Abstract:
:The previous literature on radiosurgical treatment for craniopharyngioma is sparse, because the involvement of the radiosensitive optic chiasm within the target volume (in most cases) precludes safe high single dosage. The relocatable frame, introduced at St Bartholomew's Hospital in 1989, utilizes the dosimetric advantages of stereotactic isodosimetry to treat with the safer fractionated therapy; this may well be the most advantageous methodology for larger and critically situated tumours around the chiasm. We believe that radical high dose radiosurgery (either single dose or fractioned) has a role in the treatment of selected craniopharyngiomas and our first six patients treated are presented here. There were two patients with discrete, small, solid lesions and both achieved complete responses that maintain at 1-2 years. The other four patients are more difficult to assess: one patient was treated for disease within the clivus and there is no evidence of disease progression at 18 months; one child, who was treated by fractionated radiosurgery to a solid component of a complex partly solid, partly cystic craniopharyngioma enveloping the chiasm, suffered tumour progression and died; one patient died of a hemisphere cerebovascular accident, which we believe was unrelated to the therapy, and one patient suffered malignant change 1 year after radiosurgery (a time point that we consider too early to ascribe to the radiation from this therapy). We discuss the indications for this technology in the multi-disciplinary therapy of this complex disease. It seems clear that, for low lying lesions, well below the optic apparatus, radiosurgery has an important role (possibly a primary radical radiotherapeutic role for small bulk solid masses). Where there is an inoperable solid tumour enveloping the chiasm the dosimetric advantages of the x-knife (10% internal dose gradient versus the 100% internal dose gradient of the gamma knife) plus the fractionation facility using the relocatable frame, argue for the x-knife (linear accelerator) as being the optimal radiosurgery system. These arguments also apply to acoustic neuroma therapy and preservation of hearing, the other clinical situation where a radiosensitive special sensory nerve lies within the target volume.
journal_name
Br J Neurosurgjournal_title
British journal of neurosurgeryauthors
Plowman PN,Wraith C,Royle N,Grossman ABdoi
10.1080/02688699943448subject
Has Abstractpub_date
1999-08-01 00:00:00pages
352-8issue
4eissn
0268-8697issn
1360-046Xjournal_volume
13pub_type
杂志文章abstract:BACKGROUND:The optic nerve is an unusual site of schwannoma as it lacks Schwannoma cells on it. We report a primary optic sheath schwannoma and to review the literature. CASE REPORT:A 29-year old female presented with progressive painless non-pulsatile proptosis. Ocular examination revealed only axial proptosis. Imagi...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1869181
更新日期:2021-01-08 00:00:00
abstract::Cortical venous thrombosis can present with non-specific findings including headaches and seizures. Subsequent cortical infarction has a variety of radiological appearances. The authors describe the diagnostic challenge of a case of cortical venous thrombosis presenting with focal motor seizures where imaging showed a...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2012.709552
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:Hypertensive spontaneous intracerebral hemorrhages (ICH) cause significant morbidity and mortality. In this study, we aimed to investigate the association between calcium level at admission and outcome in hypertensive ICH patients. METHODS:658 hypertensive ICH patients were enrolled from January 2...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2019.1571162
更新日期:2019-04-01 00:00:00
abstract::Thoracic complications of ventriculoperitoneal (VP) shunt are very rare. We report an unusual case of VP shunt intrathoracic migration, associated with symptomatic hydrothorax. The patient was successfully managed with revision. We reviewed the 10 cases reported in the literature and discussed the mechanism of shunt-t...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690410001681046
更新日期:2004-04-01 00:00:00
abstract::Endoscopic endonasal skull base surgery has emerged as the treatment modality of choice for a range of skull base lesions, particularly pituitary adenomas. However, navigation and manipulation of the nasal corridor and paranasal sinuses requires that surgeons are aware of effective techniques to maximize patient outco...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.1080/02688697.2020.1731424
更新日期:2020-06-01 00:00:00
abstract::Background: Vertebral body compression fractures are one of the most common causes of disability and morbidity, especially among the elderly population. The present study was performed in order to evaluate the effect of percutaneous balloon kyphoplasty (BKP) on patients' pain and quality of life (QOL) in Iran.Methods:...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1777254
更新日期:2020-06-09 00:00:00
abstract::Twenty unselected pituitary adenomas have been examined for proliferative indices (PIs), and anterior pituitary hormone expression. All but two of the tumours were non-functional with proliferative indices from less than 0.1 to 0.5%. Two tumours were null cell adenomas with PIs less than 0.1 and 0.2%. The PIs of the t...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699209002899
更新日期:1992-01-01 00:00:00
abstract::A microsurgical suction tube with an attached ball probe has been developed. It functions as a microdissector when the ball probe is in its extended position, creating a larger working field than an ordinary sucker. When the ball probe is in the repose position, it does not interfere with the suction capacity, and the...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2010.551678
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Maintenance of on-call referrals databases is on the rise in neurosurgical units across the UK and helps provide data to estimate workload. We hypothesize that these databases underestimate the workload and propose the use of the number of telephone calls to the on-call registrar as an easily obtainable and ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2012.743966
更新日期:2013-06-01 00:00:00
abstract::Failure to follow patients with hydrocephalus can expose them to potentially fatal consequences. Two cases are used to illustrate this and the merits of follow-up of these patients are discussed. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688699844574
更新日期:1998-10-01 00:00:00
abstract::A case where the administration of intrathecal gentamycin, used to treat a ventriculitis consequent upon a ventriculoperitoneal shunt infection, with a persistent elevation of the CSF leucocyte count is described. In a situation where the number of white cells in the CSF is taken to indicate resolution of infection, i...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688698909002840
更新日期:1989-01-01 00:00:00
abstract:INTRODUCTION:Intraspinal tumours are rare and principally managed surgically. Laminectomy, employed for access to the spinal canal, destroys the posterior tension band leading to a risk of kyphosis. Hemilaminectomy as an alternative may be less destructive, potentially reducing the risk of deformity and causing less po...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2014.1003026
更新日期:2015-06-01 00:00:00
abstract::A 24-year-old woman presented with a 7-week history of headache and left frontal scalp swelling. A plain radiograph and CT demonstrated a 2-cm lytic lesion in the frontal bone which was excised via craniotomy. Histology showed this to be an osteoma. Osteomas very rarely, if ever, appear as lytic lesions. The different...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688699943808
更新日期:1999-06-01 00:00:00
abstract::Attempts at radical excision of craniopharyngioma have been made increasingly possible by progress in neuroradiological imaging and the use of microscopic technique. Between 1977 and 1990, 50 patients of The National Hospital for Neurology and Neurosurgery, London, have undergone radical surgical excision of craniopha...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699109002877
更新日期:1991-01-01 00:00:00
abstract::Combining previously independently established techniques our objective was to develop and evaluate a method for bedside qualitative assessment of cerebral blood flow in neurointensive care (NICU) patients. The CT-protocol was optimized using phantoms and comparing a mobile CT-scanner (Tomoscan-M, Philips) with two st...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690500389898
更新日期:2005-10-01 00:00:00
abstract::We report a case of acute massive cerebellar infarction associated with craniocervical junction (CVJ) complex malformation in a 21-year-old male. Timely surgical intervention prevented the deterioration of his neurological status. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2016.1267329
更新日期:2018-10-01 00:00:00
abstract::Twelve patients with facial nerve neurinoma have been treated at The National Hospital, Queen Square, London, during the last 20 years. Nine tumours lay in the middle fossa arising from the area of the geniculate ganglion, two lay in the posterior fossa arising from the segment of the facial nerve in the internal audi...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699308995051
更新日期:1993-01-01 00:00:00
abstract::Epidermoid tumours are rare intracranial tumours. They are commonly found in the cerebellopontine angle and the suprasellar region. However, they are also known to occur in other locations. Anterior interhemispheric fissure epidermoid cysts are rarer still, and calcification among epidermoids is considered unusual and...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690802109812
更新日期:2009-02-01 00:00:00
abstract::Ventriculoperitoneal shunt is a commonly performed procedure. Associated complications have been well described in the literature. This is the first case report of a splenic laceration caused by the distal catheter looping around the spleen, requiring a splenectomy. Careful study of pre-operative imaging is recommende...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2012.657268
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVES:The lumbar infusion test is an invasive technique for quantifying cerebrospinal dynamics in patients with hydrocephalus. However, some patients have difficulty tolerating the duration of this procedure. Therefore, we investigated the limits of shortening the test by examining the reliability of cerebrospinal...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2011.591848
更新日期:2012-02-01 00:00:00
abstract::Growing skull fractures indicate underlying brain damage which is an important aetiological factor in their development. Two cases of growing skull fractures managed successfully with shunt surgery are presented. In one, the growing skull fracture was associated with an underlying tense occipital porencephalic cyst an...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699108998454
更新日期:1991-01-01 00:00:00
abstract::We report a previously undescribed complication of long-term epidural catheter placement for the administration of analgesia in terminal malignancy. Spinal cord compression resulted from a drug-related precipitate forming around the epidural catheter tip, which was successfully treated by surgical decompression. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688699844673
更新日期:1998-10-01 00:00:00
abstract::A combined approach for microvascular decompression of trigeminal neuralgia is reported. Arachnoid dissection of the cerebellar horizontal fissure (transhorizontal approach) allowed easy identification of the root exit zone of the trigeminal nerve. The superior semilunar lobule was pulled back rostrally so that retrac...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690020005536
更新日期:2000-12-01 00:00:00
abstract::The incidence of haemorrhagic complications of intracranial pressure monitoring (ICPM) has previously been reported. However, in these studies, the techniques employed to access the inside of the cranium varied. While 3-mm essentially blind 'twistdrill' craniostomies have been used, their role has been limited for fea...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690220148897
更新日期:2002-06-01 00:00:00
abstract::Up to a fifth of Accident and Emergency admissions are head-injury related. Alcohol is involved in a large proportion of adult head injuries and although the incidence of death due to head injury (HI) is relatively low, long-term sequelae including cognitive disturbance are frequent. Contrecoup contusions (CCs) have b...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2010.548879
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:The graft site morbidity following iliac crest harvesting is significant. To overcome this, different bone substitutes like coral dowels, solvent dissolved bovine/human bone substitutes, and carbon fiber/titanium cages have been used. This study was undertaken to assess the postoperative radiological fusion ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2017.1297362
更新日期:2017-06-01 00:00:00
abstract::A 48-year-old man with a cystic craniopharyngioma developed hypersomnia, personality changes, memory impairment and thermal dysfunction following intracystic administration of bleomycin through an Ommaya reservoir after partial removal of the tumour. The patient's neurological deterioration was thought to be related t...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699409101192
更新日期:1994-01-01 00:00:00
abstract::Purpose: Ossification of ligamentum flavum (OLF) is an infrequent cause of thoracic spinal stenosis, mostly found in Japan and other East Asian countries, and uncommon in other populations. The incidence of dural ossification (DO) ranges from 11-62%. None of the previously described imaging findings can accurately dia...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2019.1670333
更新日期:2020-12-01 00:00:00
abstract::We describe the case of a previously well, 73-year-old male patient who presented with a spontaneous high flow, carotico-cavernous fistula, 1 month following an attack of herpes zoster. We postulate that the zoster virus was the underlying cause, given the history and time frame between the preceding shingles and the ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688691003634512
更新日期:2010-06-01 00:00:00
abstract::Cerebellar haemangioblastomas commonly arise in patients with von Hippel - Lindau disease. We present the case of a 47-year-old male who has successfully undergone 10 separate procedures for symptomatic cerebellar haemangioblastomas. To our knowledge, this case is unique with respect to the frequency of symptomatic re...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690701552864
更新日期:2008-02-01 00:00:00