Abstract:
:In Cushing disease, a pituitary corticotroph neoplasm causes secondary adrenal hypercortisolism. This condition has known morbidity and mortality, underscoring the need for an efficient and accurate diagnostic approach. An 11 p.m. salivary cortisol level is a modern, simple initial screening tool for the diagnosis of Cushing syndrome. Confirmation with a 24-hour urinary free cortisol test and/or a low-dose dexamethasone suppression test may subsequently be performed. Patients with repeatedly equivocal results should be reevaluated after several months or undergo a corticotropin-releasing hormone (CRH) stimulation test following low-dose dexamethasone suppression to help rule out pseudo-Cushing states. The presence of low morning serum adrenocorticotropic hormone (ACTH) levels then distinguishes primary adrenal hypercortisolism from Cushing disease and the ectopic ACTH syndrome. Patients with moderate ACTH levels can undergo CRH stimulation testing to clarify the underlying disease because those with an ACTH-independent disorder have blunted subsequent ACTH levels. Once ACTH-dependent hypercortisolemia is detected, magnetic resonance (MR) imaging of the pituitary gland can be performed to detect a pituitary neoplasm. Normal or equivocal MR imaging results revealing small pituitary lesions should be followed up with inferior petrosal sinus sampling, a highly specific measure for the diagnosis of Cushing disease in experienced hands. If necessary, body imaging may be used in turn to detect sources of ectopic ACTH.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Gross BA,Mindea SA,Pick AJ,Chandler JP,Batjer HHdoi
10.3171/foc.2007.23.3.2subject
Has Abstractpub_date
2007-01-01 00:00:00pages
E1issue
3issn
1092-0684journal_volume
23pub_type
杂志文章,评审abstract::Patients taking antithrombotic agents are very common in neurosurgical practice. The perioperative management of these patients can be extremely challenging especially as newer agents, with poorly defined laboratory monitoring and reversal strategies, become more prevalent. This is especially true with emergent cases ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2017.8.FOCUS17447
更新日期:2017-11-01 00:00:00
abstract::Optical imaging of intrinsic signals (OIS) is a well-established neuroimaging modality by which functional cortical activity is mapped by detecting activity-related changes in cortical light reflectance. Light reflectance changes are detected by a charged-coupled device camera that captures images of the exposed corte...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2002.13.4.2
更新日期:2002-10-15 00:00:00
abstract::Cerebral vasospasm remains a feared complication from subarachnoid hemorrhage. Vasospasm typically occurs from three to fourteen days post-aneurysm rupture, with peak risk on Day 7. Up to 50% of patients with angiographic vasospasm will subsequently develop delayed cerebral ischemia; 15-20% of this subset will develop...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.V2.FOCUS14172
更新日期:2014-07-01 00:00:00
abstract::Peritumoral cysts (those arising immediately adjacent to the tumor mass) are frequently associated with benign and malignant tumors of the brain and spinal cord (syringomyelia). The cystic component of central nervous system (CNS) tumors and associated peritumoral cysts are often the cause of clinical symptoms. Becaus...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2007.22.5.10
更新日期:2007-05-15 00:00:00
abstract::The authors describe the case of a boy with Muenke syndrome, an autosomal dominant disorder associated with craniosynostosis. The family history was significant for syndromic craniosynostosis in the patient's maternal grandmother, who died in adulthood after a craniofacial reconstruction. The patient, her grandson, un...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.2.FOCUS151
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:Global outbreak of the novel coronavirus disease 2019 (COVID-19) has forced healthcare systems worldwide to reshape their facilities and protocols. Although not considered the frontline specialty in managing COVID-19 patients, neurosurgical service and training were also significantly affected. This article f...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.9.FOCUS20559
更新日期:2020-12-01 00:00:00
abstract::The histological appearance of a meningioma is an important predictor of tumor behavior and is frequently a factor in decisions concerning therapy. The relationship between histological features and prognosis is formalized in grading schemes such as those published by the World Health Organization (WHO), most recently...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC-07/10/E3
更新日期:2007-01-01 00:00:00
abstract::The best management strategy for symptomatic vertebrobasilar ischemia is currently not well-defined. Noninvasive Optimal Vessel Analysis (NOVA, VasSol, Inc.) is computer software that, using quantitative magnetic resonance (MR) angiography technology, represents the only commercially available means of noninvasively m...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC/2008/24/2/E14
更新日期:2008-01-01 00:00:00
abstract:OBJECT:The goal of this study was to review the management of intra- and extradural ependymomas. Spinal ependymomas most commonly occur as intramedullary tumors throughout the spinal axis. In the lumbosacral region, ependymomas are most commonly associated with the conus medullaris and cauda equina, but can also occur ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2003.15.5.13
更新日期:2003-11-15 00:00:00
abstract::Lumbosacral interbody fusion may be indicated to treat degenerative disc disease at L5-S1, instability or spondylolisthesis at that level, and severe neural foraminal stenosis resulting from loss of disc space height. In addition, L5-S1 interbody fusion may provide anterior support to a long posterior fusion construct...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2014.2.FOCUS13467
更新日期:2014-05-01 00:00:00
abstract:OBJECT:Clinical and radiographic results were assessed to determine the clinical outcomes and fusion rate in eight consecutive patients selected for minimally invasive transforaminal lumbar interbody fusion (TLIF) in which a percutaneous pedicle screw system was used unilaterally. METHODS:Eight patients underwent one-...
journal_title:Neurosurgical focus
pub_type: 临床试验,杂志文章
doi:
更新日期:2006-03-15 00:00:00
abstract::Since the earliest recorded history of medicine, physicians have been challenged by the difficulty in relieving the great pain experienced by individuals suffering from trigeminal neuralgia (TN). The nature of the pain and the events that incite it have been well described, but effective treatments with acceptable lev...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/foc.2005.18.5.5
更新日期:2005-05-15 00:00:00
abstract:OBJECT:The goal of this paper is to elucidate the clinical presentation of tethered cord syndrome (TCS) following repair of a myelomeningocele. METHODS:Approximately 10 to 30% of children will develop TCS following repair of a myelomeningocele. Because essentially all children with repaired myelomeningocele will have ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2004.16.2.8
更新日期:2004-02-15 00:00:00
abstract::OBJECTIVE The best management of veins encountered during the neurosurgical approach is still a matter of debate. Even if venous sacrifice were to lead to devastating consequences, under certain circumstances, it might prove to be desirable, enlarging the surgical field or increasing the extent of resection in tumor s...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.4.FOCUS18120
更新日期:2018-07-01 00:00:00
abstract:OBJECT:The surgical treatment of tumors located near eloquent cortex carries a high risk of inducing worsening neurological deficits. Intraoperative electrocorticography techniques have been developed to help identify these areas at the time of surgery in an effort to minimize such risks. The optimal anesthetic techniq...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2003.15.1.8
更新日期:2003-07-15 00:00:00
abstract::From February 4 to 11, 1945, President Franklin D. Roosevelt of the United States, Soviet Union Premier Joseph Stalin, and British Prime Minister Winston Churchill met near Yalta in Crimea to discuss how post-World War II (WWII) Europe should be organized. Within 2 decades of this conference, all 3 men had died. Presi...
journal_title:Neurosurgical focus
pub_type: 传,历史文章,杂志文章
doi:10.3171/2016.4.FOCUS1575
更新日期:2016-07-01 00:00:00
abstract:OBJECT:The authors investigated immunogene therapy for malignant glioma to determine whether its therapeutic efficacy could be improved. METHODS:Four groups of 203-glioma-bearing mice were treated with injections of phosphate-buffered saline, Semliki Forest virus (SFV)-LacZ, retrovirus vector DFG-interleukin (IL)-12, ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2000.9.6.8
更新日期:2000-12-15 00:00:00
abstract::The author addresses the issue of neurofibroma classification and implications for treatment. He emphasizes the importance of understanding that not all neurofibromas are the same and that the key differences between the types of neurofibromas involve which portions of the nerve sheath contribute to the distinctive be...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2007.22.6.4
更新日期:2007-06-15 00:00:00
abstract::Primary central nervous system lymphoma (PCNSL) is an aggressive neoplastic process that occurs in both immunocompetent and immunocompromised patients. Over the past 30 years there has been a steady increase in the number of cases in both patient populations. The imaging features for the disease and demographic charac...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2006.21.5.5
更新日期:2006-11-15 00:00:00
abstract::OBJECTIVE Sagittal malalignment decreases patients' quality of life and may require surgical correction to achieve realignment goals. High-risk posterior-based osteotomy techniques are the current standard treatment for addressing sagittal malalignment. More recently, anterior lumbar interbody fusion, anterior column ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.8.FOCUS17423
更新日期:2017-12-01 00:00:00
abstract::Direct cerebral revascularization is an important procedure in the treatment of certain complex aneurysms and skull base tumors when acute sacrifice of the internal carotid artery is required. It likely remains an appropriate treatment in a small subgroup of patients with cerebral ischemia refractory to maximal medica...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:
更新日期:2003-03-15 00:00:00
abstract::Over the past century pituitary surgery has undergone multiple revolutions in surgical technique and technological advancements that have resulted in what is now recognized as modern transsphenoidal surgery. Although the procedure is well established in the current neurosurgical literature, the historical maze that le...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/foc.2001.11.4.8
更新日期:2001-10-15 00:00:00
abstract:OBJECT:Intraneural ganglia are nonneoplastic mucinous cysts contained within the epineurium of peripheral nerves. Their pathogenesis has been controversial. Historically, the majority of authors have favored de novo formation (degenerative theory). Because of their rarity, intraneural ganglia affecting the upper limb h...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC.2009.26.2.E10
更新日期:2009-02-01 00:00:00
abstract:OBJECT:Experience with minimal-access surgical approaches for revision lumbar surgery has not been previously reported. METHODS:During a 7-month period, 10 consecutive patients with recurrent disc herniations underwent revision operations in which microendoscopic discectomy (MED) was performed. Perioperative data and ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2003.15.3.12
更新日期:2003-09-15 00:00:00
abstract:OBJECT:Tethering of the spinal cord has been a recognized cause of neurological symptoms in pediatric patients and is increasingly being recognized as a cause of symptoms in adults as well. The pathophysiology surrounding spinal cord tethering has begun to be understood in the pediatric population but is still unclear ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2010.3.FOCUS1080
更新日期:2010-07-01 00:00:00
abstract::OBJECTIVE The American Association of Neurological Surgeons launched the Quality Outcomes Database (QOD), a prospective longitudinal registry that includes demographic, clinical, and patient-reported outcome (PRO) data, to measure the safety and quality of neurosurgical procedures, including spinal surgery. Differing ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.10.FOCUS17553
更新日期:2018-01-01 00:00:00
abstract::Intracranial or brain arteriovenous malformations (BAVMs) are some of the most interesting and challenging lesions treated by the cerebrovascular neurosurgeon. It is generally believed that the combination of BAVMs and intracranial aneurysms (IAs) is associated with higher hemorrhage rates at presentation and higher r...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.6.FOCUS14165
更新日期:2014-09-01 00:00:00
abstract::Our understanding of glioblastoma multiforme (GBM), the most common form of primary brain cancer, has been significantly advanced by recent efforts to characterize the cancer genome using unbiased high-throughput sequencing analyses. While these studies have documented hundreds of mutations, gene copy alterations, and...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.10.FOCUS09212
更新日期:2010-01-01 00:00:00
abstract:OBJECT:The authors present a series of 4 patients with rare facial nerve tumors. The relevant literature is reviewed and is discussed regarding diagnostic features, the role of operative management, and surgical approach. METHODS:A retrospective chart review was conducted for patients with tumors of the facial nerve t...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2013.1.FOCUS12380
更新日期:2013-03-01 00:00:00
abstract:OBJECT:The authors undertook this study to examine the surgical approaches used to treat posterior petrous bone meningiomas at a single institution and retrospectively evaluate their surgical strategy based on a previously published classification. METHODS:Cases in which craniotomies were performed to treat posterior ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2011.2.FOCUS1119
更新日期:2011-05-01 00:00:00