Abstract:
OBJECTIVE:To evaluate the safety, efficacy, and utility of a novel surgical strategy consisting of multiple (more than two) operative stages performed during the same hospital admission with subdural grid and strip electrodes in selected pediatric extratemporal epilepsy. METHODS:Subdural grid and strip electrodes were used for multistage chronic electroencephalographic monitoring in 15 pediatric patients (age, <19 yr) with refractory localization-related epilepsy and poor surgical prognostic factors. Initial resective surgery and/or multiple subpial transections were performed, followed by further monitoring and additional resection and/or multiple subpial transections. RESULTS:Mean patient age was 9.7 years. Mean duration of total invasive monitoring was 10.5 days (range, 8-14 d). The first monitoring period averaged 6.5 days, and the second averaged 3.9 days. Additional surgery was performed in 13 of 15 patients. Two patients who did not undergo additional surgery had a Class I outcome. Rationales for reinvestigation included incomplete localization, multifocality, and proximity to eloquent cortex. Complications were minimal, including two transfusions. There were no cases of wound infection, cerebral edema, hemorrhage, or major permanent neurological deficit. Minimum duration of follow-up was 31 months. Outcomes were 60% Engel Class I (9 of 15 patients), 27% Class III (4 of 15 patients), and 13% Class IV (2 of 15 patients). CONCLUSION:In a very select group of pediatric patients with poor surgical prognostic factors, the multistage approach can be beneficial. After failed epilepsy surgery, subsequent reoperation with additional intracranial investigation traditionally is used when a single residual focus is suspected. Our results, however, support the contention that multistage epilepsy surgery is safe, effective, and useful in a challenging and select pediatric population with extratemporal medically refractory epilepsy.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Bauman JA,Feoli E,Romanelli P,Doyle WK,Devinsky O,Weiner HLdoi
10.1227/01.neu.0000148908.71296.fakeywords:
subject
Has Abstractpub_date
2005-02-01 00:00:00pages
318-34issue
2eissn
0148-396Xissn
1524-4040journal_volume
56pub_type
杂志文章相关文献
NEUROSURGERY文献大全abstract::INNOVATION IS THE driving force behind progress in neurosurgery. Most significant innovations require commercialization to ensure appropriate development and ultimate distribution to patients. There are several key factors that determine whether a particular innovation is likely to be commercially successful. Relation...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200007000-00035
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:We report the long-term follow-up of 31 patients with cavernous sinus meningiomas who were treated either with surgery and radiotherapy (RT) or with RT alone. This retrospective review was undertaken to compare long-term efficacy and morbidity of RT with or without previous surgery versus complete, aggressive...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200102000-00006
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVE:We describe a case of sickle cell anemia and multiple intracranial aneurysms and review the English-language-reported cases of sickle cell disease associated with intracranial aneurysms proven angiographically or by autopsy, to assess whether there are associations with aneurysm multiplicity and sites of aneu...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1097/00006123-199805000-00007
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVE:To improve intraoperative observation of unexposed anatomic features and to verify surgical correction, a mobile computed tomographic (CT) scanner has been introduced into the operating room. To date, intraoperative CT scanning has been used predominantly for intracranial procedures. We report on the expanded...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200008000-00019
更新日期:2000-08-01 00:00:00
abstract::Doppler ultrasonic cardiac monitoring of patients undergoing trans-sphenoidal pituitary operations in the semisitting position has revealed the occurrence of venous air embolism in 3 of 31 consecutive cases. One such case is presented. Air may be drawn into the venous system whenever a gradient exists between the site...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-197801000-00008
更新日期:1978-01-01 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::In vitro studies have shown that the nonsteroidal antiestrogen tamoxifen can suppress deoxyribonucleic acid synthesis and cell proliferation in cultured human gliomas. This growth suppression is independent of its antiestrogenic properties. Tamoxifen may act through the inhibition of the enzyme protein kinase C, which...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199206000-00014
更新日期:1992-06-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Spinal cord injury is a rare complication of neurosurgery performed with the patient in the sitting position. Previous reports showed that the level of injury is usually located at or near the C5 segmental spinal level, and the term midcervical quadriplegia has been proposed. Extensive spinal c...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000125008.93625.5e
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Cavity stereotactic radiotherapy has emerged as a standard option following resection of brain metastases. However, the optimal approach with either single-fraction or hypofractionated stereotactic radiotherapy (HSRT) remains a significant question. OBJECTIVE:To report outcomes for 5-fraction HSRT to the su...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyz162
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:While multiple new larger-bore aspiration catheters have been introduced for stroke thrombectomy, sizeable cohort outcome studies are lacking along with meaningful comparative studies to evaluate whether they represent a clinically relevant improvement compared to predecessors. OBJECTIVE:To evaluate compara...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyaa498
更新日期:2020-12-28 00:00:00
abstract::Intraoperative monitoring with electroencephalography and the use of brain protection with steroids, phenytoin, mannitol, and pentobarbital or etomidate were evaluated in 15 patients undergoing operation for an aneurysm of the upper basilar artery. One patient harbored a basilar trunk aneurysm, 1 an aneurysm of the pr...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-198912000-00008
更新日期:1989-12-01 00:00:00
abstract:OBJECTIVE:Intraoperative detection of residual tumor tissue in glioma surgery remains an important challenge because the extent of tumor removal is related to the prognosis of the disease. Multiphoton excited fluorescence tomography of living tissues provides high-resolution structural and photochemical imaging at a su...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000204885.45644.22
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate the microsurgical results of symptomatic sacral perineurial cysts of 11 patients and to discuss the treatment options of the past 10 years. METHODS:We retrospectively reviewed the records of 11 patients with symptomatic sacral perineurial cysts who underwent microsurg...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/01.NEU.0000255457.12978.78
更新日期:2007-06-01 00:00:00
abstract::Dural arteriovenous fistulas are abnormal connections of dural arteries to dural veins or venous sinuses originating from within the dural leaflets. They are usually located near or within the wall of a dural venous sinus that is frequently obstructed or stenosed. The dural fistula sac is contained within the dural le...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/NEU.0000000000000228
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Iliac screw fixation is a powerful tool used by spine surgeons to achieve fusion across the lumbosacral junction for a number of indications, including deformity, tumor, and pseudarthrosis. Complications associated with screw placement are related to blind trajectory selection and excessive soft tissue disse...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e318230517a
更新日期:2012-03-01 00:00:00
abstract::The diagnosis of malignant glioma of the optic nerves and chiasm may be difficult because these rare lesions may mimic other suprasellar lesions. We report a case of glioblastoma multiforme of the optic chiasm in which the appearance of the lesion on computed tomographic (CT) scan was consistent with that of craniopha...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198212000-00011
更新日期:1982-12-01 00:00:00
abstract:OBJECTIVE:Symptomatic dissections of the cervical carotid artery (CCA) can be spontaneous or secondary to trauma and may be associated with pseudoaneurysms. Surgical treatment is often difficult or unavailable. We report the successful use of endovascular stents in the treatment of symptomatic dissection of the CCA. M...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199904000-00037
更新日期:1999-04-01 00:00:00
abstract:BACKGROUND:The promising results of the Solitaire Flow Restoration (FR) With the Intention for Thrombectomy (SWIFT) trial recently led to Food and Drug Administration (FDA) approval of the Solitaire FR stent retriever device for recanalization of cerebral vessels in patients with acute ischemic stroke. OBJECTIVE:To re...
journal_title:Neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1227/01.neu.0000429859.96652.57
更新日期:2013-07-01 00:00:00
abstract::Stereotactic radiosurgery has been shown to treat successfully angiographically demonstrated arteriovenous malformations of the brain. Angiographic obliteration has represented cure and eliminated the risk of future hemorrhage. The role of radiosurgery in the treatment of angiographically occult vascular malformations...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199012000-00006
更新日期:1990-12-01 00:00:00
abstract::Comprehensive anatomic and clinical analyses of 39 patients with injuries involving the transverse atlantal ligament or its osseous insertions were performed to assess the morphology of the injured ligaments and the patients' capacity to heal. Injuries of the upper cervical spine were screened with plain radiographs, ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199601000-00012
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:The increasing number of neurosurgical procedures for elderly patients and the development of skull base neurosurgery have increased interest in cerebral venous injury that might occur in a neurosurgical setting. Brain-derived neurotrophic factor (BDNF) may have neuroprotective effects against cerebral venou...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e31820c048e
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:We have frequently observed the development of postoperative communicating hydrocephalus in patients undergoing decompressive hemicraniectomy. This condition may persist in some patients after cranioplasty and require permanent cerebrospinal fluid (CSF) diversion. To confirm an independent correlation between...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000290894.85072.37
更新日期:2007-09-01 00:00:00
abstract::The techniques for the treatment of intracranial arteriovenous fistulae include angiographic balloon occlusion of the fistula as well as direct surgical attack. Regardless of the method, the occurrence of severe hyperemia caused by a lack of autoregulation after obliteration of the fistula remains a significant concer...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199410000-00033
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:Resection is a critical component in the initial treatment of glioblastoma (GBM). Often GBMs are resected using an intralesional method. Circumferential perilesional resection of GBMs has been described, but with limited data. OBJECTIVE:To conduct an observational retrospective analysis to test whether peri...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyz008
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:We describe a patient with a cavernous malformation within the trigeminal nerve at the nerve root entry zone who presented with trigeminal neuralgia. CLINICAL PRESENTATION:A 52-year-old woman sought treatment after experiencing dizziness and lancinating left facial pain for almost a year. Neur...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:To develop a new saccular aneurysm model in vitro using elastase to study aneurysm initiation, growth, and rupture and to create a new in vivo aneurysm model to test endovascular therapies. METHODS:Seventeen common carotid arteries excised from freshly killed pigs and sheep were treated with seven different ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199707000-00034
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE:Acquired immunity has been demonstrated in Fischer rats bearing syngeneic 9L tumors after herpes simplex virus (HSV) thymidine kinase (TK) gene transfection and ganciclovir treatment. The nature of this immunity in rats and its relevance to the HSV TK/ganciclovir protocol for human subjects remain to be deter...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200109000-00028
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:Hyperglycemia is common and showed to be risky for poor prognosis in patients with subarachnoid hemorrhage (SAH). However, the causality and mechanism underlying this observation are not well established. OBJECTIVE:To investigate the relationship between hyperglycemia and cerebral vasospasm with its pathoge...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyx016
更新日期:2017-05-01 00:00:00
abstract:UNLABELLED:BAC1KGROUND: AG1478 is an epithelial growth factor receptor tyrosine kinase inhibitor. Epithelial growth factor receptor regulates the expression of cadherin in cells via its action on β-catenin, and N-cadherin downregulation promotes infiltration and cerebrospinal fluid (CSF) dissemination of glioma cells. ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e318215a3d0
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:Transsphenoidal surgery for Cushing's disease from a pituitary adenoma is an effective and safe treatment. Definitive preoperative diagnosis of Cushing's disease caused by a pituitary adenoma is often difficult, particularly in patients with normal imaging studies and a normal sella turcica. We present the ou...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200003000-00005
更新日期:2000-03-01 00:00:00