Abstract:
OBJECTIVE:The optimal surgical treatment for symptomatic temporal arachnoid cysts is controversial. Therapeutic options include cyst shunting, endoscopic fenestration, and craniotomy for fenestration. We reviewed the results for patients who were treated primarily with craniotomy and fenestration at our institution, to provide a baseline for comparisons of the efficacies of other treatment modalities. METHODS:A retrospective review of data for 50 children who underwent keyhole craniotomy for fenestration of temporal arachnoid cysts between 1994 and 2001 was performed after institutional review board approval. During that period, the first-line treatment for all symptomatic middle fossa arachnoid cysts was microcraniotomy for fenestration. Microsurgical dissection to create communications between the cyst cavity and basal cisterns was the goal. All patient records were reviewed and numerous variables related to presentation, cyst size and classification, treatment, cyst resolution, symptom resolution, follow-up periods, and cyst outcomes were recorded. RESULTS:Fifty temporal arachnoid cysts in 50 treated patients were identified. The average age at the time of surgery was 68 +/- 57.2 months. The follow-up periods averaged 36 months. There were 34 male and 16 female patients in the series. Twenty-six cysts were on the left side. Indications for surgery included intractable headaches (45%), increasing cyst size (21%), seizures (25%), and hemiparesis (8%). The symptoms most likely to improve were hemiparesis (100%) and abducens nerve palsies. Headaches (67%) and seizure disorders (50%) were less likely to improve. Nine patients exhibited progressive increases in cyst size in serial imaging studies. Those patients were monitored for a mean of 40 +/- 23 months before intervention. In the entire series, 82% of patients demonstrated decreases in cyst size in serial imaging studies. Of those patients, 18% demonstrated complete cyst effacement. Overall, 83% of patients with Grade II cysts and 75% of patients with Grade III cysts exhibited evidence of decreases in cyst size in long-term monitoring. Two patients required shunting after craniotomy (4%). Hospital stays averaged 3.4 days. Total surgical times averaged 115 minutes. No significant blood loss occurred (5-50 ml). Complications included spontaneously resolving pseudomeningocele (10%), transient Cranial Nerve III palsy (6%), cerebrospinal fluid leak (6%), subdural hematoma (4%), and wound infection (2%). CONCLUSION:A microsurgical keyhole approach to arachnoid cyst fenestration is a safe effective method for treating middle fossa cysts. This procedure can be performed with minimal morbidity via a minicraniotomy. Compared with an endoscopic approach, better control of hemostasis can be obtained, because of the ability to use bipolar forceps and other standard instruments. The operative time and length of hospital stay were not excessively increased.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Levy ML,Wang M,Aryan HE,Yoo K,Meltzer Hdoi
10.1227/01.neu.0000089060.65702.03keywords:
subject
Has Abstractpub_date
2003-11-01 00:00:00pages
1138-44; discussion 1144-5issue
5eissn
0148-396Xissn
1524-4040journal_volume
53pub_type
杂志文章相关文献
NEUROSURGERY文献大全abstract::A case of symptomatic diverticulum of the 4th ventricle in a 57-year-old man is presented. This clinicopathological observation supports a relationship between ventricular diverticula and ependyma-lined paraventricular cysts. ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199101000-00026
更新日期:1991-01-01 00:00:00
abstract::Clinical decision analysis is applied to the treatment decisions for four patients with unruptured familial aneurysms. The surgical treatment was uneventful in all patients except one with mild mixed aphasia and facial weakness postoperatively; these deficits disappeared in less than 2 years. In the decision analysis,...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198809000-00007
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVE:Jugular foramen tumors are rare cranial base lesions that present diagnostic and management difficulties. With the availability of new diagnostic procedures these tumors have been more precisely studied and questions of whether, when, and how these lesions should be treated often arise. Data from 106 consecut...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000163483.44754.47
更新日期:2005-07-01 00:00:00
abstract::Neurosurgery at the University of Michigan was established as a specialty three-quarters of a century ago by Max Minor Peet. It developed under the successive leadership of Edgar Allan Kahn, Richard Coy Schneider, and Julian T. Hoff. Each has made unique contributions to the program, which has a strong tradition of te...
journal_title:Neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.1227/00006123-199507000-00017
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVE:We compared long-term seizure outcome and health-related quality of life (HRQoL) of patients who underwent epilepsy surgery and matched medically treated nonsurgical controls with intractable epilepsy. METHODS:Medically treated controls were identified for patients operated on for epilepsy between January 1,...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000315999.58022.1c
更新日期:2008-02-01 00:00:00
abstract::Even though neurosurgeons exercise these enormous and versatile skills, the COVID-19 pandemic has shaken the fabrics of the global neurosurgical family, jeopardizing human lives, and forcing the entire world to be locked down. We stand on the shoulders of the giants and will not forget their examples and their teachin...
journal_title:Neurosurgery
pub_type: 历史文章,杂志文章
doi:10.1093/neuros/nyaa314
更新日期:2020-09-15 00:00:00
abstract:OBJECTIVE:Cerebral autoregulation maintains a relatively stable cerebral blood flow over a range of perfusion pressures. During exercise, regional cerebral blood flow may be elevated in particular areas of the brain. This case report presents the impact of aerobic exercise on intracranially measured pressure and brain ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000371976.21043.C8
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:We describe a case of brainstem cavernous angioma resected by the subtemporal, anterior transpetrosal approach, selected on the basis of three-dimensional anisotropy contrast (3-DAC) imaging. CLINICAL PRESENTATION:A 64-year-old woman presented with sudden headache and gait disturbance. Anatomi...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000193531.59606.CB
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:The snake venom disintegrin contortrostatin (CN) is able to inhibit tumor progression and angiogenesis in vivo and therefore is of considerable interest as a potential antitumor drug. CN specifically binds to certain integrins on the tumor cell and angiogenic endothelial cell surface and inhibits their intera...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000163426.25227.56
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:Surgical treatment of odontoid fractures that do not allow interfragmentary fracture compression involves either posterior atlantoaxial arthrodesis or additional anterior stabilization using a plate construct. The purpose of this study was to determine the clinical and radiographic outcome after anterior plat...
journal_title:Neurosurgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1227/01.NEU.0000339117.60613.8C
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Desmoplastic infantile gangliogliomas (DIGs) are extremely rare tumors that respond well to treatment. However, their biological behavior remains to be clarified. We describe two patients whose DIGs spontaneously regressed after surgery, without adjuvant therapy. CLINICAL PRESENTATION:A 9-mont...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/01.neu.0000084165.60662.6d
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Ten-year follow-up data from the US Food and Drug Administration investigational device exemption trial comparing BRYAN® Cervical Disc (Medtronic, Dublin, Ireland) arthroplasty to anterior cervical discectomy and fusion (ACDF) demonstrated that disc arthroplasty maintained range of motion and improvements in...
journal_title:Neurosurgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/neuros/nyy118
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:Computer-assisted frameless navigation techniques are used in many centers for intracranial neurosurgical procedures. In this study, we assessed the accuracy and the clinical usefulness of a frameless system based on the optical digitizer in a variety of intracranial procedures. METHODS:The optical digitizer...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199908000-00013
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Epidemiological studies have indicated that postmenopausal women have a higher incidence of intracranial aneurysms than men in the same age group. OBJECTIVE:To investigate whether estrogen or estrogen receptors (ERs) mediate protective effects against the formation of intracranial aneurysms. METHODS:Intrac...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000528
更新日期:2014-12-01 00:00:00
abstract::A randomized clinical trial of 15 patients with acute spinal cord injuries was performed to test the hypothesis that rotating treatment tables prevent deep venous thrombosis in this population. Four of 5 control (nonrotated) patients developed distal and proximal thrombi, assessed by 125I fibrinogen leg scans and impe...
journal_title:Neurosurgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1227/00006123-198705000-00001
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVE:Balancing the benefits of extensive tumor resection with the consequence of potential postoperative deficits remains a challenge in malignant astrocytoma surgery. Although studies have suggested that increasing extent of resection may benefit survival, the effect of new postoperative deficits on survival rema...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000349763.42238.E9
更新日期:2009-09-01 00:00:00
abstract::Pulmonary embolism (PE) is a devastating complication in patients with traumatic spinal cord injury (SCI). Prophylactic measures such as venous compression hose or low-dose heparin are only partially protective in reducing the risk of venous thromboembolism and are contraindicated in some patients. Because of extended...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199408000-00008
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:The Centers for Disease Control and Prevention have called for studies detailing the prevalence and burden of mild traumatic brain injury (mTBI) in the outpatient clinical setting. OBJECTIVE:The aim of this study was to describe the prevalence of outpatient visits for minor head injury and compare the numbe...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000429846.14579.41
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:The relationships between lipoprotein-associated phospholipase A2 (Lp-PLA2) level, vasospasm, and clinical outcome of patients with aneurysmal subarachnoid hemorrhage (aSAH) are still unclear. OBJECTIVE:To identify the associations between admission Lp-PLA2 and vasospasm following subarachnoid hemorrhage an...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyz041
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Basilar cranial fractures have been associated with injury to the carotid artery. We sought to determine whether fracture through the carotid canal was a significant risk factor for carotid injury. METHODS:A retrospective chart review was performed, and 230 patients with basilar cranial fractures were identi...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199706000-00012
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:This case report is presented to raise the awareness of the potential risk of reactivation of herpes simplex virus (HSV) encephalitis after intracranial surgery. CLINICAL PRESENTATION:The case of an 8-year-old male patient who suffered a reactivation of HSV encephalitis after undergoing amygdalohippocampecto...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199903000-00106
更新日期:1999-03-01 00:00:00
abstract::Three patients with transient ischemic attacks (TIAs), a stenotic or ulcerating carotid lesion, and an unruptured aneurysm are discussed. Decision analysis is used in comparing treatment strategies for each patient: clipping of the aneurysm, endarterectomy, or both, with or without platelet aggregation inhibitors. Bay...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199403000-00010
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:Bundled care payment models are becoming more prevalent in neurosurgery. Such systems place the cost of postsurgical facilities in the hands of the discharging health system. Opportunity exists to leverage prediction tools for discharge disposition by identifying patients who will not benefit from prolonged ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyz161
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:An approach to transnasal transsphenoidal debulking of pituitary tumors using endoscopic guidance is presented. METHODS:Technical details of this approach using an endoscope inserted through one nostril and operating instruments inserted through a submucosal tunnel created via the other nostril are discussed...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199607000-00046
更新日期:1996-07-01 00:00:00
abstract::The outcome after single or staged stereotactic thalamotomies in 17 patients with dystonia and 2 patients with hemiballismus is reviewed. All patients were severely disabled by their movement disorders despite optimal pharmacological therapies. Eight of the patients with dystonia (47%) showed moderate improvement imme...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/00006123-199503000-00009
更新日期:1995-03-01 00:00:00
abstract::The object of this study was to determine whether the addition of information on brain stem reflexes improves the prognostic precision of the Glasgow coma scale for patients with severe head trauma. The study is based on 109 patients with a Glasgow coma score of 7 or less during the first 24 hours after injury. The av...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198505000-00002
更新日期:1985-05-01 00:00:00
abstract::We report a case of a cerebral arteriovenous malformation presenting as a pseudotumor cerebri syndrome. The lack of mass effect, hemorrhage, or hydrocephalus, in addition to angiographic evidence of high-flow and venous outflow restriction, implicate increased cerebral blood flow and venous hypertension as the mechani...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/00006123-199503000-00020
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:In this study, information about the localization of the central sulcus obtained by magnetic source imaging (MSI) was intraoperatively translated to the brain, using frameless image-guided stereotaxy. In the past, the MSI results could be translated to the surgical space only by indirect methods (e.g., the co...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199709000-00023
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:Sodium butyrate (SB), a differentiation-inducing agent, has been demonstrated to inhibit cellular proliferation in a number of human cell lines. Its precise mechanisms remain to be clarified, however. We investigated molecular mechanisms of SB-induced growth suppression as well as the effects of SB on the inv...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200108000-00031
更新日期:2001-08-01 00:00:00
abstract::A right common carotid to distal middle cerebral artery bypass utilizing a saphenous vein graft was performed in a patient with episodic cerebral ischemia and reversible ischemic neurological deficit. The patient was relieved of his symptoms, and there was improved motor function in the left hand. Postoperative angiog...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-197803000-00010
更新日期:1978-03-01 00:00:00