bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pineal Tumors
Authors: Chang Cecil Guang-shiung , Kageyama Naoki , Mobayashi Tatsuya , Yoshida Jun , Negoro Makoto 
Published: May 2010

abstract
The clinical presentations, findings of neuroradiological examinations, laboratory findings, pathological diagnoses, methods of treatment, and results of follow-up of 43 cases of pineal tumor collected at the Nagoya University Hospital from 1958 to 1979 are reviewed. The definitions of calcification of the pineal body and of pineal tumor are given. There is a significant difference in the incidence of calcification of the pineal body between pineal teratomas and pineal germinomas. Although there is a 100% rate of calcification of the pineal body in cases of pineal germinoma, the rate is very low in cases of pineal teratoma; calcification appears in only a small percentage of the cases of teratoma mixed with germinoma or embryonal carcinoma, or both. In male patients with susprasellar germinoma, there is a high frequency of an associated pineal calcification. No pineal calcification is seen in cases of basal ganglia germinoma. The computed tomographic (CT) findings of pineal teratoma and germinoma are characteristic. CT scanning is superior for early diagnosis of suprasellar and basal ganglia germinomas.
Widened Epidural Space after Spinal Fusion
Authors: Grossman Robert I. , Davis Kenneth R. 
Published: May 2010

abstract
Two cases of widening of the L-5, S-1 anterior epidural space after lumbar laminectomy and bilateral transverse process fusion are reported. Metrizamide lumbar epidurography was valuable in assessing this apparent widening and demonstrating that this space was normal and free of disc material. Posterior traction on the dural sac is a possible explanation for this myelographic abnormality.
Epidermoid Tumors Involving the Fourth Ventricle
Authors: Rosario Marshal , Becker Dennis H. , Conley Frances K. 
Published: May 2010

abstract
The case histories of three patients with epidermoid tumors of the 4th ventricle treated by surgical excision are presented. All three cases exhibited a prolonged latent period from the onset of symptoms to the final diagnosis. Despite the strategic location and enormous size of all three tumors, only one of the patients had significant hydrocephalus. The radiographic diagnosis and differential diagnosis of epidermoid tumors are discussed.
Post-traumatic Occlusion of the Supraclinoid Internal Carotid Artery
Authors: Ajir Farroukh , Tibbetts James C. 
Published: May 2010

Abstract
Intracranial occlusion of the internal carotid artery secondary to minor head or neck injury is uncommon. We report the case of an 18-year-old man who sustained a minor head and neck injury during a fist fight and developed a left hemiparesis resulting from thrombosis of the supraclinoid portion of the right internal carotid artery. Conservative inpatient treatment with low dose heparin and aspirin resulted in a gradual, steady improvement. Two months later, after an intensive program of physical therapy, the patient showed good progress; his facial weakness had lessened and his left hemiparesis was mild. Although there is no ideal treatment for internal carotid artery occlusion secondary to minor trauma, conservative treatment should be undertaken unless there are progressive or recurring ischemic symptoms, in which case an extracranial-intracranial bypass operation should be considered.
Galactorrhea after Prolonged Traumatic Coma
Authors: de Leo Roberto , Petruk Kenneth C. , Crockford Peter 
Published: May 2010

Abstract
A 17-year-old girl suffered a traumatic acute subdural hematoma and rib fractures after a motor vehicle accident. Prolonged coma resulted, and significant galactorrhea began 4 weeks after the accident. The galactorrhea was treated successfully by the administration of 2-bromoergocryptine. The pathophysiology of this condition is discussed.
Computed Tomographic Demonstration of Giant Aneurysms of the Vertebrobasilar System
Authors: Ganti S. Ramaiah , Steinberger Abe , McMurtry James G. , Hilal Sadak K. 
Published: May 2010

Abstract
Giant aneurysms of the vertebrobasilar system can easily mimic other mass lesions in the posterior fossa and 3rd ventricle. Recently, we treated eight cases of giant aneurysm in the vertebrobasilar circulation that were demonstrated by computed tomography with angiographic correlation. We describe the salient radiological features that help to distinguish giant aneurysms from neoplasms and discuss their clinical manifestations and surgical management.
Craniosynostosis
Authors: Carmel Peter W. , Luken Martin G. , Ascherl George F. 
Published: May 2010

Abstract
Computed tomography has proven useful in children with craniosynostosis for the evaluation of deformity of the skull base. calvarium. and parenchymal brain structures. A retrospective analysis of 24 children seen during a 4-year period who had adequate preoperative, postoperative. and follow-up scans was carried out. Bone windows were used. and both bone thinning adjacent to fused sutures and thickening of affected sutures were demonstrated. Changes in calvarial contour were easily followed. Current trends in craniofacial reconstructive surgery have placed emphasis on skull base abnormalities: these are readily measured on axial computed tomographic (CT) sections. and postoperative progress may be monitored by serial scanning. In addition, new data revealing distortion of brain structures and cerebrospinal fluid pathways in these children have been obtained with CT scans. These soft tissue abnormalities had not been appreciated before the CT era, and they add a new dimension to the evaluation of these disorders. We think that these abnormalities indicate a local pressure increase on the brain at the fusion site. The restoration of parenchymal changes toward normal during the postoperative period correlated well with cosmetic improvement.
Syndrome of Inappropriate Secretion of Antidiuretic Hormone after Subara chnoid Hemorrhage
Authors: Dóczi Thomas , Bende János , Huszka Endre , Kiss József 
Published: May 2010

Abstract
The authors report a review of 290 patients admitted for the treatment of subarachnoid hemorrhage. Twenty-seven (9.3%) patients developed the syndrome of inappropriate secretion of antidituetic hormone (SIADH). The diagnosis was established by means of daily laboratory investigations (serum electrolytes and osmolality; urine sodium and osmolality; and fluid balance). The patients were divided into two groups (severs and mild SIADH) on the basis of clinical symptoms and signs and laboratory findings. High values of urine osmolality and sodium concentration in patients with low values of serum osmolality and sodium concentration were demonstrated. Thirteen (4.5%) patients had severe and 14 (4.8%) patients had mild SIADH. The source of bleeding was not discovered in 14 patients (4.8%). Nearly 10% of the patients with an aneurysm on the anterior communicating artery developed SIADH. Fluid therapy for these patients is described, and the treatement of SIADH is discussed.
Neurogenic Claudication Due to Narrowing of the Lumbar Canal by Extradural Metastatic Tumor
Authors: Martin Neil A. , Gutin Philip H. , Newman Alan B. , Pickett Jackson B. 
Published: May 2010

Abstract
Neurogenic claudication has been described in association with bony constriction of the lumbar canal. but has not previously been reported in association with extradural metastasis. We report the case of a 69-year-old who developed neurogenic claudication due to narrowing of the lumbar canal by metastatic adenocarcinoma of the prostate, Radiation therapy resulted in tumor regression and resolution of the claudication.
Prediction of Cerebellopontine Angle Tumors Based on Discriminant Analysis of Brain Stem Auditory Evoked Responses
Authors: Zappulla Rosario A. , Karmel Bernard Z. , Greenblatt Edward 
Published: May 2010

Abstract
Multivariate discriminant analysis of brain stem auditory evoked response component latency intervals in patients with cerebellopontine angle tumors allowed accurate detection of 90% (35 of 39) of the tumor population with response data recordable from at least one ear. Eighty-five per cent (23 of 27) of these could be detected by using information from the unaffected ear. One of 21 normal subjects was miselassified. Tumors significantly increased the I—III and III—V intervals on the side of the tumor. Increases in III—V interval latency were also observed on the unaffected side. The size of the tumor was significantly correlated with both discriminant scores derived from the analysis of the unaffected ear and delays in the III—V intervals from either the affected or the unaffected ear. These results were attributed to physiological factors and mechanical distortions of the brain stem. Regression equations derived from linear discriminant analysis for cerebellopontine angle tumors are presented and discussed in terms of their predictive validity.
Ommaya Reservoir Insertion Guided by Computed Tomography
Authors: Levy Walter J. , Hahn Joseph F. 
Published: May 2010

Abstract
The placement of a ventricular catheter in patients with small ventricles carries the risks of catheter malfunction and bleeding. We report the use of computed tomography (CT) to place an Ommaya reservoir in two patients with acute myelogenous leukemia and one patient with lymphoma who had normal to small ventricles. The entire procedure was carried out in the scanner and demonstrates the feasibility of operations performed in the CT scanner.
Painful Neuroma
Authors: Battista Arthur F. , Cravioto Humberto M. , Budzilovich Gleb N. 
Published: May 2010

Abstract
Sixteen months after resection of a painful neuroma and fascicle ligation of the proximal nerve segments, the fascicleligated neural tissue was examined by light and electron microscopy. No significant neuroma formation was found in the fascicle-ligated regions. The distal portion consisted mainly of connective tissue fibroblasts with an absence of neural elements. Maintaining the perineurium intact by fascicle ligation seems to alter significantly axonal regeneration in humans, as is indicated by minimal neuroma formation. Similar findings after fascicle ligation in animals have also been reported. This lack of neuroma formation after resection of a painful neuroma and fascicle ligation may play a significant role in relieving pain in patients with painful neuromas.
Prevention of Cerebral Ischemic Symptoms in Cerebral Vasospasm with Trapidil, an Antagonist and Selective Synthesis Inhibitor of Thromboxane A2
Authors: Suzuki Shigeharu , Sobata Eiji , Iwabuchi Takashi 
Published: May 2010

Abstract
The results of our previous experimental and clinical studies led us to the hypothesis that, in the pathogenesis of cerebral vasospasm, subarachnoid focal acidosis resulting from anaerobic changes of subarachnoid clots may be a factor upsetting the balanced synthesis of both thromboxane A2 and prostaglandin I2 from prostaglandin endoperoxides on the inner surface of cerebral arteries. Thus, there is a higher concentration of thromboxane A2, a prostanoid that causes arterial contraction and platelet aggregation. We tested the administration of trapidil, an antagonist and selective synthesis inhibitor of thromboxane A2, in a series of 20 cases for the prevention of cerebral vasospasm and cerebral ischemia after aneurysmal rupture. Vasospasm was demonstrated by angiography in 9 of these cases, but only 2 of the 9 showed mild signs of cerebral ischemia. Of the 20 patients, 15 were discharged from the hospital as cured and 3 had a neurological deficit at discharge. Our findings suggest the significance in symptomatic vasospasm of thrombus formation by platelet aggregation and the effectiveness of trapidil as a preventive.
Simple Technique for Monitoring Intraoperative Spinal Cord Function
Authors: Hahn Joseph F. , Lesser Ronald , Klem George , Lueders Hans 
Published: May 2010

Abstract
Interference with normal spinal cord functioning is an important. although uncommon. complication of spinal surgery. Spinal evoked potentials have been advocated as a means of monitoring spinal cord transmission during operative procedures. We have developed a simple technique using electrodes inserted into the interspinal ligaments for monitoring purposes. This has produced stable and reproducible recordings with obvious clinical benefit in the first 50 cases in which it has been used.
Retinoblastoma as a Possible Primary Intracranial Tumor
Authors: Bullitt Elizabeth , Crain Barbara J. 
Published: May 2010

Abstract
A 10-month-old infant with a small. unilateral, peripheral retinal lesion also had a large. well-encapsulated. suprasellar retinoblastoma. The primary vs. the metastatic nature of the intracranial tumor is considered. It is postulated that primary intracranial tumors may arise within areas of the central nervous system embryologically related to the retina in patients with the genetic form of retinoblastoma.
Significance of Infundibular Dilatation in Unexplained Subarachnoid Hemorrhage
Authors: Yoshida Masafumi , Anegawa Shigetaka , Moritaka Kazuhiko 
Published: May 2010

Abstract
Angiographically equivocal aneurysmal dilatation at the junction of the internal carotid and the posterior communicating arteries was noted in a patient with documented subarachnoid hemorrhage. This was initially thought to be infundibular dilatation. A craniotomy revealed an actual aneurysm. which was obliterated successfully. Whether infundibular dilatation is a preaneurysmal state or a benign dilatation is controversial. The management of angiographically noted infundibular dilatation in cases of “essential” subarachnoid hemorrhage is discussed.
Theophylline Toxicity after the Use of Aminophylline in the Treatment of Cerebral Vasospasm
Authors: Bailey Robert T. , Young Byron , Rapp Robert P. , Blouin Robert A. 
Published: May 2010

Abstract
We are reporting a case of theophylline toxicity after the initiation of i.v. aminophylline and isoproterenol in the treatment of cerebral vasospasm. The dose of aminophylline (125 mg/hour) previously recommended results in a toxic serum theophylline concentration in a majority of patients if the infusion is continued for more than 24 to 48 hours. The rapid achievement of an optimal serum level is obtained with a standard loading dose of 8.0 mg/kg. The initial infusion rate should be based on calculated pharmacokinetic data. Maintenance dosing adjustments are then based on serum determinations and the presence of toxic effects.
Pulmonary Effects of Head Trauma
Authors: Baigelman Walter , O'Brien James C. 
Published: May 2010

Abstract
Knowledge of the interrelation of the central nervous system-respiratory axis is crucial to the management of patients with head injuries with or without concomitant pulmonary-thoracic problems. Damage to the central nervous system (CNS) can result in unexplained hypoxemia, noncardiac pulmonary edema, altered patterns of respiration, and an increased risk of aspiration. The damaged thorax and lung can contribute to brain ischemia and rises in intracranial pressure. The treatment of one end of the CNS-respiratory axis is not without effect on the other end of the continuum. Corticosteroids, diuretics, mannitol. iatrogenic hyperventilation, barbiturates, and vasopressors are used in the management of patients with head trauma, but may have an impact on oxygenation and ventilation. When positive end expiratory pressure is used in the management of a pulmonary process, it should be optimized and used with caution while monitoring for its effect on intrac. ial pressure. Pulmonary toilet, while remaining a necessity, must be performed in a manner so as to minimize potential negative effects on the brain. Hyperoxia and hypothermia should be avoided. Mechanical ventilation should be used as dictated by the desired PaCO2 and not as a mandatory adjunct to endotracheal intubation.
Bilateral Acoustic Neuromas
Authors: Martuza Robert L. , Ojemann Robert G. 
Published: May 2010

Abstract
Fifteen patients with bilateral acoustic neuromas are presented. Ten patients became symptomatic before age 21. and 9 of these patients developed additional central nervous system tumors. Cutaneous manifestations of neurofibromatosis and a positive family history of this disorder were absent in many of the patients. Most patients required multiple surgical procedures, and the timing, techniques, and results of these operations are reported. The pathogenesis of these tumors, the genetic aspects of this disorder, and potential treatment alternatives are discussed.
Dental Considerations in the Sublabial Trans-sphenoidal Surgical Approach to the Pituitary Gland
Authors: Watson Stephen W. , Sinn Douglas P. , Neuwelt Edward A. 
Published: May 2010

Abstract
The sublabial trans-sphenoidal approach for the ablation of pituitary tumors can cause denervation or pulp death of some of the anterior teeth. The problem results from the bone removal necessary for placement of the nasal retractor. When bone is removed close to the apices of the anterior teeth, root injury may occur. This complication may be avoided through preoperative evaluation of skeletal and dental morphology. This evaluation revals the amount of bone between the tooth roots and the nasal floor and hence the ultimate access for the nasal retractor.
Superior Temporal Gyrus Approach to Middle Cerebral Artery Aneurysms
Authors: Heros Roberto C. , Ojemann Robert G. , Crowell Robert M. 
Published: May 2010

Abstract
Aneurysms of the bifurcation of the middle cerebral artery (MCA) can be approached through a small incision in the anterior portion of the superior temporal gyrus. The pterion and the lateral aspect of the lesser wing of the sphenoid bone are removed. The aneurysm is approached, using microsurgical techniques, by following the main divisions of the MCA to the parent trunk and the base of the aneurysm. Once the parent vessel and the origin of the major divisions are clearly identified, it is usually preferable to dissect and mobilize the entire aneurysmal complex to elucidate the anatomy and prepare the neck for clipping. This approach offers the advantages of minimal brain retraction and minimal manipulation of the main trunk and perforators of the MCA. In addition, it allows a more complete exposure of the aneurysmal complex and facilitates dissection behind the aneurysm, which is more difficult when the aneurysm is approached from the front by opening the sylvian fissure medially to laterally. A potential disadvantage of this method is that proximal control is not obtained until the base of the aneurysm is reached, but this has not been a problem in our experience. Other disadvantages are the need for a slightly larger bone flap and the potentially increased risk of epilepsy. This approach is not suitable when the main trunk of the MCA is short and the aneurysm is in front of the insula. It is also not recommended for the rare cases in which the aneurysm points back over the insula. During a 6-year period, this approach was used in 49 of 58 cases of MCA aneurysm. The only deaths in this group occurred in patients who were in deep coma before operation. Two patients were made worse by operative complications, and 2 more worsened as a result of postoperative vasospasm. There was a significant incidence of thrombophlebitis and pulmonary embolism in this series.
Comparison of Clinical Result between Microsurgical and Direct Visual Intracranial Aneurysm Surgery
Authors: Leibrock Lyal G. , Epstein Mel H. , Long Donlin 
Published: May 2010

Abstract
A retrospective study of 119 operative procedures for intracranial aneurysm was performed to compare the clinical result with microsurgical technique vs. that with standard instruments and without magnification; the operative technique was the major variable. The study demonstrated more normal patients, less intraoperative aneurysm rupture, and a greater capacity to isolate the aneurysm definitively with microsurgical technique. Anatomically and pathologically more difficult aneurysms had an even greater percentage of good clinical results when treated microsurgically. Familiarity and experience with microsurgical technique was associated with better clinical results, whereas the results with direct vision remained static.
Familial Gliomas
Authors: Chadduck William M. , Netsky Martin G. 
Published: May 2010

Abstract
Four families having multiple family members with cerebral gliomas are presented. Genetic studies were done in some, but no chromosomal abnormalities were found in this group of patients or their families. The authors recommend that careful attention be given to the family history of all glioma patients and that more extensive genetic studies be done. The formation of a registry to report cases of familial gliomas is also suggested.
Cystic Glioma of the Brain Stem with Prolonged Survival
Authors: Soffer Dov , Sahar Abraham 
Published: May 2010

Abstract
An unusual case of benign stem glioma with a 15-year survival is presented. In spite of 12 years of clinical quiescence, a focus of the tumor in the upper brain stem was found at necropsy. Morphologically, the tumor was a cystic pilocytic astrocytoma. The few previously reported similar cases in the same location were also associated with a favorable prognosis. It is suggested that, in analogy to the cystic cerebellar and cerebral astrocytomas, there is a group of cystic pilocytic astrocytomas of the brain stem with benign biological behavior.
Large Dose Thiopental Anesthesia for Intracranial Aneurysm Surgery
Authors: Sokoll Martin D. , Kassell Neal F. , Davies Loyd R. 
Published: May 2010

Abstract
Twenty patients undergoing intracranial aneurysm clipping were anesthetized with doses of thiopental sufficient to produce electroencephalographic burst suppression, nitrous oxide, oxygen, and morphine sulfate. Diuresis was induced with a combination of furosemide and mannitol. The cardiovascular effects of this anesthetic technique were studied. The central venous, pulmonary artery, pulmonary artery wedge, and systemic arterial blood pressures and the cardiac output were determined. The cardiac index and the systemic and pulmonary vascular resistance were calculated. The systemic blood pressure remained unchanged throughout the procedure except during the period of induced hypotension. The cardiac index decreased on the average from 3.3 during the control period to 2.15 litres/minute/m2 after the induction of anesthesia and diuresis (P &lt; 0.05). During sodium nitroprusside-induced hypotension, there was a further decrease in the cardiac index to 1.81 litres/minute/m2 (P &lt; 0.05). Changes in the cardiac index were associated with a significant decrease in the central venous and pulmonary artery wedge pressures (from 2.5 to 0.1 and 5.9 to 0.2 torr, respectively) and an increased systemic vascular resistance. Cardiovascular performance recovered quickly after termination of the induced hypotension and remained stable in the postoperative period. This anesthetic technique seems to be useful in the surgical repair of intracranial aneurysms.
Computed Tomography-directed Stereotaxy for Biopsy and Interstitial Irradiation of Brain Tumors: Technical Note
Authors: MacKay Alexander R. , Gutin Philip H. , Hosobuchi Yoshio , Norman David 
Published: May 2010

Abstract
A computed tomographic-stereotactic system based on the Leksell stereotactic frame has been used to implant radioactive 125I sources into (28 procedures) or to biopsy (2 procedures as biopsy only, 2 in conjunction with the implantation of a radioactive source) malignant brain tumors. In every instance, the selected target was reached precisely, allowing accurate diagnosis and treatment.