Abstract:
BACKGROUND:Compressive optic neuropathy (CON) with visual loss is, apart from corneal exposure and disfigurating proptosis, the most serious clinical sign encountered in Graves' ophthalmopathy. However, numerous different approaches and operative techniques have been proposed for orbital decompression, with varying results and side effects. The purpose of the present study was to analyze peri-operative data and long-term results in patients with severe thyroid-related orbitopathy, treated by extended pterional orbital decompression, comparing its effectiveness to other procedures. METHOD:An extended pterional orbital decompression was performed in 42 consecutive patients (59 orbits) with severe thyroid-associated ophthalmopathy after failure of medical and radiation therapy during an 11-year period. Pre- and postoperative examination included visual acuity, Hertel exophthalmometry, ocular motility, visual fields (Goldmann perimetry) and notification of complications. Long-term evaluation was carried out on average at 11 months postoperatively (range 5-26 months). FINDINGS:Visual acuity improved rapidly from a preoperative average of 0.53 +/- 0.33 (range, 0-1) to 0.77 +/- 0.31 (range, 0-1) postoperatively (p<0.001). Worsening was not seen. An average reduction of proptosis of 3.79 +/- 2.32 mm (range, 0.5-8 mm) was achieved with a mean preoperative Hertel measurement of 24.7 +/- 3.93 mm (range, 15-33 mm) (p<0.001). Double vision and restriction of eye motility was present in 76.3% of patients preoperatively and improved in 63% of patients (p<0.001). No new onsets of not already pre-existing double vision was seen. Complications included two cases of permanent palsy of the frontal branch of the facial nerve. INTERPRETATION:The extended pterional orbital decompression improved vision and decreased proptosis and restriction of extra-ocular movements in patients with severe sight-threatening and disfiguring cases of Graves' orbitopathy and is still an effective and low-risk alternative to other non-neurosurgical operative techniques. Especially new developing postdecompression strabismus can be successfully avoided.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Korinth MC,Ince A,Banghard W,Gilsbach JMdoi
10.1007/s007010200013subject
Has Abstractpub_date
2002-02-01 00:00:00pages
113-20; discussion 120issue
2eissn
0001-6268issn
0942-0940journal_volume
144pub_type
杂志文章abstract:BACKGROUND:Several studies have investigated the relation between intraoperative abnormal muscle response (AMR) findings and postoperative results in patients undergoing microvascular decompression (MVD) for hemifacial spasm (HFS). However, there is some debate over the reliability of AMR as an indicator of postoperati...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0571-x
更新日期:2005-09-01 00:00:00
abstract:STUDY DESIGN:Spinal subarachnoid hematomas are unusual and difficult to diagnose and the outcome of treatment is influenced by the lesions that frequently accompany them. OBJECTIVES:To clarify the neuroradiological diagnostic aspects of spinal subarachnoid hematoma as well as the results of treatment. BACKGROUND:Only...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-004-0458-2
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:To review current management strategies for olfactory groove meningioma (OGM)s and the recent literature comparing endoscopic endonasal (EEA) with traditional transcranial (TCA) approaches. METHODS:A PubMed search of the recent literature (2011-2016) was performed to examine outcomes following EEA and TCA fo...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-017-3303-0
更新日期:2017-10-01 00:00:00
abstract:INTRODUCTION:The gold-standard treatment for symptomatic anterior skull base meningiomas is surgical resection. The endoscope-assisted supraorbital "keyhole" approach (eSKA) is a promising technique for surgical resection of olfactory groove (OGM) and tuberculum sellae meningioma (TSM) but has yet to be compared with t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04544-x
更新日期:2020-09-05 00:00:00
abstract::In the present study the variation of the localisation and the course of the coronal suture (CS) was examined on the lateral skull X-ray. The study shows a variation of the localisation and course of the CS from the average position within +/- 4 mm in 65-77% and extreme differences between minimum and maximum values b...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01560378
更新日期:1987-01-01 00:00:00
abstract::BAK-C is a new autostabilizing interbody cage which is implanted during an anterior cervical procedure to provide stability to the motion segment and allow fusion to occur. Special instrumentation is provided with a bone collecting reamer. The system utilizes surgical site bone graft as the osteo-inductive material wi...
journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章
doi:10.1007/s007010050049
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Cerebral cavernous malformations (CCM) are known to be highly epileptogenic lesions. A number of studies on CCM surgery deal with CCM-associated seizures and/or epilepsy. In order to counsel patients with CCM-associated epilepsy, clear results from such studies would be highly useful. This study reviews the ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-010-0915-z
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Impairment of cerebral autoregulation is known to adversely affect outcome following traumatic brain injury (TBI). The phase shift (PS) method of cerebral autoregulation (CA) assessment describes the time lag between fluctuations in arterial blood pressure (ABP) and cerebral blood flow velocity (CBFV) in the...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1447-z
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:The aim of this work was to retrospectively study the long-term reliability of the common consensus endocrinological criteria for the assessment of postoperative remission of acromegaly. PATIENTS AND METHODS:In 96 consecutive patients, surgical remission of acromegaly following transsphenoidal surgery was co...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0790-7
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Age is an important factor in determining prognosis following severe head injury (SHI), although mortality in patients > or =65 years is poorly reported. The aim of this study was to document mortality in patients with SHI > or =65 years. METHODS:A retrospective analysis of prospectively collected data from...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0666-x
更新日期:2010-08-01 00:00:00
abstract::A surgical carbon dioxide laser unit (laser) has been used since 1977 in twenty-five cases of various brain tumours, including ten meningiomas (four sphenoid ridge, two parasagittal, two falx, one olfactory, one posterior fossa), eleven gliomas (seven glioblastoma, four astrocytoma), two metastatic brain tumours, one ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02074786
更新日期:1980-01-01 00:00:00
abstract::Extravasation of Onyx is a rare complication during embolization of arteriovenous malformations (AVM). We present a case of embolization that was complicated by leakage of Onyx into the cerebellum which was later encountered during surgical excision of the AVM. Our goal is to report this rare event and to outline succ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-019-04199-3
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Vaccination against tumour-associated antigens is one approach to elicit anti-tumour responses. We investigated the effect of polynucleotide (DNA) vaccination using a model antigen (E. coli lacZ) in a syngeneic gliosarcoma model (9L). METHODS:Fisher 344 rats were vaccinated thrice by intramuscular injection...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-012-1526-7
更新日期:2013-01-01 00:00:00
abstract::To evaluate the interrelationships between anterior pituitary function and the antidiuretic system in patients harbouring hypothalamo-hypophyseal tumorous lesions, combined anterior pituitary stimulation tests were performed in the pre (n = 192 patients) and postoperative (n = 151 patients) state. Basal and stimulated...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01842828
更新日期:1990-01-01 00:00:00
abstract::Experience from five cases operated on within one year (among 50 microsurgical operations at the base of the brain) persuades us to discuss the topical relations of the meningiomas of the tuberculum sellae and the modifications in operating techniques necessary. For the two contrasting types of tumour found, which are...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401930
更新日期:1977-01-01 00:00:00
abstract::Symptomatic extracranial vertebral artery (VA) dissection may need surgery. We describe such a case successfully treated with atlantoaxial fusion based on its rare dynamic angiographic findings. A 27-year-old woman suffered from repeated brainstem and cerebellar infarctions from a left extracranial VA dissecting aneur...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-016-2891-4
更新日期:2016-09-01 00:00:00
abstract::To clarify the value of clinical long-term follow-up with radiological examination, ranging from 12 to 63 months (average: 35 months), 18 consecutive patients suffering from spontaneous carotid cavernous fistula (CCF), were studied prospectively. Five aged patients without aggressive symptoms were treated conservative...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050059
更新日期:1998-01-01 00:00:00
abstract::The authors describe an approach through the temporal horn of the lateral ventricle which proved to be useful for clipping of a large dorsal type basilar bifurcation aneurysms. It facilitates the preservation of the perforating arteries behind the aneurysm, because it gives sufficient working space to move the aneurys...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01404942
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Supratentorial intracerebral haemorrhage (ICH) carries an excessive mortality and morbidity. Although surgical ICH treatment can be life-saving, the indications for surgery in larger cohorts of ICH patients are controversial and not well defined. We hypothesised that surgical indications vary substantially a...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03853-0
更新日期:2019-05-01 00:00:00
abstract::Postoperative recovery of patients with chronic subdural haematoma (CSH) was investigated by comparing pre- and postoperative coagulant and fibrinolytic activity in the haematoma contents of 15 patients with SCH. Patients in this study were treated draining the haematoma cavity without irrigation, a procedure dubbed t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050283
更新日期:1999-01-01 00:00:00
abstract::In patients with brain metastasis from lung cancer, we have been able to control local recurrence in approximately 80% of cases. But many of them tend to show brain atrophy with mental deterioration developing a few months after whole brain radiation. To prevent brain atrophy, we have attempted treating patients, whos...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401458
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVES:A number of different image-guided surgical techniques have been developed during the past decade. None of these methods can provide the surgeon with information about the dynamic changes that occur intra-operatively. MATERIAL AND METHOD:The first vertical open 0.5T MRI-scanner for intra-operative MRI-guide...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050325
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Spinal dural arterio-venous fistulae (SDAVF) are slow-flow extramedullary vascular lesions which account for 75-80% of all spinal vascular malformations. At present there is no agreed view with regard to the best therapeutic option being surgical or endovascular, and several reports favour one or other form ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-008-1560-7
更新日期:2008-06-01 00:00:00
abstract::In the present note, the cause of root compression in cases with degenerative lumbar spondylolisthesis is discussed in order to clarify the best method of surgery and to avoid iatrogenic damage of the cauda equina if a transpedicular fusion is going to be performed. The root compression is due to osteophytes growing o...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02187192
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:The optimal management of Chiari I malformation during pregnancy remains uncertain. Labor contractions, which increase intracranial pressure, and neuraxial anesthesia both carry the theoretical risk of brainstem herniation given the altered CSF dynamics inherent to the condition. Mode of delivery and planned...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04308-7
更新日期:2020-07-01 00:00:00
abstract::Due to the limited absorptive capacity of the pleural cavity, infants and young children are not generally ideal candidates for ventriculopleural shunts. We report using chest cavities as alternate for temporary diversion of CSF in a young child. Venous access to the cervical region could not be utilized because of sc...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400595
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Cerebrospinal fluid (CSF) drainage has been variably employed to lower intracranial pressure (ICP) in patients with severe head injury. The efficacy of this manoeuvre remains under-explored (Brain Trauma Foundation Recommendation-optional treatment). This work seeks to report the results of CSF drainage via ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1735-8
更新日期:2013-11-01 00:00:00
abstract::Firstly, 14 patients are described who developed either an acquired Chiari malformation (ACM) alone (7 cases) or ACM and syringomyelia (7 cases) after lumbar subarachnoid space (SAS) shunting or in one case, epidural anaesthesia with SAS penetration. Four groups are considered: 3 cases with craniofacial dysostosis and...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050119
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Evolving of a single centre by means of different transsphenoidal approaches during the survey of methodological advances in pituitary surgery is presented. MATERIALS AND METHODS:Ninety-three consecutive patients with pituitary adenomas underwent transphenoidal pituitary operations at Gulhane Military Medic...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-008-0135-y
更新日期:2008-11-01 00:00:00
abstract::The long-term outcome in 26 patients following operation of intracranial saccular aneurysms before the age of twenty is presented. The duration of follow-up ranged from 4 to 33 years (mean 14 years). The oldest patient is now 51 years old. 19 patients (73%) made a complete or good recovery with resumption of normal li...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01476214
更新日期:1985-01-01 00:00:00