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, followed by surgical resection of the tumor has resulted in improved patient survival. To accomplish oncologic excision, resection of the involved brachial plexus elements is still standard practice in most centers, resulting in loss of hand function and/or development of neuropathic pain. We present a modification of this protocol that incorporates induction chemoradiation, surgical resection of the lung tumor by a thoracic surgeon, and neurolysis and preservation of the brachial plexus by a neurosurgeon. Improved survival outcome, especially in patients demonstrating a pathologic complete response, with preservation of hand function, supports our hypothesis that involved brachial plexus does not need resection in these patients.
journal_name
Neurosurg Clin N Amjournal_title
Neurosurgery clinics of North Americaauthors
Davis GA,Knight SRdoi
10.1016/j.nec.2008.07.002subject
Has Abstractpub_date
2008-10-01 00:00:00pages
545-57, v-viissue
4eissn
1042-3680issn
1558-1349pii
S1042-3680(08)00031-4journal_volume
19pub_type
杂志文章abstract::The pineal gland has been studied through philosophy and science for thousands of years. Its role in human physiology was not well understood until the scientific community first started to report on pineal pathology in the eighteenth century. Throughout the nineteenth and twentieth centuries, reports on pineal tumors...
journal_title:Neurosurgery clinics of North America
pub_type: 历史文章,杂志文章
doi:10.1016/j.nec.2011.04.001
更新日期:2011-07-01 00:00:00
abstract::Spinopelvic fixation techniques are evolving and now seem to be converging. Good S1 pedicle fixation is the initial key anchor point. The tricortical technique tests out as the best. Supplemental fixation options are available. The most efficacious seems to be iliac fixation, followed by two-level structural interbody...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2007.02.009
更新日期:2007-04-01 00:00:00
abstract::Whenever possible, maximal safe resection is the first intervention for management of glioblastoma. Resection offers tissue for diagnosis, decompression of the brain, cytoreduction, and has been associated with prolonged survival in numerous retrospective studies. In this review, we provide a critical overview of the ...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2020.08.002
更新日期:2021-01-01 00:00:00
abstract::Inadequate healing is an important mechanism for aneurysm development and recanalization after embolization. Matrix coils have been shown by experimental studies to enhance vascular repair and fibrosis, thus reducing the risk of recanalization. The clinical application of Matrix coils represents the transition from pu...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2005.03.001
更新日期:2005-07-01 00:00:00
abstract::Acute toxicity from radiation of skull base tumors typically resolves spontaneously within days to weeks after completion of therapy. Long-term complications have a latency of months to years after radiation and are usually irreversible. The need to keep the probability of chronic toxicity at an acceptable level has d...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:2000-10-01 00:00:00
abstract::Computed tomography-based stereotactic biopsy procedures for diagnosing intracranial tumors are common today. In addition, point stereotaxis is used to center a craniotomy over a superficial lesion or to find a deep one. Technical innovations have improved performance of these operations. The author describes the inst...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章
doi:
更新日期:1990-10-01 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::The intracranial electroencephalogram (iEEG) is essential in decision making for epilepsy surgery. Although localization of epileptogenic brain regions by means of iEEG has been the gold standard for surgical decision-making for more than 70 years, established guidelines for what constitutes genuine iEEG epileptic act...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2020.03.007
更新日期:2020-07-01 00:00:00
abstract::Cranial dural arteriovenous fistulas (DAVFs) represent an important class of cranial vascular lesions. The clinical significance of these lesions is highly dependent on the pattern of venous drainage, with cortical venous reflux being an important marker of an aggressive, high-risk fistula. For asymptomatic benign fis...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2011.09.004
更新日期:2012-01-01 00:00:00
abstract::Cranioplasty following craniectomy for trauma is a common, safe neurosurgical procedure that restores the natural cosmesis and protective barrier of the skull and may be instrumental in normalizing cerebrospinal fluid dynamics after decompressive surgery. Understanding the factors influencing patient selection and tim...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2016.11.008
更新日期:2017-04-01 00:00:00
abstract::The basic premises of thermographic analysis for low back problems are that variations in skin temperature signify certain and specific underlying disease processes. The newer technologic advances for monitoring skin temperature raise the questions of whether thermography is an adequate substitute for invasive diagnos...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1991-10-01 00:00:00
abstract::Cervical spina bifida, either occult or overt, is relatively uncommon. These lesions tend to be associated with other abnormalities of the central nervous system and spine. For the occult dysraphic lesions, a Klippel-Feil syndrome is a particular association, especially the type I variety. For the spina bifida cystica...
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::Medial temporal lobe epilepsy associated with mesial temporal sclerosis (MTS) is perhaps the most well-defined epilepsy syndrome that is responsive to structural interventions such as surgery. Several minimally invasive techniques have arisen that provide additional options for the treatment of MTS while potentially a...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2015.08.011
更新日期:2016-01-01 00:00:00
abstract::Intracerebral hemorrhage (ICH) is a significant cause of morbidity and mortality. With the aging population, increased use of anticoagulants, and changing racial and ethnic landscape of the United States, the incidence of ICH will increase over the next decade. Improvements in preventative strategies to treat hyperten...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2013.03.002
更新日期:2013-07-01 00:00:00
abstract::Patients harboring intracranial aneurysms may experience secondary brain injury around the time of aneurysm repair, either from the repair process itself or secondary to altered cerebral vascular physiology following subarachnoid hemorrhage. Management of patients with aneurysms includes strategies to avoid or minimiz...
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::Pituitary tumors manifest with a variety of unique localizing signs and symptoms that neurosurgeons and neuro-ophthalmologists must readily identify. Visual disturbances may be the presenting complaint. Loss of central visual acuity, visual field deficits, and mechanisms of diplopia are discussed with case examples us...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1999-10-01 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::Offering real-time, high-resolution images via intraoperative ultrasound is advantageous for a variety of peripheral nerve applications. To highlight the advantages of ultrasound, its extraoperative uses are reviewed. The current intraoperative uses, including nerve localization, real-time evaluation of peripheral ner...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2017.05.013
更新日期:2017-10-01 00:00:00
abstract::Neurosurgical practice requires a solid foundation in the principles and interpretation of the neuro-ophthalmologic examination. In this article, the techniques used in the neuro-ophthalmologic examination to assess visual acuity, ocular motility, visual fields, the pupils, the eyelids, and the fundus are reviewed. An...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1999-10-01 00:00:00
abstract::Glioblastoma (GBM) is infiltrative neoplasm with limited treatment options and poor overall survival. Stereotactic radiosurgery (SRS) allows spatially precise and conformal delivery of high doses of radiation. Salvage SRS for locally recurrent GBM was shown to improve patient survival and have more favorable safety pr...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2020.08.007
更新日期:2021-01-01 00:00:00
abstract::Therapeutic approaches are still a matter of debate. Given the complexity of the sacral anatomy and the vicinity of major neural structures and vital organs, advantages of radical resection for local disease control must be weighed against the anticipated treatment morbidities and complications. It becomes imperative ...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2004.04.009
更新日期:2004-10-01 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
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::The major changes in health care delivery today further cloud the perspectives of patient autonomy, participation, and justice and the ideals of the virtuous practice of medicine. A Workable Integrative Negotiation approach with COAST permeating the medical setting and health agenda, however, can help promote effectiv...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1995-10-01 00:00:00
abstract::The role of intracranial pressure monitoring as an adjunct to the clinical examination, CT scanning, and other diagnostic modalities has become increasingly recognized. This article presents a brief overview of the present status of this technique and touches on prospects for further developments. ...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1991-04-01 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::Interest in surgery for focal cortical dysplasia has grown with the enhanced ability to detect these lesions preoperatively with modern imaging techniques. This article focuses on the surgical management of epilepsy associated with focal cortical dysplasia. The authors highlight the approaches practiced at Yale Univer...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章
doi:10.1016/s1042-3680(02)80010-9
更新日期:2002-01-01 00:00:00
abstract::With careful patient selection, timely neuroendovascular therapy can improve the clinical outcome of patients suffering from cerebrovascular ischemic disease. The current indications, techniques, recent experiences, limitations, and future directions of balloon angioplasty and local intra-arterial/intravenous thrombol...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:2000-01-01 00:00:00
abstract::The human brain harbors stem cells in the subventricular zone (SVZ). The authors have collected postmortem and intraoperative tissue from adult human patients and found that it contains a unique ribbon of astrocytes that proliferate in vivo and can function as neural stem cells in vitro. Furthermore, they have conduct...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nec.2006.10.013
更新日期:2007-01-01 00:00:00
abstract::This article reviews the authors' experience with image-guided surgery for brain metastases and discusses specifically the impact of the frameless viewing wand system on standard craniotomy techniques for this disorder. Topics discussed include patient selection, interactive image-guided neurosurgical resection of bra...
journal_title:Neurosurgery clinics of North America
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00