bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determination of filling volumes in HydroCoil-treated aneurysms by using three-dimensional computerized tomography angiography
Authors: Deshaies Eric M. , Bagla Sandeep , Agner Celso , Boulos Alan S. 
Published: January 2008

Object
Coil embolization of aneurysms has been shown to be as safe and effective as surgical clip ligation, but has a higher recurrence rate. Advances in coil technology aim to reduce aneurysm recurrence by coating the devices with biological substances. An example of this is MicroVention's HydroCoil, which is a platinum coil coated with hydro-gel that improves filling volumes by swelling when it contacts blood. The goal of this study was to determine whether this new coil type significantly reduced or prevented recurrences of aneurysms.

Methods
The authors used three-dimensional computerized tomography angiography to determine aneurysm volumes accurately in 12 patients prior to coil embolization. The percentage filling volume was subsequently calculated for each aneurysm after treatment with HydroCoils and the immediate and 6-month follow-up angiographically confirmed occlusions were evaluated. The data demonstrated that both anterior and posterior intracranial aneurysms with diameters of 3 to 25 mm and volumes of 0.03 to 4.8 ml had filling volumes of 0.02 to 1.36 ml, resulting in filling volumes from 23% in a giant ophthalmic artery aneurysm to 80% in a small anterior communicating artery aneurysm. All of the aneurysms except for the giant one demonstrated stable occlusion on angiographic studies obtained at the 6-month follow-up review.

Conclusions
HydroCoil embolization of intracranial aneurysms is safe and effective for small, large, and very large aneurysms. The percentage filling volume is greater than that reported for bare platinum coils in every case except the giant aneurysm. Nevertheless, angiographically confirmed occlusion is not directly related to percentage filling volume, but rather to the ability to occlude the aneurysm neck.
CyberKnife radiosurgery for idiopathic trigeminal neuralgia
Authors: Lim Michael , Villavicencio Alan T. , Burneikiene Sigita , Chang Steven D. , Romanelli Pantaleo , McNeely Lee , McIntyre Melinda , Thramann Jeffrey J. , Adler John R. 
Published: January 2008

Object
Gamma knife surgery is an accepted treatment option for trigeminal neuralgia (TN). The safety and efficacy of CyberKnife radiosurgery as a treatment option for TN, however, has not been established.

Methods
Forty-one patients were treated between May 2002 and September 2004 for idiopathic TN at Stanford University and the Rocky Mountain CyberKnife Center. Patients with atypical pain, multiple sclerosis, or previous radiosurgical treatment or a follow-up duration of less than 6 months were excluded. Patients were evaluated for the level of pain control, response rate, time to pain relief, occurrence of hypesthesia, and time to pain recurrence with respect to the length of the nerve treated and the maximum and the minimum dose to the nerve margin.
Thirty-eight patients (92.7%) experienced initial pain relief at a median of 7 days after treatment (range < 24 hours–4 months). Pain control was ranked as excellent in 36 patients (87.8%), moderate in two (4.9%), and three (7.3%) reported no change. Six (15.8%) of the 38 patients with initial relief experienced a recurrence of pain at a median of 6 months (range 2–8 months). Long-term response after a mean follow-up time of 11 months was found in 32 (78%) of 41. Twenty-one patients (51.2%) experienced numbness after treatment.

Conclusions
CyberKnife radiosurgery for TN has high rates of initial pain control and short latency to pain relief compared with those reported for other radiosurgery systems. The doses used for treatment were safe and effective. Higher prescribed doses were not associated with improvement in pain relief or recurrence rate. The hypesthesia rate was related to the length of the trigeminal nerve treated.
Technique of microvascular decompression
Authors: Jannetta Peter J. , Mclaughlin Mark R. , Casey Kenneth F. 
Published: January 2008

Vascular compression of the trigeminal nerve in the cerebellopontine angle is now generally accepted as the primary source or “trigger” causing trigeminal neuralgia. A clear clinicopathological association exists in the neurovascular relationship. In general, pain in the third division of the trigeminal nerve is caused by rostral compression, pain in the second division is caused by medial or more distant compression, and pain in the first division is caused by caudal compression.
This discussion of the surgical technique includes details on patient position, placement of the incision and craniectomy, microsurgical exposure of the supralateral cerebellopontine angle, visualization of the trigeminal nerve and vascular pathological features, microvascular decompression, and wound closure. Nuances of the technique are best learned in the company of a surgeon who has a longer experience with this procedure.
Assessment of pain control, quality of life, and predictors of success after gamma knife surgery for the treatment of trigeminal neuralgia
Authors: Jawahar Ajay , Wadhwa Rishi , Berk Caglar , Caldito Gloria , Delaune Allyson , Ampil Federico , Willis Brian , Smith Donald , Nanda Anil 
Published: January 2008

Object
There are various surgical treatment alternatives for trigeminal neuralgia (TN), but there is no single scale that can be used uniformly to assess and compare one type of intervention with the others. In this study the objectives were to determine factors associated with pain control, pain-free survival, residual pain, and recurrence after gamma knife surgery (GKS) treatment for TN, and to correlate the patients' self-reported quality of life (QOL) and satisfaction with the aforementioned factors.

Methods
Between the years 2000 and 2004, the authors treated 81 patients with medically refractory TN by using GKS. Fifty-two patients responded to a questionnaire regarding pain control, activities of daily living, QOL, and patient satisfaction.
The median follow-up duration was 16.5 months. Twenty-two patients (42.3%) had complete pain relief, 14 (26.9%) had partial but satisfactory pain relief, and in 16 patients (30.8%) the treatment failed. Seven patients (13.5%) reported a recurrence during the follow-up period, and 25 (48.1%) reported a significant (> 50%) decrease in their pain within the 1st month posttreatment. The mean decrease in the total dose of pain medication was 75%. Patients' self-reported QOL scores improved 90% and the overall patient satisfaction score was 80%.

Conclusions
The authors found that GKS is a minimally invasive and effective procedure that yields a favorable outcome for patients with recurrent or refractory TN. It may also be offered as a first-line surgical modality for any patients with TN who are unsuited or unwilling to undergo microvascular decompression.
Surgical anatomy of supratentorial midline lesions
Authors: Yaşargil M. Gazi , Türe Uğur , Yaşargil ¸ Dianne C. H. 
Published: January 2008

Object
In this paper the authors correlate the surgical aspects of deep median and paramedian supratentorial lesions with the connective fiber systems of the white matter of the brain.

Methods
The cerebral hemispheres of 10 cadaveric brains were dissected in a mediolateral direction by using the fiber dissection technique, corresponding to the surgical approach.

Conclusions
This study illuminates the delicacy of the intertwined and stratified fiber laminae of the white matter, and establishes that these structures can be preserved at surgical exploration in patients.
The anterior sylvian point and the suprasylvian operculum
Authors: Ribas Guilherme Carvalhal , Ribas Eduardo Carvalhal , Rodrigues Consuelo Junqueira 
Published: January 2008

Object
The sylvian fissure or lateral sulcus is the most identifiable feature of the superolateral brain surface and constitutes the main microneurosurgical corridor, given the high frequency of approachable intracranial lesions through this route. The anterior sylvian point (ASyP) divides this fissure in its main anterior and posterior rami and was evaluated in this study for its morphology, exact location, and sulcal and neural relationships to assess its suitability as an initial, visually identifiable landmark for further neuroimaging and intraoperative estimation of its adjoining suprasylvian structures.

Methods
This study is based on 32 formalin-fixed cerebral hemispheres. The brains were removed from the skulls of 16 cadavers after the introduction of plastic catheters through properly positioned burr holes; the number of specimens for some of the analyzed data differed because of incorrect positioning of catheters or damage to the studied structures caused by the initial steps of the study.
The ASyP had a cisternal aspect in 94% of the specimens and was always located inferior to the triangular part of the inferior frontal gyrus, 2.3 ± 0.5 cm in front of the inferior rolandic point. The ASyP was located underneath the 1.5-cm-diameter cranial area of the anterior aspect of the squamous suture. Its adjoining structures that compose the suprasylvian operculum have constant basic morphological configurations.

Conclusions
The ASyP underlies the anterior aspect of squamous suture just behind the pterion, can be easily recognized, and constitutes a reliable initial sulcal landmark for further estimation of the suprasylvian sulcal and gyral structures. The suprasylvian operculum can be understood as a series of convolutions roughly arranged as a V-shaped convolution, with its vertex constituted by the ASyP, followed by three U-shaped convolutions and one C-shaped convolution.
An anteromedial approach to the temporal horn to avoid injury to the optic radiation fibers and uncinate fasciculus: anatomical and technical note
Authors: Coppens Jeroen R. , Mahaney Kelly B. , Abdulrauf Saleem I. 
Published: January 2008

Object
The aim of this study was to define an anteromedial approach to the temporal horn via a transsylvian approach to avoid injury to the optic radiation fibers as well as the uncinate fasciculus. This route was compared with standard surgical approaches to the temporal horn, and their relationship to the optic radiation and uncinate fasciculus was reviewed.

Methods
Three cadaveric brain specimens were prepared with freezing and thawing cycles according to the Klingler technique. Dissection was performed in a lateral-to-medial fashion with the help of wooden spatulas. Photographs were taken through the operating microscope at every level of the dissection. The dissection was continued until the optic radiation was encountered. Particular attention was paid to the relationship of the uncinate fasciculus with the optic radiation. An anteromedial transsylvian approach was defined to enter the temporal horn without injuring the optic radiation or the uncinate fasciculus.

Conclusions
A transsylvian anteromedial approach through the pyriform cortex at the level of the anterior and superior surface of the uncus enables a safe entry into the temporal horn without injury to the optic radiation fibers or the main part of the uncinate fasciculus.
Surgical outcomes and seizure control rates after resection of dysembryoplastic neuroepithelial tumors
Authors: Sandberg David I. , Ragheb John , Dunoyer Catalina , Bhatia Sanjiv , Olavarria Greg , Morrison Glenn 
Published: January 2008

Object
In this study the authors review the outcomes in pediatric patients who presented with seizures and underwent resection of dysembryoplastic neuroepithelial tumors (DNETs). The authors focus on the diagnostic evaluation and surgical techniques that facilitate gross–total tumor resection and subsequent freedom from seizures.

Methods
Eighteen patients between the ages of 1 month and 13 years who presented with seizures underwent resection of DNETs between January 1992 and December 2004. Preoperative evaluation included magnetic resonance (MR) imaging and interictal scalp electroencephalography (EEG) in all patients, functional MR imaging in eight patients, video monitoring with ictal scalp EEG in 12 patients, interictal single-photon emission computerized tomography (SPECT) scanning in one patient, and ictal SPECT scanning in two patients. Thirteen patients underwent one-stage procedures, whereas five underwent two-stage procedures (implantation of monitoring electrodes followed by tumor resection), either for functional language mapping (three patients) or due to inconclusive preoperative data (two patients). Intraoperative electrocorticography (ECoG) was performed in 17 patients and led to resection of the cerebral cortex beyond the tumor margins in 10 of them. According to operative reports, gross–total tumor resections were achieved in all patients, but one child had minimal residual tumor on postoperative MR images that has remained stable. The only surgical complication was a transient third cranial nerve palsy. Over a median follow-up duration of 1.6 years, all patients are seizure free and without radiographically detected tumor recurrence.

Conclusions
Dysembryoplastic neuroepithelial tumors are a highly treatable cause of epilepsy in children. Excellent rates of complete tumor resection and seizure control with minimal morbidity can be attained using intraoperative ECoG and two-stage surgical procedures when appropriate.
Expanded endonasal approach: the rostrocaudal axis. Part II. Posterior clinoids to the foramen magnum
Authors: Kassam Amin , Snyderman Carl H. , Mintz Arlan , Gardner Paul , Carrau Ricardo L. 
Published: January 2008

Object
Transsphenoidal approaches have been used for a century for the resection of pituitary and other sellar tumors. Recently, however, the standard endonasal approach has been expanded to provide access to other parasellar lesions. With the addition of the endoscope, this expansion has significant potential for the resection of skull base lesions.

Methods
The anatomical landmarks and surgical techniques used in expanded (extended) endoscopic approaches to the clivus and cervicomedullary junction are reviewed and presented, accompanied by case illustrations of each segment (or module) of approach.
The caudal portion of the midline anterior skull base and the cervicomedullary junction is divided into modules of approach: the middle third of the clivus, its lower third, and the cervicomedullary junction. Case illustrations of successful resections of lesions via each module of the approach are presented and discussed.

Conclusions
Endoscopic expanded endonasal approaches to caudally located midline anterior skull base and cervicomedullary lesions are feasible and hold great potential for decreased morbidity. The effectiveness and appropriate use of these techniques must be evaluated by close examination of outcomes as case series expand.
Transcavernous approach to diseases of the anterior upper third of the posterior fossa
Authors: Krisht Ali F. 
Published: January 2008

Object
The region in the upper anterior third of the posterior fossa is a surgically hidden, narrow corridor between the petroclival surface anteriorly and the surface of the brainstem posteriorly. Although several approaches have been described to help surgeons reach this region, few of them enable practitioners to reach the different corners of the area and provide as wide a view as the one achieved using the transcavernous route.

Methods
A transcavernous approach was used in 91 cases (50 complex upper basilar artery [BA] aneurysms, 30 upper petroclival junction meningiomas, five trigeminal nerve schwannomas, three upper clival chordomas, and three anterior pontine lesions) involving the anterior upper third of the posterior fossa. The approach uses the pretemporal route with exposure of the lateral wall of the cavernous sinus. It entails removal of the anterior clinoid process. The posterior clinoid process is also removed when necessary. The approach leads to the upper basilar region. It is widened inferiorly to expose the anterior aspect by removal of the posterior clinoid process and the petroclival osseous and dural elements. Its lateral extension exposes the region of the Meckel cave and it can be widened by removal of the petrous apex.
Seventy patients experienced new transient mild cranial neuropathies, 67 of whom recovered fully. Surgically related ischemic morbidities occurred in three patients with BA aneurysms (one small medial thalamic infarct, ataxia due to superior cerebellar artery ischemia, and distal middle cerebral artery embolus in a patient with atrial fibrillation in whom anticoagulation therapy was stopped). All the neuropathies in patients with BA aneurysms were oculomotor and recovery was the rule in all of them. Three new permanent cranial neuropathies occurred in the patients with meningiomas. In seven patients with preoperative neuropathy, two had partial improvement. Five patients with atypical meningiomas were treated with postoperative radiation therapy. Progression occurred later in four patients who were treated with gamma knife surgery. There were no surgery-related deaths. More than 1 year of follow-up data were available in 85 patients, and 94% of those patients were in an active and functional state (Glasgow Outcome Scale scores of 4 and 5).

Conclusions
The safety achieved with the transcavernous route allows surgeons to achieve wide exposures to lesions involving the anterior upper third of the posterior fossa. It is an approach that should be mastered by every neurosurgeon dealing with cranial lesions.
Technical strategies to approach aneurysms of the vertebral and posterior inferior cerebellar arteries
Authors: Krayenbühl Niklaus , Guerrero Carlos A. , Krisht Ali F. 
Published: January 2008

Object
Aneurysms of the vertebral artery (VA) and proximal posterior inferior cerebellar artery (PICA) are rare and challenging lesions, as they are located in front of the brainstem and surrounded by the lower cranial nerves. Many different approaches have been described for their treatment, and have yielded different results. With the use of different examples of lesions, the authors describe their surgical strategy in the management of VA and PICA aneurysms.

Methods
The far-lateral approach was used, and the potential of its different extensions according to the specific anatomical location and configuration of different types of aneurysms is emphasized.

Conclusions
With the present knowledge of the microsurgical anatomy in the region of the foramen magnum, the far-lateral approach can be tailored to the specific anatomical and morphological configuration of an aneurysm in this region with good surgical results.
Embryonic stem cell–derived astrocytes: a novel gene therapy vector for brain tumors
Authors: Uzzaman Mahmud , Benveniste Ronald J. , Keller Gordon , Germano Isabelle M. 
Published: January 2008

Object
For gene therapy strategies currently in clinical trials, viral vectors are used to deliver transgenes directly to normal and tumor cells within the central nervous system (CNS). The use of viral vectors is limited by several factors. The aim of this study was to assess whether embryonic stem cell (ESC)–derived astrocytes expressing a doxycycline-inducible transgene can be used as a vector for gene therapy.

Methods
The authors generated a pure population of ESC-derived astrocytes carrying a transgene, tumor necrosis factor–related apoptosis-inducing ligand (TRAIL), inserted in the chromosome under the control of a highly regulated doxycycline-inducible expression system. Fully differentiated ESC-derived astrocytes were stereotactically transplanted in the mouse brain, and then cell migration and transgene expression were studied.

Results
The ESC-derived astrocytes started to migrate from the transplant site 48 hours after the procedure. They were found to have migrated throughout the brain tissue by 6 weeks. Transplanted ESC-derived astrocytes expressed the TRAIL transgene after doxycycline induction throughout the duration of the experiment. Teratoma formation was not observed in long-term experiments (12 weeks).

Conclusions
These data show that ESC-derived astrocytes can be used as delivery vectors for CNS tumors. This technique might have a major impact on the treatment of patients with malignant gliomas and a wide spectrum of other neurological diseases.
Pokemon expression in malignant glioma: an application of bioinformatics methods
Authors: Rovin Richard A. , Winn Robert 
Published: January 2008

Object
In this report the authors review the role of bioinformatics in the design of a research project in which the molecular genetics of malignant glioma were studied. A project to characterize Pokemon expression in malignant glioma was developed, refined, and implemented using bioinformatics methods.

Methods
Using the resources available from the National Center for Biotechnology Information, the messenger RNA (mRNA) sequence for Pokemon was determined. With this information and online primer design tools, novel primers were designed that would specifically amplify Pokemon mRNA by using reverse transcription–polymerase chain reaction assays.

Conclusions
The promise of bioinformatics is in the rapid and widespread dissemination and analysis of genomic information. This information is then used in research investigating the genetic basis of disease. In this paper the authors review the bioinformatics methods used in their study of Pokemon expression in malignant glioma.
Oligodendroglioma: clinical study and survival analysis correlated with chromosomal anomalies
Authors: Hamlat Abderrahmane , Saikali Stephan , Chaperon Jacques , Le Calve Michèle , Gedouin Daniel , Ben-Hassel Mohamed , Guegan Yvon 
Published: January 2008

Object
Demonstration of the loss of chromosomes 1p and 19q in the presence of a brain neoplasm marks the emergence of genotype as a prognostic indicator. The authors report gene expression data for oligodendroglioma and correlate genotype with response to therapy. Gene expression subgroups may represent distinct types of disease.

Methods
Eighty-seven cases of supratentorial oligodendroglioma were selected from 145 cases treated in a single center between January 1990 and December 2001. Fluorescence in situ hybridization was used to determine the status of chromosomes 1p and 19q. Parameters evaluated included clinical data and radiological and histological features. Univariate and multivariate analyses were performed and a probability value less than 0.05 was considered significant.
The patients included 48 women and 39 men. The overall mean age at presentation was 45 years for women and 36 years for men (p = 0.006). The univariate analysis identified the following as favorable prognostic factors: younger patient age (p = 10−5), female sex (p = 0.0025), seizure as a presenting symptom (p = 10−5), normal clinical examination (p = 10−5), absence of lesion enhancement on neuroimaging studies (p = 0.0231), lack of histological necrosis (p = 0.0003), absence of mitoses (p = 0.0014), 1p and 19q deletions (p = 0.0001), absence of recurrence (p = 0.0021), and adjuvant radiotherapy and/or chemotherapy (p = 10−5). The multivariate analysis identified patient age (p = 10−5) and chromosomal anomalies (p = 0.002) as independently linked to survival. Three molecular subtypes emerged: oligodendroglioma with 1p and 19q deletions, oligodendroglioma demonstrating polysomia and a lack of meaningful response to radiotherapy or chemotherapy, and oligodendroglioma with no 1p-9q deletion in which partial response was seen.

Conclusions
According to our data, oligodendrogliomas could be divided into three molecular subtypes. Although chemotherapy seems efficient for managing this tumor, additional studies should be conducted to compare the efficacy of radiotherapy and chemotherapy.