a 4 French Fogarty catheter is introduced into Meckl's cave, and its balloon is inflated tightly for a few minutes with soluble contrast agent to compress the gasserian ganglion and rootlets, under light endotracheal anesthesia. All patients experience immediate pain relief, with mild numbness in all three divisions, but with corneal sparing. Often, weakness of ipsilateral mastication appears transiently. In 33 procedures performed in 25 patients aged 48 to 86, with a follow-up period of 6 months to 7 years, there were 25 long-lasting cures (76%) and 8 recurrences. These results are fully comparable to those of other “destructive” procedures. There was no anesthetic complication and no mortality. The advantages of this procedure, besides its efficacy and low rate of dysesthesia, include absence of discomfort for the patient, short operative time, technical ease for the neurosurgeon, minimal morbidity, and no risk to corneal sensation. We think that microvascular decompression (MVD) should be the first operation considered for trigeminal neuralgia, but we advocate BCR as the procedure of choice in the aged and medically infirm, especially when V1 pain is present, in patients with multiple sclerosis, for recurrences after other procedures, and in virtually any situation in which MVD is, for some reason, not feasible.
Ruptured Middle Cerebral Artery Aneurysm with Intracerebral Hemorrhage in Younger Patients Appearing Moribund: Emergency Operation?
Authors: Brandt Lennart , Sonesson Bengt , Ljunggren Bengt , Säveland Hans 
Published: May 2010

Abstract
Four women, aged 39 to 46 years, were urgently admitted to our neurosurgical unit after strokes. On admission, all appeared moribund, presenting with deep coma, pupils bilaterally dilated and fixed, decerebrate posture, and markedly abnormal respiratory patterns. Computed tomography revealed subarachnoid hemorrhage with an associated large intracerebral hematoma and pronounced shift of midline structures in all four cases. Because of the clinical appearance, the patients were given urea and were operated without preceding angiography. The origin of the hemorrhage was identified as a middle cerebral artery (MCA) bifurcation berry aneurysm in one patient and giant MCA aneurysms in the other three. The hematomas were evacuated, and the aneurysms were occluded. All four patients received intravenous nimodipine, none showed any sign of delayed ischemic deterioration, and all regained full consciousness within a few days. One patient died 3 weeks later from a pulmonary embolus. Three patients are presently at home with moderate focal neurological deficits and moderate to marked cognitive impairment. The psychosocial readjustment was very good in a patient with a left giant aneurysm, satisfactory in a patient with a right giant aneurysm, and unsatisfactory in a patient with a right berry aneurysm. The indications, ethical considerations, and technical aspects of operating on seemingly moribund patients who probably harbor a ruptured MCA aneurysm are discussed.
Segmental Neurofibromatosis
Authors: Rawlings Charles E. , Wilkins Robert H. , Cook Wesley A. , Burger Peter C. 
Published: May 2010

Abstract
Of the various forms of neurofibromatosis, the best known are peripheral neurofibromatosis (von Recklinghausen's disease) and central neurofibromatosis. There is a rare form called segmental neurofibromatosis, in which the cutaneous and neural changes are limited to one sector of the body and with which there is usually no family history of neurofibromatosis. We report four patients with this disorder and stress the value of repetitive, limited excision of peripheral nerve tumors in their management.
Supratentorial Gliomas: Surgical Considerations and Immediate Postoperative Results Gross Total Resection versus Partial Resection
Authors: Ciric Ivan , Ammirati Mario , Vick Nicholas , Mikhael Michael 
Published: May 2010

Abstract
Forty-two patients with supratentorial gliomas not involving the basal ganglia (extraganglionic) were studied pre- and postoperatively with computed tomographic (CT) scans to evaluate the effect of the extent of surgical resection on the immediate postoperative results. Thirty-three patients (79%) had malignant astrocytic gliomas (glioblastoma or anaplastic astrocytoma), 4 patients (10%) had well-differentiated astrocytomas, and 5 (12%) had oligodendrogliomas. The median age was 58 years, and the median Karnofsky rating was 70. There was no operative mortality. Six patients (14%) had surgical complications. A gross total resection was defined as the absence of any abnormal enhancement on the postoperative CT scan. A nearly gross total resection had been accomplished when less than 10% of the preoperatively enhancing mass was still seen. A partial resection was indicated by the presence of more than 10% of the enhancing lesion on the postoperative CT scan. A gross total or nearly gross total resection was accomplished in 36 patients (86%), and an improved or stable postoperative neurological status was present in 35 of these patients (97%). In contrast, the rate of neurological morbidity after a partial resection was 40%. Supratentorial extraganglionic gliomas, regardless of their histological type, generally were well-circumscribed lesions except at the level of the ventricular wall, where glioblastomas and anaplastic astrocytomas blended with the subependymal white matter from which they seemed to arise. (Neurosurgery 21: 21-26, 1987)
Cerebellopontine Angle Tumor Causing Contralateral Trigeminal Neuralgia: A Case Report
Authors: Snow Robert B. , Fraser Richard A. R. 
Published: May 2010

Abstract
A case of trigeminal neuralgia caused by a contralateral acoustic neurinoma is reported. The patient's tic pain was completely alleviated after removal of the tumor. Previously reported cases of trigeminal neuralgia caused by contralateral cerebellopontine angle tumors are reviewed, and the pathophysiology of this disorder is discussed. (Neurosurgery 21: 84-86, 1987)
Optic Nerve Avulsion Secondary to Traumatic Enucleation
Authors: Middleton Troy H. , Smith Robert R. 
Published: May 2010

Abstract
Optic nerve injuries may be associated with craniofacial trauma. Actual avulsion of the optic nerve secondary to traumatic enucleation, however, is a unique injury that has secondary neurosurgical complications. Two cases of such an injury are presented. (Neurosurgery 21: 89-91, 1987)
Transclival Penetrating Injury
Authors: Miller P. , Lipschitz R. 
Published: May 2010

Abstract
A case of a stab wound of the cranium with a retained knife blade is presented. The blade had an unusual course through the base of the skull-the point of the knife penetrated the clival line to end in the posterior fossa. Although the blade was in close proximity to the basilar artery, it was judged safe to extract the knife by blind removal. The patient had no neurological deficit postoperatively. (Neurosurgery 21: 92-94, 1987)
Sciatica: An Early Manifestation of Thoracic Vertebral Osteochondroma
Authors: Buckler Richard A. , Chad David A. , Smith Thomas W. , Davidson Robin I. 
Published: May 2010

Abstract
We describe a 36-year-old woman with a thoracic vertebral osteochondroma who presented with radicular leg pain. This benign tumor is uncommon in the vertebral column, and radicular pain is an unusual manifestation of a thoracic spinal lesion. Myelography and computed tomography aided in diagnosis; surgical resection resulted in an excellent clinical response. (Neurosurgery 21: 98-100, 1987)