bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pleomorphic Xanthoastrocytoma: Report of Two Cases
Authors: Stuart Gordon , Appleton D.B. , Cooke Robin 
Published: May 2010

Abstract
Two cases of pleomorphic xanthoastrocytoma are presented to draw attention to this relatively benign variant of glioma. The circumscribed tumors, each with a cystic component, were located superficially, one in the mesial right temporal lobe and one in the right temporoparietal region. The patients were aged 12 and 14 years, and it is now almost 7 years since the onset of symptoms in the 12-year-old boy. The optimal plan of management is discussed. (Neurosurgery 22:422-427, 1988)
Technical Note: The Removal of Free Peritoneal Catheters in the Revision of Ventriculoperitoneal Shunts
Authors: Pomeranz Shlomo , Rapapport Harry Z. , Umansky Felix , Shalit Mordechai N. 
Published: May 2010

Abstract
The widespread usage of ventriculoperitoneal shunts has been followed by a plethora of complications. One of these complications, the separation and migration of the distal tubing to be free intraperitoneally, has been relatively disregarded in the literature both as a phenomenon and as to treatment. We present our experience with nine such cases, four involving two peritoneal catheters. Unless contraindicated, we think that such tubing should be removed during shunt revision by single digit blind palpation of the tubing. No complications arose from this procedure, and the postoperative course was uneventful. The indications for this procedure are discussed in relation to the relevant literature. (Neurosurgery 22:436-438, 1988)
Linear Accelerator as a Neurosurgical Tool for Stereotactic Radiosurgery
Authors: Winston Ken R. , Lutz Wendell 
Published: May 2010

Abstract
A new system has been developed for stereotactically delivering prescribed high doses of radiation to precisely located volumes of approximately 0.6 to 10.0 ml within the brain. A Brown-Roberts-Wells stereotactic apparatus and a 6-MeV linear accelerator equipped with a special collimator (12.5 to 30 mm in diameter) have been adapted. The 20-mm collimator allows treatment of a nearly spherical volume of 2.1 ml. Outside the treatment field, the dosage declines to 80% of the dose prescribed for the periphery of the lesion over a distance of 1.8 mm and to 50% over the next 3.4 mm. Localization can be accomplished via computed tomography or cerebral angiography. Treatment is accomplished with an arcing beam of photon radiation with the turntable (couch) in each of four positions. The entire system has been extensively tested for accuracy in alignment and distribution of radiation. Errors have been measured for the alignment of the apparatus and for the process of localization. Safety of operation was emphasized throughout the design and testing phase. (Neurosurgery 22:454-464, 1988)
Local Control of Recurrent Clival and Sacral Chordoma after Interstitial Irradiation with Iodine-125: New Techniques for Treatment of Recurrent or Unresectable Chordomas
Authors: Kumar Pradeep P. , Good Roger R. , Skultety F. Miles , Leibrock Lyal G. 
Published: May 2010

Abstract
Using new 125I brachytherapy techniques, we were able to deliver safely a tumor volume dose of 16,000 rads to a previous irradiated, large, recurrent sacral chordoma by means of the intraoperative interstitial implantation of 229 low activity 125I seeds and 40,000 rads to a previously irradiated, small, recurrent clival chordoma by means of the transnasal needle implantation of two high activity 125I seeds. Iodine-125 brachytherapy was followed by regression of tumor, lessening of symptoms, and bony recalcification in both cases. (Neurosurgery 22:479-483, 1988)
Controlled Study of Nimodipine in Aneurysm Patients Treated Early after Subarachnoid Hemorrhage
Authors: Mee Edward , Dorrance Deborah , Lowe Derek , Neil-Dwyer Glenn 
Published: May 2010

Abstract
We enrolled 75 consecutive patients admitted with subarachnoid hemorrhages in a randomized, double-blind, placebo-controlled trial to determine the effect of early intervention with nimodipine on outcome and cerebral blood flow. The cardioprotective effect of nimodipine was assessed by measuring the electrocardiographic changes over the first 3 days of drug treatment. There was a mild lowering of the mean cerebral blood flow in the nimodipine-treated group over the 21-day period. Analysis of the continuous electrocardiographic traces showed no difference between the nimodipine and placebo groups in the frequency or type of abnormality detected. At 3 months, 4 of the 38 patients receiving nimodipine had died, compared with 10 of the 37 placebo-receiving patients. Of the 50 eligible patients who had a proven cerebral aneurysm, 1 patient (4%) on nimodipine died compared with 6 (24%) receiving placebo (0.01 &lt; P &gt; 0.05, x2 test; approximate 95% confidence interval for mortality difference, 0.4% to 39.6%). We conclude that nimodipine does not increase the cerebral blood flow or protect the heart after a subarachnoid hemorrhage. There were no side effects from nimodipine. The trend toward improved outcome should be verified in a larger series of patients. (Neurosurgery 22:484-491, 1988)
Cerebrovascular Disorders Associated with von Recklinghausen's Neurofibromatosis: A Case Report
Authors: Sobata Eiji , Ohkuma Hiroki , Suzuki Shigeharu 
Published: May 2010

Abstract
A 28-year-old woman with von Recklinghausen's neurofibromatosis (NF-1) had a huge hematoma in the left posterior nuchal region. Carotid and vertebral angiograms revealed marked stenosis at the C3 portion of the left internal carotid artery, slight moyamoya staining, occlusion of the left vertebral artery at the atlas level, and a right internal carotid artery aneurysm. The radiographic, clinical, and histological features of this case are discussed together with a review of 42 similar cases found in the literature. (Neurosurgery 22:544-549, 1988)
Transvenous Balloon Occlusion of the Cavernous Sinus: An Alternative Therapeutic Choice for Recurrent Traumatic Carotid-Cavernous Fistulas
Authors: Shimizu Takeo , Waga Shiro , Kojima Tadashi , Tanaka Kimito 
Published: May 2010

Abstract
We report a case of traumatic carotid-cavernous fistula (CCF) that recurred some 9 years after carotid trapping. The recurrent CCF was accompanied by a huge aneurysmal dilatation of the cavernous sinus. Transarterial balloon occlusion of the proximal internal carotid artery failed to occlude the fistula completely because of collateral flow to the fistula. The fistula was completely occluded by a transvenous approach via the jugular vein and inferior petrosal sinus using detachable balloons. The transjugular-inferior petrosal approach to the cavernous sinus can be an alternative for the treatment of traumatic CCF when the transarterial approach has failed to occlude the cavernous sinus. (Neurosurgery 22:550-553, 1988)
Unusual Type of Spinal Arteriovenous Malformation
Authors: Aminoff Michael J. , Gutin Philip H. , Norman David 
Published: May 2010

Abstract
We describe an uncommon type of spinal arteriovenous malformation that is intradural rather than dural and that consists of a true fistula rather than a nidus of abnormal vessels between the anterior spinal artery and a draining vein. Its clinical significance and treatment are discussed. (Neurosurgery 22:589-591, 1988)
Slit Ventricle Syndrome Presenting with Paroxysmal Hypersomnia in an Adult: Case Report
Authors: Korfali Ender , Aksoy Kaya , Safi Imran 
Published: May 2010

Abstract
The slit ventricle syndrome (SVS), defined as intermittent shunt malfunction without substantial ventricular enlargement, is usually observed in shunted children with small, slitlike ventricles. This syndrome has been attributed to recurrent obstruction of the ventricular catheter, which then causes an increase of intracranial pressure. Only rarely has the SVS been reported in adults. We describe a 29-year-old woman whose shunt malfunction presented with longlasting paroxysmal hypersomnia and was diagnosed with computed tomographic evidence of small lateral ventricles. This episodic hypersomnia presented every 2 to 3 weeks and each episode lasted 1 to 2 weeks. After revision of the ventricular catheter, her symptoms stopped and she remained well. (Neurosurgery 22:594-595, 1988)
Synovial Cysts of the Spine
Authors: Onofrio Burton M. , Mih Alexander D. 
Published: May 2010

Abstract
A series of 13 patients with synovial or ganglion cysts of the spinal facet joints causing nerve root compression is reported. These cysts were found in both the cervical and the lumbar spine, and the anatomical location of each cyst corresponded to the patient's signs and symptoms. In no case was there evidence of intervertebral disc abnormality found at operation. The patients ranged from 49 to 77 years of age and included 4 men and 9 women. Radiographic evidence of facet degenerative change and degenerative spondylolisthesis was frequently but not invariably noted. The extradural defects defined with positive contrast myelography or postmyelography computed tomographic scanning were usually posterior or posterolateral to the common dural sac and were misinterpreted as extruded discs in the majority of cases. Treatment consisted of laminectomy and surgical excision of cysts. All patients reported improvement or resolution of their presenting symptoms.
The Critical First Minutes after Subarachnoid Hemorrhage
Authors: Grote Ernst , Hassler Werner 
Published: May 2010

Abstract
Six patients were observed during recurrent subarachnoid hemorrhage (SAH). Three each had an open skull and intact dura mater and demonstrated an extreme increase in intracranial pressure (ICP) that developed within 1 minute and then declined over several minutes. Three other patients were investigated with transcranial Doppler sonography before, during, and after recurrent bleeding, and their hemodynamics were studied. There is conclusive evidence that acute spontaneous SAH is often followed by an intracranial circulatory arrest lasting for several minutes and caused by a peak of ICP in the range of mean arterial levels. The mechanisms involved are discussed. There are strong indications that this temporary intracranial circulatory arrest promotes hemostasis, but may constitute a severe ischemic event.
Carotid Endarterectomy in Symptomatic Elderly Patients
Authors: Loftus Christopher M. , Biller José , Godersky John C. , Adams Harold P. , Yamada Thoru , Edwards Pamela S. 
Published: May 2010

Abstract
Fifty-three of 203 consecutive carotid endarterectomies (26%) performed on the Neurosurgical Service at the University of Iowa were in patients over 70 years of age (mean age, 73.4). This series included 38 men and 15 women. Thirty-three patients (62%) presented with transient ischemic attacks, and the remaining 38% were functional stroke patients. Medical risk factors in this group included hypertension in 70%, previous myocardial infarction in 26%, angina in 17%, peripheral vascular disease in 23%, and diabetes in 13%. Sixty-four per cent of the patients had been previously treated with antihypertensive drugs, 43% with antiplatelet agents, and 4% with anticoagulants. Noninvasive vascular evaluation was performed in 25 of 53 (47%) patients, and all underwent angiography before operation. There were no angiographic complications. All patients were operated on with full-channel electroencephalographic (EEG) monitoring. Indwelling shunts were required in 6 of 53 (11%) cases. Intraoperative heparin was given and not reversed; the mean dose was 5100 units. The mean clamp time was 48 minutes. Patch grafts, fashioned from common facial or saphenous veins, were used in 2 patients. Eight patients had contralateral carotid occlusions, but only 2 (25%) required indwelling shunt placement based on EEG criteria. There were no perioperative deaths in this series. One patient had a postoperative stroke, and 1 patient had a postoperative nonfatal myocardial infarction. Transient surgical complications included 3 wound hematomas, 1 wound abscess, and 2 self-limited cranial nerve palsies (13%). The mean follow-up was 12.7 months, during which no new neurological events were identified in any patient. Carotid endarterectomy can be performed in symptomatic elderly patients with a risk/benefit ratio equal to that of younger patients.
Treatment of Symptomatic Syringomyelia with a Ventriculoperitoneal Shunt: A Case Report with Magnetic Resonance Scan Correlation
Authors: Ogilvy Christopher S. , Borges Lawrence F. 
Published: May 2010

Abstract
This report describes a patient with communicating syringomyelia associated with enlarged cerebral ventricles who was managed by placing a ventriculoperitoneal shunt. His clinical improvement was rapid and dramatic. A comparison of preoperative and postoperative magnetic resonance scans documents shrinkage of the cervical syrinx.
Cellular Blue Nevus (“Melanocytoma”) of the Spinal Meninges: Electron Microscopic and Immunohistochemical Features
Authors: Lach B. , Russell N. , Benoit B. , Atack D. 
Published: May 2010

Abstract
A primary cellular blue nevus (melanocytoma) of the spinal canal in a 21-year-old woman is reported. Light microscopic examination revealed a melanotic neoplasm with histological patterns resembling schwannoma, dermal nevi, and neuroblastic-like tumor. The ultrastructural features of the neoplastic cells were similar to those in dermal blue nevi and melanomas. There was no evidence of arachnoidal cell differentiation. Immunohistochemistry revealed positive reactions for S-100 protein and neuron-specific enolase in many cells and no reactions for glial fibrillary acidic protein, cytokeratins, epithelial membrane antigen, 70-kD neurofilament protein, or Leu-7. Vimentin was strongly positive in the melanocytic cells as well as in the arachnoidal cells of involved meninges. The ultrastructural and immunohistochemical features support the nevoid nature of this tumor, which is frequently mislabeled as “melanotic meningioma.”
Pre- and Postoperative Changes in Brain Tissue Surrounding a Meningioma
Authors: Trittmacher Susan , Traupe Horst , Schmid Anton 
Published: May 2010

Abstract
A retrospective study in 33 patients with intracranial meningioma demonstrates that two pathological mechanisms are involved in causing a hypodense area around the actual tumor: pressure-induced atrophy that persists after operation and true cerebral edema of unclear cause. The extent of the hypodense area is not related to tumor location or tumor size. A relationship between meningioma with a malignant tendency and the hemispheric spread of hypodensity can be observed.
Factors Possibly Influencing the Prognosis of Oligodendroglioma
Authors: Sun Zhen Min , Genka Shigeru , Shitara Nobuyuki , Akanuma Atsuo , Takakura Kintomo 
Published: May 2010

Abstract
Fifty-seven cases of oligodendroglioma (including eight cases of malignant oligodendroglioma) treated at the University of Tokyo Hospital between 1961 and 1985 were analyzed for factors influencing the survival rate. Factors related to a poor outcome were findings of malignancy and symptoms of dementia. Survival rate and postoperative survival period were not influenced significantly by radiation therapy, extent of resection, tumor characteristics, or ABO blood groups.
The Paraclinoid Carotid Artery: Anatomical Aspects of a Microneurosurgical Approach
Authors: Knosp Engelbert , Müller Gerd , Perneczky Axel 
Published: May 2010

Abstract
The paraclinoid area is investigated anatomically for possible microneurosurgical approaches to the C3 segment of the internal carotid artery and to structures in the vicinity of the anterior siphon knee. Removal of the anterior clinoid process reveals a tight connective tissue ring that fixes the internal carotid artery to the surrounding osseous structures at the point of its transdural passage. Transection of this fibrous ring opens a microsurgical pathway to the carotid C3 segment. The artery is surrounded by a loose connective tissue layer that allows blunt preparation along the C3 segment, without compromising the cranial nerves and without damaging venous compartments of the cavernous sinus. This approach provides neurosurgical access to paraclinoidal aneurysms, to partly intracavernous aneurysms, and to carotid-ophthalmic aneurysms, allowing control of the proximal aneurysm neck and of the parent artery itself. In cases of tumors involving the medial sphenoid ridge, the apex of the orbit, or the cavernous sinus, the pericarotid connective tissue can serve as a guide layer for access along the internal carotid artery.
Distal Ulnar Neuropathy from Carpal Ganglia: A Clinical and Electrophysiological Study
Authors: Cavallo Michele , Poppi Massimo , Martinelli Paolo , Gaist Giulio 
Published: May 2010

Abstract
The clinical and electrophysiological observations in two cases of distal ulnar neuropathy from carpal ganglia are reported. In the first case, the ganglion was compressing the ulnar nerve just proximal to its division; in the second case, the ganglion was compressing the deep branch of the ulnar nerve just at its origin. In both cases, both axonal degeneration and segmental demyelination were present. A clinical classification of the compression syndromes of the deep ulnar branch is proposed.
Tuberculoma of the Ulnar Nerve: Case Report
Authors: Nucci Francesco , Mastronardi Luciano , Artico Marco , Ferrante Luigi , Acqui Michele 
Published: May 2010

Abstract
A peripheral nerve tuberculoma, the third on record, involved the ulnar nerve, as did the other two. This case report is followed by a discussion of the pathogenesis and diagnosis of this lesion. Its pathogenesis is unclear. Direct infection from a tuberculous sister was disproved, and infection via a local wound is highly unlikely. A previous, silent form of tuberculosis seems to have been the cause.
Successful Surgical and Anesthetic Management of Vein of Galen Aneurysm in a Neonate in Congestive Heart Failure
Authors: Matjasko Jane , Robinson Walker , Eudaily Daniel 
Published: May 2010

Abstract
A 12-day-old infant in intractable cardiac failure due to a vein of Galen malformation was treated successfully with serial ligation of the majority of the vessels feeding the malformation. Despite some residual vascular supply to the malformation, the congestive heart failure has disappeared and growth and development have been normal over a 3-year follow-up period.
Lymphocytic Adenohypophysitis: Clinical, Radiological, and Magnetic Resonance Imaging Characterization
Authors: Levine Steven N. , Benzel Edward C. , Fowler Marjorie R. , Shroyer John V. , Mirfakhraee Mansour 
Published: May 2010

Abstract
Lymphocytic adenohypophysitis is a rare nonneoplastic cause of a pituitary mass. We report the case of an 18-year-old woman who presented with complaints of headaches and visual disturbances after an otherwise uncomplicated pregnancy and delivery. She had an elevated serum prolactin level and a pituitary mass visualized by magnetic resonance imaging (MRI). The tissue removed by transsphenoidal resection was an inflammatory mass composed of lymphocytes, plasma cells, and moderate fibrosis surrounding islands of hyperplastic lactotrophs. This is the first case of lymphocytic adenohypophysitis visualized by MRI. As in this case, lymphocytic adenohypophysitis is frequently confused with a prolactin-secreting pituitary tumor before operation and pathological examination of the tissue. The clinical characteristics and radiological features of and an approach to managing patients with lymphocytic adenohypophysitis are reviewed and discussed.
Computed Tomography of the Postoperative Intervertebral Disc and Lumbar Spinal Canal : Investigation of Twenty - five Patients after Successful Operation for Lumbar Disc Herniation
Authors: Montaldi Stefano , Fankhauser Heinz , Schnyder Pierre , de Tribolet Nicolas 
Published: May 2010

Abstract

Twenty-five patients with good outcome after operation for lumbar disc herniation underwent unenhanced computed tomography (CT) and plain radiography of the lumbar spine before, 5 to 7 days after, and 6 lo 7 weeks after the operation to define the radiological features ofthe postoperative disc and spinal canal. After operation, the center of the disc appears hypodense. The anterior and lateral borders remain sharply delimited, but in 44% of the cases the posterior border shows an image suggesting the persistence of disc herniation. In 84% of the cases, there are major changes in the spinal canal with complete occlusion of the extradural space on the operated side by a heterogeneous material the attenuation value of which ranged between those of cerebrospinal fluid and disc. The outline of the dural sac and of the nerve root is lost. This aspect did not significantly change between the 1st and the 6 th postoperative week, except for the disappearance of any air within the canal and a slight movement on the dural sac toward the operated side. From these major radiological modifications found in asymptomatic postoperative patients, it is concluded that positive CT in patients with the failed back surgery syndrome has limited value. Myelography is preferred as the primary neuroradiological investigation.
Structural Mechanics of the Blowout Fracture: Numerical Computer Simulation of Orbital Deformation by the Finite Element Method
Authors: Takizawa Hideo , Sugiura Kazuaki , Baba Motoki , Tachisawa Takayuki , Kadoyama Shigeru , Kabayama Toshio , Ohno Hitoshi , Fuseya Youko 
Published: May 2010

Abstract

Blowout fractures most frequently involve the orbital floor. The contour of the orbit has been postulated as one of the factors responsible for this phenomenon, but only a few studies have been carried out. The present study was planned to determine the effect of the contour of the orbit when intraorbital pressure is raised to simulate the hydraulic mechanism of blowout fracture. The profile of the orbit was estimated from five dry human skulls, and the measurements were approximated to frame models. The deformation of these models by raised intraorbital pressure was calculated by computer simulation using the finite element method. In all ofthe orbital models, the deformation of the orbital floor was significantly greater than that of the roof. These findings verified that the orbital roof has a higher resistance than the floor against raised intraorbital pressure. We suspect that this resistance is due to the arched shape of the orbital roof, whereas the floor is rather flat.
Septation in Syringomyelia and Its Possible Clinical Significance
Authors: Lederhaus Scott C. , Pritz Michael B. , Pribram Henry F. W. 
Published: May 2010

Abstract

A 3-year-old boy with a septated syrinx and several other dysraphic features is presented. The literature regarding the cause, diagnosis, and pathology of septation in syringomyelia is reviewed. This case raises two points. First, the septated pattern may be associated with an elevated pressure in the syrinx. Second, despite the septations, the syrinx may communicate freely.
Multiple Thoracic Disc Herniations: Case Report
Authors: Shikata Jitsuhiko , Yamamuro Takao , Iida Hirokazu , Kashiwagi Naoya 
Published: May 2010

Abstract

Multiple thoracic disc herniation is rare, and one of the main problems in its treatment has been the lack of accuracy in diagnostic tests. Now, with the advent of computed tomographic scanning with metrizamide in the subaraehnoid space, the accuracy has been greatly improved. With computed tomographic scanning, the type and level of the lesion can be demonstrated, even when the myelographic study is unclear. Our report describes the case of a 38-year-old man with multiple thoracic intervertebral disc herniation, who also exhibited symptoms of spinal cord compression. Computed tomographic metrizamide myelography clearly showed anterior compression of the spinal cord due to disc herniation at T5-T6, T6-T7, T7-T8, T8-T9, and T9-T10. Removal ofthe herniated discs was followed by interbody fusion using autogenous bone grafts, and excellent results were obtained.