Abstract:
:The traditional dilemma making surgery for diffuse low-grade gliomas (DLGGs) challenging is underlain by the need to optimize tumor resection in order to significantly increase survival versus the risk of permanent neurological morbidity. Development of neuroimaging led neurosurgeons to achieve tumorectomy according to the oncological limits provided by preoperative or intraoperative structural and metabolic imaging. However, this principle is not coherent, neither with the infiltrative nature of DLGGs nor with the limited resolution of current neuroimaging. Indeed, despite technical advances, MRI still underestimates the actual spatial extent of gliomas, since tumoral cells are present several millimeters to centimeters beyond the area of signal abnormalities. Furthermore, cortical and subcortical structures may be still crucial for brain functions despite their invasion by this diffuse tumoral disease. Finally, the lack of reliability of functional MRI has also been demonstrated. Therefore, to talk about "maximal safe resection" based upon neuroimaging is a non-sense, because oncological MRI does not show the tumor and functional MRI does not show critical neural pathways. This review proposes an original concept in neuro-oncological surgery, i.e. to resect DLGG to the boundaries of brain functions, thanks to intraoperative electrical mapping performed in awake patients. This paradigmatic shift from image-guided resection to functional mapping-guided resection, based upon an accurate study of brain connectomics and neuroplasticity in each patient throughout tumor removal has permitted to solve the classical dilemma, by increasing both survival and quality of life in DLGG patients. With this in mind, brain surgeons should also be neuroscientists.
journal_name
J Neurosurg Scijournal_title
Journal of neurosurgical sciencesauthors
Duffau Hsubject
Has Abstractpub_date
2015-12-01 00:00:00pages
361-71issue
4eissn
0390-5616issn
1827-1855pii
R38Y9999N00A150033journal_volume
59pub_type
杂志文章,评审abstract::Echinococcosis is a potentially fatal parasitic disease that can affect many animals and humans. The disease results from infection by tapeworm larvae of the genus Echinococcus--notably, E. granulosus, E. multilocularis, E. vogeli andE. oligarthrus. Cyst hydatid disease is usually seen in adults, and mainly affects li...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:2010-06-01 00:00:00
abstract::The incidence of kinking and coiling of the internal carotid artery in an unselected series of 1,010 angiographies is reported. The angiographies of patients with cerebrovascular insufficiency and those of patients with other brain diseases were separately reviewed. On the basis of a statistical comparison, the findin...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
abstract::The authors present the results of a long-term follow up of 52 juvenile head-injured patients who showed early epileptic seizures. The purpose of this study is to stress the role of long-term prognosis in the early seizures and to determine in which cases a treatment preventing late seizures is eligible. They consider...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
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abstract::Computed tomography was performed in a patient with a median nerve tumor at the arm, histologically confirmed as neurilemmoma. Neurilemmoma was a slightly hypodense, solid tumor with no vascular contrast enhancement. To our knowledge this is the first CT description of a median nerve neurilemmoma at the arm. According...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章,评审
doi:
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abstract::The filum terminale is an exceptional location for isolated hemangioblastoma. Only five cases are reported in literature, prior to the magnetic resonance imaging era. A 57-year-old man was referred to our Department with a prolonged history of progressive back pain, particularly severe when recumbent, and recurrent un...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:2001-03-01 00:00:00
abstract::Starting from January 2008, we systematically irrigated the surgical wounds of patients undergoing spine surgery with a solution of povidone-iodine and hydrogen peroxide. We prospectively recorded the clinical data of patients who underwent spine surgery during 2008 and we compared the results with retrospectively rev...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章,收录出版
doi:
更新日期:2011-06-01 00:00:00
abstract::A case of a 52-year-old male presented with an unusual penetrating brain injury with nasal entry. At admission he had erythema of periorbital soft tissue in the left eye and epistaxis. His neurological condition was lethargic (Glasgow Coma Scale of 13) with nonfluent aphasia. Computed tomography scan revealed intracra...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:2002-03-01 00:00:00
abstract::Between 1985 and 1993, we treated seven cases of optic nerve sheath meningiomas. The median age at onset of their symptoms was 42.14 years. All of the patients were aged between 27 and 60 females with a slowly progressive lesion. Computed tomography and/or magnetic resonance imaging were used as diagnostic procedure i...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract::The Authors report a case of intracranial meningioma in two sisters, with no evidence of neurofibromatosis. A study of the karyotype has been performed; in one patient we have found a pericentric inversion of one chromosome 9. The possible role of the genetical factors in the develop of familial meningiomas is discuss...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章,评审
doi:
更新日期:1987-07-01 00:00:00
abstract:BACKGROUND:Adjacent-level disease after anterior cervical discectomy and fusion (ACDF) occurs in a significant proportion of patients and frequently requires revision operation. Methods using traditional plates typically require removal of the plate with anecdotally increased operative-time and morbidity. We review our...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:10.23736/S0390-5616.18.04172-3
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abstract::Posterior dynamic stabilization of the lumbar spine is spreading as a viable alternative to spinal fusion, aiming to achieve an equally satisfactory clinical outcome without making the spine completely rigid. We describe the feasibility of a minimally invasive surgical technique used to implant a hybrid system and per...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:10.23736/S0390-5616.17.03950-9
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abstract:BACKGROUND:Peripheral nerve lesions in the upper limbs occur predominantly in reproductive-age men and are often caused by sharp objects. Microsurgery is the choice treatment for these injuries, and regeneration after surgery typically is evaluated with clinical and electrophysiological examinations. The aim of this st...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Economical studies on surgery of intracranial aneurysms have considered only the significant benefit of surgical approach on unruptured aneurysms and no studies have been performed comparing cost/benefit analysis of early vs delayed surgery. The present study was retrospectively performed in order to verify ...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1998-06-01 00:00:00
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journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:2016-01-20 00:00:00
abstract::The authors describe 2 patients with solitary cerebral metastasis occurring 13 years after treatment for a renal tumor in one and 17 in the other. Both patients are alive 30 and 36 months after surgery respectively. The pathogenetic and therapeutic features typical of this type of solitary metastasis with late-onset a...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract::A case of cerebral gumma is reported. The appearance of this kind of lesion is exceptional at the present time. Gummas are the expression of localized meningovascular forms of neurosyphilis and their clinical symptoms and signs are similar to those of any other space-occupying intracranial lesion. Computed tomography ...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1985-04-01 00:00:00
abstract::The association in the same patient between two meningiomas and an astrocytoma of the third ventricle is presented. All tumors were removed in two surgical sessions. The unusual occurrence of such associations, except for the so-called phakomatoses, is emphasized. Other similar cases drawn from the literature are tabl...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1988-10-01 00:00:00
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journal_title:Journal of neurosurgical sciences
pub_type: 临床试验,杂志文章
doi:10.23736/S0390-5616.18.04384-9
更新日期:2018-08-01 00:00:00
abstract:INTRODUCTION:To determine the association between magnetic resonance imaging (MRI)-detected vulnerable Carotid Plaques and clinical presentation related to ipsilateral carotid artery territory. EVIDENCE ACQUISITION:We searched three databases including Ovid MEDLINE, Ovid EMBASE, and Scopus from 2000 to 2018 for studie...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:10.23736/S0390-5616.19.04820-3
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:The impact of COVID-19 outbreak in the neurosurgical practice has been dramatic, imposing several limitations. The aim of this study is to present how the neurosurgical departments of Emilia-Romagna, a northern Italian region, have re-set their organization to maintain the higher standard of care as possible...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:10.23736/S0390-5616.20.05018-3
更新日期:2020-06-11 00:00:00
abstract::Cavernous malformations are vascular lesions that occur in all parts of the central nervous system but most commonly in the cerebral hemispheres; unusually they may be found along the midline (basal ganglia, pineal region or brain stem), into the ventricle possibly encroaching upon the fourth and third ventricle. We r...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract:AIM:Fractionated stereotactic radiotherapy is an alternative to radiosurgery or conformal radiotherapy when meningiomas are surgically inaccessible, incompletely removed, or recurrent. The authors report preliminary results of a feasible trial on hypofractionated stereotactic radiotherapy (hFSRT) in patients (pts) with...
journal_title:Journal of neurosurgical sciences
pub_type: 临床试验,杂志文章
doi:
更新日期:2009-03-01 00:00:00
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journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:10.23736/S0390-5616.20.04850-X
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journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
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更新日期:2020-04-29 00:00:00
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journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:2006-09-01 00:00:00
abstract::The occurrence of a so called azygous anomaly of the distal ACA, consisting in a single branch, is rare. Authors report two cases of azygous aneurysm on which surgery was performed successfully, and describe their angiographic characteristics, the frequent association of an aneurysm with azygous and the morphological ...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract:: ...
journal_title:Journal of neurosurgical sciences
pub_type: 信件
doi:10.23736/S0390-5616.17.04043-7
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Many neurosurgeons advocate subpial technique as the best technique to remove supratentorial gliomas. However, few authors clearly defined advantages and features of this technique. The aim of our study is to describe microsurgical subpial technique related to glioma surgery, with regard to its safety and co...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:10.23736/S0390-5616.20.05046-8
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journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:10.23736/S0390-5616.17.04083-8
更新日期:2020-10-01 00:00:00
abstract::A short review of polyamines and their possible clinical interest and applications in the field of brain neoplasms is presented. Dosage of CSF polyamines was proved to be useful in monitoring patients with medulloblastomas and others malignancies with meningeal involvement. Polyamines and their enzymes in neoplastic t...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章,评审
doi:
更新日期:1982-07-01 00:00:00