Hypotensive endovascular test occlusion of the carotid artery in head and neck cancer.

Object: To evaluate the reliability of balloon test occlusion with hypotensive challenge (BTO and HC) as a predictor of neurological complications before internal carotid artery (ICA) sacrifice in patients with advanced head and neck cancer, the authors retrospectively reviewed the medical records of patients presenting to their institutions between 1992 and 1997 in whom this preoperative assessment was performed.

Methods: Eleven patents who were candidates for extended comprehensive neck dissection (ECND) and potential ICA sacrifice were included in the study. Eight patients tolerated the test and underwent endovascular occlusion or surgical ligation of the ICA before ECND (four patients), preservation of the ICA at the time of surgery (three patients), or palliative therapy (one patient).

Multiple meningiomas arising during long-term therapy with the progesterone agonist megestrol acetate. Case report.

In this report the authors describe a woman with low-grade endometrial stromal sarcoma who was treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy. After receiving megestrol acetate continuously for 19 years for chronic hormone suppression, she began to experience progressive dementia. Magnetic resonance imaging revealed 11 separate intracranial meningiomas of various sizes.

The integration of neurosurgical techniques in current head and neck skull base surgery.

The recent advances in neurosurgery, applied to the growing field of skull base surgery, provide surgeons with new techniques to avoid the devastating complication of CSF leak, to improve patient selection by reducing the risk of stroke while expanding the operative options available to patients with head and neck malignancies, and to aid operative care through improved surgical planning and intraoperative localization.

Neural-dural transition at the medial anterior cranial base: an anatomical and histological study with clinical applications.

Object: Few anatomical studies have been focused on the morphological features and microscopic anatomy of the transition from the intracranial space to the medial anterior cranial base. The authors of the current study performed histological analyses to define the structure of the transition from neural foramina to the cranial base (neural-dural transition) at the cribriform plate, particularly as related to cerebrospinal fluid (CSF) fistula formation and surgical intervention in the region.

Methods: The medial anterior cranial base was resected in six cadaveric specimens.

Resection followed by radiosurgery for advanced juvenile nasopharyngeal angiofibroma: report of two cases.

Objective And Importance: Experience with the management of juvenile nasopharyngeal angiofibroma (JNA) by gamma knife radiosurgery is limited. We report control of the disease in two patients with advanced-stage JNA treated with primary resection followed by gamma knife stereotactic radiosurgery of residual disease.

Clinical Presentation: An 18-year-old man presented with chronic sinusitis, worsening headaches, diplopia, and left-sided facial numbness.

Magnetic resonance imaging correlation in pediatric spinal cord injury without radiographic abnormality.

Object: The authors conducted a study to determine correlations between clinical syndromes and early magnetic resonance (MR) imaging-documented findings in children with spinal cord injury without radiographic abnormality (SCIWORA).

Methods: The authors retrospectively reviewed the records obtained in 20 patients who presented with SCIWORA to the Children's Hospital of Buffalo between 1992 and 1999. Initial neurological syndromes, subsequent hospital course and outcome, and early MR imaging findings obtained using conventional sequences on a 1.