bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypertrophic Neurofibrosis with Onion Bulb Formation in an Isolated Element of the Brachial Plexus
Authors: de los Reyes R. A. , Chason J. L. , Rogers J. S. , Ausman J. I. 
Published: May 2010

Abstract
A patient with hypertrophic neurofibrosis limited to the posterior cord of the brachial plexus is reported. The clinical and pathological features of this entity and the published experience to date are reviewed.
Microsurgical and Standard Removal of the Protruded Lumbar Disc
Authors: Wilson Donald H. , Harbaugh Robert 
Published: May 2010

Abstract
The operation of lumbar discectomy has been improved steadily since its introduction by Mixter and Barr in 1934. The present standard operation represents an accumulation of techniques that became available to succeeding generations of neurosurgeons. The addition of microsurgical technique may be the most recent means to refine the process of lumbar discectomy. One hundred cases of microsurgical discectomy were compared to the same number of standard operations, all performed by one surgeon and analyzed by another. The patient profiles were the same; the operative results showed that the standard discectomy was of good quality and that microsurgical discectomy could equal it; in comparing postoperative results, however, microsurgical discectomy was superior to the standard operation: patients returned to their usual activities in half the time. The advantage of the microsurgical technique is its capacity to preserve better the integrity of normal tissue and to impose less trauma on the body. From this analysis, we conclude that microsurgical discectomy represents a small but significant refinement of standard discectomy.
Development of Intracranial Saccular Aneurysms
Authors: Salar Giuseppe , Mingrino Salvatore 
Published: May 2010

Abstract
The authors report two patients with an aneurysm of the carotid siphon who underwent cervical carotid artery ligation. After many years these patients showed evidence of an aneurysm of the contralateral intracranial internal carotid artery. Possible congenital, arteriosclerotic, and mechanical factors causing aneurysm enlargement are discussed.
Visual Loss from Pituitary Tumor Masked by Optic Nerve Drusen
Authors: Lowder Careen Y. , Tomsak Robert L. , Zakov Nicholas Z. , Hahn Joseph 
Published: May 2010

Abstract
A case of optic nerve drusen and progressive loss of central visual acuity is reported. Despite the presence of optic nerve drusen. the loss of central visual acuity that cannot be explained by a retinal abnormality is a strong indication for further neuro-ophthalmological evaluation.
Hyperprolactinemia, Hypopituitarism, and Chiasmal Compression Due to Carcinoma Metastatic to the Pituitary
Authors: Leramo O. B. , Booth J. D. , Zinman B. , Bergeron C. , Sima A. A. F. , Morley T. P. 
Published: May 2010

Abstract
Carcinoma metastatic to the anterior pituitary gland may simulate prolactinoma. We are reporting a case of chiasmal compression and hyperprolactinemia caused by metastatic adenocarcinoma.
Cardiopulmonary Monitoring during Graded Cervical Internal Carotid Artery Occlusion
Authors: Pritz Michael B. 
Published: May 2010

Abstract
The intravascular volume and cardiac status of two patients who were thought to be at high risk to develop ischemic symptoms while undergoing graded cervical internal carotid artery occlusion were monitored by a dye dilution technique. Based on information obtained from this multivariable quantitative cardiopulmonary monitoring, measures were taken to maintain normo- to hypervolemia and to maximize cardiac performance. These medical adjuncts were thought to decrease the possibility of ischemic deficits while gradual occlusion of the internal carotid artery was being performed.
Metrizamide Computed Tomographic Cisternography for the Diagnosis of Occult Lesions of the Hypothalamic-Hypophyseal Axis in Children
Authors: Pang Dachling , Rosenbaum Arthur E. , Wilberger James E. , Gutai James P. 
Published: May 2010

Abstract
In children, hypothalamic-hypophyseal syndromes such as diabetes insipidus, precocious puberty, growth retardation, and panhypopituitarism can be due either to structural lesions or to functional disorders of the cerebral endocrine complex. When clinical and endocrinological parameters fail to distinguish between these etiologies, neuroradiographical diagnosis becomes extremely important. Although conventional intravenously enhanced computed tomography (IVCT) is satisfactory for the diagnosis of lesions larger than 1 cm, metrizamide CT cisternography (MCTC) greatly improves the diagnostic yield for smaller juxtapituitary masses in the suprasellar cistern, clearly defines their sizes and relationships with contiguous structures, and definitively confirms the diagnosis of empty sella syndrome. Six patients with endocrinopathies and normal or ambiguous IVCT findings are presented to illustrate how MCTC can influence their management and outcome without the patient discomfort and technical complexity associated with pneumoencephalography.
Delayed Complications of Craniocerebral Trauma
Authors: Shallat Ronald F. , Taekman Michael S. , Nagle Richard C. 
Published: May 2010

Abstract
A young man incurred a head injury with transiently impaired consciousness, multiple skull fractures, and monocular blindness. After 3 weeks he developed an intracerebral hemorrhage, which resolved without operative intervention. One week later he presented with massive epistaxis from a traumatic aneurysm of the right cavernous carotid artery, which extended into the sphenoid sinus. This was treated successfully by gradual occlusion of the carotid artery. Theories of the pathogenesis of these lesions as well as the rationale for treatment are discussed.
Intraventricular Tension Pneumocephalus as a Complication of Paranasal Sinus Surgery
Authors: Davis Dudley H. , Laws Edward R. , McDonald Thomas J. , Salassa John R. , Phillips Lawrence H. 
Published: May 2010

Abstract
A case of intraventricular tension pneumocephalus occurring as a complication of paranasal sinus surgery is presented. The pathophysiology of tension pneumocephalus is discussed and emphasis is placed on the potentially life-threatening increase in intracranial pressure that occurs. Tension pneumocephalus requires prompt diagnosis and treatment.
Management of Clotted Aneurysm of the Vein of Galen
Authors: Dean David F. 
Published: May 2010

Abstract
Nine clotted vein of Galen aneurysms have been reported. The author reports a case in a 4-month-old hydrocephalic male infant who underwent biopsy and drainage of the aneurysm. The case had been diagnosed as an avascular mass on a computed tomographic scan. There is a 2-year follow-up period on this patient. The literature on clotted aneurysms of the vein of Galen is reviewed.
Spinal Subdural Hematoma Associated with Anticoagulant Therapy in a Patient with Spinal Meningioma
Authors: Toledo Ezra , Shalit Mordechai N. , Segal Ricardo 
Published: May 2010

Abstract
A case of spontaneous subdural hematoma inthe cervicothoracic region associated with a small meningioma in a patient on anticoagulant therapy is presented. The neurological complications of anticoagulant therapy are discussed briefly. Progressive neurological deterioration in a patient on anticoagulant therapy should prompt the performance of an emergency myelogram and a possible laminectomy in spite of the potential risks of these procedures. Intraspinal bleeding occurs more frequently in the form of an epidural hematoma, but the clinical presentation may not allow differentiation from a subdural hematoma. The possible causal relation between the asymptomatic spinal meningioma, the anticoagulant therapy, and the formation of the subdural hematoma is discussed.
Gliomas of the Septal Area in Children
Authors: Page Larry K. , Clark Ronald 
Published: May 2010

abstract
Five patients presented at 2 to 20 years of age with low grade gliomas: one ependymoma, one oligodendroglioma, and three astrocytomas. These tumors are thought to have arisen from the multipotential cells in the subependymal plate of the supracommissural part of the septal area. The clinical presentation, treatment, and long term survival are discussed.
Combined Transoral and Median Labiomandibular Glossotomy Approach to the Upper Cervical Spine
Authors: Arbit Ehud , Patterson Russel H. 
Published: May 2010

abstract
A surgical approach to the clivus and anterior spine from C-1 to the upper part of C-5 is described. It is a direct approach that provides a wider and longer exposure than does the transoral approach. Despite the seemingly radical incision, the cosmetic deformity and functional loss are minimal. This approach is useful for the surgical treatment of a variety of processes that are situated ventral to the upper cervical spinal cord and the cervicomedullary junction.
Facial Pain Associated with a Middle Fossa Arachnoid Cyst
Authors: Martuza Robert L. , Ojemann Robert G. , Shillito John , Wepsic James G. 
Published: May 2010

abstract
Two cases of anterior middle fossa arachnoid cyst associated with facial pain are reported. In one case a cystoperitoneal shunt provided pain relief: in the other case, no operation was necessary. A discussion of the origin, evaluation, and treatment of arachnoid cysts is presented.
Extramedullary Hematopoiesis Causing Spinal Cord Compression
Authors: Pile-Spellman John , Adelman Lester , Post Kalmon D. 
Published: May 2010

abstract
A case of compressive myelopathy secondary to extramedullary hematopoiesis is presented. The similarities and differences between this disorder and myelopathy secondary to metastatic disease are discussed. If diagnosed early, this condition should improve with treatment.
Use of Anticoagulants, Electroencephalographic Monitoring, and Barbiturate Cerebral Protection in Carotid Endarterectomy
Authors: Gross C. E. , Adams H. P. , Sokoll M. D. , Yamada T. 
Published: May 2010

abstract
This paper describes a treatment protocol for threatened stroke in patients amenable to carotid endarterectomy. The protocol includes the use of perioperative anticoagulation, intraoperative electroencephalographic (EEG) monitoring, and hypertension or barbiturates to protect the brain against documented ischemia intraoperatively. The rationale and methods for protecting the patient from the threat of thromboembolism and cerebral ischemia during each of the periods of specific risk are discussed. The most unique feature of this protocol is the use of thiopental-induced EEG burst suppression for ischemia unresponsive to hypertension during carotid clamping, which has obviated the use of a potentially dangerous and cumbersome in-line arterial shunt.
Delayed Sciatic Palsy after Total Hip Replacement
Authors: Edwards Michael S. , Barbaro Nicholas M. , Asher Stephen W. , Murray William R. 
Published: May 2010

abstract
A 33-year-old woman with a 22-year history of juvenile rheumatoid arthritis developed right lower extremity sciatica 32 months after total hip arthroplasty. Physical examination and electromyography localized the abnormality to the sciatic nerve proximal to the midthigh level, involving the branch to the short head of the biceps femoris muscle. At surgical exploration, a sharp spur of methyl methacrylate, used to cement the acetabular prosthesis to the acetabulum, was found to have eroded through the lateral half of the sciatic nerve. The sciatica was relieved by neurolysis. The etiology of sciatic neuropathy after total hip replacement is reviewed.
Neurinoma of the Abducens Nerve
Authors: Bing-huan Chen 
Published: May 2010

abstract
A patient presented with signs of increased intracranial pressure and a right 6th nerve paresis. The diagnostic evaluation with ventriculography indicated a tumor of the right cerebellopontine angle. At operation a neurinoma arising from the right 6th nerve was encountered. Postoperatively the patient recovered function in her 6th nerve.
Congenital Inclusion Dermoid Cyst of the Anterior Fontanel in a Japanese Infant
Authors: Yuasa Hiroshi , Tokito Sumitaka , Izumi Kazuo , Oyama Mitsuru 
Published: May 2010

abstract
We report an 8-month-old Japanese female infant with a congenital inclusion dermoid cyst of the anterior fontanel. At operation it was located beneath the pericranium. The analysis of the fluid contents of the cyst and the histological findings are described.
Comparison of Percutaneous Radiofrequency Gangliolysis and Microvascular Decompression for the Surgical Management of Tic Douloureux
Authors: Burchiel Kim J. , Steege Timothy D. , Howe John F. , Loeser John D. 
Published: May 2010

Abstract
Forty-two patients with tic douloureux underwent posterior fossa craniectomy and microvascular decompression (MVD) or partial rhizotomy of the trigeminal nerve and were followed an average of 25 months after operation. Thirty-six patients were found to have anatomical distortion of the nerve by an artery, vein, bony prominence, or a combination of factors, and 30 patients (83%) of this group have remained pain-free postoperatively. Six patients had no discernible pathological condition at the time of operation and underwent partial trigeminal rhizotomy. No patient underwent repeated MVD or rhizotomy, although 4 patients whose pain recurred after MVD underwent rhizotomy at a second operation. Eight of the 10 patients treated by rhizotomy are currently pain-free. The overall success rate of the entire group is 90%~2% experienced a complication, and there was 1 perioperative death. Seventy-eight patients with tic douloureux who underwent 92 percutaneous radiofrequency trigeminal gangliolysis (PRTG) procedures were evaluated an average of 56 months postoperatively. Sixty-eight per cent of these patients when evaluated 1 year postoperatively were pain-free. However, only 35% of the PRTG procedures resulted in continued pain relief 5 years after operation. Twelve of the 78 patients (15%) required repeat gangliolysis because of recurrent tic pain. Considering all 78 patients treated with 92 PRTG procedures, 64% were pain-free at follow-up examination. PRTG was associated with an 8% risk of complications, which included anesthesia dolorosa, corneal anesthesia with keratitis, and significant facial paresthesias. Both PRTG and MVD have advantages. MVD should be considered because: (a) it attacks what is believed to be the primary etiology of tic douloureux, (b) the trigeminal nerve is preserved, (c) postoperative pain relief does not depend upon the production of sensory deficit, and (d) it may have a greater potential for producing long-lasting pain relief. However, PRTG has other advantages: (a) it avoids the risks of craniectomy, (b) it is repeated easily if tic pain recurs, (c) morbidity is minimal and therde is essentially no risk of mortality, and (d) it is much less expensive.
Multiple Meningiomas Evaluated by Computed Tomography
Authors: Lusins John O. , Nakagawa Hiroshi 
Published: May 2010

Abstract
There were 15 cases of multiple meningiomas in a consecutive series of 168 cases of meningioma studied by computed tomography during the last 5 years. This incidence of 8.9% is significantly higher than the 1 to 3% incidence reported previously. A brief clinical survey of the 15 cases and a description of the location of the meningiomas as demonstrated by computed tomography are presented. The possible cause of the higher incidence and various theories of the etiology of multiple meningiomas are explored.
Pathogenesis and Prophylaxis of Postlaminectomy Deformity of the Spine after Multiple Level Laminectomy
Authors: Yasuoka Shozo , Peterson Hamlet A. , Laws Edward R. , MacCarty Collin S. 
Published: May 2010

Abstract
The pathogenesis of postlaminectomy spinal deformity and instability in children was evaluated by reviewing appropriate roentgenographic findings. First, we reviewed spine roentgenograms of patients below 40 years of age who underwent spinal fusion for deformity and instability of the spine developing after a multiple level laminectomy. Two types of deformity were recognized on the roentgenograms: increased mobility between the vertebral bodies and wedging deformity of the ventral aspect of the vertebral bodies. Second, we did a follow-up study of another group of patients who had undergone laminectomy. We found the same two types of deformity in children, but not in adult patients. The incidence of deformity was higher after laminectomies of the cervical or cervicothoracic region than after lumbar laminectomies. Our data suggest that postlaminectomy spinal deformity can develop in children without irradiation or facet injury. The deformity is due to a wedging change in the cartilaginous portion of the vertebral body and to the viscoelasticity of ligaments in children. When treatment of this complication becomes necessary, anterior fusion may be effective in arresting progression. Prophylactic measures against the development of deformity are discussed. Our hypothesis concerning the mechanism of development of this complication supports the rationale of osteoplastic laminar resection and reconstruction instead of laminectomy, particularly in the management of children.
Intraspinal Localization of the Somatosensory Evoked Potential
Authors: Cohen Alan R. , Young Wise , Ransohoff Joseph 
Published: May 2010

Abstract
Somatosensory evoked potentials (SEPs) are used widely for monitoring neurophysiological function in experimental spinal injury. Yet the spinal pathways for SEP conduction remain unclear. Consequently, we sought to define specific changes in the SEP after interruption of selected spinal pathways. We activated cortical SEPs with sciatic nerve stimulation in 11 anesthetized (25 mg of pentobarbital per kg) cats after a multilevel thoracic laminectomy. The most consistent wave form component was an initial positivity (IP) at a 17- to 19-ms onset latency. We then used a Cavitron ultrasonic surgical aspirator to interrupt specific spinal pathways. A unilateral dorsal column lesion abolished the ipsilateral IP, but did not affect conduction in the contralateral column. Bilateral dorsal column lesions obliterated the IP, but sometimes left some longer latency components. Interruption of all but the ventral columns abolished the SEPs. When we interrupted all spinal pathways but the dorsal columns, an intact IP remained. In fact, a distinct IP was conducted through a single dorsal column after the division of all other spinal cord pathways. We conclude that, in the barbiturate-anesthetized cat: (a) the most consistent SEP wave form is an initial positivity at a 17- to 19-ms onset latency, (b) the integrity of the dorsal columns is both necessary and sufficient to conduct a normal-appearing IP component of the SEP. (c) the lateral columns may carry some longer latency component of the SEP. (d) the ventral columns carry no component of the SEP, and (e) bilateral recording may be useful for detecting asymmetry of injury.
Chronic Encapsulated Intracerebral Hematoma
Authors: Hirsh Leonard F. , Spector Harvey B. , Bogdanoff Bruce M. 
Published: May 2010

Abstract
Intracerebral hematomas producing chronic neurological disability are reported rarely. Two cases of chronic intracerebral hematoma are described. Each case was associated with a thick, fibrous capsule found histologically to arise from an occult vascular malformation. When such encapsulation is discovered surgically, a vascular anomaly must be suspected.
Epidermoid Tumor of the Cerebellopontine Angle
Authors: Fein Jack M. , Lipow Kenneth , Taati Fashid , Lansem Thomas 
Published: May 2010

Abstract
The extent of spread of an epidermoid tumor in the posterior fossa may be difficult to discern preoperatively. Conventional computed tomographic (CT) studies may not outline the tumor capsule, and the low attenuation of the tumor itself may not allow a distinction from cerebrospinal fluid. CT metrizamide cisternography was helpful in delineating the inferior pole of an epidermoid tumor, which could then be delivered through a transtentorial approach.
Segmental Arachnoiditis after Posterior Fossa Operation
Authors: Epstein Fred , Allen Jeffrey 
Published: May 2010

Abstract
A 16-year-old boy was noted to have an apparent intradural sacral mass 6 weeks after the excision of a 4th ventricle ependymoma. Although spinal axis radiation was considered, it was decided to make a definitive tissue diagnosis. At sacral laminectomy, only segmental arachnoiditis was found. The implications of this finding are the subject of this case report.
Pituitary Hormone Response to Head Injury
Authors: King Lionel R. , Knowles Harvey C. , McLaurin Robert L. , Brielmaier Joan , Piziak Veronica K. 
Published: May 2010

Abstract
Measurements of the serum levels of pituitary hormones were made in six patients with uncomplicated head injury. Samples were obtained at 4-hour intervals for 72 hours to evaluate diurnal rhythms. Three of the six patients revealed elevations of serum growth hormone (GH) and prolactin, but no trends could be established. Likewise, three patients had marked elevations of luteinizing hormone and lesser elevations of follicle-stimulating hormone, but no pattern was discernible. The level of thyroid-stimulating hormone was stable and remained in the normal range throughout. GH was measured after intravenous glucose loading. A paradoxical rise reverted to normal at the late follow-up evaluation. It is suggested that the abnormal levels were related to abnormal hypothalamic function rather than to pituitary damage.
Intratumoral Hemorrhage after a Ventriculoperitoneal Shunting Procedure
Authors: Waga Shiro , Shimizu Takeo , Shimosaka Shinichi , Tochio Hiroshi 
Published: May 2010

Abstract
Ventriculoperitoneal shunting has been accepted as a safe and useful preliminary procedure that lowers the mortality and morbidity of definitive surgery for tumors causing obstructive hydrocephalus. We are reporting four patients with intratumoral hemorrhage as a complication of shunting. The hemorrhage was massive and fatal in two patients, one with an unverified pineal tumor and the other with a malignant astrocytoma of the thalamus. The hemorrhage was small and limited in the other two patients, one with a glioblastoma of the thalamus and the other with a cerebellar astrocytoma. On the basis of this experience, we conclude that the possibility of intratumoral hemorrhage should be taken into consideration when planning the preoperative management of obstructive hydrocephalus caused by brain tumors. It is possible that ventricular decompression may result in rapid motion and distortion of the intracranial structures and a sudden imbalance between intracranial and intratumoral pressures, leading to vascular insufficiency, congestion, and then hemorrhage within the tumor.
Chordoma of the Cervical Spine
Authors: Murali Raj , Rovit Richard L. , Benjamin M. Vallo 
Published: May 2010

Abstract
Etight cases of chordoma limited to the cervical spine are presented. The radiological features are analyzed. Although there is no single diagnostic feature, the combination of osteosclerosis and lysis, multiple vertebral involvement, and the presence of a pre- or paracervical mass is strongly suggestive of a chordoma. Although none of our patients can be considered cured, we recommend an anterior cervical approach with radical removal of the tumor and interbody fusion followed by immobilization in a halo vest and postoperative radiation therapy. The biological behavior of the tumor is extremely variable, and multiple operations for symptomatic recurrences may be helpful.
Postoperative Cervical Pseudomeningocele as a Cause of Delayed Myelopathy
Authors: Helle Todd L. , Conley Frances K. 
Published: May 2010

Abstract
A spinal cord-injured patient developed progressive myelopathy 6 months after operative decompression of the cervicomedullary junction. At the time of the initial operation, the dura mater had been left open. A computed tomographic body scan revealed a cervical pseudomeningocele, which was repaired surgically. After operation, there was reversal of the patient's progressive neurological dysfunction.