bluuebunny/crossref_metadata_2025_split huggingface dataset:
Causes of Unfavorable Outcome after Early Aneurysm Operation
Authors: Ljunggren Bengt , Säveland Hans , Brandt Lennart 
Published: May 2010

Abstract
In a consecutive series of 160 patients in Hunt and Hess Neurological Grades I to III who were operated upon for a ruptured supratentorial aneurysm within 3 days after the hemorrhage, 42 patients (26%) had an unfavorable outcome. Delayed ischemic cerebral dysfunction with permanent deficit accounted for the unfavorable outcome in 18 patients (43% of all unfavorable results or 11% of the total series), whereas the unfavorable outcome was due to deficit ascribed to surgical trauma in 11 patients (26% of all unfavorable results or 7% of the total series) and to the initial hemorrhage in 7 patients (17% of all unfavorable results or 4% of the total series). Impaired outflow of cerebrospinal fluid with shunt dependency occurred in 3% of the total series. Of the patients with an unfavorable outcome, 17 (40%) had had arterial hypertension before the hemorrhage. The incidence of unfavorable outcome in good grade patients (Grades I and II) was not influenced by timing of operation (Day 1, 2, or 3 after hemorrhage). The results favor the opinion that it is principally the patient's condition during the acute stage that determines the outcome.
Factors in Predicting Outcome from Operation in Patients with Prolactin-secreting Pituitary Adenomas
Authors: Nelson Paul B. , Goodman Michael , Maroon Joseph C. , Martinez A. Julio , Moossy John , Robinson Alan G. 
Published: May 2010

Abstract
Forty female patients with pituitary adenomas were studied retrospectively to determine whether factors could be identified that would help predict outcome from operation. Twenty-five patients had a normal prolactin level (⩽30 ng/ml) during the early postoperative period (⩽3 months) and 15 patients had persistent disease (prolactin &gt; 30 ng/ml). Nine of the 25 patients who initially had normal prolactin levels during the early postoperative period were found to have elevated prolactin levels during the late postoperative period (&gt;3 months). As has been shown previously, tumor size and preoperative prolactin levels were important factors in predicting surgical outcome. Patients with smaller (Hardy Grades I and II) tumors had significantly better outcome than those with larger (Hardy Grades III and IV) tumors. Patients with successful surgical outcomes had significantly lower preoperative prolactin values (204 ng/ml) than those with operative failures (524 ng/ml). In addition to the known factors, the patient's age at the time of operation, the length of amenorrhea, and the patient's growth hormone response to insulin hypoglycemia were newly identified as factors that helped predict surgical outcome. Patients who were ⩽26 years of age and who had had amenorrhea for ⩽6 years at the time of operation had significantly better surgical outcomes. Patients with normal growth hormone responses to stimulation testing had significantly better surgical outcomes than those with a blunted preoperative growth hormone response. The data suggest that prolactin-secreting pituitary tumors may cause a progressive disorder for which operative cure may be obtained only early in the disease.
Spinal Hemangiomas
Authors: Healy Michael , Herz David A. , Pearl Lorraine 
Published: May 2010

Abstract
Three new cases of spinal cord compression due to vertebral hemangioma are reported. The clinical presentation, with spinal pain, radicular radiation, and paraparesis, is similar to that of primary lymphoma, metastatic tumor, and disc disease. If the characteristic plain film changes of vertical trabeculations and striations are present, the preoperative diagnosis is facilitated, but in the majority of cases these are not seen. In some instances, vertebral body or pedicle erosion is present. A myelographic epidural block will be seen on further study. Spinal arteriography can prove helpful. Surgical decompression results in marked neurological improvement if intervention takes place before the onset of complete paralysis. The authors recommend that the diagnosis of vertebral hemangioma be considered in the differential diagnosis of epidural spinal cord compression whenever a primary malignant neoplasm cannot be identified.
Dermoid Cyst Communicating with the Subarachnoid Space and Lateral Ventricle: Demonstration by Metrizamide Computed Tomographic Cisternography
Authors: Wakai Susumu , Narita Junichi , Hashimoto Kazumasa , Nagai Masakatsu 
Published: May 2010

Abstract
The authors report a case of a dermoid cyst in the right anterior cranial fossa, which communicated spontaneously with both the subarachnoid space and the lateral ventricle. The communication was demonstrated by metrizamide computed tomographic cisternography before operation and was verified during operation.
Dumbbell Ganglioneuroma of the Lumbar Spine Associated with a Herniated Intervertebral Disc: Case Report
Authors: Oro John James , Geise August William 
Published: May 2010

Abstract
Paraspinal ganglioneuromas with extension into the spinal extradural space are rare tumors. Their management usually requires cooperation with surgeons of other specialties. The authors describe a case of a dumbbell ganglioneuroma arising from the lumbar sympathetic ganglia in a patient presenting with a herniated lumbar disc. The clinical features, radiographic analysis, and surgical approach to these tumors are briefly discussed.
Two-Dimensional Echographic Localization of Intracardiac Cerebrospinal Fluid Shunt Catheters
Authors: Soyeur Daniel , Born Jacques , Lenelle Jacques , Stevenaert Achille 
Published: May 2010

Abstract
This study evaluated the ability of two-dimensional echocardiography (2D echo) to detect and localize the distal end of ventriculoatrial shunt catheters in the cardiac chambers of hydrocephalic patients. Twenty-eight patients were studied, and the performances of 2D echo and standard chest x-ray filming were compared. Although standard chest x-ray filming allowed accurate determination of the catheter position in only half of the patients, 2D echo afforded clear visualization and accurate localization of the catheter in all instances. By its precise definition of intracardiac anatomical landmarks and its excellent time determination, 2D echo can provide valuable information on the movements of the catheter's distal end during the cardiac cycle, during head flexion or rotation, and during deep breathing movements. Some interesting observations were made with 2D echo. A to-and-fro motion of the catheter tip through the tricuspid orifice during the cardiac cycle was visualized in two instances. The combination of head movements and deep respiratory movements induced a variation in the position of the catheter tip. The magnitude of this displacement was 6 cm at the most. Two patients underwent reoperation for lengthening or shortening of the catheter. The operative findings confirmed the ultrasonic localization in both cases where the chest x-ray film had failed to identify or adequately locate the catheter tip. It is concluded that 2D echo is a safe, innocuous, and accurate method with which to locate the distal end of a ventriculoatrial shunt. It is the only available technique that provides visualization of intracardiac structures and cardiac cycle reference. In our neurosurgical unit, 2D echo is now considered the standard reference procedure to localize postoperatively the distal end of ventriculoatrial shunts and to follow patients in an attempt to appreciate the ideal timing for prophylactic lengthening of the shunt.
Transthoracic Anterolateral Decompression for Thoracic Spinal Lesions
Authors: Lobosky Jeffrey M. , Hitchon Patrick W. , McDonnell Dennis E. 
Published: May 2010

Abstract
Since 1978, the authors have treated 11 patients with lesions of the ventral thoracic spine via a transpleural anterolateral approach. Each of the patients presented with pain and paraparesis, 8 had sensory dysfunction, and 6 had demonstrated sphincteric disturbances. All 11 had radiographic confirmation of anterior cord compromise, and each underwent an anterior decompression, with 8 requiring graft stabilization. There were no surgical mortalities, and the postoperative complications were limited. In follow-up, 10 of the 11 patients had complete resolution of their preoperative pain and were able to ambulate independently, Remission of sensory disturbances was noted in 6 patients, and 5 regained sphincteric control. The authors have found that this approach is both safe and effective, with several advantages over conventional laminectomy and posterolateral techniques.
Intracranial Neoplasms during the First Year of Life: Analysis of One Hundred Consecutive Cases
Authors: Jooma Rashid , Hayward Richard D. , Grant Norman D. 
Published: May 2010

Abstract
One hundred infants with intracranial tumors symptomatic during the 1st year of life were studied. They differed from older children in having a higher percentage of supratentorial tumors and in the fact that 90% of the tumors were of neuroectodermal origin. Vomiting, alteration of psychomotor development, and macrocrania were the most common presenting features. The “diencephalic syndrome” was seen in 5 infants, and subarachnoid hemorrhage due to tumor was diagnosed in 4. Computed tomography as the primary investigation is increasing the number of neoplasms diagnosed in this age group, although review of the skull roentgenograms in the series disclosed an abnormality in 92%. Eighty of the tumors were verified, 68 by a cranial operation and the rest at autopsy, Of the verified neoplasms, 20% were medulloblastomas, 12.5% were choroid plexus papillomas, and 10% were cerebellar astrocytomas. The cumulative average survival was 27 months but, for those who underwent a tumor operation, the average survival was 37 months. The operative mortality was 30%. Thirty-nine patients were irradiated, and this subset had a 5-year survival rate of 43%. The morbidity was high irrespective of radiotherapy; 60% of those who survived 1 year were moderately or severely disabled. Those infants receiving more than 5000 rads of whole brain radiation tended to have greater deficits in the long term. When analyzed separately, patients treated after 1970 had greatly improved mortality and morbidity rates.
Placement of a Ventriculoatrial Shunt Using External Jugular Catheterization: Technical Note
Authors: Tomita Tadanori 
Published: May 2010

Abstract
A technique for the insertion of the atrial end of a ventriculoatrial shunt is described. The technique utilizes a J-wire and an open end atrial catheter inserted through the external jugular vein into the right atrium under fluoroscopy. It is safe and effective, even in young infants.
Compressive Myelopathy Associated with Type VI Mucopolysaccharidosis (Maroteaux-Lamy Syndrome)
Authors: Wald Steven L. , Schmidek Henry H. 
Published: May 2010

Abstract
Spinal cord compression with resultant myelopathy is a frequent occurrence in patients with mucopolysaccharidoses. Etiological factors include developmental abnormalities of the cervical spine and infiltration of the dura mater by the accumulated products of mucopolyssacharide metabolism. Compression at the thoracolumbar junction is rare, but was found in a child with the characteristic physical and biochemical stigmata of the Maroteaux-Lamy syndrome (mucopolysaccharidosis VI). An anterolateral approach to remove the compressing bony elements resulted in symptomatic improvement. Careful radiological evaluation is required so that all surgical options can be considered. Patients with metabolic storage diseases and the capacity for normal intellectual function warrant aggressive surgical care to optimize neurological function.
Lateral Extracavitary Approach to the Spine for Thoracic Disc Herniation: Report of 23 Cases
Authors: Maiman Dennis J. , Larson Sanford J. , Luck Elizabeth , El-Ghatit A. 
Published: May 2010

Abstract
Twenty-three patients were operated upon for thoracic disc herniation between 1973 and 1982. The lateral approach to the vertebral column was used in each. Most patients had severe local pain; 13 had severe myelopathy or complete motor paralysis, including 4 who had become paraplegic after laminectomy. Eleven patients had calcified discs or osteophytic ridges. Air myelography and computed tomography were diagnostic in all cases. Postoperatively, 17 patients achieved significant relief of pain, 20 improved neurologically, and none became worse. Complications of the operation were minimal. The lateral extracavitary approach to the spine is a valuable technique for the management of thoracic disc herniation.
Epidural Hematoma Complicating Paget's Disease of the Skull: A Case Report
Authors: Drapkin Allan J. 
Published: May 2010

Abstract
A case of epidural hematoma associated with Paget's disease of the skull, following minimal head trauma, is presented. Review of the literature yielded only one previously reported case of this association. Factors of relevance in the development of epidural hematoma in patients with Paget's disease of the skull are discussed, and steps to consider in that situation are recommended. In view of the steady increase in the elderly population of this country, this association is likely to become more frequently seen.
Acute Traumatic Vertebral Arteriovenous Fistula: Balloon Occlusion with the Use of a Contralateral Approach
Authors: Miller Richard E. , Hieshima Grant B. , Giannotta Steven L. , Grinnell Verity S. , Mehringer Mark C. , Kerin Douglas S. 
Published: May 2010

Abstract
A traumatic fistula of the left vertebral artery to vertebral and epidural veins with an expanding suboccipital false aneurysm was trapped by endovascular occlusion with detachable balloons. The lesion was not amenable to treatment using the left vertebral artery alone for access. Distal trapping was accomplished by catheterizing the (contralateral) right vertebral artery and placing the balloon retrograde into the distal segment of the left vertebral artery. This maneuver extends the range of vertebral artery lesions for which detachable balloons, either alone or as an adjunct to operation, can be used.
Chronic Spinal Epidural Hematoma Presenting as Lumbar Stenosis: Clinical, Myelographic, and Computed Tomographic Features
Authors: Nehls Daniel G. , Shetter Andrew G. , Hodak John A. , Waggener John D. 
Published: May 2010

Abstract
The case of a patient with a chronic spinal epidural hematoma presenting as lumbar stenosis is described. There was no history of major trauma to the lumbar spine, anticoagulant use, or coagulopathy. The clinical, myelographic, and CT findings are presented and discussed.
Intracranial Primary Nonlymphomatous Sarcomas in Children: Experience with Eight Cases and Review of the Literature
Authors: Tomita Tadanori , Gonzalez-Crussi Frank 
Published: May 2010

Abstract
Eight infants and children with intracranial primary nonlymphomatous sarcoma were studied clinically and histologically. Treatment consisted of surgical resection and postoperative radiation therapy. Only one patient received chemotherapy. Two patients are alive after 10 years, but the other six patients died 3 to 33 months after operation. Two illustrative cases with neuroradiological, light microscopic, and ultrastructural findings are presented: both cases showed radiological evidence of intracranial arterial encasement by sarcoma and computed tomographic evidence of multifocal lesions. The pertinent literature is reviewed to illuminate the more refined nature of primary sarcomas of the central nervous system. Irrespective of treatment, the majority of the patients had a limited survival and only a few lived longer than 5 years. Total resection seemed to afford the best prognosis, whereas the efficacy of radiation therapy and chemotherapy is indefinite.
Posterior Fossa Epidural Hematoma during Childhood
Authors: Ammirati Mario , Tomita Tadanori 
Published: May 2010

Abstract
Four cases of childhood posttraumatic posterior fossa epidural hematoma diagnosed by computed tomography (CT) are reported. All four patients presented with relatively minor symptoms after sustaining head trauma and returned to normal after evacuation of the hematoma. The pertinent literature concerning posterior fossa epidural hematoma in children is reviewed. The role of CT in the early detection of lesions when the associated clinical symptoms are mild is emphasized.
Meningoencephalitis Complicated by Pituitary Insufficiency and a Spontaneously Resolving Suprasellar Mass
Authors: Jew Katherine , Piziak Veronica , Gilliland Paul F. , Hurley Douglas L. 
Published: May 2010

Abstract
A 53-year-old woman presented with acute meningoencephalitis associated with anterior and posterior pituitary insufficiency. A computed axial tomogram (CT) of the head revealed a suprasellar mass. The meningoencephalitis, presumably of bacterial origin, resolved after antibiotic therapy and, on a repeat CT, the suprasellar mass had disappeared. Five months after the initial illness, the patient's diabetes insipidus had resolved, anterior pituitary function had improved, and there was no sign of the suprasellar mass. The presence of a suprasellar mass in conjunction with acute meningoencephalitis and anterior and posterior pituitary insufficiency should raise the suspicion that the mass is not neoplastic and may be infectious or inflammatory in origin.
Intracerebral Arteriovenous Malformation Fed by the Anterior Ethmoidal Artery: Case Report
Authors: Terada Tomoaki , Kikuchi Haruhiko , Karasawa Jun , Nagata Izumi 
Published: May 2010

Abstract
The authors report a case of intracerebral arteriovenous malformation fed by the anterior ethmoidal artery. The nidus was located in the brain parenchyma, although its feeder was a dural artery. The etiology of this rare condition is discussed.
Microscopic Decompression of the Anterior Upper Cervical Spine: A Case of Odontoid Malunion to the Atlas
Authors: Miller Jimmy , Parent Andrew D. 
Published: May 2010

Abstract
For the past 20 years, the transoral approach to the upper cervical spine has been utilized for odontoid fractures, the removal of an abnormal odontoid process, decompression of basilar impression, and biopsy or resection of nasopharyngeal or metastatic tumors. The effectiveness and safety of this procedure is well documented. Use of the surgical microscope adds to the efficiency and safety of the procedure. We are reporting a case of fusion of the odontoid base to the anterior arch of the atlas. To our knowledge, this entity has not been described previously. The spinal cord was protected by an initial posterior fusion of C-1, C-2, followed in 10 days by a tracheostomy and the transoral removal of the anterior C-1 arch and the abnormal dens. Because the medical history did not reveal a source of trauma, it is supposed that the patient had malunion of the odontoid process to C-2, with subsequent migration and fusion of the dens to the C-1 arch.
Persistent Trigeminal Artery Associated with Intracranial Arterial Aneurysm
Authors: Garza-Mercado Román , Cavazos Elisamaría 
Published: May 2010

Abstract
Two patients with persistent trigeminal artery associated with a ruptured arterial intracranial aneurysm arising from the ipsilateral internal carotid artery at the level of the posterior communicating artery are presented. One patient underwent successful clipping of the aneurysm. The other patient died on the x-ray table shortly after admission during the performance of emergency carotid angiography. In each patient, the anomalous vessel was considered to be incidental.
The Sitting Position in Neurosurgery: A Retrospective Analysis of 488 Cases
Authors: Standefer Michael , Bay Janet W. , Trusso Russell 
Published: May 2010

Abstract
The records of 488 patients who underwent neurosurgical procedures in the sitting position were reviewed with special attention to the development of complications related to this operative position. The complications encountered included air embolus, pneumocephalus, subdural hematoma, compressive peripheral neuropathy, and orthopedic and dermatological problems. The 30-day operative mortality was 2.5%. These complications and methods of prevention, diagnosis, and treatment are discussed in detail, and the literature concerning the sitting position in neurosurgery is reviewed.
The Brain as a Sponge: A Computed Tomographic Look at Hakim's Hypothesis
Authors: Penn Richard D. , Bacus James W. 
Published: May 2010

Abstract
Hakim's hypothesis, which explains the brain's adaptation to pressure in hydrocephalus and the enlargement of ventricular volume, was studied with computed tomographic (CT) scanning. The critical element in the theory is that brain water decreases when there is a pressure gradient within brain tissue. Extraaxial hematomas uniformly increase the CT density of adjacent brain tissue, and this is best explained by water shifts out of the tissue. In hydrocephalus cases studied early after shunting (10 days or less), a decrease in ventricular volume is accompanied by an overall decrease in the CT density of the brain. These CT changes support Hakim's view of the brain as a sponge that can change its hydration under pathological conditions.
Evoked Potential Correlates of Posttraumatic Amnesia after Closed Head Injury
Authors: Papanicolaou Andrew C. , Levin Harvey S. , Eisenberg Howard M. , Moore Bartlett D. , Goethe Katherine E. , High Walter M. 
Published: May 2010

Abstract
The P-300 component of evoked potentials to a rare tone was measured in normal volunteers and in patients with closed head injuries who either were confused (in posttraumatic amnesia) or had recovered from posttraumatic amnesia and were oriented at the time of recording. The latency of this component, which reflects cortical processing of stimuli, varied reliably, with the degree of orientation being longest for confused patients and shortest for normal subjects. On the basis of these data, we suggest that the P-300 latency can be used as a physiological index of cognitive function in patients with closed head injury.
Intradural Rupture of Lumbar Intervertebral Disc: Report of Three Cases with Review of the Literature
Authors: Lesoin F. , Duquennoy B. , Rousseaux M. , Servato R. , Jomin M. 
Published: May 2010

Abstract
The intradural herniated disc is a rare complication of disc herniation. A study of the literature shows that this location is often responsible for severe neurological deficit with loss of sphincter control and a complete block shown on the myelogram. We report three cases to demonstrate the radioclinical interpretation of intradural herniated disc and the possibility of definite and misleading symptoms.
Contralateral Parafalcine Approach for Parasagittal and Callosal Arteriovenous Malformations
Authors: de Almeida Gilberto Machado , Shibata Milton Kazunori , Nakagawa Edson J. 
Published: May 2010

Abstract
Most neurosurgeons prefer an ipsilateral approach for medial surface arteriovenous malformations, Based on recent surgical experiences, we believe that a contralateral approach has some advantages in dealing with such lesions. Two cases are reported, and the rationale for the contralateral approach is discussed.
History of Frontal Lobotomy in the United States, 1935-1955
Authors: Anastasia Kucharski 
Published: May 2010

Abstract
The history of frontal lobotomy is a dramatic chapter in the development of medical treatment. Based on experimentally induced lesions in primates, lobotomies were introduced as procedures designed to modify the affect and behavior of hospitalized mental patients. Within 10 years, variations in surgical techniques were numerous, and the treatment was an accepted alternative in many hospitals in the United States. Patients on whom the operation was performed had a variety of diagnoses, including schizophrenia, obsessive-compulsive disorder, and affective illness. With the introduction of neuroleptic medication and behavior and milieu therapies, this surgical treatment for the emotional component of psychiatric illness fell into disuse. As its legacy to medicine, frontal lobotomy provided neuroanatomical information from which contemporary biological theories of behavior developed.