bluuebunny/crossref_metadata_2025_split huggingface dataset:
Liver Abscess: Complication of a Ventriculoperitoneal Shunt
Authors: Fisher Robert A. , Rodziewicz Gerard , Selman Warren R. , White Robert J. , Vibhakar Shardul D. 
Published: August 2004

Abstract
Liver abscess is a previously unreported complication of ventriculoperitoneal shunting. We present such a case, which was diagnosed by computed tomography (CT) and managed by CT-guided percutaneous catheter drainage of the liver abscess, appropriate antibiotics, and shunt externalization.
Vertebral Osteochondroma Causing Spinal Cord Compression: Case Report
Authors: Karian John M. , DeFilipp Gary , Buchheit William A. , Bonakdarpour Akbar , Eckhardt Wil 
Published: August 2004

Abstract
A case of spinal cord compression secondary to an osteochondroma of the vertebral body of T-4 is reported. Computed tomography aided in the display of the lesion and the planning of its resection.
Combined Supra-Infrasellar Approach for Large Pituitary Tumors
Authors: Loyo Mauro , Kleriga Enrique , Mateos Humberto , de Leo Roberto , Delgado Andres 
Published: August 2004

Abstract
A combined supra-infrasellar approach for the resection of very large pituitary tumors is described. We think that it is superior to either the transsphenoidal or the intracranial approaches to these difficult tumors.
Occult Esophageal Perforation Associated with Cervical Spine Fracture
Authors: Tomaszek David E. , Rosner Michael J. 
Published: August 2004

Abstract
A case of surgically confirmed cervical esophageal perforation associated with burst fractures of two cervical vertebral bodies is presented. We also describe a second case in which an incidentally discovered abscess of the cervical region could have been the result of esophageal perforation secondary to spine injury. Both patients had negative positive contrast esophagograms. This complication of cervical spine injury is extremely rare, and diagnosis can be difficult. Cervical esophageal perforation must be considered in the face of unexplained cervical, thoracic, or systemic sepsis and in the presence of an unexplained cervical mass. Severe cervical fracture with or without subluxation seems to constitute the anatomical basis for the entity. The treatment consists of drainage and antibiotics aimed at oral flora. The clinical features, diagnostic tests, and surgical management of this entity are reviewed.
Case Report: Polysomnographic Effects of Thalamotomy for Torsion Dystonia
Authors: Jankel William R. , Niedermeyer Ernst , Graf Martin , Kalsher Michael J. 
Published: August 2004

Abstract
We report a patient with torsion dystonia whose polysomnographic recordings revealed poor sleep and a pronounced and almost continuous type of spindle activity during non-rapid eye movement sleep. Rapid eye movement sleep was also reduced. These changes proved to be independent of medications. After a clinically successful unilateral thalamic operation, a normalization of sleep parameters and a reduction of the high amplitude sleep spindles was observed. implying that the regulation of sleep spindles and the advancement of dystonic symptoms are affected by a common mechanism.
Pain Relief after Hypophysectomy
Authors: Ramirez Lincoln F. , Levin Allan B. 
Published: August 2004

Abstract
Thirteen series of patients who underwent surgical or chemical hypophysectomy for the relief of pain associated with cancer were reviewed. In 10 series, involving 334 patients with breast or prostate cancer, surgical hypophysectomy produced pain relief in 70% of the patients afflicted with either tumor, including some with no evidence of hormone dependence. These results were then compared with the results of chemical hypophysectomy. This procedure was performed in 3 series involving 533 patients, of whom 24% had cancer other than breast or prostate. Chemical hypophysectomy produced pain relief in over 75% of the patients, regardless of tumor type or hormonal dependence. The possible role of the pituitary, the hypothalamus, and endogenous opiates in mediating the pain relief associated with hypophysectomy was examined. The mechanism by which pain relief is achieved remains unclear, but there is significant evidence that this relief is not related directly to the expected fall in the levels of known pituitary hormones. Evidence is provided that pain relief is the result of a hypothalamic pain-suppressing capability triggered by hypophy-sectomy. On the basis of both clinical data and the mechanism of action, we conclude that surgical and chemical hypophysectomy are fundamentally similar procedures.
Results of Extracranial-Intracranial Arterial Bypass for Intracranial Internal Carotid Artery Stenosis: Review of 105 Cases
Authors: Weinstein R.Philip , Rodriguez y Baena R. , Chater L.Norman 
Published: August 2004

Abstract

Extracranial-intracranial arterial bypass was performed for intracranial internal carotid artery stenosis in 105 patients who had ischemic symptoms 1 to 3 months before operation. The degree of stenosis, measured angiographically, was 60 to 98%. The postoperative bypass patency rate, determined angiographically or by Doppler examination, was 97%. The surgical mortality rate was 1%, and the permanent surgical morbidity rate was 2%. During a mean follow-up period of 54 months, 22 patients died: 10 deaths were caused by cardiac disease and 3 were related to stroke, 2 of which were ipsilateral to the bypass. One patient was lost to follow-up. Seventy-three of the 82 survivors (89%) had no further transient ischemic attacks or stroke after operation. Seven patients had a late stroke: 5 were ipsilateral, 1 was contralateral, and 1 was vertebrobasilar. Three of these strokes were fatal. The overall late death rate was 4% per year, and the late death rate from neurological causes was 0.6% per year. The late stroke rate was 1.5% per year, and the rate of ipsilateral late stroke in patients who had a patent bypass was 0.6% per year. We conclude that extracranial-intracranial arterial bypass for symptomatic intracranial internal carotid artery stenosis is a reasonably safe and technically satisfactory procedure that has a potential for improving outcome, compared with the natural history of the disease.
Brain Tumors and Plasmin Inhibitors
Authors: Sawaya Raymond , Cummins J.C. , Kornblith L.P. 
Published: August 2004

Abstract

Four different intracranial neoplasms inhibited purified plasmin in an in vitro assay. The greatest inhibition (80%) was observed with extracts of a parasagittal meningioma that had invaded and completely occluded the sinus. Significant inhibition (&gt;40%) was also observed with extracts prepared from a glioma surgically removed from a patient who had suffered three thromboembolic episodes during the preceding several months. Lesser (&lt;30%) inhibition was obtained with extracts from two other patients who had no evidence of thromboembolic complications. This report constitutes the first demonstration of plasmin inhibition activity in association with brain tumors. Further studies will be required to test the hypothesis that certain intracranial tumors may escape host antitumor fibrinolytic activity by producing plasmin inhibitors and that plasmin inhibitors may play a role in the thromboembolic complications frequently seen in patients with intracranial neoplasms.
Use of Intraventricular and Intrathecal Morphine in Intractable Pain Associated with Cancer
Authors: Nurchi Giancarlo 
Published: August 2004

Abstract

The use of the intraventricular or subarachnoid administration of morphine in the treatment of intractable pain secondary to cancer is described. The drug, in doses ranging from 0.33 to 4.00 mg, was administered by the percutaneous injection of an Ommaya reservoir or by a spinal tap. The duration of analgesia ranged from 36 to 150 hours. The indications for and side effects of this type of therapy are considered.
Percutaneous Radiofrequency Upper Thoracic Sympathectomy: A New Technique
Authors: Wilkinson Harold A. 
Published: August 2004

Abstract

The author describes a new technique for performing unilateral or bilateral upper thoracic sympathectomy safely, effectively, and more easily than by any of the surgical methods now in use. The technique described is one of percutaneous radiofrequency sympathectomy, which is usually done on a day surgery or outpatient surgery basis. The technique has been effective and well tolerated in a small group of patients.
Abnormal Serum Melatonin Levels in Patients with Intrasellar Tumors
Authors: Dempsey Robert J. , Chandler William F. 
Published: August 2004

Abstract

Melatonin, a pineal indoleamine, is postulated to be of importance in a regulatory fashion in hypothalamic and pituitary function. Attempts to utilize its random serum level as a consistent marker of pineal tumors have not been successful. Fifteen patients were studied to determine whether the normal diurnal variation in serum melatonin as determined by radioimmunoassay was altered by the presence of an intrasellar pituitary region tumor. A normal diurnal cycling of melatonin (high level at night, low level at midday coupled to the light-dark cycle) was seen in controls consisting of patients admitted for spinal or supratentorial procedures (a.m. melatonin, 15.4,± 3.7 pg/ml; p.m. melatonin, 57.1 ± 16.3 pg/ml). This normal pattern of melatonin levels was altered in the group of patients with intrasellar tumors (a.m. melatonin, 28.9 ± 6.7 pg/ml; p.m. melatonin, 28.4 ± 7.3 pg/ml). Hospitalization and operation caused nonspecific alterations in the pattern of melatonin in both groups. These results suggest that the pattern of secretion rather than the absolute midday value of melatonin may be of greater importance as evidence of altered pineal and pituitary neuroendocrine regulation.
Spinal Metastatic Disease: Analysis of Factors Determining Functional Prognosis and the Choice of Treatment
Authors: Barcena Alejandro , Lobato Ramiro.D , Rivas Juan , Cordobes Francisco , de Castro Servando , Cabrera Antonio , Lamas Eduardo 
Published: August 2004

Abstract

The authors surveyed 31 surgical and radiotherapy series comprising over 2300 patients with spinal metastases to determine the influence of factors such as tumor biology and topography, pretreatment neurological status, the presence of a myelographic block, the progression rate of symptoms, and the general medical condition of the patient on both the functional prognosis and the choice of treatment. Both life expectancy and the functional results after therapy are mainly dependent on tumor biology, which in turn determines radiosensitivity. The remaining factors seem to have only complementary predictive power. Because radiotherapy has been found to be as effective as operation plus radiotherapy in the management of the majority of patients with spinal metastases, it is very important to improve the selection of surgical candidates (less than 42% of the total cases) to prevent unnecessary surgery-related morbidity and mortality. Factors considered important in the selection of therapy are the location of the tumor within the spinal canal, the neurological status at the time of treatment, and the systemic condition of the patient.
Therapeutic Occlusion of the Vertebral Artery for Unclippable Vertebral Aneurysm: Relationship between Site of Occlusion and Clinical Outcome
Authors: Yamada Kazuo , Hayakawa Toru , Ushio Yukitaka , Yukitaka Yoshikazu , Koshino Kentaro , Bitoh Shoji , Takimoto Noboru 
Published: August 2004

Abstract

Six cases of unclippable vertebral aneurysms were treated by therapeutic occlusion of the proximal vertebral artery. In three cases, the vertebral artery was clipped proximal to the posterior inferior cerebellar artery (PICA), and all of these patients had a postoperative embolic complication or a fatal subarachnoid hemorrhage. In two cases, the vertebral artery was clipped distal to the PICA and in one case the PICA was absent and the vertebral artery was clipped proximal to the aneurysm. All three of these patients did well without any neurological deficit, Possible mechanisms of the complications are discussed, and the importance of not clipping the PICA is stressed.
Peripheral Aneurysms of the Posterior Inferior Cerebellar Artery
Authors: Yamamoto Isao , Tsugane Ryuichi , Ohya Masaki , Sato Osamu , Ogura Koichiro , Hara Makota 
Published: August 2004

Abstract

Nonmycotic peripheral posterior inferior cerebellar artery (PICA) aneurysms are rare. The authors report six cases of peripheral PICA aneurysm. Two of these are unusual; one was fusiform and another was a double aneurysm arising from the peripheral PICA. The previously reported 40 cases of peripheral PICA aneurysm are reviewed.
Acute Hydrocephalus in an Elderly Woman with an Aneurysm of the Vein of Galen
Authors: Rosenfeld Jeffrey V. , Fabinyi Gavin C. A. 
Published: August 2004

Abstract

A patient with a previously diagnosed vein of Galen aneurysm presented with acute hydrocephalus. This unusual case is described, and the possible pathogenesis of the condition is discussed. To our knowledge, this is the oldest patient yet described with this complication of vein of Galen aneurysm.
Cerebral Vasospasm after Head Injury
Authors: Pasqualin Alberto , Vivenza Carlo , Rosta Luisa , Licata Claudio , Cavazzani Paolo , Da Pian Renato 
Published: August 2004

Abstract

Cerebral vasospasm occurs frequently after head injury. Correlation between neurological deterioration and vasospasm has been reported previously, but delayed neurological deterioration secondary to vasospasm in head injury is a rare occurrence. We report the case of a 57-year-old man who, after a motorcycle accident, developed an acute subdural hematoma and a thick subarachnoid deposition of blood in the left sylvian-insular cistern. After surgical evacuation of the hematoma, the patient improved until the 10th postoperative day, when he developed aphasia and a right hempiparesis. Angiography demonstrated multitapering spasm, and a computed tomographic (CT) scan showed persistence of the cisternal deposition of blood. Despite therapy with hypervolemia, the patient improved only slightly. The association of head injury with substantial subarachnoid hemorrhage producing vasospasm has been considered rarely. Delayed posttraumatic vasospasm secondary to blood degradation products seems to play some role in the vasospasm after head injury. CT scanning may be useful in predicting vasospasm in such patients, and digital subtraction angiography might be useful in demonstrating it.
Planum Sphenoidale Meningioma Mimicking Pituitary Apoplexy: A Case Report
Authors: Marano Stephen R. , Sonntag Volker K.H. , Robert F. Spetzler 
Published: August 2004

Abstract

A patient with a planum sphenoidale meningioma mimicking a classic case of pituitary apoplexy is presented. A review of the apoplectiform onset of meningiomas is included.
Multiple Intradural Arachnoid Diverticuli: The Need for Complete Myelography
Authors: Schroeder Kurt A. , Venes Joan L. 
Published: August 2004

Abstract

A 12-year-old boy presented with enuresis, leg weakness, and lower extremity spasticity. An initial lumbar water-soluble contrast myelogram disclosed an arachnoid diverticulum. After the insertion of a cystopleural shunt, the patient improved and was dry. However, 2 months later the patient became enuretic and developed weakness. Repeat myelography showed a second arachnoid diverticulum located in the midthoracic region. This second diverticulum was treated by marsupialization of the cyst wall to the subfascial space. The authors stress the need for complete myelography in patients with intradural spinal arachnoid diverticuli and present a brief review of the literature.
Gliosarcoma at the Site of a Surgically Treated Actinomyces Cerebral Abscess
Authors: Prager Jordan , Zaret Bruce S. , Davidson Robin , Smith Thomas W. 
Published: August 2004

Abstract

We describe a man who developed a gliosarcoma at the site of a previously surgically decompressed frontal Actinomyces israelii brain abscess. We review the clinical profile of gliosarcoma and the possible role of the abscess and operation in the induction of this malignancy.
Intradural Spinal Metastasis in Ewing's Sarcoma: Case Report and Review of the Literature
Authors: Wald Steven L. , Roland Thomas A. 
Published: August 2004

Abstract

Ewing's sarcoma is a rare primary osseous neoplasm of children and young adults. The use of radiotherapy and adjuvant chemotherapy has favorably influenced the outcome of patients and dramatically reduced the rate of local disease recurrence. However, distant metastasis, usually to the lung and skeletal system, continues to be a frequent preterminal event. Metastasis to the central nervous system is infrequent unless related to adjacent bone involvement. We report a case of intraneural, intradural metastasis in a young man with a previously treated Ewing's sarcoma of the ilium. Metastasis to this part of the nervous system has not been previously reported.
Cervicomedullary Junction Tumor Diagnosed by Nuclear Magnetic Resonance Scanning: Case Report
Authors: Kaufman Bruce A. , Kaufman Benjamin , Rekate Harold L. 
Published: August 2004

Abstract

A neurofibroma of the cervical medullary region was accurately delineated using nuclear magnetic resonance (NMR) scanning. The tumor and its compression of the spinal cord were so well visualized that evaluation by myelography and postmyelographic computed tomography (CT) was unnecessary. NMR scanning should be considered as a replacement for myelography with CT in the initial evaluation of cervicomedullary spinal cord tumors.
Superficial Dorsal Horn of the Adult Human Spinal Cord
Authors: Bowsher David , Abdel-Maguid Thoraya .E 
Published: August 2004

Abstract

Golgi studies in the adult human spinal cord reveal 10 cell types in the first three laminae. Five are Golgi Type II or ipsilateral proprioneurons of short or long range-the latter including Waldeyer cells. Several of the cells in this group have dendrites that help to form interlaminar boundaries on the gray-white boundary. Two of the four cell types in Lamina II have dendritic fields that correspond exactly to the primary afferent terminal axonal fields described in the cat by Rethelyi (1977). Three cell types, one in each lamina, can be tentatively homologized with monkey spinothalamic cells described by other authors. Our previously described classification method based on dendritic patterns suggests that the Golgi Type II interneurons and ipsilateral proprioneurons belong to two different cell families (and Waldeyer cells to a third), whereas the putative spinothalamic neurons are all different cell types.
Neuropharmacology of the Dorsal Root Entry Zone
Authors: Blumenkopf Major Bennett 
Published: August 2004

Abstract

The finding of a number of peptides in the central nervous system and the discovery of the endogenous opiates represent major recent advances in the understanding of neural transmission. A number of these neuropeptides are found in the dorsal root entry zone and may play a role in pain. An analysis of changes in distribution of substance P, methionineenkephalin, and somatostatin after simulated nerve root avulsion injury suggested a possible mechanism for deafferentation pain. A review of the localizations and actions of these peptides in the dorsal root entry zone is included.
Spinal Peptidergic and Catecholaminergic Systems and Nociception
Authors: Howe J.R. , Zieglgänsberger W. 
Published: August 2004

Abstract

The authors review recent findings about the electrophysiology and anatomy of spinal peptidergic systems. The role of spinal catecholaminergic systems in nociception is also discussed. Recent data about the action of norepinephrine on dorsal horn neurons are presented.
Depression of Nociceptive Sensory Activity in the Rat Spinal Cord Due to the Intrathecal Administration of Drugs: Effect of Diazepam
Authors: Jurna Ilmar 
Published: August 2004

Abstract

The intrathecal (i.t.) administration of morphine inhibits nociceptive motor responses and activity in ascending axons evoked by stimulation of nociceptive afferent nerve fibers (nociceptive sensory response) in the rat. The i.t. administration of cholecystokinin octapeptide and ceruletide inhibits nociceptive motor responses, but does not affect ascending nociceptive activity. This shows that drug-induced depression of nociceptive motor responses is not always associated with depression of the nociceptive sensory response of the spinal cord. The microiontophoretic application of substance P excites single dorsal horn neurons that respond to noxious stimulation, whereas the i.t. administration of substance P inhibits both nociceptive motor and sensory responses. Thus, the results obtained from the i.t. administration of a drug may differ from those obtained from its application to single spinal neurons. Diazepam inhibits spinal reflexes and may reduce pain sensation in humans. To assess whether a spinal action is involved in the pain-relieving effect of diazepam, experiments were carried out on spinalized rats in which activity evoked by the stimulation of nociceptive and nonnociceptive afferent nerve fibers of the sural nerve was recorded from single ascending axons below the site of spinal cord transection. Diazepam, 20 ųg i.t., reduced activity evoked by afferent A delta and C fiber stimulation and by stimulation of afferent A beta fibers. The depressant effect caused by diazepam, 2 mg/kg i.v., on C fiber-evoked ascending activity was reduced by the i.t. injection of the benzodiazepine antagonist, Ro 15-1788 (40 ųg), an imidazodiazepine. It is concluded that the depression by diazepam of C fiber-evoked ascending activity contributes to pain relief caused by the drug.
Dorsal Root Rhizotomy and Avulsion in the Cat: A Comparison of Long Term Effects on Dorsal Horn Neuronal Activity
Authors: Ovelmen-Levitt Janice , Johnson Betty , Bedenbaugh Purvis , Nashold Blaine S. 
Published: August 2004

Abstract

We performed an extracellular microelectrode analysis of the neuronal activity of cells located in deeper laminae of dorsal horns that had been deafferented by ipsilateral lumbar dorsal root rhizotomy or avulsion. Special attention was given to those cells that were recorded in preparations that were more than 6 weeks chronic. We compared the results to those obtained in nondenervated controls and in experiments in which the spinal cord was acutely transected at a midthoracic level, but had intact dorsal roots. There was an increase in ipsilateral flank and contralateral input in the chronically deafferented as compared to nondenervated controls. Differences were observed between long term rhizotomized and avulsed dorsal horns. Receptive fields extended on to flank and thoracic dermatomes after rhizotomy, often requiring only light cutaneous stimuli. Receptive fields were more restricted with avulsion injury, generally requiring moderate to strong, superficial or deep pinch. Histological analysis revealed consistent differential damage to the medial portion of Lissauer's tract with avulsion injury and subsequently more gliosis in the substantia gelatinosa. The loss of this propriospinal pathway may explain the lack of receptive field expansion on to the thoracic dermatomes and the stronger natural stimuli that were required. A higher percentage of cells with bilateral and inhibitory receptive fields was found in experiments in which the spinal cord was transected at a midthoracic level than in the controls. Ipsilateral excitatory receptive fields were also expanded as compared with control observations, but were not found on the flank. It is concluded that descending fibers have an inhibitory influence on both excitatory and inhibitory receptive fields, both ipsilaterally and contralaterally, which can be released by acute spinal cord transection. These alterations or release from inhibition may form a substrate for observations made after dorsal root denervations.