Abstract:
:We identified 35 patients who had undergone stereotactic radiosurgery (SRS) for their biochemically proven Cushing's disease in order to assess the efficacy of SRS with regard to control of hypercortisolism, improvement of clinical features and prevention of tumor progression, and subsequent incidence of hypopituitarism. Seventeen (49%) patients achieved control of their cortisol levels following SRS; the mean time to normalization was 7.5 months (range: 1-33). Four (19%) patients experienced recurrent hypercortisolism at a mean time of 35.5 months following therapy (range: 17-64). Control of tumor progression was achieved in 91% patients. Fourteen (40%) patients demonstrated a new pituitary deficiency following SRS. Our results suggest that cortisol levels are normalized more efficiently and with a lower recurrence rate with SRS than with conventional fractionated external beam radiotherapy (EBT). We have confirmed the near 100% tumor control rate reported with SRS. The percentage of patients developing pituitary insufficiency following SRS is less than that of patients having undergone EBT; however, deficits occurred up to 10 years posttreatment. We advocate the use of SRS as the primary therapeutic modality in those patients who are poor surgical candidates, or as the adjunct treatment to microsurgery in eliminating residual tumor cells or disease that is not easily amenable to resection.
journal_name
Stereotact Funct Neurosurgjournal_title
Stereotactic and functional neurosurgeryauthors
Devin JK,Allen GS,Cmelak AJ,Duggan DM,Blevins LSdoi
10.1159/000083476keywords:
subject
Has Abstractpub_date
2004-01-01 00:00:00pages
254-62issue
5-6eissn
1011-6125issn
1423-0372pii
83476journal_volume
82pub_type
杂志文章abstract::Today's image guidance systems are the foundation of minimally invasive diagnosis and therapy and are the basis for the rational design of the neurosurgical operating room of the future. The building blocks of this procedural arena will be (1) high-resolution MR/CT anatomic imaging supplemented with (2) functional ima...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000029773
更新日期:1999-01-01 00:00:00
abstract::Posttraumatic stress disorder (PTSD) is a prevalent and highly disabling psychiatric disorder that is notoriously difficult to treat. At some point in their lifetimes, 5-8% of men, 10-14% of women, and up to a quarter of combat veterans carry this diagnosis. Despite pharmacological and behavioral therapies, up to 30% ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000343148
更新日期:2013-01-01 00:00:00
abstract::The longevity of batteries in internal pulse generators (IPGs) used clinically for deep brain stimulation is not known. We conducted a study to assess the life span of these batteries. From 1993 to 2000, 163 single-channel batteries were surgically implanted in our institution. The electrical settings utilized in pati...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000075161
更新日期:2003-01-01 00:00:00
abstract::Endoscopic pituitary surgery is a minimally invasive method which allows simple transnasal transphenoidal surgical access without retractors, and has been used by our team in 536 patients from 1993 to 1999. In 326 of these patients, computer-aided image-guided techniques (CAN) were used in conjunction with endoscopy. ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000056481
更新日期:2000-01-01 00:00:00
abstract::Six cases of acoustic neurinomas with macrocystic components are presented. In three cases the cystic portion was within the tumor, while in the other three, the cyst was peritumoral, in the form of a cul-de-sac within the arachnoid, in other words it was not a true tumor cyst. The six tumors are from a series of 74 a...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099775
更新日期:1996-01-01 00:00:00
abstract::Subacute and chronic continuous electrical stimulation at the epileptic focus in the hippocampus or parahippocampal cortex at 130 Hz, 0.21-1.0 ms, 2.5-3.5 V (about 200-300 microA) induces a decrease in focal EEG epileptic interictal activity and also in the occurrence of clinical seizures. This may represent an altern...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000064610
更新日期:2001-01-01 00:00:00
abstract::Between February 1993 and March 1994, 75 metastases, 16 gliomas and 2 AIDS-related malignant lymphomas were treated with Gamma Knife radiosurgery. Metastatic brain tumors (54% lung cancer, 14% breast cancer, 13.5% melanoma) were the most frequent and clinically rewarding cases. So-called local control was achieved in ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098764
更新日期:1995-01-01 00:00:00
abstract::Reinstallation of the Sheffield Gamma Knife Unit was completed in early November, 1991, following the replacement of the cobalt sources. Two methods were used to evaluate the isodose configuration within the replenished unit. The first method used a scanning microdensitometer to interrogate films exposed within a sphe...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100672
更新日期:1993-01-01 00:00:00
abstract::At the KUL University of Leuven a workstation for the planning of neurosurgical stereotactic procedures has been developed. Its benefits are illustrated in three exemplary cases. The CT and/or MR images, acquired under stereotactic conditions, are transmitted via a PACS network (picture archiving and communication sys...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100284
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Microvascular decompression (MVD) has been the right choice for glossopharyngeal neuralgia (GPN) patients. However, whether glossopharyngeal/vagal nerve root rhizotomy should be combined with MVD is still controversial. OBJECTIVE:To evaluate whether glossopharyngeal/vagal nerve root rhizotomy during MVD is ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000505712
更新日期:2020-01-01 00:00:00
abstract::To elucidate the radiobiological effect of Gamma Knife radiosurgery on brain tumors, we performed a histological study on nine cases. In two, the material was obtained at autopsy and in seven following surgery. In the central region of the radiation field, destructive changes occurred both in tumor cells and in vessel...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099695
更新日期:1996-01-01 00:00:00
abstract::Microrecordings were performed during pallidotomy and thalamotomy for Parkinson's disease (PD). Neuronal activity in globus pallidus (GP) was in general agreement with previous studies of human and primate models of PD. Neuronal activity, where frequency of tremor appeared to oscillate independently from peripheral in...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000029643
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Brain metastasis (BM) is the most common brain malignancy and a common cause of death in cancer patients. However, the relative outcome-related advantages and disadvantages of surgical resection (SR) and stereotactic radiosurgery (SRS) in the initial treatment of BM are controversial. METHOD:We systematical...
journal_title:Stereotactic and functional neurosurgery
pub_type: meta分析
doi:10.1159/000509319
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Deep brain stimulation (DBS) and the proper target for chronic cluster headache (CCH) are still subjects of controversy. OBJECTIVES:We present our long-term results of analysis of the target and its structural connectivity. METHODS:Fifteen patients with drug-resistant CCH underwent DBS in coordinates 4 mm ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000489937
更新日期:2018-01-01 00:00:00
abstract::A prospective study on the effects of bilateral anterior capsulotomy in patients with refractory obsessive-compulsive disorder (OCD) is presented. A total of 18 procedures were performed in 15 patients. The mean duration of the OCDs was 18.1 +/- 5.6 years (range 11-26 years). The mean total Yale-Brown Scale (Y-BOCS) s...
journal_title:Stereotactic and functional neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1159/000075110
更新日期:2003-01-01 00:00:00
abstract::Transient postoperative confusion (POC) occurs in 5-25% of patients following bilateral subthalamic nucleus stimulation. We retrospectively reviewed data on 96 patients who underwent bilateral subthalamic nucleus deep brain stimulation for Parkinson's disease. Nine percent of patients developed POC. There was no signi...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000086676
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Several subcortical structures have been targeted for surgical treatment of dystonia, including motor thalamus, internal segment of globus pallidus (GPi), and more recently, the subthalamic nucleus (STN). Deep brain stimulation of GPi is currently the preferred surgical treatment, but it is unclear if target...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000112428
更新日期:2008-01-01 00:00:00
abstract::In nearly all deep brain stimulation (DBS) applications, the same quadripolar electrode design is used for different anatomical targets even if shape and volume differences exist between nuclei. Taking into account the electrode location within the internal globus pallidus (GPi) and the size of the GPi, 2 electrodes w...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000303524
更新日期:2010-01-01 00:00:00
abstract::Great advances in imaging technology allows the surgeon to visualize the entire brain surface during surgery. However, the cerebral convolutions are extremely complex, so that it is often difficult to define the central area precisely. Using the curvilinear reconstruction technique (Gyroview) and MRI, we have analyzed...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000029597
更新日期:1998-01-01 00:00:00
abstract::The author has performed 108 stereotactic thalamotomies using MRI (MGSTs) without ventriculography in 77 cerebral palsy (CP) patients with dyskinesia(s) from January 1992 to January 1997. The clinical results were verified in terms of improvement of major preoperative symptom and patient's (or relative's) satisfaction...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099891
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Deep brain stimulation (DBS) implantation under general anesthesia (GA) is of great importance for patients with disabling off-medication symptoms or medical comorbidities. However, the relative advantages/disadvantages of routine local anesthesia (LA) surgery versus GA regarding clinical outcomes are contro...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1159/000505079
更新日期:2019-01-01 00:00:00
abstract::The hospital charges for all craniotomies and transsphenoidal procedures were gathered for a 4-year period from a single, non-profit hospital serving San Diego. Calif., USA. Of the individuals in this community 65% are covered by a variety of managed health care programs which have greatly discounted hospital receipts...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099736
更新日期:1996-01-01 00:00:00
abstract::In this study, we investigated the efficacy of brachytherapy in the treatment of 138 patients with intracranial neoplasms of the CNS. Of the total number of patients, 50 presented with glioblastoma multiforme, 45 presented with low-grade glioma, 19 presented with anaplastic astrocytoma, 23 presented with metastases an...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000075100
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:We have developed an overlaid three-dimensional image (Volumegraph)-guided navigation system that allows navigation during operative procedures. The three-dimensional image is superimposed on the patient's head and body via a semi-transparent mirror. The Volumegraph can display three-dimensional images in the...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099897
更新日期:1997-01-01 00:00:00
abstract::Treatment of patients with nasopharyngeal carcinoma (NPC) using external beam radiation therapy (XRT) alone results in significant local recurrence. To improve local control, stereotactic radiosurgery (SRS) was used to boost radiation to the primary tumor site following XRT in 23 patients with NPC. SRS was delivered u...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000029753
更新日期:1999-01-01 00:00:00
abstract::The diagnostic yield of stereotactic biopsies depends upon safely sampling the most representative regions of masses. Potentially, localization information presently available from CT and MR scans might be improved by considering regional levels of cerebral metabolism by PET. In 10 selected stereotactic biopsies of in...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098986
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Writer's cramp is a specific movement disorder with hand muscle cramps in writing, being classified into focal and action-specific dystonia. Stereotactic surgery, such as thalamotomy and deep brain stimulation (DBS), has been reported for writer's cramp; however, the number of reported cases is still scarce ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000366004
更新日期:2014-01-01 00:00:00
abstract::Electric stimulation applied to the posterior surface of the spinal cord (SCS) is an established treatment in certain chronic pain syndromes resistant to conventional therapeutic procedures. Despite the clinical value of SCS, the mechanisms behind the efficacy of the method are largely unknown. Several neurotransmitte...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100634
更新日期:1993-01-01 00:00:00
abstract::The purpose of this study was to analyze the feasibility and utility of 3D imaging to help lead positioning during a deep brain stimulation (DBS) procedure. A bilateral subthalamic DBS procedure was conducted in 2 patients for idiopathic Parkinson's disease. Subthalamic nucleus targeting was based on preoperative ster...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000280823
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:Stereotactic biopsies are subject to sampling errors (essentially due to target selection). The presence of contrast enhancement is not a reliable marker of malignancy. The goal of the present study was to determine whether perfusion-weighted imaging can improve target selection in stereotactic biopsies. MET...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000338092
更新日期:2012-01-01 00:00:00