bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cerebral Circulation during Arteriovenous Malformation Operation
Authors: Barnett Gene H. , Little John R. , Ebrahim Zeyd Y. , Jones Stephen C. , Friel Harry T. 
Published: May 2010

Abstract
The circulatory changes in the cortex around a cerebral arteriovenous malformation (AVM) were studied in 18 patients. The AVMs had rapid circulation times with early draining veins on angiography. Local cortical blood flow (ICoBF) was measured with cortically applied thermister/Peltier stack arrays. The AVMs had a more pronounced effect on ICoBF at a 2- to 4-cm distance from the AVM margin than in the adjacent cortex. Mean preexcision ICoBF was 62.9 ± 6.7 (SE) ml/100 g/minute (i.e., similar to normal controls) near the AVM margin and 43.0 ± 4.2 ml/100 g/minute far (i.e., &gt;2 cm) from the AVM. CO2 reactivity (COR) before excision was 1.1 ± 0.3 ml/100 g/minute/torr of CO2 (i.e., similar to normal controls) at near sites and 0.6 ± 0.3 ml/100 g/minute/torr of CO2 at far sites. The mean postexcision near ICoBF remained stable at 55.8 ± 5.1 ml/100 g/minute at near sites, but the far ICoBF significantly increased (P &lt; 0.05) to 57.2 ± 6.8 ml/100 g/minute. The cortical feeding artery pressure was substantially below the normal cortical artery pressure in 50% of the cases studied. Pressure in these arteries normalized after occlusion and AVM excision, resulting in a rapid increase in cortical artery perfusion pressure. Draining red vein pressure, which was elevated before AVM excision, also dropped after excision, contributing to the increase in perfusion pressure. Two patients who developed the normal perfusion pressure breakthrough syndrome (PBS) after operation had low ICoBF and disturbed COR before AVM excision and marked increase of ICoBF after excision. Factors that contribute to the development of PBS include: (a) low ICoBF around an AVM; (b) impaired COR; (c) low cortical artery pressure before AVM excision; (d) normalization in cortical artery pressure after AVM removal; and (e) substantial increase in ICoBF after AVM removal. Maintenance of a low systemic arterial blood pressure during the early postoperative period is essential in reducing the risk of severe cerebral edema.
Incidence and Management of Complications of Transsphenoidal Operation for Pituitary Adenomas
Authors: Black Peter McL. , Zervas Nicholas T. , Candia Guillermo L. 
Published: May 2010

Abstract
Two hundred fifty-five consecutive transsphenoidal procedures for pituitary adenomas were reviewed to evaluate complications and their management. There were no operative deaths. Cerebrospinal fluid (CSF) rhinorrhea was the most common complication, occurring in 2.7% of cases; diabetes insipidus was next, lasting less than 1 year in 1.6% of patients and over a year in 0.4%. Sinusitis occurred in 1.2% of patients, and delayed epistaxis occurred in 0.8%. Postoperative hematomas, meningitis, hydrocephalus, and deep venous thrombosis each occurred in 0.4% of cases. These results are discussed in the context of previous reports, including an international survey of pituitary surgeons. Although transsphenoidal surgery has a low morbidity and mortality, it is nevertheless associated with potentially serious difficulties that should be expeditiously recognized and managed.
Glioblastoma after Radiotherapy for Craniopharyngioma: Case Report
Authors: Ushio Yukitaka , Arita Norio , Yoshimine Toshiki , Nagatani Masaaki , Mogami Heitaro 
Published: May 2010

Abstract
A 6-year-old girl developed a glioblastoma in the basal ganglia and brain stem 5 years after surgical excision and local irradiation (5460 cGy) for craniopharyngioma. Clinical and histological details are presented, and the literature on radiation-induced gliomas is reviewed. (Neurosurgery 21: 33-38, 1987)
Craniosynostosis and Hydrocephalus
Authors: Golabi Mahin , Edwards Michael S. B. , Ousterhout Douglas K. 
Published: May 2010

Abstract
Ten cases of craniosynostosis associated with hydrocephalus were found in a retrospective review of 250 cases of children with craniosynostosis. Four children had Pfeiffer's syndrome, 3 had Crouzon's syndrome, 2 had kleeblattschädel with multiple anomalies and therefore could not be classified into a definite syndrome, and 1 had isolated sagittal synostosis. Of these 10 children, 5 had kleeblattschädel, two with Crouzon's syndrome, one with Pfeiffer's syndrome, and 2 with multiple anomalies. In all patients, hydrocephalus was controlled by a shunting procedure. Possible causes of hydrocephalus in association with craniosynostosis are discussed. (Neurosurgery 21: 63-67, 1987)
Malignant Nerve Sheath Tumor of the Facial Nerve: Case Report and Discussion
Authors: Muhlbauer Michael S. , Clark Craig W. , Robertson Jon H. , Gardner Gale L. , Dohan Curtis F. 
Published: May 2010

Abstract
The third reported case of a malignant nerve sheath tumor of the facial nerve is presented. The clinical course and pathological findings are described and serve as the basis for a discussion concerning malignant nerve sheath tumors arising in the cranial nerves. (Neurosurgery 21: 68-73, 1987)
Common Carotid Occlusion for Unclippable Carotid Aneurysms: An Old but Still Effective Operation
Authors: Swearingen Brooke , Heros Roberto C. 
Published: May 2010

Abstract
We present a selected series of nine patients with unclippable internal carotid artery aneurysms to illustrate our current approach to this problem. Eight of the nine underwent common carotid ligation after preoperative angiographic evaluation. Tolerance to carotid occlusion was determined intraoperatively by awake examination, electroencephalogram (EEG) monitoring, and carotid stump pressure measurements. No patient developed a permanent deficit; seven of eight treated aneurysms have thrombosed. Our experience and review of the literature indicate that most ischemic complications after carotid ligation seem to be thromboembolic, rather than due to “low flow” from poor collateral circulation. For this reason, we have gradually come to favor common carotid (CCA) over internal carotid (ICA) occlusion in many of these patients. After CCA occlusion, the ICA frequently remains open and embolic complications are therefore less likely. An extracranial-intracranial bypass procedure is performed only in those patients with poor collateral circulation demonstrated by cross compression angiographic studies, by the development of new deficits during test occlusion, or by the appearance of EEG changes during test occlusion. We suggest that CCA ligation remains a useful alternative in the management of unclippable internal carotid aneurysms.
Computed Tomography-guided Stereotactic Aspiration of Posterior Fossa Hematomas: A Supine Lateral Retromastoid Approach
Authors: Niizuma Hiroshi , Suzuki Jiro 
Published: May 2010

Abstract
We report a supine lateral retromastoid approach for computed tomography-guided stereotactic aspiration of hematomas of the posterior fossa. The method involves horizontal insertion of the aspiration needle at the suboccipital region with the patient in a supine position with the head turned 30 to 40° away from the lesion and with slight forward flexion of the neck. Eleven hematomas have been removed through this approach thus far, nine cerebellar and two pontine. With this technique, general anesthesia is not needed and operative invasion is minimal, allowing hematoma aspiration in patients in whom operation would previously not have been indicated. An additional merit is the suitability of this method for elderly patients.
Long Term Intrathecal Administration of Morphine: A Comparison of Bolus Injection via Reservoir with Continuous Infusion by Implanted Pump
Authors: Brazenor Graeme Alexander 
Published: May 2010

Abstract
Twenty-six cases of chronic intrathecal morphine administration are described: 19 cases utilizing the Spinalgesic injectable subcutaneous reservoir and 7 cases utilizing the Infusaid implanted infusion pump. In 25 cases, the morphine was delivered into the spinal subarachnoid space, and in 1 case of thalamic pain it was delivered into the temporal horn of the ipsilateral cerebral ventricle. The average duration of usage of the system was 132 days. The efficacy of the method was excellent: 23 of 26 patients used no other analgesics or only minor ones such as aspirin, paracetamol, or dextropropoxyphene. The complication rate was low, with no infections under the author's care, and only 4 catheter blockages (1 by tumor). There have been no complications in the 7 patients with implanted pumps. From this experience, the author concludes that the implanted pump is now the method of choice in all patients who can afford it and for whom the life expectancy outside an institution is in excess of 60 days. A special and relatively absolute indication for the pump is the situation of pain in the arm, head, or neck areas, in which case the constant morphine levels likely to be achieved with the pump may prevent failure of the method due to intractable nausea or emesis. The subcutaneous reservoir is otherwise to be preferred if the patient's disease is progressing rapidly, if the patient is already institutionalized and likely to remain so, or where the cost of the implanted pump would cause hardship. Either method of delivery of morphine to the subarachnoid space can provide incomparable analgesia without clouding of consciousness, with a very low complication rate. (Neurosurgery 21:484-491, 1987)
Clinicopathological Relations of Cerebral Cavernous Angiomas: Observations in Eleven Cases
Authors: Steiger Hans J. , Markwalder Thomas M. , Reulen Hans-J. 
Published: May 2010

Abstract
Eleven cases of cerebral cavernous angiomas (cavernomas) were observed within a period of 3 years. Two patients presented with cerebral hemorrhage, five with epilepsy, three each with a progressive focal neurological deficit, and one with papilledema. The unruptured lesions had a heterogeneous density on computed tomography with relatively little contrast enhancement. Two lesions contained major cysts. In one of these cases, the cyst measured 5.5 cm in diameter, had an enhancing membrane, and was surrounded by brain edema. Angiography did not show hypervascularity in any instance. During exploration and histological processing, special attention was paid to signs of previous silent hemorrhages and to the degree of encapsulation of the lesion. Iron deposits (signs of previous hemorrhages) were seen to varying degrees inside all cavernomas as well as in the surrounding gliotic cerebrum, and a causal relation between iron deposits and epileptic seizures seems likely. Encapsulation was minimal with the ruptured cavernomas and particularly prominent with the cystic lesions. The membrane of the giant cystic lesion with peripheral brain edema had a histological structure similar to that of the membranes of chronic subdural hematomas. It is suggested that continuous growth of cavernoma cysts is the result of recurrent hemorrhages from sinusoids of the malformation and from the neocapillary network of the cyst membranes.
Metastatic Tumor of the Pituitary Gland
Authors: Nelson Paul B. , Robinson Alan G. , Martinez Julio A. 
Published: May 2010

Abstract
Although metastatic tumors of the pituitary gland and the sellar region are not common, they may radiographically mimic a pituitary tumor. Because the metastasis frequently involves the posterior lobe and because lateral extension to the cavernous sinus is common, patients may present with ptosis, diplopia, or diabetes insipidus. Decrease in anterior pituitary function is less common. Metastatic tumors contain abundant vascular networks, as evidenced by frequent blush on cerebral angiography and increased bleeding at operation. We report the case of a 57-year-old woman who presented with rapid onset of bilateral ptosis and ophthalmoplegia and was found to have a metastatic carcinoma within the pituitary gland.
Dorsal Root Entry Zone Lesions for the Treatment of Brachial Plexus Avulsion Injuries: A Follow-up Study
Authors: Friedman Allan H. , Nashold Blaine S. , Bronec Peter R. 
Published: May 2010

Abstract
Dorsal root entry zone (DREZ) lesions have been shown to yield short term relief from the pain associated with a brachial plexus avulsion injury. Because of the propensity of pain to recur after neuroablative procedures, 39 patients with pain after a brachial plexus avulsion injury were observed for 14 months to 10 years after DREZ lesions were made. Fifty-four per cent of these patients were afforded good pain relief. Of 21 patients who had multiple small lesions made within the DREZ, 15 (72%) were afforded good pain relief. (Neurosurgery 22:369-373, 1988)
Ambulatory Microsurgery for Ruptured Lumbar Discs: Report of Ten Cases
Authors: Cares Herbert L. , Steinberg Robert S. , Robertson Edgar T. , Caldini Paolo 
Published: May 2010

Abstract
Advances in microsurgical techniques combined with a widening interest in same-day surgery led us to investigate ambulatory lumbar discectomy. We could find no precedent in the literature. Ten patients with classic ruptured lumbar discs confirmed by computed tomography chose to participate. They were aged 31 to 51, seven men and three women, in excellent general health. A microsurgical approach through a 25-mm skin incision was performed. The technique emphasized removal of suffiient medial facet to allow excision of the disc with minimal or no root retraction. Once awake in the recovery room, patients were transferred to a separate ambulatory step-down unit. They were discharged only after they had voided, ambulated, taken oral nourishment, and been examined by the surgeon. A visiting nurse checked the patient at home the evening of operation and the next day. All returned to their usual occupation between 3 and 14 days postoperatively. All were satisfied and would choose the outpatient program again. Our experience indicates that ambulatory lumbar microdiscectomy can be a safe, effective option for selected patients. (Neurosurgery 22:523-526, 1988)
Giant Aneurysm Arising from the Anterior Cerebral Artery and Causing an Isolated Homonymous Hemianopsia
Authors: Versavel Mark , Witmer Jan P. , Matricali Bart 
Published: May 2010

Abstract
A case of a giant aneurysm arising from the anterior cerebral artery and producing a left homonymous hemianopsia is presented. The aneurysm caused lateral compression of the posterior part of the optic chiasm. After preoperative dynamic assessment of the circle of Willis by angiography and by electroencephalographic recording during carotid artery compression, the aneurysm was trapped with microclips on the anterior cerebral artery proximal and distal to it. Visual field examination 6 months postoperatively showed complete visual field recovery. This is the first case of homonymous hemianopsia caused by an angiographically proven giant aneurysm of the ACA. (Neurosurgery 22:560-563, 1988)
Partially Thrombosed Aneurysm Presenting as the Sudden Onset of Bitemporal Hemianopsia
Authors: Aoki Nobuhiko 
Published: May 2010

Abstract
A case is presented in which the sudden onset of bitemporal hemianopsia was caused by partial thrombosis associated with enlargement of an unruptured anterior communicating artery aneurysm. The features of the sequential computed tomographic scans resembled those of pituitary apoplexy, reemphasizing the necessity for cerebral angiography in preoperative evaluation. The clinical significance of the warning signs of cerebral aneurysm during the era of computed tomography is discussed. (Neurosurgery 22:564-566, 1988)
Radicular Compression Due to Lumbar Intraspinal Gas Pseudocyst: Case Report
Authors: Demierre Bertrand , Ramadan Aymen , Hauser Hermann , Reverdin Alain , Rilliet Bénédict , Berney Jean 
Published: May 2010

Abstract
A case of sciatic pain syndrome is reported. Computed tomography showed evidence of gas in the spinal canal, and at operation a gas-filled pseudocyst was found in the spinal canal, without herniated disc. The cause of this unique case is discussed in relation to the spinal vacuum phenomenon.
Segmental Spinal Dysgenesis
Authors: Scott R. Michael , Wolpert Samuel M. , Bartoshesky Louis E. , Zimbler Seymour , Karlin Lawrence 
Published: May 2010

Abstract
Segmental spinal dysgenesis is characterized by focal agenesis or dysgenesis of the lumbar or thoracolumbar spine, with focal abnormality of the underlying spinal cord and nerve roots. Children are symptomatic at birth with lower limb deformities and neurological deficits that may be segmental. Myelography and computed tomography disclose hypoplastic or absent vertebrae and atrophic or absent neural elements adjacent to the bony deformity; the spinal column distal to the abnormality may be partially bifid, but is otherwise normal. Spinal ultrasonography was a helpful diagnostic adjunct in one patient. Surgery may be helpful in decompressing partially functioning spinal cord or nerve roots, but may exaggerate the tendency toward spinal instability. The embryology of this abnormality is not clear, but two children had other anomalies suggesting a spinal dysraphic syndrome, and its cause is probably related to a segmental maldevelopment of the neural tube.
Middle Cerebral Artery Aneurysm Due to Nocardia asteroides: Case Report of Aneurysm Excision and Extracranial-Intracranial Bypass
Authors: Hadley Mark N. , Spetzler Robert F. , Martin Neil A. , Johnson Peter C. 
Published: May 2010

Abstract
Nocardia asteroides is an uncommon human pathogen typically encountered in immunocompromised patients. Primary central nervous system (CNS) nocardiosis is rare and usually manifests as cerebritis or abscesses. The case of a young woman who presented with CNS Nocardia abscesses complicated by an infective middle cerebral artery aneurysm is reported. Treatment, which included abscess aspiration, aneurysm excision, and end-to-end extracranial to intracranial bypass and prolonged antibiotic therapy, resulted in an excellent outcome. This case and the management of CNS nocardiosis are reviewed.
Scalp and Calvarial Masses of Infants and Children
Authors: Ruge John R. , Tomita Tadanori , Naidich Thomas P. , Hahn Yoon S. , McLone David G. 
Published: May 2010

Abstract

Review of 70 children presenting with a solitary nontraumatic lump on the head revealed that 61% ofthe lesions were dermoid tumor, 9% were cephalhematoma deformans, 1% were eosinophilic granuloma, and 4% were occult menin goceles and encephaloceles. Most of the dermoid cysts occurred along sutural lines, but some did not. One of the eosinophilic granulomas was located over the sagittal suture. Seventeen per cent of the “lumps” had significant intracranial extension. An additional 20% of the lumps extended intracranially, but only to the dura mater. Work-up of these lesions should include initial plain skull roentgenograms to assess multiplicity and appropriate computed tomographic scans to assess possible intracranial extension.
Multilevel Lumbar Laminotomies for Focal Spinal Stenosis: Case Report
Authors: Aryanpur John , Ducker Thomas 
Published: May 2010

ABSTRACT
We describe a case of spondylotic lumbar spinal stenosis in an infirm elderly patient successfully treated with multilevel laminotomies. This procedure is less stressful to patients than a full laminectomy. In a selected subgroup of patients with “hourglass” spondylotic stenosis, it may provide adequate decompression.
Intracytoplasmic Lumina in Meningioma: An Ultrastructural and Immunohistological Study
Authors: Vakili Saeed T. , Muller Jans 
Published: May 2010

ABSTRACT
Three surgically removed meningotheliomatous meningiomas with hyaline inclusions or pseudopsammoma bodies were studied. Ultrastructurally, the lumina seemed to be predominantly intracytoplasmic, defined by a systemic unit membrane; they displayed abundant microvilli and contained granular or filamentous material, vacuoles, vesicular bodies, and lamellar structures. The cytoplasm surrounding the intracytoplasmic lumina was electron-dense and contained tonofilments and desmosomal junctions. All three meningiomas showed expression of carcinoembryonic antigen, cytokeratin, and epithelial membrane antigen in the cells surrounding the hyaline bodies. Keratin, α-1-antitrypsin, and immunoglobulin M showed weak positive staining. There was widespread vimentin except in the cells with hyaline inclusions. Glial fibrillary acidic protein and S100 were negative. These results provide additional confirmation of immunohistochemical data that can serve as evidence for epithelial and secretory differentiation in meningiomas.
Treatment of Scaphocephaly with Sagittal Craniectomy and Biparietal Morcellation
Authors: Greene Clarence S. , Winston Ken R. 
Published: May 2010

ABSTRACT
A series of 50 consecutive patients with scaphocephaly treated by a new operation are reported, and the results are reviewed in detail. The treatment consists of a broad sagittal craniectomy plus extensive morcellation of both parietal bones and, occasionally, the squamous portion of the occipital bone, without dislodging the bony fragments from their dural attachments. The procedure can be done relatively rapidly (median operative time = 55 min) and with minimal loss of blood (median transfusion = 85 ml). The results are analyzed by several criteria and are considered to be excellent.
Microsurgical Removal of Arteriovenous Malformations of the Basal Ganglia
Authors: Malik Ghaus M. , Umansky Felix , Patel Suresh , Ausman James I. 
Published: May 2010

ABSTRACT
Arteriovenous malformations in the basal ganglia region have been a problem in neurosurgical practice. We report six cases of deep-seated malformations fed mainly by the perforating branches of the middle cerebral artery. There were no deaths in the series. Four patients returned to their previous activities, and the other two patients had persistent hemiparesis and dysphasia, present preoperatively, with worsening in one case. Both of these patients improved and are independent. We show the feasibility of satisfactory microsurgical treatment of these lesions based on the knowledge of microanatomical studies.
Posttraumatic Dissecting Aneurysm of the Anterior Cerebral Artery: Case Report
Authors: Amagasa Masaharu , Sato So , Otabe Kazunori 
Published: May 2010

ABSTRACT
A case of cerebral infarction in the territory of the anterior cerebral artery after a minor head injury is reported. It is possible that direct or mechanical damage by the edge of the falx or stretching and shearing of the anterior cerebral artery after an acute shift of the corpus callosum caused the localized lesion of the left anterior cerebral artery. We think that this mechanical injury caused a dissecting aneurysm or a cerebral arterial dissection, which was diagnosed by sequential angiographic changes.
Midline Lumbar Ganglion/Synovial Cyst Mimicking an Epidural Tumor: Case Report and Review of Pathogenesis
Authors: Azzam Charles J. 
Published: May 2010

ABSTRACT
A case of a midline lumbar extradural ganglion/synovial cyst causing lumbar canal stenosis and mimicking an epidural tumor is presented. The lesion was demonstrated by a magnetic resonance imaging study, and relief of symptoms was achieved with decompressive laminectomy and total removal of the mass. The pathogenesis of lumbar ganglion/synovial cyst is reviewed.
Stab Wounds to the Temporal Fossa
Authors: Haworth C. S. , de Villiers J. C. 
Published: May 2010

Abstract
Stab wounds to the temporal fossa appear as a characteristic clinical entity. Patients admitted with stab wounds to the head during the period 1970 to 1986 were reviewed retrospectively. Of these, 10 met the criteria of having suffered a stab wound that penetrated the skull and dura mater of the temporal fossa. Injury to the internal carotid artery-cavernous sinus complex (3 patients) or to the basilar artery-pons region (5 patients) was frequent. Two other patients experienced injury to the trigeminal nerve and the petrous ridge. The mechanical, neurological, radiological, and prognostic features of knife wounds to this region are discussed.