bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modified Prone Position for Cranial Remodeling Procedures in Children with Craniofacial Dysmorphism: A Technical Note
Authors: Park T.S. , Haworth Charles S. , Jane John A. , Bedford Robert B. , Persing John A. 
Published: May 2010

Abstract
A new head position for use during operation on young children with cranial deformities is described. The position allows exposure of the entire calvarium from the supraorbital ridges to the posterior rim of the foramen magnum. It is a modification of the conventional prone position involving hyperextension of the neck. The authors have safely used this position to perform one-stage radical cranial remodeling procedures that previously required two stages. The advantages of this position and the methods for achieving it are discussed.
Stereotactic Removal of a Migrating Ventricular Catheter
Authors: Blacklock Bob J. , Maxwell Robert E. 
Published: May 2010

Abstract
Retained ventricular catheters are usually well tolerated but, when infection is present, their removal becomes imperative because such catheters serve as a nidus for persistent infection. Minimally invasive methods for the removal of retained catheters are desirable. The removal of an infected, retained, subcortical ventricular catheter using stereotactic techniques is descrided. The authors think that this method is a safe and effective first step in dealing with this difficult problem.
Spontaneous Intratumoral Hemorrhage after Ventriculoperitoneal Shunting
Authors: Zuccarello Mario , Dollo Carmen , Carollo Carla 
Published: May 2010

Abstract
We report a 1/12-year-old child with an ependymoma in the posterior cranial fossa. As the computed tomographic scan showed evidence of marked triventricular hydrocephalus, the patient underwent ventriculoperitoneal shunting. Two hours after operation, he developed a fatal intratumoral hemorrhage. The indications and contraindications of ventricular external or internal drainage before posterior cranial fossa tumor removal are briefly discussed.
Spontaneous Cerebrospinal Fluid Rhinorrhea: Evolving Concepts in Diagnosis and Surgical Management Based on the Mayo Clinic Experience from 1970 through 1981
Authors: Hubbard Jerry L. , McDonald Thomas J. , Pearson Bruce W. , Laws Edward R. 
Published: May 2010

Abstract
Spontaneous cerebrospinal fluid (CSF) rhinorrhea, occurring in the absence of recent trauma, is a distinct clinical entity that can be difficult to diagnose and treat. The case records of 28 patients with this entity were reviewed retrospectively. Pertinent historical data and the results of radiographic evaluation are discussed. The patients were classified into one of three major etiological categories: congenital anomaly, delayed posttraumatic, and tumor groups. The fistulas causing the rhinorrhea were approached extracranially or intracranially, depending on the suspected cause and location. A cure was obtained in 22 of the 27 patients surgically treated (81%). Seventeen patients were cured by a single operation, 5 were cured after multiple operations, and 5 continued to leak despite surgical treatment. Three of the 5 patients who were surgical failures had intracranial tumors, and 2 of them died from complications of persistent fistulas. With the use of a multidisciplinary team approach, an extracranial operation (transethmoidal or transsphenoidal) to repair a spontaneous CSF leak offers a high success rate and is associated with minimal morbidity in appropriately selected patients.
Surgical Treatment of Spinal Cord Compression in Patients with Lung Cancer
Authors: Sundaresan Narayan , Bains Manjit , McCormack Patricia 
Published: May 2010

Abstract
We analyzed the clinical features, radiological findings, and results of surgical treatment in series of 25 patients with lung cancer and invasion of the spine. In 12 of the 25 (40%) patients, involvement of the spine was present at the time of initial presentation of malignancy. Computed tomography revealed the presence of a large paravertebral soft tissue mass with destruction of adjacent ribs in the majority. The surgical approach consisted of an anterolarteral exposure through a formal thoracotmy in 22 patients and a thoracobadominal flank approach in the 3 patients with lumbar lesions. All gross tumor was resected from the involved paravertebral tissues, vertebral body, and epidural space. Immediate stabilization of the spine was then achieved with methyl methacrylate. Local brachytherapy (iridium-192 implants) was used in 19 patients. After treatment, 87% were ambulatory, and 67% maintained ambulation for more than6 months. Our data suggest that compression of the spinal cord in many patients with lung cancer results from direct extension of tumor through the chest wall. Because the majority of such patients often have localized disease involving the spine, aggressive surgical treatment is indicated.
Posttraumatic Acute Arterial Subdural Hematoma Manifested during Anesthesia
Authors: Mann Kirpal S. , Yue Chung P. , Ho Yik H. , Chan Fu L. 
Published: May 2010

Abstract
Traumatic acute arterial subdural hematomas are rare and are associated with a high mortality rate. The authors report a case in which the initial computed tomographic (CT) scan examination failed to reveal a hematoma. Within the subsequent 4 hours, while recovering from anesthesia given so that hemostasis of bleeding soft tissue injuries could be obtained, the patient suddenly developed bilaterally dilated pupils, both nonreactive to light. A repeat CT scan then revealed large subdural and intracerebral hematomas. The case is discussed and the pertinent literature is reviewed.
Persistent Primitive Trigeminal Artery, Cavum Septi Pellucidi, and Associated Cerebral Aneurysm in a Patient with Polycystic Kidney Disease: Case Report
Authors: Matsumura Masaru , Wada Hirociyo , Nojiri Ken 
Published: May 2010

Abstract
A 51-year-old man with polycystic kidney disease had a persistent primitive trigeminal artery, cavum septi pellucidi, and an unruptured cerebral aneurysm. He had a history of long-standing hypertension, but not of subarachnoid hemorrhage. Computed tomograms revealed cavum septi pellucidi. Because of the polycystic kidney disease, we performed four-vessel cerebral angiography, which revealed a persistent primitive trigeminal artery and a cerebral aneurysm at the bifurcation of the left internal carotid artery. The neck of the aneurysm was clipped successfully without producing any neurological deficit. The clinical significance of the combination of these multiple anomalies and cerebral aneurysms is discussed.
Falcine Chondrosarcoma: Case Report and Literature Review
Authors: Cybulski George R. , Russell Eric J. , D'Angelo Charles M. , Bailey Orville T. 
Published: May 2010

Abstract
We present a case of falcine chondrosarcoma in a 58-year-old man. Only a few other examples of chondrosarcomas in this location and a total of approximately 50 intracranial cases have been reported. Because its rarity prevents any group of neurosurgeons from collecting a large experience in managing this tumor, we reviewed descriptions of previous cases to determine the natural history of intracranial chondrosarcomas. The distinguishing features of this rare tumor are compared with previous examples of intracranial tumors derived from cartilage and more common tumors in the parasagittal region, such as meningioma.
Extradural and Hourglass Cervical Neurinomas: The Vertebral Artery Problem
Authors: George B. , Laurian C. , Keravel Y. , Cophignon J. 
Published: May 2010

Abstract
Eleven cases of cervical neurinomas with an extradural component were operated on with control of the vertebral artery as the first step of the surgical procedure. The lateral anterior approach was used first in each case with excellent results. In the case of hourglass tumors (seven cases), a complementary posterior approach was performed to remove the intradural portion. Primary control of the vertebral artery in cases of extradural or hourglass neurinoma is a logical and safe procedure in the attempt to achieve complete and bloodless tumor removal.
Gunshot Wound to the Pons with Functional Neuroanatomical and Electrophysiological Correlation
Authors: Clark Jonathan B. , Bellegarrigue Roberto B. , Salcman Michael 
Published: May 2010

Abstract
We describe a patient with a gunshot wound to the brain that traversed the left cerebellar hemisphere and terminated in the left lateral midpons. The clinical findings, operative course, neuroradiographic features, and evoked potential data are correlated with the functional anatomy of the pons. It is possible to demonstrate that a local lesion in the lateral pons causes a hemiparesis, worse in the upper extremity, thus suggesting a somatotopic localization of the pontine corticospinal tract not previously described.
Brain Biopsy in Cases of Neonatal Herpes Simplex Encephalitis
Authors: Baumann Robert J. , Walsh John W. , Gilmore Robin L. , Lee Charles , Wong Peter , Wilson H. David , Markesbery William R. 
Published: May 2010

Abstract
Neonatal herpes simplex encephalitis (HSE) can represent a difficult diagnostic problem when it occurs without concomitant mucocutaneus lesions and usually requires brain biopsy for diagnosis. Asymptomatic for the initial 2 to 4 weeks of life, the three infants we describe with localized HSE came to medical attention only because they developed persistent seizures and other nonspecific symptoms. Lumbar spinal fluid obtained from these children at clinical presentation showed an encephalitic pattern. Radionuclide brain scans revealed focal uptake of isotope in a variety of cortical areas, and electroencephalograms (EEGs) demonstrated repetitive, high amplitude, polyphasic sharp waves arising from analogous regions. Computed tomography (CT) showed nonspecific ill-defined areas of low density or contrast enhancement that did not correlate well with radionuclide, EEG, or clinical findings in two neonates. No infant had predominant temporal lobe involvement. Because these data suggested a multifocal, encephalitic process, all three infants underwent brain biopsy. A widespread infiltration of leukocytes and macrophages was observed in each specimen, and abundant intranuclear inclusions were present. Electron microscopy revealed abundant herpesvirus particles, and herpes simplex virus (HSV) was subsequently isolated from each sample. From our observations and our review of the literature, we propose the following criteria as indications for brain biopsy: Brain biopsy is warranted to rule out HSE when a neonate presents with seizures, cerebrospinal fluid mononuclear pleocytosis with a negative gram stain, and focal, cortical disease on EEG and radionuclide scan. Additionally, a history of maternal genital HSV infection is helpful but may be absent, the child may have an asymptomatic interval after birth, the CT data can be nonspecific, and, in contrast to adults and older children, neonates with HSV typically lack temporal lobe involvement. Early diagnosis combined with prompt institution of appropriate antiviral therapy could reduce the mortality and morbidity from this destructive illness.
Simulation of a Prolactin-secreting Adenoma by an Intrasellar Craniopharyngioma
Authors: Gamblin George T. , James L. Patrick , Thomas John , Six Eric , Eil Charles 
Published: May 2010

Abstract
We report here an unusual case of a 21-year-old woman who presented with amenorrhea, galactorrhea, and hyperprolactinemia (66 to 81 ng/ml) secondary to an unsuspected intrasellar craniopharyngioma. The results of preoperative endocrine testing were compatible with the presence of a prolactin-secreting adenoma. Moreover, high resolution computed tomographic scanning revealed an uncalcified hypodense sellar mass that did not enhance after contrast administration, a feature shared by many prolactinomas. This report illustrates that amenorrhea, galactorrhea, mild to moderate hyperprolactinemia, and a sellar mass should not automatically be attributed to the presence of a prolactin-secreting adenoma.
Technical Note: The Use of Nitroglycerin Ointment after Precarious Neurosurgical Wound Closure
Authors: Lehman Ralph A.W. , Page Robert B. , Saggers Gregory C. , Manders Ernest K. 
Published: May 2010

Abstract
It is suggested that the application of nitroglycerin ointment to neurosurgical wound closure exhibiting skin pallor or cyanosis can minimize necrosis and dehiscence. Examples of the use of this agent in patients undergoing myelomenin-gocele closure as well as in a premature infant undergoing ventriculoperitoneal shunting are described.
Magnetic Resonance Imaging of Acoustic Neuromas
Authors: DeFilipp Gary J. , Buchheit William A. 
Published: May 2010

Abstract
Ten patients with neurosensory hearing loss and computed tomographic (CT) evidence of acoustic neuromas were evaluated with magnetic resonance imaging (MRI). Tumors ranged in size from 0.8 to 3.7 cm. With the use of spin echo pulse sequences, all tumors were identified by MRI and appeared as masses with signal intensities greater than that of cerebrospinal fluid and equal to or greater than that of brain stem. Two patients who previously had undergone operation for acoustic neuromas were evaluated with MRI. In one patient with CT evidence of tumor recurrence, the lesion could not be identified by MRI. MRI holds promise of becoming a primary diagnostic modality for the evaluation of acoustic neuromas.
Limitations of Brain Stem Auditory Evoked Potentials for Intraoperative Monitoring during a Posterior Fossa Operation: Case Report and Technical Note
Authors: Piatt Joseph H. , Radtke Rodney A. , Erwin William C. 
Published: May 2010

Abstract
We have encountered an example of the insensitivity of brain stem auditory evoked potentials (BAEPs) for monitoring the brain stem during a posterior fossa operation. the addition of somatosensory evoked potential recording to conventional BAEP protocols is readily accomplished and is likely to improve the sensitivity of intraoperative electrophysiological assessment of brain stem function.
Chronic Encapsulated Intracerebral Hematoma during Infancy: Case Report
Authors: Terada Tomoaki , Okuno Takashi , Moriwaki Hiroshi , Nakai Ekini , Komai Norihiko 
Published: May 2010

Abstract
Chronic encapsulated intracerebral hematoma is a rare condition. Only four cases have been reported. The cause of this condition is unclear. A case of chronic encapsulated intracerebral hematoma in an 1-year-old infant is reported, and the characteristic findings and their causes are discussed with a literature survey.
Cranial Asymmetry and Lambdoid Synostosis in a Sibship
Authors: Lohse Dean C. , Duncan Charles C. , Ment Laura R. 
Published: May 2010

Abstract
In craniosynostosis, as in all congenital diseases, the interaction of hereditary and neonatal environmental factors can be separated only in rare cases. Four siblings with an asymmetry of the posterior right portion of the skull are presented. The youngest of the four suffered from severe cyanotic congenital heart diseases and secondarily suffered from ischemic/hypoxic cerebral injury. This child had complete synostosis of the right lambdoid and posterior sagittal sutures by the age of 5½; months. The cranial asymmetry was less pronounced in each of the older children and was nearly undetectable in the oldest, a 7½;-year-old girl. True synostosis was not present in any of the older siblings. It is suggested that an autosomal-dominant hereditary condition caused a hypotrophic mesenchymal relationship of occipitotemporal ontogenesis. This condition was compensated for through childhood by the molding effect of the brain in the older three siblings. The systemic disease and delayed cerebral growth in the youngest probably led to the complete picture of craniosynostosis.
Accessory Nerve Neurinoma Mimicking a Brain Stem Tumor on Angiography: Report of a Case
Authors: Matsushima Toshio , Fukui Masashi , Matsunaga Masayuki , Kitamura Katsutoshi , Hasuo Kanehiro 
Published: May 2010

Abstract
A case of accessory nerve neurinoma presenting with a so-called “intraaxial mass sign” on the angiograms is reported. The tumor originated from the intracranial portion of the accessory nerve and displaced the lateral medullary segment of the posterior inferior cerebellar artery posterolaterally. The displacement of the artery can be understood by the microanatomical relations.
Sacral Fracture with Pseudomeningocele and Cerebrospinal Fluid Fistula: Case Report and Review of the Literature
Authors: Hadley Mark N. , Carter Philip L. 
Published: May 2010

Abstract
A patient who sustained an isolated transverse sacral fracture is presented. A large ventral sacral pseudomeningocele with cerebrospinal fluid (CSF) fistula developed. Eighteen previous cases of traumatic pseudomeningocele have been documented. A review of those cases leads these authors to conclude that: (a) transverse sacral fractures are rare and have not been reported in association with a pseudomeningocele formation; (b) at the 4th sacral vertebra, this is the lowest reported pseudomeningocele; and (c) CSF fistula with sacral fracture is distinctly uncommon, reported in only one previous case. The presenting symptoms, diagnostic evaluation, treatment, and prognosis are discussed.
Intraventricular Morphine in Paraneoplastic Painful Syndrome of the Cervicofacial Region: Experience in Thirty-eight Cases
Authors: Lenzi Aberto , Galli Giuseppe , Gandolfini Massimo , Marini Giovanni 
Published: May 2010

Abstract
The authors report their personal experience with the administration of microdoses of morphine hydrochloride by the intraventricular route through a subcutaneous reservoir for the treatment of paraneoplastic painful syndrome of the cervicofacial region in 38 patients. The results obtained are very encouraging.
Cystic Supratentorial Gliomas: Natural History and Evaluation of Modes of Surgical Therapy
Authors: Loftus Christopher M. , Copeland Brian R. , Carmel Peter W. 
Published: May 2010

Abstract
The management of cystic supratentorial gliomas is hampered by lack of documentation of the natural history of these lesions and by a lack of evaluation of modes of surgical therapy. We analyzed these factors in 25 patients with solitary cysts operated upon over a 20-year period. Two distinctive patterns of symptoms were seen: short duration (increased pressure and hemiparesis), most often heralding a malignant lesion, and long duration (commonly seizure disorder), associated more often with a benign pathological condition. Large solitary cysts were found in tumors of all histological grades. Surgical procedures included extirpation, biopsy/partial resection, cyst communication to ventricle or marsupi-alization, burr hole aspiration, aspiration via an indwelling reservoir, and cyst-peritoneal shunting. Radiotherapy, given in all cases, did not prevent cyst recurrence. Of the 25 patients, 76% are alive and remain cystfree at follow-up intervals of 1 to 16 years (mean, 3.2). Five patients died from their tumors, with a mean survial of 33 months after decompression. In 7 of 8 patients with cysts largely or entirely within the basal ganglia or thalamus, successful operative cyst control was achieved. Patients with solitary cystic gliomas seem to have a favorable prognosis, and vigorous efforts to control cyst recurrence and limit disability are warranted. Analysis of our data suggests that craniotomy for tumor resection, cyst decompression, and tissue diagnosis is the initial procedure of choice. Cyst recurrence without major solid tumor should be controlled by computed tomography-guided tap or shunt drainage. Reexploration is indicated when cyst reaccumulation is accompanied by clear regrowth of a solid component.
The “Hyperacute” Extraaxial Intracranial Hematoma: Computed Tomographic Findings and Clinical Significance
Authors: Greenberg Jonathan , Cohen Wendy A. , Cooper Paul R. 
Published: May 2010

Abstract
Thirteen patients with acute subdural and epidural hematomas were found to have fresh, unclotted blood at the time of surgical decompression several hours after injury. Computed tomographic (CT) scans of these patients demonstrated areas of hyperdensity, corresponding to clotted hematoma, admixed with areas of isodensity, corresponding to liquid blood. Active bleeding from identifiable loci was found in 11 patients, 4 of whom had massive hemorrhages. Clotting abnormalities ranging from slightly elevated laboratory test results to a full-blown clinical picture of disseminated intravascular coagulation occurred in 8 patients. We describe the CT pictures of these “hyperacute” lesions, and we postulate that such CT presentations indicate either the presence of ongoing active intracranial bleeding or the onset of a coagulopathy complicating the management of these lesions.
Multiple Unusual Aneurysms and Arteriovenous Malformation in a Single Patient: A Case Report
Authors: Nehls Daniel G. , Carter Philip L. 
Published: May 2010

Abstract
A patient with multiple unusual aneurysms and an arteriovenous malformation (AVM) is presented. Aneurysms involving the meningohypophyseal trunk and the feeding vessel of the AVM were observed. Two additional aneurysms assumed a pantaloon appearance. The largest aneurysm was responsible for the patient's subarachnoid hemorrhage. This aneurysm and two adjacent aneurysms were clipped successfully, and the patient made an uneventful recovery. Subsequent angiography revealed a stable appearance of the remaining aneurysms and AVM. (Neurosurgery 17:97-100, 1985)
Evaluation of Spinal Cord Stimulation for Postapoplectic Spastic Hemiplegia
Authors: Nakamura Saburo , Tsubokawa Takashi 
Published: May 2010

Abstract
We used spinal cord stimulation (SCS) in patients with postapoplectic spastic hemiplegia in an attempt to reduce the spasticity. Three patients with spastic hemiplegia due to apoplexia were selected for the treatment. Reduction of spasticity was observed 3 to 9 days after the stimulation. Electrophysiological evaluation of the spasticity from the H reflex revealed a remarkable improvement in all three patients. The mechanism of reduction of spasticity has not yet been clarified, although a direct or indirect effect on the reticulospinal tract is thought to play a role.
An Unusual Spinal Meningioma in a Child: Case Report
Authors: Liu Hsiu Chih , De Armond Stephen J. , Edwards Michael S. B. 
Published: May 2010

Abstract
Meningiomas seldom occur in children, and spinal meningioma in a child is rare. We report the case of a boy, 3 years and 5 months of age, who had an unusual atypical meningioma involving the subarachnoid space from T-2 to the cauda equina. To our knowledge, no similar case has been reported previously.
Spinal Cord Compression Due to Postoperative Cervical Pseudomeningocele
Authors: Hanakita Junya , Kinuta Yuji , Suzuki Takanori 
Published: May 2010

Abstract
A case of spinal cord compression due to postoperative cervical pseudomeningocele is reported. A 63-year-old man had undergone osteoplastic laminectomy of the C-3 through C-6 laminae for quadriplegia after a traffic accident 1 year and 4 months earlier. Computer-assisted tomography with metrizamide injection showed a pseudomeningocele in the paraspinous area at the C-3 through C-6 level.
Giant Aneurysm of an Azygos Anterior Cerebral Artery: Report of Two Cases and Review of the Literature
Authors: Hayashi Minoru , Kobayashi Hidenori , Kawano Hirokazu , Handa Yuji , Kabuto Masanori 
Published: May 2010

Abstract
The authors present two cases of a largely thrombosed giant aneurysm of an azygos anterior cerebral artery. An aneurysm of an azygos artery is rare, and a giant aneurysm in this location is extremely rare.