Abstract:
BACKGROUND:Giant pituitary adenomas (> 4 cm) are a surgical challenge. We present our experiences in surgical management of these tumors in a series of 250 patients. METHODS:Two hundred and fifty patients with giant pituitary adenomas were managed surgically at our center over last 13 years. Majority (92%) of patients presented with visual deterioration. Non-functioning tumors were found in 136 patients (54.3%). Among functioning adenomas, 63 patients (25.4%) had prolactinomas and 45 patients (18%) had GH-secreting adenomas; while 3 patients each had LH and ACTH- secreting adenomas. The maximum tumor diameter varied from 4 to 10.5 cm, with mean diameter of 5.4 cm. The factors determining choice of operative approach and surgical outcomes in these tumors were analyzed. RESULTS:Overall, 273 surgical procedures were performed in 250 patients. Of these, 110 were transsphenoidal, while 163 were transcranial approaches. A single surgical procedure was performed in 227 patients (89.2%). 23 patients (9.2%) underwent re-exploration either because of postoperative apoplexy or residual tumor. Overall, near total (>90%) tumor excision could be achieved in 74%, with improved vision in 53% and good outcome in 75% patients. The mortality and morbidity were 4.4% and 14%, respectively. CONCLUSIONS:The main goal of surgical treatment of giant pituitary adenoma is maximum possible tumor extirpation with minimal side effects, which can be achieved by careful preoperative planning of operative approach, based on directions of tumor extensions and invasiveness. Maximal surgical removal of giant adenomas offers best chances to control tumor growth when followed with adjuvant medical and radiation therapies.
journal_name
Br J Neurosurgjournal_title
British journal of neurosurgeryauthors
Sinha S,Sharma BSdoi
10.3109/02688690903370305subject
Has Abstractpub_date
2010-02-01 00:00:00pages
31-9issue
1eissn
0268-8697issn
1360-046Xjournal_volume
24pub_type
杂志文章abstract:PURPOSE:There is an abundance of articles published on low-grade glioma. The aim of this study was to identify and review the 50 most-cited articles on low-grade glioma, and to perform a bibliometric analysis. METHODS:In June 2017, we performed a basic search of the Web of Science database using "low-grade glioma mana...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1549314
更新日期:2019-04-01 00:00:00
abstract::The operative management and early post-operative outcome of 16 consecutive cases of paediatric penetrating head injury treated by a single surgeon at a military trauma centre in Southern Afghanistan are retrospectively analysed. The majority of cases of injury were caused by fragments from exploding munitions. The ai...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2013.767314
更新日期:2013-08-01 00:00:00
abstract:INTRODUCTION:Society of British Neurological Surgeons (SBNS) meetings are important national events which allow for the presentation of current academic work. The publication rate of presented abstracts is considered a proxy marker of the scientific strength of a conference. We aimed to determine the publication fate o...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2014.915008
更新日期:2015-04-01 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::From autopsy and neuroradiological studies a maximum prevalence of unruptured intracranial aneurysms (UA) of 0.5% in the general population is revealed. Studies concerning the incidence of aneurysmal subarachnoid haemorrhage (SAH) revealed 10 cases per 100,000 inhabitants per year. From these epidemiological parameter...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3109/02688698809001008
更新日期:1988-01-01 00:00:00
abstract::CNS lymphoma involving the trigeminal nerve is a rare condition which presents as a cavernous sinus lesion. It may mimic the radiological appearance of other lesions, and biopsy is essential before considering empirical radiotherapy for lesions in this region. We report the radiological, histopathological and operativ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2013.835374
更新日期:2014-04-01 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::Two cases with a unique association of Rathke's cleft cysts and a growth hormone-secreting pituitary adenoma in the same tumour tissue are reported. The embryological pathogenesis, diagnostic evaluation and treatment of these lesions are discussed. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688699550041755
更新日期:1995-01-01 00:00:00
abstract::Objective: Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a useful therapy to improve motor functions and reduce dependence on medication in patients with Parkinson's disease (PD). The purpose of the study is to assess the long-term clinical outcomes of STN-DBS and to determine the optimal placement of...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1775786
更新日期:2020-06-12 00:00:00
abstract::Over a 2-year period, 22 consecutive comatose patients (Glasgow Coma Score of less than or equal to 8) with intraventricular haematomas were managed with prolonged external ventricular drainage via an external one-way valve regulated system. The mean duration of drainage was 12 days. The overall mortality was 23%. Acc...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688698809029600
更新日期:1988-01-01 00:00:00
abstract::We present a series of eight patients undergoing circumferential neural decompression and stabilization of the thoracolumbar spine via a single midline posterior approach, with complete vertebrectomy for a variety of indications. Four had primary tumours, two secondary tumours, one patient had tuberculosis and one had...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690701837273
更新日期:2008-04-01 00:00:00
abstract::Fibrous dysplasia (FD) is an uncommon benign fibro-osseous abnormality of bone, of unknown aetiology and equal sex incidence, which is most commonly restricted to one bone (monostotic FD: MFD, 70%). Less commonly multiple bones are affected (polyostotic FD: PFD, 27%). Vertebral involvement is uncommon (4%), but more c...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.1080/02688690400012525
更新日期:2004-10-01 00:00:00
abstract::Twenty patients bearing malignant brain tumours (18 glioblastoma multiforme, one malignant meningioma, one melanoma metastasis) were treated 25 times with photodynamic therapy (PDT)--the combination of Hematoporophyrin derivative and light at 630 nm (40-120 J/cm2). Sixteen times the PDT was followed immediately by a s...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688698808992675
更新日期:1988-01-01 00:00:00
abstract::Intracerebral haemorrhage is a devastating condition lacking effective therapies, with an uncertain role for surgery in many. Early research described an ischaemic penumbra around the haematoma, representing an area of potential therapeutic intervention. This article discusses the evidence for and against the existenc...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2011.578773
更新日期:2011-08-01 00:00:00
abstract:AIM:Cervical Spondylotic Myelopathy (CSM) is a disabling condition arising from arthritic compression and consequent injury of the cervical spinal cord. Stratification of CSM severity has been useful to inform clinical practice and research analysis. In the UK the Myelopathy Disability Index (MDI) is a popular assessme...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1839741
更新日期:2020-11-10 00:00:00
abstract::Giant anterior circulation aneurysms and some basilar aneurysms can cause problems due to their size, the presence of clot in the aneurysm and the difficulty of applying a clip without kinking the perforating vessels. By utilising cardiopulmonary bypass via the femoro-femoral perforating vessels. By utilising cardiopu...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688698709035310
更新日期:1987-01-01 00:00:00
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::Epidermoid cyst may rarely arise within the lateral wall of the cavernous sinus (CS) and produce clinical symptoms mimicking the Tolosa-Hunt syndrome. Pathogenically, it is suggested that some of the subpopulation of cells arising from the neural crest which give rise to skin, may remain entrapped in the meninges arou...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.1080/02688690050206747
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVES:We aimed to compare quality of life (QoL) after surgical decompression of the thoracic outlet versus non-operative therapy in patients with neurogenic thoracic outlet syndrome (N-TOS). DESIGN AND METHODS:We retrospectively identified 46 patients, diagnosed with N-TOS between 1999 and 2008. Twenty-four opera...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2010.489656
更新日期:2010-10-01 00:00:00
abstract::The clinical course of 21 patients who underwent syringopleural shunting for syringomyelia is summarised. All the patients were continuing to deteriorate at the time of the operation. Objective improvement was seen in nine patients following the procedure but three subsequently deteriorated. Contralateral syrinx sympt...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688698709034342
更新日期:1987-01-01 00:00:00
abstract::Spinal tumours in pregnancy are rare. Spinal tumours account for only 10-15% of all primary central nervous system (CNS) tumours. Most spinal tumours in pregnant women have been described as meningiomas or vascular tumours. We present the unique case of a pregnant patient presenting with a CD 99+ primary spinal centra...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2017.1302073
更新日期:2019-06-01 00:00:00
abstract::Confusion frequently occurs in patients with gliomas for a number of reasons. One cause is a superimposed intracerebral infection. The case of a 73-year-old man who deteriorated after debulking of a high-grade glioma is described. However, he was successfully treated for Listeria monocytogenes (L. monocytogenes) diagn...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2010.535927
更新日期:2011-06-01 00:00:00
abstract::Post-traumatic hypopituitarism has remained as an obscured cause of worsening morbidity and mortality in head injury patients. Researchers have for decades been puzzled by the mechanism of pituitary dysfunction in these cases. Amongst other causes like direct injury, vascular injury etc, an immunological basis of hypo...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1485875
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Nerve and muscle biopsy are common procedures often performed by junior surgical trainees. This educational review article describes the operative details of performing biopsies of muscle and nerve. Indications, pre-operative investigations and complication rates are described to aid in proper patient select...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3109/02688697.2013.793288
更新日期:2013-12-01 00:00:00
abstract::A case is presented of a 35-year-old man, who suffered intermittent hydrocephalic attacks due to a large subependymoma arising within the left lateral ventricle. The sparse literature on this rare tumour is reviewed. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3109/02688699409002398
更新日期:1994-01-01 00:00:00
abstract::We describe a sciatic schwannoma spanning the sciatic notch in a 39-year-old woman with persistent pelvic pain after caesarean delivery. The tumour was detected by pelvic CT scan and MRI. Anterior transabdominal surgery allowed the en bloc removal of both the pelvic and the buttock component of the tumour. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690600603776
更新日期:2006-02-01 00:00:00
abstract::We report a case of extensive osteomyelitis of the skull vault from a human bite. The presentation and surgical management of this unusual condition is described. The microbiological findings are comparable to known patterns of infection after human bites. Surgical management and prophylaxis after this injury are disc...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688699746582
更新日期:1997-04-01 00:00:00
abstract::Seventy patients with spinal arteriovenous malformations (AVMs) referred to the author over a 25-year period (1958-82), were equally divided between congenital, intradural and acquired, dural lesions. Amongst the intradural AVMs, were 22 with subarachnoid haemorrhage (SAH), a presenting feature in 18. The clinical fin...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699209002895
更新日期:1992-01-01 00:00:00
abstract::Early changes of the activity of enzymes such as creatine kinase in the cerebrospinal fluid (CSF) or serum are often investigated after head injuries to assess the extent of brain damage and establish a reliable prognosis. The purpose of the present study was to determine levels of creatine kinase isoenzyme CK-BB in t...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688698808992666
更新日期:1988-01-01 00:00:00
abstract::We report the fourth case of Carbapenem-resistant Klebsiella pneumoniae (CRKP) meningitis and the only one associated with brain abscess formation. A 29-years-old male patient developed septic shock 13 days after a right nasopharyngeal AVM resection. CRKP was grown from CSF with a MIC for meropenem ≥16 mg/L. Intraveno...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1530729
更新日期:2019-07-25 00:00:00