Abstract：
:In summary, over a period of approximately four decades, an important new pathologic process was identified. There is no longer any doubt that the deposition of the subarachnoid clot in the basal cisterns can, over the course of a few days, lead to a progressive, severe vasoconstriction. This, in turn, can reduce cerebral blood flow to the distal brain, which, depending on a multitude of factors, can result in cerebral infarction. It is highly likely that the erythrocyte is the most important blood element in the pathophysiology of this process. The exact mechanism by which the blood vessel is forced into this destructive spasm remains to be elucidated. Significant steps have been taken to avoid the consequences of vasospasm by using hypertension and hypervolemia (or at the very least avoiding iatrogenic hypotension and hypovolemia). These measures have resulted in a reduced incidence of delayed ischemia. Because clot has been shown to cause vasospasm, it has seemed only logical that the early removal of clot would be efficacious in its prophylaxis. Experimental and clinical evidence to support this view has been gathered. Therapeutic measures based on it have been shown to be effective in the experimental situation but await controlled clinical evaluation. In the past decade, thanks to such trials, one of the calcium antagonist drugs has been shown to be effective in improving the outcome following subarachnoid hemorrhage, probably on the basis of reducing the frequency and extent of infarction by small vessel dilatation or neuronal protection. Although patients still die from this lethal complication of subarachnoid hemorrhage, it is difficult not to have some measure of optimism, based on the history just reviewed, that cerebral vasospasm will be a treatable disease within a few decades.
journal_name
Neurosurg Clin N Amjournal_title
Neurosurgery clinics of North Americaauthors
Weir Bsubject
Has Abstractpub_date
1990-04-01 00:00:00pages
265-76issue
2eissn
1042-3680issn
1558-1349journal_volume
1pub_type
历史文章,杂志文章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：:Basilar bifurcation aneurysms are technically challenging and their treatment is often associated with greater morbidity than aneurysms located in the anterior circulation. These lesions can be treated using surgical, endovascular, or a combination of techniques. Several surgical approaches have evolved to treat basil...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1998-10-01 00:00:00
abstract：:There is no clear plane between the dura and arachnoid in situ. Instead of the virtual subdural space, there is a dura-arachnoid interface layer, which is structurally the weakest throughout the meninges. An extravasation of blood within the dural border layer splits it, leaving a few tiers of dural border cells over ...
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：: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：: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：:In adults, symptomatic scoliosis is usually a de novo primary degenerative deformity that develops in the fifth or sixth decade or an unrecognized or untreated idiopathic deformity with superimposed degeneration. The evaluation and treatment of adult scoliosis must focus on addressing patient symptoms while limiting t...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2006.05.002
更新日期：2006-07-01 00:00:00
abstract：:Shunt failure remains a disheartening complication of shunt surgery. The number of adjustable factors in attempting to reduce the rate is small. The clinical presentation and timing of shunt malfunction are well documented. Although the shunt design trials have been negative to date, valves have important effects that...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：2001-10-01 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：: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：:Intracranial metastases are the single most costly neurologic ailment. This article provides the clinician with detailed statements of the patterns of their appearance and tumors of origin. Most common causative cancers are of lung, breast, or melanoma origin. Aggressive therapies carry with them the risk of nervous s...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1996-07-01 00:00:00
abstract：:Management of anticoagulation and antiplatelet medications after neurosurgery can be complex, especially given that these patients have multiple medical comorbidities. In turn, neurosurgical patients are at high risk for the development of venous thromboembolism after surgery, so neurosurgeons must consider the use of...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2018.06.008
更新日期：2018-10-01 00:00:00
abstract：:Recently, endoscopic intraventricular surgery has been performed successfully in several clinical series. Although the therapeutic results must be compared with conventional surgery, neuroendoscopy seems to be a safe surgical technique when performed by surgeons with appropriate experience and refined endoscopic tools...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s1042-3680(03)00063-9
更新日期：2003-10-01 00:00:00
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：: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：:This article reviews the role of modalities that directly monitor brain parenchyma in patients with severe traumatic brain injury. The physiology monitored involves compartmental and perfusion pressures, tissue oxygenation and metabolism, quantitative blood flow, pressure autoregulation, and electrophysiology. There a...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2016.05.010
更新日期：2016-10-01 00:00:00
abstract：:Although craniofacial problems are commonly detected during the neonatal period, only a selected subgroup of lesions require early intervention. Such lesions are characterized either by their potential for causing early neurologic impairment, infection, or other severe sequelae if treatment is delayed or by the fact t...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1998-01-01 00:00:00
abstract：:The technique of stereotactic proton radiosurgery is discussed in depth in this article. The physics of the proton beam in radiosurgery is explained, and the different factors of beam delivery are examined. These key factors (correspondence to shape, accuracy of delineation of volume, correspondence to volume, and acc...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章
doi：
更新日期：1999-04-01 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：: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：: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：: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：: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：:Malignant large artery stroke is associated with high mortality of 70% to 80% with best medical management. Decompressive craniectomy (DC) is a highly effective tool in reducing mortality. Convincing evidence has accumulated from several randomized trials, in addition to multiple retrospective studies, that demonstrat...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2017.02.010
更新日期：2017-07-01 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：:Glioblastoma multiforme is a malignant, relentless brain cancer with no known cure, and standard therapies leave significant room for the development of better, more effective treatments. Immunotherapy is a promising approach to the treatment of solid tumors that directs the patient's own immune system to destroy tumo...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2009.09.001
更新日期：2010-01-01 00:00:00
abstract：:Herniated lumbar discs are rare in teh pediatric population. The clinical features,diagnostic modalities, and treatment are discussed in detail.The overall surgical results have been excellent in more than 90% of patients in most series. The differences between children and adults with herniated lumbar discs are empha...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1993-01-01 00:00:00
abstract：:Medical therapy with a dopamine agonist is the most effective for treatment of a prolactin-producing adenoma and is considered as primary treatment. Surgery and pituitary radiation are reserved for patients who either do not tolerate or do not respond to a dopamine agonist drug. A somatostatin analogue is effective me...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s1042-3680(02)00072-4
更新日期：2003-01-01 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：: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
