Abstract:
:Tissue diagnosis is necessary for optimal treatment of pineal region tumors in children. Preoperative staging should include craniospinal MR imaging with and without gadolinium DTPA enhancement, CSF sampling for cytology, and measurement of biologic tumor markers in serum and CSF. Surgical approach is determined by results of preoperative MR imaging and the extent of resection by the results of staging and intraoperative frozen-section histopathologic evaluation. There is no longer a role for the radiation test dose (2000 cGy) in the management of these tumors. Postoperative treatment is based on histopathology and extent of disease. Benign tumors are treated with surgery only, and nondisseminating focal tumors with surgery and focal radiation therapy. Non-germinoma malignant germ cell tumors are best treated with neoadjuvant chemotherapy followed by radiation therapy given focally for focal disease; craniospinal radiation therapy is reserved for patients with evidence of disseminated disease at the completion of induction chemotherapy.
journal_name
Neurosurg Clin N Amjournal_title
Neurosurgery clinics of North Americaauthors
Baumgartner JE,Edwards MSkeywords:
subject
Has Abstractpub_date
1992-10-01 00:00:00pages
853-62issue
4eissn
1042-3680issn
1558-1349journal_volume
3pub_type
杂志文章,评审abstract::This article defines open myelomeningocele and describes its development in the embryo. The anatomic features of the neural placode, pia-arachnoid, and dorsal versus ventral roots are well described. The surgical technique and prenatal and postnatal care are detailed. Anomalies associated with open myelomeningocele ar...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1995-04-01 00:00:00
abstract::When medical treatment for trigeminal neuralgia fails or is limited by significant side effects, neurosurgeons need to inform their patients of all the available treatment options. The best treatment for the patient depends on the age of the patient, medical comorbidities, and the risks the patient is willing to assum...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2004.03.002
更新日期:2004-07-01 00:00:00
abstract::Pineoblastomas (PBs) represent the most aggressive of the pineal parenchymal tumors. Routine treatment consists of operative management of obstructive hydrocephalus and cerebrospinal fluid studies followed by maximal resection and adjuvant chemotherapy/radiotherapy, resulting in a median survival of 20 months. Importa...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2011.05.001
更新日期:2011-07-01 00:00:00
abstract::Stereotactic radiosurgery is used for many indications. In functional neurosurgery, it is used to modulate the function of axons, neurons, and related brain circuits. In this article, indications, current techniques, and outcomes are discussed. ...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2013.06.001
更新日期:2013-10-01 00:00:00
abstract::Child abuse is a widespread phenomenon which is increasingly recognized in our culture. In this chapter, the epidemiology, clinical presentation, and commonly associated injuries are reviewed. The typical presentation and clinical assessment of inflicted head injury is also described. ...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s1042-3680(02)00002-5
更新日期:2002-04-01 00:00:00
abstract::This article describes the presentation of tussive headaches in the adult population. Posterior headaches can also occur in patients with basilar invagination, and they may require occipital cervical fusion. Lower cranial nerve dysfunction is another common presenting symptom in adult Chiari patients. Almost 25% of sy...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2015.07.001
更新日期:2015-10-01 00:00:00
abstract::Spinal tumors compose a vast heterogeneous group of neoplasms that are classified by origin into vertebral column, spinal canal, or paraspinal region tumors. Tumors with both intraspinal (intracanalicular) and paraspinal (extracanalicular) components that communicate via an intravertebral foramen are defined as "dumbb...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2004.02.007
更新日期:2004-04-01 00:00:00
abstract::Medical errors are common and dangerous, estimated to cause over 400,000 deaths per year in the United States alone. The field of neurosurgery is not immune to these errors, and many studies have begun analyzing the frequency and types of errors that neurosurgical patients experience, along with their effects and caus...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2014.11.011
更新日期:2015-04-01 00:00:00
abstract::An in-depth knowledge of intracranial and extracranial collateral anastomoses, overt or hidden, is crucial for an interventionist to devise optimal endovascular strategies to manage a host of pathologic conditions; to ascertain potential pitfalls; and, ultimately, to avoid complications that could have been prevented ...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2009.04.013
更新日期:2009-07-01 00:00:00
abstract::Perioperative complications of carotid endarterectomy (CEA) are uncommon but potentially devastating. The authors review strategies aimed at minimizing morbidity of surgical treatment of carotid occlusive disease. Multiple components of the perioperative course of patients who undergo CEA must be tightly controlled to...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:2000-04-01 00:00:00
abstract::Carotid occlusive disease remains an important cause of ischemic stroke. The results of large, randomized, clinical trials have established the benefit of surgical revascularization in patients with symptomatic or asymptomatic carotid stenosis. The introduction of balloon angioplasty and stenting of the extracranial c...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章
doi:10.1016/j.nec.2008.07.011
更新日期:2008-07-01 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::Cerebral vasospasm is a cause of significant morbidity and mortality in patients with subarachnoid hemorrhage (SAH). Most cases of vasospasm can be managed medically. Medical strategies for treatment include hemodynamic augmentation to improve cerebral perfusion pressure and medical therapy to prevent or reduce cerebr...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2009.10.007
更新日期:2010-04-01 00:00:00
abstract::Cerebral venous sinus (sinovenous) thrombosis (CSVT) in childhood is a rare, but underrecognized, disorder, typically of multifactorial etiology, with neurologic sequelae apparent in up to 40% of survivors and mortality approaching 10%. There is an expanding spectrum of perinatal brain injury associated with neonatal ...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2010.03.006
更新日期:2010-07-01 00:00:00
abstract::Although timing for surgical intervention after spinal cord injury remains controversial, there is accumulating evidence suggesting that early surgery may improve neurologic outcomes, particularly with incomplete spinal cord injury, and may reduce non-neurologic complications and health care resource utilization. More...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2016.08.005
更新日期:2017-01-01 00:00:00
abstract::Advances in imaging have made possible confident diagnosis of infiltrative pontine gliomas without biopsy. When the diagnosis is in doubt, stereotactic biopsy is the procedure of choice. Surgical intervention is restricted to tumors with a dorsally exophytic component and other rare circumstances. ...
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
abstract::Intrathecal drug delivery has been well established an effective and safe method for the treatment of pain, including palliative cancer-related and chronic nonmalignant pain. In this article, we discuss the role of intrathecal pain therapy in the management of chronic, refractory nonmalignant pain. Common indications,...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2018.12.010
更新日期:2019-04-01 00:00:00
abstract::Parkinson's disease (PD) affects more than 1 million people in the United States, which makes it one of the most common age-related neurodegenerative disorders, second only to Alzheimer disease. In light of this significant health problem, this review places emphasis on the exciting prospect of using stem cells as an ...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2006.10.015
更新日期:2007-01-01 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::Hemostasis is a cell-based process that is regulated in a tissue-specific manner by the differential expression of procoagulant and anticoagulant factors on endothelial cells from different sites throughout the vasculature. The central nervous system, in particular, exhibits unique mechanisms of hemostatic regulation ...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2018.05.001
更新日期:2018-10-01 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::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::Pancoast tumors (superior sulcus tumors or apical lung tumors) typically invade structures at the thoracic outlet, including the inferior elements of the brachial plexus (C8, T1 nerve roots and lower trunk). Historically, these tumors are rapidly fatal, but newer treatment with induction chemotherapy and radiotherapy,...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章
doi:10.1016/j.nec.2008.07.002
更新日期:2008-10-01 00:00:00
abstract::Anterior cervical discectomy and corpectomy for the treatment of cervical spondylosis,cervical disc herniation, and ossification of the posterior longitudinal ligament enjoy favorable rates of fusion and successful clinical outcomes. Although the complications from these procedures have been well described, the pathog...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2005.07.004
更新日期:2005-10-01 00:00:00
abstract::Degenerative lumbar spondylolisthesis is one of the most common causes of low back pain and is defined as displacement of one vertebra over subjacent vertebra, associated with degenerative changes, without an associated disruption or defect in the vertebral ring. Undersetanding natural history of degenerative spondylo...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2019.02.003
更新日期:2019-07-01 00:00:00
abstract::Intrathecal drug delivery represents an advanced modality for refractory chronic pain patients as well as intractable spasticity. This article reviews the advantages and indications for intrathecal therapy, as well as recommendations for proper patient selection using a multidisciplinary team to provide a global asses...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2014.06.006
更新日期:2014-10-01 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::The primary goal of any surgical approach is to adequately visualize and treat the pathologic condition with minimal disruption to adjacent normal anatomy. The work of several researchers has revealed the promise of minimally invasive endonasal neurosurgery and paved the way for broader applications of the technology....
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2010.07.010
更新日期:2010-10-01 00:00:00
abstract::There are two hypotheses on how chronic subdural hematoma causes hemiparesis and other focal neurologic symptoms without, in most cases, leaving permanent neurologic deficits. One hypothesis is that the reduced regional cerebral blood flow (rCBF) caused by either compression or distortion of the local or remote brain ...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:2000-07-01 00:00:00
abstract::Computer-assisted medical imaging technology provides useful tools for the in vivo study of congenital craniofacial deformities. Using these tools, a standardized operation for infants with nonsyndromal unicoronal synostosis has been shown to consistently normalize orbital dimensions and decrease exocranial base angul...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章
doi:
更新日期:1991-07-01 00:00:00