Abstract:
:Every neurosurgeon develops his or her own standard approach to common intracranial pathologies in terms of the order in which different stages are performed and which instruments are used to perform individual tasks. The majority of the basic steps in performing a craniotomy are learned through repetition and practice during residency training. Significant amounts of energy are devoted to mastering technical skills and developing an operative rhythm. What often receives little attention is the historical origin of the instruments that make the work possible. The Freer elevator represents a particularly interesting example. To people unfamiliar with the accomplishments of turn-of-the-century laryngologist Otto "Tiger" Freer, it can be assumed that the name of the instrument in one's hand is simply named for what it can do, that is, to "free" the nasal mucosa from the bony and cartilaginous septum during the transsphenoidal approach. The technique this master surgeon spent his life and career perfecting is now repeated almost daily by skull base neurosurgeons approaching pathologies from the inferior frontal lobe to the foramen magnum. In reviewing his life and work, the authors of this paper discovered an interesting creative process that led to the design of the eponymous instrument. Additionally, they discovered important advances toward the development of the transnasal approach and in our understanding of the anterior skull base. They present a historical perspective on the life and accomplishments of Dr. Freer and the ubiquitous surgical instrument that he invented and popularized.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Chittiboina P,Connor DE Jr,Nanda Adoi
10.3171/2012.6.FOCUS12137subject
Has Abstractpub_date
2012-08-01 00:00:00pages
E12issue
2issn
1092-0684journal_volume
33pub_type
传,历史文章,杂志文章abstract:OBJECT:Multiple brain metastases are a common health problem, frequently found in patients with cancer. The prognosis, even after treatment with whole-brain radiation therapy (WBRT), is poor, with an average expected survival time of less than 6 months. Investigators at numerous centers have evaluated the role of stere...
journal_title:Neurosurgical focus
pub_type: 杂志文章,随机对照试验
doi:10.3171/foc.2000.9.2.5
更新日期:2000-08-15 00:00:00
abstract::In this review of the literature the goal was to determine the frequency and relevance of hemodynamic instability after carotid artery (CA) angioplasty and stent placement. Hemodynamic instability after CA angioplasty and stent placement is a well-recognized phenomenon that occurs in 29 to 51% of patients undergoing t...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2005.18.1.7
更新日期:2005-01-15 00:00:00
abstract::Arteriovenous fistulae of the internal maxillary artery are exceedingly rare, with less than 30 cases reported in the literature. Most of these lesions are congenital, iatrogenic, or posttraumatic. The most common presentation of internal maxillary artery fistulae is pulsatile tinnitus and headache. Because these lesi...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.1.FocusVid.18479
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:Acute traumatic subdural hematoma (atSDH) can be a life-threatening neurosurgical emergency that necessitates immediate evacuation. The elderly population can be particularly vulnerable to tearing bridging veins. The aim of this study was to evaluate inpatient morbidity and mortality, as well as predictors of...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.7.FOCUS20439
更新日期:2020-10-01 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::There is evidence that the neurosurgical procedure of cranioplasty is as ancient as its better-known counterpart, trephination. With origins in pre-Incan Peru, cranioplasty remains an important reconstructive procedure for modern craniofacial surgery teams to master. Solutions to the often challenging problem of repai...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章,评审
doi:10.3171/2014.1.FOCUS13504
更新日期:2014-04-01 00:00:00
abstract:OBJECT:The authors performed a retrospective study to assess the impact of functional neuronavigation and intraoperative MRI (iMRI) on surgery of extratemporal epileptogenic lesions on postsurgical morbidity and seizure control. METHODS:Twenty-five patients (14 females and 11 males) underwent extratemporal resections ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2013.2.FOCUS12397
更新日期:2013-04-01 00:00:00
abstract::Cellular replacement therapy attempts to improve functioning of the diseased human central nervous system (CNS). In this second installment of a 2-part review, the authors discuss the major challenges to the translation of in vitro and animal studies of neural stem cell (NSC) therapy in the clinical setting. This anal...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC/2008/24/3-4/E22
更新日期:2008-01-01 00:00:00
abstract::Hypothalamic hamartomas are uncommon but well-recognized developmental malformations that are classically associated with gelastic seizures and other refractory seizure types. The clinical course is often progressive and, in addition to the catastrophic epileptic syndrome, patients commonly exhibit debilitating cognit...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2013.3.FOCUS1355
更新日期:2013-06-01 00:00:00
abstract::Surgery of the mind has a rather checkered past. Though its history begins with the prehistoric trephination of skulls to allow "evil spirits" to escape, the early- to mid-20th century saw a surge in the popularity of psychosurgery. The 2 prevailing operations were topectomy and leukotomy for the treatment of certain ...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2017.6.FOCUS17259
更新日期:2017-09-01 00:00:00
abstract:OBJECT:Bell palsy remains the most common cause of facial paralysis. Unfortunately, this term is often erroneously applied to all cases of facial paralysis. METHODS:The authors performed a retrospective review of data obtained in 11 patients who were treated at a university-based referral practice between July 1988 an...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2002.12.5.3
更新日期:2002-05-15 00:00:00
abstract::For many years, the experience of neurosurgeons from the German Armed Forces was limited to the peacetime care of patients in Germany. In 1995, German military neurosurgeons were deployed abroad for the first time. Since the beginning of the International Security Assistance Force mission, there has been a rapidly inc...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2010.2.FOCUS1010
更新日期:2010-05-01 00:00:00
abstract::Trigeminal neuropathic pain is a syndrome of severe, constant facial pain related to disease of or injury to the trigeminal nerve or ganglion. Causes of this type of pain can include injury from sinus or dental surgery, skull and/or facial trauma, or intentional destruction for therapeutic reasons (deafferentation) as...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2006.21.6.9
更新日期:2006-12-15 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::Cervical spondylotic myelopathy (CSM) often can be surgically treated by either ventral or dorsal decompression and fusion. However, there is a lack of high-level evidence on the relative advantages and disadvantages for these treatments of CSM. The authors' goal was to provide a comprehensive review of the relative b...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2013.4.FOCUS13103
更新日期:2013-07-01 00:00:00
abstract::Resection of insular tumors in the dominant hemisphere poses a significant risk of postoperative motor and language deficits. The authors present a case in which intraoperative awake mapping and multi-modal imaging was used to help preserve function while resecting a dominant insular glioma. The patient, a 55-year-old...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.10.FocusVid.18259
更新日期:2018-10-01 00:00:00
abstract:OBJECT:Hypothalamic hamartomas (HHs) are devastating lesions causing refractory epilepsy, rage attacks, social ineptitude, and precocious puberty. Microsurgical and/or endoscopic resection offers an excellent risk/benefit profile for cure or improvement of epilepsy. METHODS:The authors reviewed a prospective database ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2010.11.FOCUS10250
更新日期:2011-02-01 00:00:00
abstract::OBJECTIVE Stereotactic needle biopsies are usually performed for histopathological confirmation of intracranial lymphomas to guide adequate treatment. During biopsy, intraoperative histopathology is an effective tool to avoid acquisition of nondiagnostic samples. In the last years, 5-aminolevulinic acid (5-ALA)-induce...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.3.FOCUS1859
更新日期:2018-06-01 00:00:00
abstract::Spine surgery carries an inherent risk of damage to critical neural structures. Intraoperative neurophysiological monitoring (IONM) is frequently used to improve the safety of spine surgery by providing real-time assessment of neural structures at risk. Evidence-based guidelines for safe and efficacious use of IONM ar...
journal_title:Neurosurgical focus
pub_type: 杂志文章,meta分析,评审
doi:10.3171/2012.9.FOCUS12235
更新日期:2012-11-01 00:00:00
abstract::OBJECTIVEPituitary adenomas occur in a heterogeneous patient population with diverse perioperative risk factors, endocrinopathies, and other tumor-related comorbidities. This heterogeneity makes predicting postoperative outcomes challenging when using traditional scoring systems. Modern machine learning algorithms can...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.8.FOCUS18268
更新日期:2018-11-01 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
abstract::Drug addiction represents a significant public health concern that has high rates of relapse despite optimal medical therapy and rehabilitation support. New therapies are needed, and deep brain stimulation (DBS) may be an effective treatment. The past 15 years have seen numerous animal DBS studies for addiction to var...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2018.5.FOCUS18163
更新日期:2018-08-01 00:00:00
abstract::Vagus nerve stimulation (VNS) is a key tool in the treatment of patients with medically refractory epilepsy. Although the mechanism of action of VNS remains poorly understood, this modality is now the most widely used nonpharmacological treatment for drug-resistant epilepsy. The goal of this work is to review the hist...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.6.FOCUS09126
更新日期:2009-09-01 00:00:00
abstract:OBJECT:Parallel advancements in image guidance technology and minimal access techniques continue to push the frontiers of minimally invasive spine surgery (MISS). While traditional intraoperative imaging remains widely used, newer platforms, such as 3D-fluoroscopy, cone-beam CT, and intraoperative CT/MRI, have enabled ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2013.5.FOCUS13150
更新日期:2013-08-01 00:00:00
abstract:OBJECT:For patients with glioblastoma multiforme, median survival time is approximately 14 months. Longer progression-free and overall survival times correlate with gross-total resection of tumor. The ability to identify tumor cells intraoperatively could result in an increased percentage of tumor resected and thus inc...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2013.12.FOCUS13488
更新日期:2014-02-01 00:00:00
abstract:OBJECT:This paper describes a consecutive series of skull base meningiomas resected using an endoscopic endonasal approach through various corridors at a single institution over 7 years. The impact of case selection and experience, the presence of a cortical cuff between the tumor and surrounding vessels, and brain ede...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.7.FOCUS14321
更新日期:2014-01-01 00:00:00
abstract:OBJECT:This review summarizes the continuous study of low-power laser radiation treatment of a severely injured peripheral nerve. Laser phototherapy was applied as a supportive factor for accelerating and enhancing axonal growth and regeneration after injury or a reconstructive peripheral nerve procedure. In nerve cell...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC.2009.26.2.E8
更新日期:2009-02-01 00:00:00
abstract::OBJECTIVE Tectal gliomas constitute a rare and inhomogeneous group of lesions with an uncertain clinical course. Because these supposedly benign tumors are frequently followed up by observation over many years, the authors undertook this analysis of their own case series in an effort to demonstrate that the clinical c...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.3.FOCUS1850
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:Frailty has been recognized as a predictor of adverse surgical outcomes across multiple surgical disciplines, but until now the relationship between frailty and intracranial meningioma surgery has not been studied. The goal of the present study was to determine the relationship between increasing frailty (det...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.7.FOCUS20324
更新日期:2020-10-01 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