bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regrowth Patterns of Supratentorial Gliomas: Estimation from Computed Tomographic Scans
Authors: Tsuboi Koji , Yoshii Yoshihiko , Nakagawa Kunio , Maki Yutaka 
Published: May 2010

Abstract
To clarify the regrowth patterns of benign and malignant gliomas, we chose 27 intervals (between two operations or between an operation and autopsy) from 21 patients with pathologically verified recurrent supratentorial gliomas. Serial computed tomographic (CT) scans of these cases were analyzed to determine (a) the doubling time (Td) calculated from the change in volume of enhanced and low density areas, (b) the enhancement effect graded from 0 to 4 according to the Hounsfield number, and (c) the presence of dissemination and contralateral extension. We studied 5 benign gliomas (including 1 case of radiation necrosis), 8 malignant astrocytomas, and 8 glioblastomas. The Td's of enhanced areas on CT scans of benign gliomas, malignant astrocytomas, and glioblastomas were 937 ± 66.5 days, 65.1 ± 29.4 days, and 48.1 ± 20.9 days, respectively. The Td's of low density areas were 895 ± 130.6 days, 70.8 ± 22.2 days, and 50.5 ± 14.7 days. There was a significant correlation between the Td's of the enhanced and low density areas (0.97). The enhancement effect increased at recurrence in 55% of the cases, with an average increase of 1.1 grades. The increase in enhancement effect at recurrence showed a tendency to become smaller as the tumor's degree of anaplasia increased. Radiotherapy was effective in significantly retarding the growth rate of malignant gliomas, whose Td's were doubled. Although the Td's of both enhanced and low density areas of benign gliomas were significantly longer than those of malignant gliomas, there was no significant difference in the Td's of enhanced areas between malignant astrocytomas and glioblastomas. Dissemination and contralateral extension occurred at almost the same ratios in malignant astrocytomas and glioblastomas at recurrence. These data indicate that the regrowth pattern of malignant astrocytoma closely resembles that of glioblastoma in spite of morphological distinction. This method was easy and practical for evaluating the biological malignancy of supratentorial gliomas from CT scans, and it can offer us useful clinical information.
Successful Intraspinal Extradural Sacral Nerve Stimulation for Bladder Emptying in a Victim of Traumatic Spinal Cord Transection
Authors: Talalla Andrew , Bloom Joseph W. , Nguyen Quang 
Published: May 2010

Abstract
This report concerns a patient with a functionally complete spinal cord transection due to trauma at T-6. Her clinical syndrome of a motor and sensory paraplegia was accompanied by hyperreflexic detrusor dysfunction. Radiofrequency-coupled bilateral stimulation of the 3rd sacral nerves in their intraspinal but extradural course achieved reliable, effective emptying of the bladder. This single case suggests that successful stimulation of the sacral neural outflow may not require intrathecal placement of stimulating electrodes, sensory rhizotomy, or pudendal neurotomy. (Neurosurgery 19:955-961, 1986)
Operative Exposure and Management of the Petrous and Upper Cervical Internal Carotid Artery
Authors: Sekhar Laligam N. , Schramm Victor L. , Jones Neil F. , Yonas Howard , Horton Joseph , Latchaw Richard E. , Curtin Hugh 
Published: May 2010

Abstract
The exposure and operative management of the petrous and upper cervical internal carotid artery (ICA) in 29 patients is detailed. Twenty-seven of these patients had extensive cranial base neoplasms (benign or malignant), 1 had an inflammatory cholesteatoma, and 1 had an aneurysm of the upper cervical ICA immediately proximal to the carotid canal. Preoperative studies useful in the evaluation of these patients included computed tomography, magnetic resonance imaging, cerebral and cervical angiography, and a balloon occlusion test of the ICA with evaluation of neurological status and of cerebral blood flow. The exposure of the upper cervical and petrous ICA was useful to obtain proximal control of the cavernous ICA, aided in the operative approach to extensive petroclival, intracavernous, and parapharyngeal neoplasms, and enabled the total resection of 23 of 27 such tumors. A subtemporal and preauricular infratemporal fossa approach was most commonly used for the exposure of the artery. Intraoperative arterial management consisted of exposure and decompression only, dissection from encasing neoplasm, resection of the invaded arterial segment and vein graft reconstruction, or intentional arterial occlusion. Vascular complications included 1 stroke due to delayed arterial occlusion, 1 stroke and death due to infection spreading from the nasopharynx with bilateral ICA rupture, and 1 pseudoaneurysm formation secondary to wound infection necessitating postoperative balloon occlusion of the ICA. Nonvascular complications included facial nerve paralysis in 10 patients (usually temporary), glossopharyngeal and vagal paralysis in 13 patients requiring Teflon injection of the vocal cord in 9, temporary difficulties with mastication in 9 patients, and wound infection in 3. The surgical exposure and management of the upper cervical and petrous ICA may permit a total operative resection of extensive cranial base neoplasms and is also an alternative for the management of vascular lesions involving these segments of the artery. With malignant neoplasms extending from the nasopharynx, postoperative infection remains a problem and may best be resolved by the use of a vascularized rectus abdominis muscle flap to reconstruct defects of the nasopharynx. Bilateral ICA encasement by neoplasms is also a major problem to be solved. The value of such an aggressive approach to the management of malignant neoplasms remains to be proven.
Mural Tumors with Cysts in the Cerebral Hemispheres of Children
Authors: Tomita Tadanori , McLone David G. , Naidich Thomas P. 
Published: May 2010

Abstract
Thirteen infants and children with mural tumors (i.e., cysts with mural nodules) in the cerebral hemisphere are presented. The tumors comprise five benign astrocytomas, three ependymomas, two choroid plexus papillomas, one oncocytoma, one hamartoma, and one primitive neuroectodermal tumor. Computed tomography showed well-enhanced mural nodules. Cyst walls did not enhance in any but one, in which the enhancement was attributed to hemorrhage in the cyst. None of the cyst walls contained neoplastic cells. Cerebral angiography was performed in all patients, and five showed extensive vascularity in the tumor nodule. The importance of preoperative angiography is emphasized. Total extirpation of the mural nodule without excision of the cyst wall led to excellent prognosis for these patients.
Unilateral S-1 Root Compression Syndrome Caused by Fracture of the Sacrum
Authors: Epstein Nancy E. , Epstein Joseph A. , Carras Robert 
Published: May 2010

Abstract
Unilateral S-1 nerve root compression after an S-1 sacral fracture was found in an 18-year-old man after a motor vehicle accident. The positive myelogram, myelogram-computed tomogram, and magnetic resonance studies led to surgical intervention. Marked bony callous formation contiguous with the S-1 alar fracture protruded into the canal and was responsible for tethering the S-1 nerve root. A right L-5 hemilaminectomy, an L-4, L-5 and L-5, S-1 medial facetectomy, and foraminotomy facilitated nerve root decompression. Postoperatively, the patient was markedly improved. The authors suggest a more aggressive attitude in the diagnostic, radiographic, and surgical management of sacral fractures now that more specific technical facilities are available to define the precise character of the lesions involved.
Metastasizing Meningioma
Authors: Russell Tom , Moss T. 
Published: May 2010

Abstract
A very unusual case of metastatic spread of a meningioma is described. The clinical presentation was of extradural spinal cord compression, without evidence of a primary tumor. Computed tomography did not reveal any intracranial meningioma; the histopathology of the extradural spinal tumor was identical with that of two intracranial meningiomas previously excised.
Carotid Artery Occlusion and Ocular Ischemia: Therapy Control with Evoked Potentials
Authors: Mehdorn Maximilian H. , Nau Heinz-Eugen , FÖrster Michael 
Published: May 2010

Abstract
We present a patient with internal carotid artery occlusion and ischemic oculopathy in whom extracranial-intracranial arterial bypass improved vision. Visual evoked potentials were studied to obtain objective criteria for indication and follow-up evaluation and confirmed that the improved vision was due to improved retinal function. (Neurosurgery 19:1031-1034, 1986)
Neurofibromatosis Presenting with Aqueductal Stenosis Due to a Tumor of the Aqueduct: Case Report
Authors: Hosoda Kohkichi , Kanazawa Yasuhisa , Tanaka Junichi , Tamaki Norihiko , Matsumoto Satoshi 
Published: May 2010

Abstract
A 17-year-old boy with neurofibromatosis presented with delayed puberty and epileptic seizures of recent onset. A computed tomographic scan revealed aqueductal stenosis due to a tumor of the aqueduct. This tumor was found at autopsy to be a pilocytic astrocytoma. Aqueductal stenosis in neurofibromatosis is uncommon and has been considered to be a result of periaqueductal gliosis. This seems to be the first report of neurofibromatosis associated with a tumor of the aqueduct.
Burning Hands Syndrome Revisited
Authors: Wilberger James E. , Abla Adnan , Maroon Joseph C. 
Published: May 2010

Abstract
The burning hands syndrome of spinal cord injury was first described in 1977. The syndrome is characterized by burning dysesthesias and paresthesias in the hands and may be associated with either cervical fracture/dislocation or no detectable cervical spine abnormalities. A case of burning hands syndrome without cervical spine injury is presented in which somatosensory evoked potentials and magnetic resonance imaging were used to delineate the pathophysiology of this syndrome.
Contralateral Trigeminal Neuralgia as a False Localizing Sign in Intracranial Tumors
Authors: Florensa R. , Llovet J. , Pou A. , Galitó E. , Vilato J. , Colet S. 
Published: May 2010

Abstract
Three cases of contralateral trigeminal neuralgia as a false localizing sign in intracranial tumors are reported. In each patient (meningioma, 2 cases; cholesteatoma, 1 case) the tumor was asymptomatic, so that intracranial tumor had not been suspected preoperatively. In all cases, tumors were large and firm. The tumor was supratentorial in two cases. In one case, a cortically mediated mechanism may have caused the neuralgia, whereas in the remaining two cases distortion and displacement of the brain stem and compression of the contralateral Meckel's cave would explain the trigeminal nerve signs.
Cisternal Drainage after Early Operation of Ruptured Intracranial Aneurysm
Authors: Kawakami Yasuto , Shimamura Yutaka 
Published: May 2010

Abstract
The authors reviewed 22 cases of intracranial aneurysm of the anterior part of the circle of Willis. All patients presented with the signs and symptoms of subarachnoid hemorrhage (SAH) and were in good neurological condition on admission. In all cases, early operation was performed to obliterate aneurysm. Subarachnoid blood clots were extensively removed and cisternal drainage was done. With topical application of povidone-iodine and intravenous administration of antibiotics, cisternal drainage continued for 14 days or more after the onset of SAH in 21 cases. Five patients developed symptomatic vasospasm, which was treated with hypervolemia and hypertension, and three received shunts later for chronic hydrocephalus. The overall result demonstrated that 21 patients were independent and had returned to their previous social lives. Therefore, it was strongly recommended that patients is good neurological condition after SAH secondary to ruptured intracranial aneurysm be treated with early operation, removal of subarachnoid clots, and long term application of cisternal drainage.
Acute Hydrocephalus after Aneurysmal Subarachnoid Hemorrhage
Authors: Milhorat Thomas H. 
Published: May 2010

Abstract
The incidence and clinical aspects of acute hydrocephalus were examined in 200 patients with recently ruptured intracranial aneurysms. The following conclusions were reached: (a) Acute hydrocephalus is an important complication of aneurysmal subarachnoid hemorrhage that occurs in approximately 20% of all cases and exhibits an incidence that tends to parallel clinical grade (Grade I, 3%; Grade II, 5%; “Good” Grade III, 21%; “Bad” Grade III, 40%; Grade IV, 42%; Grade V, 26%). (b) Impaired consciousness leading to a general downgrading of clinical status was the predominant clinical finding (93%), but neither this nor other nonspecific signs of increased intracranial pressure were distinguishable from the effects of the precipitating hemorrhage. (c) The computed tomographic signs of acute hydrocephalus are distinctive and consist of selective ballooning of the frontal horns, rostral-caudal enlargement of the cerebral ventricles, and a halo of periventricular hyperdensity (edema) that evolves in sequence with ventricular changes. (d) The treatment of choice is external ventricular drainage, which results in prompt and often dramatic improvement in approximately two-thirds of the patients.
Moyamoya Disease Presenting as Intracerebral Hemorrhage during Pregnancy: Case Report and Review of the Literature
Authors: Enomoto Hitomi , Goto Hiroshi 
Published: May 2010

Abstract
Intracranial hemorrhage during pregnancy is rare. The authors present a case of moyamoya disease associated with pregnancy. A 32-year-old woman who was at 32 weeks of gestation experienced sudden severe headache followed by loss of consciousness. Computed tomography revealed an intracerebral hematoma in the left temporal lobe, and left carotid angiograms revealed moyamoya disease. The patient underwent emergency craniotomy, the hematoma was removed, and encephaloduroarteriosynangiosis was performed. The patient showed good recovery and, 2 months later, delivered a child vaginally without any trouble. Most intracranial hemorrhages during pregnancy result from cerebral aneurysms or arteriovenous malformations (AVMs), and few cases due to moyamoya disease have been reported. It is generally believed that subarachnoid hemorrhage due to cerebral aneurysms is likely to occur during the middle trimester of gestation, with the risk increasing progressively toward the third trimester. This may be explained by the fact that the cardiac output increases rather acutely from the first to the middle trimester. There seems to be no significant correlation between the stage of pregnancy and the occurrence of hemorrhage due to AVM. Most authors think that the operative indications for intracranial hemorrhage during pregnancy should be the same as for the nonpregnant state.
Raeder's Syndrome Associated with Intracranial Internal Carotid Artery Aneurysm
Authors: Kashihara Kengo , Ito Haruhide , Yamamoto Shinjiro , Yamano Kiyotoshi 
Published: May 2010

Abstract
Raeder's syndrome consists of oculosympathetic paresis and ipsilateral facial pain, with variable involvement of the trigeminal and oculomotor nerves. A 63-year-old woman experienced severe facial pain, a partial Horner's syndrome, and restriction of ocular movements on the left side. A left carotid angiogram disclosed a giant aneurysm of the cavernous portion of the internal carotid artery. This is the third reported case of Raeder's syndrome due to aneurysm of the intracranial internal carotid artery. Her facial pain was relieved by carotid ligation, and serial computed tomographic scans showed decrease of aneurysmal size.
Pituitary Apoplexy, Bilateral Carotid Vasospasm, and Cerebral Infarction in a 15-Year-Old Boy
Authors: Pozzati Eugenio , Frank Giorgio , Nasi Maria Teresa , Giuliani Giuliano 
Published: May 2010

Abstract
The authors report a case of pituitary apoplexy associated with oculomotor defects and focal cerebral signs; the visual pathways were intact. Computed tomography documented a mass of heterogeneous density within an enlarged sella turcica and a right parietal infarct. Angiograms revealed bilateral carotid spasm and occlusion of the right angular artery. Treatment was conservative. Control angiograms showed spontaneous resolution of the vasospasm and recanalization of the cortical artery. The patient made a complete neurological recovery; he needed only treatment with vasopressin due to transient diabetes insipidus. The risk of vasospasm and brain ischemia should be kept in mind when treating pituitary apoplexy. The early occurrence of vasospasm in our case suggests the participation of powerful vasoactive agents liberated from the tumor.
Civilian Gunshot Wounds to the Spinal Cord and Cauda Equina
Authors: Benzel Edward C. , Hadden Theresa A. , Coleman James Edward 
Published: May 2010

Abstract
We evaluated 42 patients with neurological deficits after civilian gunshot wounds to the spine. Thirty-five of these patients (the study population presented here) received their initial and follow-up care at Louisiana State University Medical Center in Shreveport over a 4-year period. Each patient had incurred a single gunshot wound to the spinal cord or cauda equina with an accompanying neurological deficit. The patient population was divided into three groups. Group 1 patients had incurred a complete motor and sensory loss below the injury (20 patients (57%)). Group 2 patients had incurred incomplete spinal cord injuries (9 patients (26%)), whereas Group 3 patients had cauda equina injuries (6 patients (17%)). Myelography was performed for all Group 2 and 3 patients as well as Group 1 patients in whom the trajectory of the bullet did not explain a higher level of neurological injury (3 patients (15%)). A decompressive operation was performed in the patients whose myelography showed neural compression. Three patients in Group 1 (15%), 5 patients in Group 2 (56%), and 5 Group 3 patients (83%) underwent operation. All 3 Group 1 patients who underwent operation had some improvement of nerve root function postoperatively. All operated Group 2 and 3 patients had improvement of myelopathic or radicular function postoperatively. All began improving within several days of operation, implying a cause and effect relationship. None of the 17 nonoperated Group 1 patients improved neurologically, whereas 3 of the 4 nonoperated Group 2 patients improved. The single nonoperated Group 3 patient improved neurologically. It is concluded that patients with incomplete neurological injuries after civilian gunshot wounds to the spine can expect radicular or myelopathic improvement. Decompressive operation is indicated in selected cases with unexpected radicular injuries or incomplete myelopathic injuries with myelographic evidence of neural compression. A stepwise improvement in neurological function over that expected without operation should be realized in these cases.
Synovial Cyst of the Cervical Spine
Authors: Jabre Anthony , Shahbabian Set , Keller Jeffrey T. 
Published: May 2010

Abstract
A case of acute posttraumatic myelopathy resulting from hemorrhage into synovial cysts bilaterally at the C-6, C-7 facet joints is presented. The pathogenesis of synovial cysts remains unclear, although reports in the literature have implicated trauma leading to cyst enlargement. Hemorrhage into the cavity of the synovial cysts resulted in epidural compression of the spinal cord in this patient. Because spinal synovial cysts cannot be unequivocally diagnosed preoperatively, other more common conditions must be considered in the differential diagnosis. Radiographic analysis including plain films, computed axial tomography, and metrizamide myelography are of value in establishing a neurological diagnosis. Surgical decompression and excision of the lesion may result in significant neurological improvement.
Lumbar Spinal Stenosis Associated with Renal Osteodystrophy
Authors: Spatola Mark A. , Apfelbaum Ronald I. 
Published: May 2010

Abstract
A case of coexisting lumbar spinal stenosis and renal osteodystrophy is reported. The presence of renal osteodystrophy is known to have predated the onset of neurological complaints. The patient's symptoms were relieved with surgery. Although a causative relationship between renal osteodystrophy and spinal stenosis has not been reported previously, it seems likely in this case.
Persistent Nerve Root Compression by Buckling of the Longitudinal Ligament after Chemonucleolysis
Authors: Beatty Robert M. 
Published: May 2010

Abstract
Buckling of the posterior longitudinal ligament with compression against the thecal sac was the cause of persistent positional back pain after chemonucleolysis. Computed tomography in the supine and prone positions was helpful in making the diagnosis, and the cause was confirmed at laminectomy.
Metrizamide-enhanced Computed Tomography as an Adjunct to Metrizamide Myelography in the Evaluation of Lumbar Disc Herniation and Spondylosis
Authors: Voelker Joseph L. , Mealey John , Eskridge Joseph M. , Gilmor Richard L. 
Published: May 2010

Abstract
Eighty patients with operatively proven lumbar disc herniation or lumbar spondylosis were preoperatively evaluated with metrizamide myelography followed by metrizamide-enhanced computed tomography (CT). The x-ray films were reviewed without knowledge of the operative findings, and the patients were subdivided into those with disc extrusions, spondylosis, or recurrent abnormalities. For the group as a whole, CT was correct in 82% and myelography was correct in 77%. Both CT and myelography together were accurate in 91%, a significant improvement (P&lt;0.02). The authors conclude that, if both studies are performed, the percentage of cases correctly diagnosed is increased. Therefore, both metrizamide myelography and metrizamide-enhanced CT should be obtained in selected cases. A review of the literature is included.
Electrophysiological Monitoring during Basilar Aneurysm Operation
Authors: Little John R. , Lesser Ronald P. , Luders Hans 
Published: May 2010

Abstract
Intraoperative brain stem auditory evoked potential (BAEP) and somatosensory evoked potential (SEP) monitoring was evaluated in 16 patients each undergoing intracranial operation for basilar artery aneurysm. The 16 patients had 18 posterior circulation aneurysms, including 2 patients with 2 aneurysms. Fourteen aneurysms arose from the rostral basilar artery, 2 arose from the midbasilar artery, 1 arose from the vertebrobasilar junction, and 1 arose from the proximal segment of the posterior cerebral artery. Five aneurysms were classified as giant (i.e., &gt;25 mm), and 5 aneurysms were large (i.e., 15 to 25 mm). Ten patients had BAEP and SEP monitoring, 4 had BAEP monitoring only, and 2 had SEP monitoring only. Two patients showed significant abnormalities during operation, including 1 patient with transient changes in the BAEP when the lower pons and the 8th cranial nerve were retracted. Another patient had progressive increases in latency and decreases in amplitude and subsequent loss of the SEP cortical components during a period of intermittent temporary rostral basilar artery occlusion. Wave P13 was also lost during that period. The cortical components as well as Wave P13 returned after circulation was restored. The BAEPs were unchanged in the same patient during the period of temporary basilar artery occlusion. Fourteen patients had no significant abnormalities. There were no consistent changes during the various stages of operation. BAEP and SEP monitoring failed to identify ischemic events in 4 patients with neurological findings of brain stem ischemia immediately after operation (i.e., 25% false-negative studies). Failure of these techniques to predict brain stem ischemia seemed to be the result of two factors: (a) the ischemic events involved relatively small areas and (b) the ischemic zones did not include the neural pathways that were being monitored. These limitations were particularly relevant for the aneurysm at the basilar bifurcation, the most common location for posterior circulation aneurysm.