Abstract：
:Medical therapy with a dopamine agonist is the most effective for treatment of a prolactin-producing adenoma and is considered as primary treatment. Surgery and pituitary radiation are reserved for patients who either do not tolerate or do not respond to a dopamine agonist drug. A somatostatin analogue is effective medical therapy for patients with acromegaly, and this is usually administered if there is persistent GH hypersecretion after surgical resection. Medical treatment for patients with Cushing's disease is directed at the adrenal glands to reduce cortisol hypersecretion. Unfortunately, there is no effective medical therapy to reduce pituitary corticotropin production. Medical therapy for a gonadotrope adenoma with a dopamine agonist or somatostatin analogue has limited utility but is employed in patients who are unable to undergo surgery and may delay or prevent additional tumor growth. Many patients with a pituitary adenoma can be successfully treated with one treatment, either a dopamine agonist for a prolactinoma or surgery for other types of tumors. A substantial number of patients require multimodality therapy, however, including medical therapy, surgery, and pituitary radiation. Because the biologic behavior of pituitary adenomas varies considerably, a patient with a pituitary adenoma requires lifelong regular monitoring for hormone hypersecretion, tumor recurrence, and development of new pituitary hormone deficiency. A coordinated plan of care among endocrinologists, neurosurgeons, neuroophthalmologists, and radiation therapists is necessary to provide optimal care for these patients.
journal_name
Neurosurg Clin N Amjournal_title
Neurosurgery clinics of North Americaauthors
Vance MLdoi
10.1016/s1042-3680(02)00072-4keywords:
subject
Has Abstractpub_date
2003-01-01 00:00:00pages
81-7issue
1eissn
1042-3680issn
1558-1349pii
S1042-3680(02)00072-4journal_volume
14pub_type
杂志文章,评审abstract：:Shunt failure remains a disheartening complication of shunt surgery. The number of adjustable factors in attempting to reduce the rate is small. The clinical presentation and timing of shunt malfunction are well documented. Although the shunt design trials have been negative to date, valves have important effects that...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：2001-10-01 00:00:00
abstract：:Temporal lobe epilepsy is not a single clinicopathologic entity but a group of syndromes requiring different surgical solutions. Anatomic resections planned for the treatment of these syndromes are aimed at pathologic substrates minimizing ablation of normal tissue. Most of these procedures involve mesial and lateral ...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1993-04-01 00:00:00
abstract：:Interventional MRI (iMRI) holds great promise for optimally guiding and monitoring restorative and functional neurosurgical procedures. This technology has already been used to guide ablative therapies and insert deep brain stimulation electrodes, and many future applications are envisioned. An optimized software inte...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2009.04.003
更新日期：2009-04-01 00:00:00
abstract：:Flatback syndrome is characterized by loss of normal lumbar lordosis, resulting in forward tilt of the trunk, inability to stand erect, back pain, and thigh pain from chronic hip flexion and knee bending. The usual etiology is iatrogenic, through previous fusions or with extension instrumentation. Surgical treatments ...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2007.01.007
更新日期：2007-04-01 00:00:00
abstract：:Endovascular embolization is a frequently used adjunct to operative resection of meningiomas. Embolization may decrease intraoperative blood loss, operative time, and surgical difficulty associated with resection. The specific clinical applications of this treatment have not been defined clearly. Procedural indication...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2015.11.005
更新日期：2016-04-01 00:00:00
abstract：:In this review, we focus on novel surgical techniques and spinal arthroplasty systems inactive development. First, we discuss systems that allow for minimally invasive approaches to the lumbar disc space: (1) lateral approaches, (2) posterior approaches,and (3) oblique approaches. These techniques offer the potential ...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2005.08.001
更新日期：2005-10-01 00:00:00
abstract：:Advanced age is associated with a less favorable outcome following aneurysmal SAH, in large part, because of associated medical conditions. Nevertheless, available data suggest that elderly patients often benefit from aggressive treatment and that a reasonable outcome at a reasonable cost can be expected in selected p...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1998-07-01 00:00:00
abstract：:In the hands of the inexperienced, endoscopic carpal tunnel release bears a substantial risk for neurovascular injury. For those thoroughly trained in this technique, it is a fast and elegant but also more expensive way to achieve carpal tunnel release. If performed uneventfully, it minimizes trauma and avoids a subst...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2008.07.023
更新日期：2009-01-01 00:00:00
abstract：:Intracranial metastases are the single most costly neurologic ailment. This article provides the clinician with detailed statements of the patterns of their appearance and tumors of origin. Most common causative cancers are of lung, breast, or melanoma origin. Aggressive therapies carry with them the risk of nervous s...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1996-07-01 00:00:00
abstract：:Medical management of the post-epilepsy surgery patient depends on careful preoperative consideration of that patient's medical, social, cognitive, and emotional status. Outcome expectations should be realistic. Families should be warned that existing cognitive and psychobehavioral problems may not be following surger...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-07-01 00:00:00
abstract：:The pelvic incidence defines the amount of lordosis required in the lumbar spine, and a lumbar lordosis within 11° of the pelvic incidence defines alignment of the lumbo-pelvic region. Pelvic tilt is a compensatory mechanism that allows patients to achieve sagittal balance in the setting of decreased lumbar lordosis w...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2018.03.003
更新日期：2018-07-01 00:00:00
abstract：:In this era of modern neurosurgery, we are able to provide adequate amelioration of disabling symptoms for the small subset of patients who have conditions that may make them unacceptable candidates for invasive stereotactic neurosurgical intervention. Gamma Knife radiosurgical thalamotomy is an effective and useful a...
journal_title：Neurosurgery clinics of North America
pub_type： 临床试验,杂志文章,评审
doi：
更新日期：1999-04-01 00:00:00
abstract：:This article investigates the role of radiosurgery and stereotactic radiotherapy in the management of vestibular schwannomas (VS), reviewing the authors' own prospective cohort and the current literature. For patients with large Stage IV VS (according to the Koos classification), a combined approach with deliberate pa...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2013.06.002
更新日期：2013-10-01 00:00:00
abstract：:In adults, symptomatic scoliosis is usually a de novo primary degenerative deformity that develops in the fifth or sixth decade or an unrecognized or untreated idiopathic deformity with superimposed degeneration. The evaluation and treatment of adult scoliosis must focus on addressing patient symptoms while limiting t...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2006.05.002
更新日期：2006-07-01 00:00:00
abstract：:Widespread adoption of electronic medical records (EMRs) in the United States is transforming the practice of medicine from a paper-based cottage industry into an integrated health care delivery system. Most physicians and institutions view the widespread use of EMRs to be inevitable. But the transformation has not be...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2014.11.018
更新日期：2015-04-01 00:00:00
abstract：:With proper staging, patients with parenchymal brain metastases from solid tumors are usually found to have widespread extracranial disease. Systemic chemotherapy offers the potential advantage of simultaneous therapy of both intracranial and extracranial tumor. Limited data is available on the efficacy of drug therap...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1996-07-01 00:00:00
abstract：:Electrical stimulation of the spinal cord for the relief of pain was first reported in 1967. Since that time, there have been marked improvements in patient selection criteria, hardware, technology, and methods for implantation, which have resulted in substantial improvement in the overall results achieved with spinal...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-01-01 00:00:00
abstract：:In the normal growth of the cranial base, an outline of prenatal development stressed the common vertebrate plan, the patterning of mesenchymal tissues formed from and influenced by migrating neural crest cells. Details are given of the sequences of chondrification and ossification. Postnatal growth is approached in t...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-07-01 00:00:00
abstract：:Central neurocytoma (CN) is a well-differentiated tumor of neural cells occurring within the ventricles. It is composed of monomorphic cells with round, regular nuclei within clear cytoplasm and must be distinguished from other clear cell tumors. Immunohistochemical markers of CN that aid in diagnosis include synaptop...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2014.09.001
更新日期：2015-01-01 00:00:00
abstract：:The combination of separation surgery and stereotactic body radiotherapy optimizes the treatment of metastatic spine tumors. The integration of SBRT into treatment paradigms produces superb local control rates and consequently has diminished the role of surgery from principle treatment to one of adjuvant therapy. Unde...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2019.11.001
更新日期：2020-04-01 00:00:00
abstract：:The indications for the surgical management of supratentorial cavernous malformations are outlined and the results following operation are presented in this article. Surgery is indicated for most patients who present with seizures, neurologic deficit, or headache. The surgical approaches to lesions in the cerebrum are...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1999-07-01 00:00:00
abstract：:For the neurosurgical oncologist, a specialty practice in gliomas represents an intersection of tailored surgical approaches, emerging intraoperative technologies, expanding surgical trial portfolios, and new paradigms in glioma biology. Assembling these disparate pieces into a cohesive career trajectory is a difficul...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2018.08.013
更新日期：2019-01-01 00:00:00
abstract：:Recent evidence supports the notion that the incidence of Cushing disease is higher than previously thought. Transphenoidal surgery, in the hands of experienced neurosurgeons, is currently considered the first-line treatment of choice. However, an examination of remission and recurrence rates in long-term follow-up st...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2012.06.012
更新日期：2012-10-01 00:00:00
abstract：:Clival, petroclival, and foramen magnum meningiomas are challenging lesions to manage independently of the selected surgical approach. The expanded endoscopic endonasal approach (EEA) provided a safe alternative on the armamentarium of skull base approaches. There is a paucity of literature regarding endoscopic manage...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2015.03.006
更新日期：2015-07-01 00:00:00
abstract：:In summary, over a period of approximately four decades, an important new pathologic process was identified. There is no longer any doubt that the deposition of the subarachnoid clot in the basal cisterns can, over the course of a few days, lead to a progressive, severe vasoconstriction. This, in turn, can reduce cere...
journal_title：Neurosurgery clinics of North America
pub_type： 历史文章,杂志文章
doi：
更新日期：1990-04-01 00:00:00
abstract：:Aggressive surgical as well as medical management strategies have had limited success with improving outcomes from spontaneous intracerebral hematomas. Future prospects of treatment will undoubtedly focus on less invasive, better tolerated procedures to remove hematomas in select patients. Some success has been achiev...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-07-01 00:00:00
abstract：:Chondrosarcomas are indolent but invasive chondroid malignancies that can form in the skull base. Standard management of chondrosarcoma involves surgical resection and adjuvant radiation therapy. This review evaluates evidence from the literature to assess the importance of the surgical approach and extent of resectio...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2012.08.002
更新日期：2013-01-01 00:00:00
abstract：:Satisfactory therapy for an avulsion injury of the brachial plexus has yet to be described. Dorsal root entry zone lesions will usually mitigate the searing pain which is so disabling in some of these patients. Neurotization procedures are effective in restoring limited function to these patients. The most useful isol...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章
doi：
更新日期：1991-01-01 00:00:00
abstract：:Shared decision making is a collaborative decision-making process between health care providers and patients or their surrogates, taking into account the best scientific evidence available while considering the patient's values, goals, and preferences. Decision aids are tools enabling SDM. This article discusses share...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2017.11.009
更新日期：2018-04-01 00:00:00
abstract：:Successful surgery within the brain stem parenchyma demands precise knowledge of the surface anatomy, relationship between surface and deep structures, microscopic anatomy, and functional anatomy of the brain stem. Emphasis on correlative knowledge of these aspects of brain stem anatomy will improve the success of bra...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1993-07-01 00:00:00
