Abstract:
OBJECTIVE:The aim of this study was to translate new evidence about management of spinal metastases in a practical and reliable score for surgeons, radiation oncologists and oncologists, able to establish the need for surgery regardless the available technology and settings. PATIENTS AND METHODS:Three main items were identified and graded: Neurological status (0-5 points), Stability of the spine according to the Spinal Instability Neoplastic Score (SINS) Score (0-5 points), and Epidural compression according to the Epidural Spinal Cord Compression (ESCC) scale (0-3 points). Patients were considered suitable for surgery with ASA score < 4 and ECOG score <3. A retrospective clinical validation of the NSE score was made on 145 patients that underwent surgical or non surgical treatment. RESULTS:Agreement between the undertaken treatment and the score (88.3% of patients), resulted in a strong association with improvement or preservation of clinical status (neurological functions and mechanical pain) (p < 0.001) at 3 and 6 months. In the non-agreement group no association was recorded at the 3 and 6 months follow-up (p 0.486 and 0.343 for neurological functions, 0.063 and 0.858 for mechanical pain). CONCLUSION:Functional outcomes of the study group showed that the proposed NSE score could represent a practical and reliable tool to establish the need for surgery. Agreement between the score and the performed treatments resulted in better clinical outcomes, when compared with patients without agreement. Further validation is needed with a larger number of patients and to assess reproducibility among surgeons, radiation oncologists, and oncologists.
journal_name
Clin Neurol Neurosurgjournal_title
Clinical neurology and neurosurgeryauthors
Cofano F,Di Perna G,Zenga F,Ducati A,Baldassarre B,Ajello M,Marengo N,Ceroni L,Lanotte M,Garbossa Ddoi
10.1016/j.clineuro.2020.105896subject
Has Abstractpub_date
2020-08-01 00:00:00pages
105896eissn
0303-8467issn
1872-6968pii
S0303-8467(20)30239-0journal_volume
195pub_type
杂志文章abstract::Twenty-one children with brain-stem glioma are discussed. Sixteen received radiotherapy and five were too sick to be irradiated. The mean survival was 3.4 weeks for the non-irradiated group and 8.7 months for the treated group, two of the latter being still alive five and ten months after diagnosis. From the literatur...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(79)90032-5
更新日期:1979-01-01 00:00:00
abstract::The importance of surgery and maximal extent of resection (EOR) is well established in primary low-grade glioma (LGG) management. However, the role of surgery in the management of recurrent LGG is less clear. A recent review on the management of recurrent LGG concluded there was insufficient evidence to recommend surg...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2016.09.013
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Endoscopic endonasal (EE) transsphenoidal surgery is an important surgical approach to the treatment of sellar pathology, particularly for pituitary adenomas. Risk factors for the radiographic recurrence of pituitary adenomas resected using a purely endoscopic approach have not been established. This study i...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2014.01.020
更新日期:2014-04-01 00:00:00
abstract::Localizing the semiology of ictal fear and seizure onset in epilepsy patients is commonly challenging due to limited value of routine electroencephalography (EEG) and very few surgical attempts. Here we reported a case of refractory epilepsy characterized by aura of extreme fear and hypermotor seizures, in which the l...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2017.10.025
更新日期:2017-12-01 00:00:00
abstract::Among posterior fossa tumors, schwannomas arising from glossopharyngeal nerve are rare; only about 30 cases of glossopharyngeal neuroma have been described. Though a typical 'jugular foramen syndrome' has been described for tumors of this region, the clinical onset may often closely resemble that of acoustic neuromas ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(97)00016-4
更新日期:1997-08-01 00:00:00
abstract::Comorbid cerebrovascular disease (CVD) can occur in idiopathic Parkinson's disease (IPD) but its reported prevalence varies considerably. CVD may alter the clinical presentation, course and prognosis in IPD. We aimed to determine the prevalence of radiological and clinical CVD in a neurology clinic IPD population. We ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2011.05.014
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:The objective of this study is to investigate the application of transcranial magnetic stimulation combined with neuronavigation for preoperative mapping of the language area in neurosurgical interventions on the opercular area of the dominant hemisphere. METHODS:Five patients were operated upon gliomas in t...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2010.05.005
更新日期:2010-10-01 00:00:00
abstract::An increasing number of patients referred for neuroimaging studies unrelated to multiple sclerosis (MS) are found to have incidental lesions suggestive of MS in their nervous systems but many such patients do not develop clinical symptoms and signs and remain as "subclinical MS" (SCMS). MRI and cerebrospinal fluid (CS...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2005.11.010
更新日期:2006-03-01 00:00:00
abstract::Controversy exists about whether depression following stroke represents a biologically mediated change or a psychological reaction to the deficits. We present a patient with an acute isolated personality change and depression following a lacunar infarct of the left internal capsule, who was unaware of his affective ch...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(02)00113-0
更新日期:2003-04-01 00:00:00
abstract:PURPOSE:For the last few years wafers of Gliadel have been inserted into the operation cavity in patients with glioblastoma multiforme. This is followed by concurrent radio-chemotherapy with temozolomide (TMZ) according to the Stupp protocol. Only a few studies have investigated this kind of treatment regimen and the i...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2012.02.056
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:To describe the patient's self assessed health related quality of life (saHRQoL) based upon the medical outcome study 36-item short form health survey (SF-36) as well as the factors of influence upon the saHRQoL following surgery for petroclival (PCM) and lateral posterior surface of the pyramid (LPPM) mening...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2018.01.016
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVES:To describe clinical, radiological findings, and outcome in a multiethnic population of stroke survivors with basilar artery occlusive disease (BAOC). METHODS:Forty patients with infarcts in the basilar artery (BA) territory, alive 30 days after the ictus, participated in the study. BA stenosis (>50%) or oc...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2009.11.019
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:To analyse the prevalence and incidence of dementia in a population of community-dwelling elderly (aged 75-80), living in socio-economically differing districts of Antwerp (Belgium), taking into account possible gender and educational differences. METHODS:A longitudinal cohort study (N=825) with a 3-year fol...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2011.07.030
更新日期:2011-11-01 00:00:00
abstract::Measurement of beat-to-beat variations was employed in a group of 14 chronic alcoholics and compared with a group of normal individuals. A significant increase in the number of runs was found in the alcoholics reflecting impaired neurogenic control of the heart. It is concluded that cardiac neuropathy should be consid...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(81)90044-5
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Ventriculoperitoneal shunt obstruction remains a major problem in pediatric neurosurgery. We analyzed the tissue reaction to ventriculoperitoneal shunts and compared the histology versus time elapsed to shunt failure. METHODS:85 ventricular catheter tissues samples obtained from 71 patients were reviewed al...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2014.09.029
更新日期:2014-12-01 00:00:00
abstract::Ependymomas account for 3-9% of all neuroepithelial tumors. A peculiar variant of ependymoma known as "giant cell ependymoma" ("GCE") is especially rarely reported, it may pose some difficulties for the diagnosing neuropathologist. Here we present a case of a giant cell ependymoma occuring in a 17-year-old patient wit...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2007.09.018
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:Gliomas are a group of center nervous system tumors of glial origin. Most are characterized by diffuse infiltrative growth in the surrounding brain. Patients almost always ultimately die from their disease. The drastically increased knowledge about the molecular abnormalities, these are linked with tumor grad...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2011.11.005
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:Fractures of the thoracolumbar spine can cause pain, long-term reductions in quality of life (QOL), and neural deficits. The aim of this study was to investigate the effects of methylene blue (MB) on preventing postoperative pain and improving QOL in patients with throracolumbar fractures undergoing posterior...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.clineuro.2016.08.018
更新日期:2016-11-01 00:00:00
abstract:OBJECT:The purpose of this study was to analyze the relationship of axial diffusivity (AD) and radial diffusivity (RD) in peritumoral edema of high grade glioma, metastasis, and meningioma, and to differentiate tumor-infiltrated edema from pure vasogenic edema. MATERIALS AND METHODS:Twenty patients with high-grade gli...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2012.12.031
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVES:The aim of the present study was to examine the changes in the measurement of functions during and after pulse methylprednisolone (MP) treatment during a clinically isolated syndrome (CIS) attack, using the multiple sclerosis functional composite (MSFC) and Expanded Disability Status Scale (EDSS), and to com...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2013.09.003
更新日期:2013-12-01 00:00:00
abstract::A case of a primary non-Hodgkin's lymphoma of the CNS is reported in which a complete and stable disappearance of an enhancing mass lesion on the CT scan after treatment with dexamethasone was followed by the occurrence of a high-grade malignant lymphoma in the opposite hemisphere 18 months later. The long-lasting and...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(89)90119-4
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVES:It is well-known that Rathke's cleft cysts (RCCs) infrequently cause headache, endocrinological dysfunction, and visual disturbance, and in rare cases, cause diabetes insipidus (DI). Although surgical evacuation of the cyst content can result in high rates of symptomatic improvement, not only the treatment e...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2018.02.031
更新日期:2018-04-01 00:00:00
abstract::As the prevalence of cancer in the general population increases, a greater proportion of patients will present with symptomatic metastatic lesions to the spine. While surgery has been historically considered the treatment of choice for spinal cord/nerve root compression, mechanical instability and intractable pain, ra...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2014.08.003
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:To report the technical nuances and clinical outcomes of posterior atlantoaxial facet joint reduction, fixation and fusion (AFRF) technique as a revision procedure for BI and AAD patients with failed suboccipital decompression and large occipital bone defect. PATIENTS AND METHODS:We reviewed 32 patients with...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.105793
更新日期:2020-07-01 00:00:00
abstract::A 44-year-old man presented with symptoms of periodic ataxia, dysarthria, nausea and excessive sweating during the last twenty years. These symptoms could be provoked by physical or emotional stress and disappeared after bedrest for several hours. No other members of his family were known to have such complaints. Acet...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(85)90063-0
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVE:To obtain information on functional integrity of the facial nerve by transcranial electrical motor evoked potentials independent of nerve visualization and to improve prediction of postoperative function. PATIENTS AND METHODS:In a prospective clinical study, 68 patients with cerebello-pontine angle tumors an...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2011.06.011
更新日期:2011-12-01 00:00:00
abstract::Single Photon Emission Computed Tomography (SPECT) has been used in the last five years as a method for cerebral bloodflow imaging, especially in cerebral infarction. In this study the first experiences in the Netherlands are presented. In 57.6% of our patients lesions, defined by SPECT were larger than those found by...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(86)80042-7
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVE:Cerebral microbleeds (CMB) on gradient-echo T2*-weighted magnetic resonance image (MRI) are frequently seen in patients with cerebral diseases. In this observational study we assessed whether CMB are a predictive factor for first-ever cerebrovascular events. PATIENTS AND METHODS:This study consisted of 698 s...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2009.08.011
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:Thromboembolic events, seizures, neurologic symptoms and adverse effects from corticosteroids and chemotherapies are frequent clinical complications seen in Glioblastoma (GB) patients. The exact impact these have on dismal patient outcome has not been fully elucidated. We aimed at assessing treatment associat...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2015.01.006
更新日期:2015-07-01 00:00:00
abstract::Symptomatic spontaneous intratumoral hemorrhage is a rare event in a patient with a brain tumor (BT). Although the treatment of choice in such a case is surgical removal of both the tumor and the hemorrhage, the optimal timing for surgical intervention has not been clearly established, particularly in those who presen...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2004.12.023
更新日期:2005-12-01 00:00:00