bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Dorsal Column Stimulation in the Treatment of Chronic Pain
Authors: Young Ronald F. 
Published: August 2004

Abstract
Dorsal column stimulation (DCS) was used in the treatment of chronic intractable pain in 51 patients. Twenty-five of the patients had back and leg pain secondary to the treatment of intervertebral disc disease; 11 had postoperative pain after general or thoracic surgical procedures. The remainder suffered pain related to multiple sclerosis, spinal cord injury, carcinoma, and peripheral vascular disease. Pain had been present for a mean of 24 months. Thirty-seven patients underwent DCS electrode placement by open laminectomy, and 11 had percutaneous epidural DCS electrode placement. Three patients first underwent epidural DCS electrode implantation and subsequently had DCS electrode implantation by laminectomy. No major complications were noted, although multiple lesser complications required 33 additional operative procedures for correction. Follow-up periods ranged from 12 to 67 months, with a mean of 38 months. Immediately after implantation. 47% of the patients reported that they had essentially complete pain relief, but 3 years later this had decreased to 8%. No patient followed for 4 years or longer reported complete pain relief. Thirty-three per cent of the patients discontinued the regular use of narcotics for pain relief after DCS electrode implantation. Unfortunately, only 16% were able to return to gainful employment or full physical activity after DCS. Based on these data and a review of the literature, the following conclusions are made: (a) assessment of success in the treatment of chronic pain is strongly dependent on the criteria used for patient evaluation: (b) with the criteria of this report, DCS is a relatively ineffective treatment for chronic pain; (c) epidural percutaneous DCS systems are no more effective than are those placed by laminectomy, and, because of technical problems with epidural systems (mainly lead breakage and migration), the latter may actually be less effective; and (d) at present DCS seems to play a minor role in the treatment of chronic intractable pain.
An Automated Tumor Resection Device for Neurological Surgery
Authors: Lazar Martin L. , Wang Carl , Bland James E. 
Published: August 2004

Abstract
A pneumatically activated cutting probe has been designed for the neurosurgical removal of nervous system tumors or diseased tissue. The hand-held probe is formed of concentric slender tubes, one reciprocating inside the other. A scalpelsharp edge on the tip of the inner tube moves in a shear motion past a stationary port on one side near the distal end of the outer tube. The reciprocating motion of the inner tube is provided by a pneumatic power source housed in a separate control console.
Technical Considerations for Facilitation of Selective Percutaneous Radiofrequency Neurolysis of the Trigeminal Nerve
Authors: Apfelbaum Ronald I. 
Published: August 2004

Abstract
Fine points of the technique of selective percutaneous radiofrequency trigeminal neurolysis relative to patient preparation. accurate and rapid foramen ovale puncture, electrode positioning, and neurolytic lesions are discussed. These measures. which have evolved from our experience in treating trigeminal neuralgia by this method over the last 4 years, have made the procedure safer and less painful but also significantly more expedient.
Spinal Subarachnoid Hematoma after Lumbar Puncture Producing Acute Thoracic Myelopathy
Authors: Diaz Fernando G. , Yock Douglas H. , Rockswold Gaylan L. 
Published: August 2004

Abstract
A case of subarachnoid hematoma after a difficult lumbar puncture and anticoagulation is presented. Subarachnoid adhesions preventing the free flow of spinal fluid at the T-6 level served to limit the cranial progression of the hemorrhage and produced a transverse myelopathy at that level. The underlying pathology, clinical course, and myelographic findings are reviewed. Pertinent literature is presented.
Endodermal Sinus Tumor of the Pineal Region
Authors: Lee Sang H. , Sundaresan Narayan , Berta Jereb , Galicich Joseph H. 
Published: August 2004

Abstract
A 13-year-old boy presented with symptoms and signs of a posterior 3rd ventricle tumor associated with raised levels of serum and cerebrospinal alpha-fetoprotein. The patient underwent subtotal resection of the tumor followed by craniospinal radiation. Histopathological examination revealed a pure endodermal sinus tumor. Endodermal sinus tumors represent a rare type of germ cell tumor, only 13 intracranial cases having been reported in the literature.
Syndrome of Inappropriate Antidiuretic Hormone Secretion after Spontaneous Subarachnoid Hemorrhage
Authors: Wise Burton L. 
Published: August 2004

Abstract
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) developed approximately 7 days after a spontaneous subarachnoid hemorrhage in a 63-year-old woman with an anterior cerebral artery aneurysm. The hyponatremia associated with this syndrome resulted in a deterioration of the patient's clinical condition and focal neurological signs, which simulated the clinical deterioration after spontaneous subarachnoid hemorrhage that is often caused by other intracranial pathological conditions. The focal neurological signs in particular are likely to be interpreted as indicating one of these other conditions. Prompt recognition and treatment of the SIADH resulted in prompt improvement, and we were then able to proceed with the planned craniotomy for the aneurysm. The syndrome and its importance are discussed.
Intracranial Clips: An Examination of the Devices Used for Aneurysm Surgery
Authors: Manuel Dujovny , Nir Kossovsky , Ram Kossowsky , Alfred Perlin , Ricardo Segal , Fernando G. Diaz , James I. Ausman 
Published: August 2004

Abstract
A properly functioning aneurysm clip is of paramount importance in the surgical ablation of intracranial aneurysms. An appropriate match between the closing force needed to ablate an aneurysm and the force exerted by the aneurysm clip must be achieved. In this study, the opening and closing forces exerted by several commonly used aneurysm clips were tested. There was a strong correlation between the classification of the clips, according to the Dujovny system, and their mechanical behavior. Minimal variability among different lots of the same clip type and minimal hysteresis were generally exhibited by the alpha mobile fulcrum class clips, such as the Yasargil, Vari-Angle McFadden, Scoville, and Mayfield clips. Significant exceptions included several types of Mayfield and Drake clips. In contrast, pivot class clips generally showed twice as much lot variability among different lots, as well as a significant amount of hysteresis. Clips of this class include the Vari-Angle, Heifetz, and Pivot clips. Because significant variations in clip force exist and because several other factors can compound these differences, it is suggested that aneurysm clips be individually tested for their closing forces before they are used in an operation.
Tentorial Meningiomas: Surgical Management and Results
Authors: Laligam N. Sekhar , Peter J. Jannetta , Joseph C. Maroon 
Published: August 2004

Abstract
We report the clinical features, radiological studies, operative management, and follow-up data in a series of 27 patients with tentorial meningiomas. Headache and extremity or gait ataxia were the most common presenting symptoms. Signs of elevated intracranial pressure and cranial nerve, pyramidal, or cerebellar deficits were the most common findings on neurological examination. Computed tomography was the single most important diagnostic tool. Cerebral arteriography was considered important to define arterial and venous relationships to the tumor. Two patients in the series underwent cerebrospinal fluid shunting only. The others underwent an operation on the tumor, with or without a shunt. There were 2 postoperative deaths early in the series, 1 due to cerebellar swelling and the other due to brain stem infarction. With an average follow-up of 5.5 years, 19 patients are independent and have resumed their premorbid level of activity. The pathological anatomy of these lesions is described. The different operative approaches to this tumor are discussed.
Cerebral Edema Associated with Meningiomas: Possible Role of a Secretory-Excretory Phenomenon
Authors: Jacques Philippon , Jean Francois Foncin , Raoul Grob , Abbas Srour , Michel Poisson , Bertrand F. Pertuiset 
Published: August 2004

Abstract
A retrospective study of cerebral edema in 40 patients with intracranial meningiomas seems to demonstrate that the extent of edema is not related to anatomical factors such as location. Histological type is more significant; cerebral edema is usually observed with meningothelial forms. Furthermore, the study of tumor cells by electron microscopic methods indicates that secretory-excretory activity is closely associated with the production of peritumoral edema. The ultrastructural aspects of this secreted material are described, but further biochemical studies are necessary to determine its exact nature. The possible role of tumoral steroid receptors in the secretory-excretory phenomenon is discussed.
Neurological Improvement Associated with Late Decompression of the Thoracolumbar Spinal Cord
Authors: Dennis J. Maiman , Sanford J. Larson , Edward C. Benzel 
Published: August 2004

Abstract
We reviewed the cases of 20 patients admitted to our institution with thoracolumbar spinal cord injury who had previously undergone laminectomy and/or spinal instrumentation. Thirteen patients had a mass in the spinal canal, and 7 had kyphotic deformities. The lateral extracavitary approach to the spine and posterior stabilization when indicated were done in each. Seventeen patients obtained substantial neurological improvement. All 7 patients with kyphosis regained the ability to walk, as did all but 3 of the nonambulatory patients with a mass in the spinal canal. Morbidity was limited to pneumothorax and 1 case of late kyphosis associated with premature removal of the spinal fixation devices. Elective anterior approaches for reconstruction of the spinal canal with appropriate stabilization afford the best opportunity for neurological improvement in cases of thoracolumbar spinal cord injury.
Posterior Stabilization with an Interlaminar Clamp in Cervical Injuries: Technical Note and Review of the Long Term Experience with the Method
Authors: Renn O. Holness , William S. Huestis , William J. Howes , Roland A. Langille 
Published: August 2004

Abstract
An alternative method of cervical fixation utilizing a stainless steel clamp is described. The clamp is applied to the adjoining laminae of involved vertebrae in those cervical dislocations and subluxations with posterior instability. The long term results of this method have been most satisfactory, as indicated by our follow-up of 51 patients treated during the last decade.
Asymptomatic Leptomeningeal Dissemination of Tumor to the Spinal Cord: Report of Three Cases
Authors: Tadanori Tomita 
Published: August 2004

Abstract
Three children with a history of malignant tumor (cerebellar medulloblastoma in two cases and adrenal neuroblastoma in one case) are discussed. All three had diffuse leptomeningeal dissemination, which was confirmed at autopsy. Computed tomography (CT) revealed diffuse enhancement of the intracranial subarachnoid spaces after the administration of contrast material. Despite the absence of spinal cord signs and symptoms, autopsy showed severe diffuse seeding of neoplastic cells in the spinal subarachnoid space giving the spinal cord the appearance of a “bamboo stick.” Myelography is necessary to disclose clinically silent spinal cord lesions when CT or cerebrospinal fluid cytological examination reveals evidence of subarachnoid dissemination of tumor.
Spasmodic Torticollis as a Cause of Ulnar Nerve Entrapment
Authors: Saul I. Weingarden , Harold P. Weingarden 
Published: August 2004

Abstract
Spasmodic torticollis is thought to be a central nervous system disorder with no peripheral nervous system component. Several consecutive patients with spastic torticollis were found to have ulnar nerve compromise at the elbow on the side ipsilateral to the direction of chin turning. This article describes three such patients in detail. It is postulated that the cause is the stereotypical posture assumed by these patients in using their hand to maintain a neutral head position. The chronic leaning and elbow flexion place the ulnar nerve at risk for the development of pressure neuropathy.
Contralateral Trigeminal Nerve Dysfunction as a False Localizing Sign in Acoustic Neuroma: A Clinical and Electrophysiological Study
Authors: Matthew Koenig , Krishna Kalyan-Raman , Om N. Sureka 
Published: August 2004

Abstract
A 49-year-old woman presented with right facial sensory impairment due to trigeminal nerve dysfunction caused by a contralateral acoustic neuroma. The mechanism of the falsely localizing trigeminal involvement is probably displacement and distortion of the brain stem by the large mass lesion and not increased intracranial pressure. A preoperative orbicularis oculi reflex study was abnormal and indicative of right trigeminal nerve dysfunction; after surgical removal of the tumor, the orbicularis oculi reflex study was normal. We conclude that a false localizing sign of trigeminal nerve dysfunction can occur rarely on the contralateral side in patients with large posterior fossa tumors, especially tumors arising from the cerebellopontine angle, and should be considered in the differential diagnosis of hemifacial sensory disturbance.
Microvascular Decompression of the Eighth Cranial Nerve for Disabling Tinnitus without Vertigo: A Case Report
Authors: Tadashi Kudo , Kenjiro Ito 
Published: August 2004

Abstract
We report a patient with disabling tinnitus that responded dramatically to microvascular decompression of the 8th cranial nerve. The most annoying, episodic, high pitched tinnitus disappeared immediately after the operation. Two types of constant tinnitus either persisted or recurred after the procedure. Nevertheless, the remaining tinnitus is much reduced compared to the preoperative level. The patient was able to return to his previous work 2 months after operation.
Use of Trapezius Muscle for Closure of Complicated Upper Spinal Defects
Authors: Alan E. Seyfer , Allen S. Joseph 
Published: August 2004

Abstract
Dehiscence of cervicothoracic incisional wounds is an occasional complication of laminectomy. Subsequent healing can be further compromised by associated immunodeficiency, malignancy, infection, previous radiotherapy, and cerebrospinal fluid fistula. Two such cases that responded dramatically to the use of a lower trapezius muscle flap are described. Pertinent anatomical and surgical considerations are reviewed.
Computed Tomographic Discography in the Evaluation of Extreme Lateral Disc Herniation
Authors: Edgardo J. C. Angtuaco , John C. Holder , Warren C. Boop , Eugene F. Binet 
Published: August 2004

Abstract
Thin section, high resolution computed tomographic (CT) scans of the lumbar spine produce images that can show herniated intervertebral discs without intravenous or intrathecal contrast enhancement. With this technique, the diagnosis of posterolateral and midline herniation has been greatly facilitated. This communication reports the use of CT discography in the preoperative evaluation of two patients who were shown at discography and proven at operation to have extreme lateral disc herniations.
Multiple Meningiomas of the Cervical Spinal Cord Associated with Klippel-Feil Malformation and Atlantooccipital Assimilation
Authors: Peter O. Holliday , Courtland Davis , Jean Angelo 
Published: August 2004

Abstract
A case of multiple meningiomas confined solely to the cervical spinal canal in association with multiple bony abnormalities of the cervical spine is presented. The relationship of this entity to neurofibromatosis, whether the central type or a form fruste, is explored. It is suggested that multiple meningiomas unassociated with other central or peripheral tumors may present a distinct clinical entity and may occur in an as yet uncharacterized familial pattern.
Pituitary Apoplexy: A Review
Authors: Erico Ramos Cardoso , Eric Weston Peterson 
Published: August 2004

Abstract
The authors present a critical review of the literature on the hemorrhagic complications of pituitary adenomas, especially those leading to apoplexy. They emphasize the distinction between pituitary apoplexy, hemorrhages leading to sudden endocrine alterations, and asymptomatic hemorrhages. Moreover, they speculate upon the possible pathophysiology of pituitary apoplexy and its predisposing factors. The clinical presentation, natural history, radiological findings, and differential diagnosis are also discussed. Finally, the historical evolution of the treatment of pituitary apoplexy is reviewed, with emphasis on the surgical treatment.
Electrothrombosis of Spontaneous Carotid-Cavernous Fistula by Copper Needle Insertion
Authors: Michiharu Nishijima , Kazuyo Kamiyama , Nobuo Oka , Shunro Endo , Akira Takaku 
Published: August 2004

Abstract
Electrothrombosis by copper needle insertion was used to treat three cases of spontaneous carotid-cavernous fistula. These patients had been treated conservatively for 6 months or more, but their symptoms had not improved. Angiography showed that the feeding arteries were branches of both the ipsilateral internal and the ipsilateral external carotid artery. Frontotemporal craniotomy was performed, and copper needles were inserted transdurally into the cavernous sinus. Closure of the fistula was verified by intraoperative angiography in all cases, and the symptoms improved after the operation. However, one patient had postoperative transient 3rd nerve palsy. Another had Gerstmann's syndrome due to narrowing of the internal carotid artery by a needle and worsening of the preoperative 6th nerve palsy. In one case, the operation was uneventful. Based on our experience, we discuss several problems with this technique.
Evoked Potential Correlates of Recovery from Aphasia after Focal Left Hemisphere Injury in Adults
Authors: Andrew C. Papanicolaou , Harvey S. Levin , Howard M. Eisenberg 
Published: August 2004

Abstract
An evoked potentials (EPs) paradigm that has been effective in demonstrating asymmetries in hemispheric activation during cognitive tasks was used to assess cerebral reorganization for language in recovered aphasics. Cortical click EPs were recorded bilaterally in normal volunteers, recovered aphasics who had sustained focal left hemisphere injury, and nonaphasic patients with diffuse injuries during a control condition of attending only to the click and during a verbal memory task. During that task, EP amplitude attenuation occurred in the left hemisphere for the normal subjects and the nonaphasic patients and in the right hemisphere for the recovered aphasics. These contrasting asymmetries in hemispheric activation suggest that a shift of hemispheric specialization for verbal processing contributes to the recovery of linguistic competence in adult aphasics.
Can Neuropsychological Tests Detect the Sites of Cerebrovascular Stenoses and Occlusions?
Authors: Anne Dull Baird , Kenneth M. Adams , Mark W. Shatz , Gregory G. Brown , Fernando Diaz , James I. Ausman 
Published: August 2004

Abstract
Conventional neuropsychological data may not mirror the site of cerebrovascular stenosis in a patient with mild to moderate symptoms. In this study, three groups of cerebral revascularization candidates failed to differ on an extended Halstead-Reitan battery: patients with symptoms and angiographic results referable to the carotid arterial system, subjects with clinical signs and neuroradiological findings referable to the vertebrobasilar arterial system, and patients with symptoms of cerebral ischemia but negative angiograms. Consistent with previous work, these patients generally were mildly impaired on neuropsychological tests, even though many were not symptomatic at the time of assessment. Neuropsychological tests seem to be sensitive to the presence and severity of cerebral ischemia, but in isolation may not be sufficient to determine the loci of vascular stenoses. The incongruence between angiographic and neuropsychological findings underlines the importance of distinguishing among different levels and types of measurements in defining subgroups of cerebral revascularization candidates. Collaboration among neuroscientists will further our understanding of the interrelationships among neurodiagnostic tests.
Further Studies with a Noninvasive Method of Intracranial Pressure Estimation
Authors: Donald York , Mark Legan , Steve Benner , Clark Watts 
Published: August 2004

Abstract
A linear relationship between elevated intracranial pressure in patients with hydrocephalus and with cerebral edema and a latency shift of the N2 wave of the flash-evoked cortical potential is demonstrated. Although the relationship is good at pressures of 200 to 300 mm H2O, it is excellent at pressures above 300 mm H2O. This relationship establishes a reliable noninvasive method of estimating intracranial pressure.
Treatment of Tic Douloureux and Hemifacial Spasm by Posterior Fossa Exploration: Therapeutic Implications of Various Neurovascular Relationships
Authors: Joseph H. Piatt , Robert H. Wilkins 
Published: August 2004

Abstract
A series of 152 posterior fossa explorations for tic douloureux and hemifacial spasm has been reviewed with assessment of outcome at the last follow-up examination. Among 103 cases of tic followed for an average of 48.3 months. 79 patients (77%) obtained good or excellent symptomatic relief, and there were 24 failures or recurrences (23%). Of 48 cases of hemifacial spasm followed for an average of 42.1 months, there were good or excellent results in 42 cases (87.5%); only 6 patients (12.5%) experienced failure or recurrence. Patients noted to have arterial contact at the 5th nerve entry zone responded significantly better to microvascular decompression than did patients with no arterial contact. Further, patients noted to have anatomical distortion of the 5th nerve by an artery or wedging of an artery into the crevice between the nerve and the pons had significantly better outcomes after microvascular decompression than did patients with other kinds of arterial contact. Partial sensory rhizotomy proved to be a highly effective alternative to microvascular decompression in cases of doubtful neurovascular compression. It was not possible to define similar neuroanatomical criteria predictive of response to microvascular decompression in patients with hemifacial spasm.
Successful Removal of an Arteriovenous Malformation in the Basal Ganglia
Authors: Rutka James T. , Tucker William S. 
Published: August 2004

Abstract
This report describes the successful removal of a ruptured dominant hemisphere arteriovenous malformation that arose in the region of the basal ganglia and was supplied by the lenticulostriate arteries. Obliteration of the lesion was accomplished by a transcerebral approach from above, utilizing the preexisting hematoma cavity.
Primary Intracranial Germinoma Presenting as Lower Cranial Nerve Involvement: Case Report and Review of the Literature
Authors: Aguila Luis A. , Chou Samuel M. , Bay Janet W. 
Published: August 2004

Abstract
Primary intracranial germinomas are classically known as midline lesions, occurring most commonly in the pineal and suprasellar regions, and will usually present with symptoms related to increased intracranial pressure or hypothalmic dysfunction. Involvement of both the pineal and the suprasellar region in the same patient (double midline lesions) is relatively rare (7%). Dissemination of germinoma to both cerebellopontine angles, in addition to the double midline lesions, with the initial clinical presentation of lower cranial nerve involvement has not been previously reported. We encountered such an unusual case, which prompted this report and review of the literature.