The influence of choice of therapy on quality of life in patients with neurogenic thoracic outlet syndrome.

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 operated and 22 conservatively treated patients were sent questionnaires on their current symptoms and QoL. A matched control group (n = 24) of healthy individuals was selected for QoL comparison. Statistics were performed with linear and logistic regression analysis. RESULTS:ANOVA revealed a significant QoL difference between the three groups (p = 0.001). Separate analysis between groups demonstrated that all patients with N-TOS-like symptoms have a lower QoL than healthy controls (p = 0.001 resp. p  < or =  0.000). No difference was found between conservatively and surgically treated patients (p = 0.26). EQ-5D response rate was 83%. Of the 24 surgically treated patients, 15 would choose surgery again in a similar situation, although 4 did not benefit in terms of symptom reduction. Symptom relief and VAS pain scores in the conservatively and surgically treated patients did not show significant differences (p = 0.95 resp. p = 0.40). CONCLUSIONS:All patients with N-TOS have a significantly decreased QoL compared with healthy individuals, regardless of the type of therapy they received. In this small study, surgical decompression fails to improve QoL in patients with N-TOS to the level measured in the healthy control group, despite symptom reduction consistent with previous reports. Variables significantly associated with outcome were duration of symptoms and localisation (variables included in the prediction model: age, sex, duration of symptoms, presence of paraesthesias, localisation, Adson's, Wright's and Roos' test, history of trauma, cervical arthrosis). In the perspective of QoL, the benefit of decompressive surgery is questionable. Improving patient selection seems imperative in order to achieve better results in our surgically treated patients.

journal_name

Br J Neurosurg

authors

Bosma J,Van Engeland MI,Leijdekkers VJ,Vahl AC,Wisselink W

doi

10.3109/02688697.2010.489656

subject

Has Abstract

pub_date

2010-10-01 00:00:00

pages

532-6

issue

5

eissn

0268-8697

issn

1360-046X

journal_volume

24

pub_type

杂志文章
  • Endovascular stenting of the transverse sinus in a patient presenting with benign intracranial hypertension.

    abstract::The authors present a 37-year-old lady with symptoms and signs suggestive of benign intracranial hypertension (BIH). Routine CT and MRI scans were normal. Further investigations were performed with magnetic resonance venography (MRV) and cerebral venography. These revealed obstruction of the right transverse sinus wit...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690310001627821

    authors: Ogungbo B,Roy D,Gholkar A,Mendelow AD

    更新日期:2003-12-01 00:00:00

  • Extradural arachnoid cysts: a study of seven cases.

    abstract::Analysis of the management of 7 cases of extradural arachnoid cyst is presented. A brief review of the literature on the subject is presented. Seven cases of extradural arachnoid cysts were treated surgically between the years 1996 to 2002. These patients were analysed retrospectively. The average follow-up period was...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690400012368

    authors: Kulkarni AG,Goel A,Thiruppathy SP,Desai K

    更新日期:2004-10-01 00:00:00

  • Studies of regional subdural pressure gradients during craniotomy.

    abstract::We investigated subdural pressure gradients within the operative field of the exposed intact dura in 53 patients with space-occupying lesions during craniotomy. In 37 patients with supratentorial brain tumour paired measurements of subdural pressure were studied in either the same horizontal or vertical plane. In 16 p...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/026886900408414

    authors: Bundgaard H,Cold GE

    更新日期:2000-06-01 00:00:00

  • Neurosurgery and the Internet.

    abstract::The Internet is a global computer network which has recently become accessible for many reasons to the general public. The growth in its use for entertainment purposes is now being mirrored by its application to medical interests requiring rapid communication. Neurosurgery as a speciality has a tradition of adapting q...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688699646853

    authors: Phillips NI

    更新日期:1996-12-01 00:00:00

  • Factors responsible for early postoperative mental alterations after bilateral implantation of subthalamic electrodes.

    abstract:INTRODUCTION:Early postoperative mental changes are the most frequent problem after bilateral subthalamic electrode implantation. The study aims to find an association between them and factors related to patient, disease and surgery, including the size of the third ventricle as brain atrophy marker. MATERIAL AND METHO...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2016.1226256

    authors: Hrabovsky D,Balaz M,Rab M,Feitova V,Hummelova Z,Novak Z,Chrastina J

    更新日期:2017-04-01 00:00:00

  • Effects of surgery on cognitive functioning of elderly patients with intracranial meningioma.

    abstract::Few data are available concerning the outcome of surgical removal of intracranial meningioma in elderly patients. Surgical criteria and prognostic factors are considerations in the decision as to whether neurosurgical removal should be attempted in elderly patients. The present study appears to be the first to examine...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690151127608

    authors: Tucha O,Smely C,Lange KW

    更新日期:2001-04-01 00:00:00

  • Stereotactic multiple arc radiotherapy. I. Vascular malformations of the brain: an analysis of the first 108 patients.

    abstract::Between March 1989 and December 1993, 101 patients with inoperable arteriovenous malformations (AVMs) and seven patients with inoperable angiographically occult malformations (AOVMs) have been treated with stereotactic multiple arc radiotherapy (SMART). All patients (excluding one patient with a brain stem AOVM) were ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688699550041070

    authors: Sebag-Montefiore DJ,Doughty D,Biggs D,Plowman PN

    更新日期:1995-01-01 00:00:00

  • Surgical treatment of pineal cysts in non-hydrocephalic and neurologically intact patients: selection of surgical candidates and clinical outcome.

    abstract:PURPOSE:Management of patients presenting for various nonspecific complaints without clear neurological abnormalities and with normal ventricular size remains highly controversial. We intended to share our rationale for surgical treatment of patients who show symptoms of transient increase of intracranial pressure owin...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2018.1530731

    authors: Koziarski A,Podgórski A,Zieliński GM

    更新日期:2019-02-01 00:00:00

  • A case report of the management of multiple metachronous haemangioblastomas in a patient with von Hippel - Lindau disease.

    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

    authors: Newman S,Wasserberg J

    更新日期:2008-02-01 00:00:00

  • Bow Hunter's syndrome combined with ipsilateral vertebral artery dissection/pseudoaneurysm: case study and literature review.

    abstract::Background: Bow hunter's syndrome (BHS), also known as rotational vertebral artery occlusion syndrome, is rare. Occasionally, it combines with dissection/pseudoaneurysm of the ipsilateral VA.Methods: We report a case of BHS combined with ipsilateral VA dissection/pseudoaneurysm and review eight similar cases reported ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2020.1718604

    authors: Xue S,Shi H,Du X,Ma X

    更新日期:2020-02-03 00:00:00

  • Angiographic characteristics of unruptured middle cerebral artery aneurysms predicting perforator injuries.

    abstract:PURPOSE:The aim of the present study was to delineate preoperative factors that may predict perforator injuries following open surgery for an unruptured middle cerebral artery (MCA) aneurysm. METHODS:The authors conducted a retrospective review of 85 consecutive patients who underwent surgical clipping of 91 unrupture...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2010.535924

    authors: Yeon JY,Kim JS,Hong SC

    更新日期:2011-08-01 00:00:00

  • Bicoronal frontobasal approach with a limited, midline orbital bar osteotomy - a technical note.

    abstract::The frontobasal approach remains a workhorse for removing large olfactory groove meningiomas. Removal of the orbital bar in addition to standard bifrontal craniotomy allows for additional basal exposure, minimising brain retraction and allowing early and direct access to both the vascular supply and dural origin of th...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2015.1071329

    authors: Patel K,Kolias AG,Kirollos RW

    更新日期:2016-01-01 00:00:00

  • Functional surgery for Parkinson's disease treatment: a structured analysis of a decade of published literature.

    abstract::The aim of this study was to analyse and compare published data during the last decade on the different approaches to Parkinson's disease surgery. Eighty-eight papers published between 1990 and 2001 fulfilled the inclusion criteria. Full-text and prospective papers on lesion and stimulation of GPi or STN were assessed...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1080/02688690410001732625

    authors: Boucai L,Cerquetti D,Merello M

    更新日期:2004-06-01 00:00:00

  • Role of gamma knife radiosurgery for recurrent or residual World Health Organization grade II and III intracranial meningiomas.

    abstract::Background: To analysis the role of gamma knife radiosurgery (GKRS) in treatment of the recurrent or residual World Health Organization (WHO) grade II and III meningiomas.Methods: Between 1995 and 2015, a total of 1163 meningioma patients were treated with GKRS at our single institute; 26 atypical and 6 anaplastic men...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2020.1726285

    authors: Kim M,Cho YH,Kim JH,Kim CJ,Roh SW,Kwon DH

    更新日期:2020-06-01 00:00:00

  • Severe methanol intoxication with atypical symptoms and imaging changes: a fatal case report.

    abstract::Acute methanol intoxication can occur as accidental ingestion of adulterated spirits. We report a 51-year-old male patient with high anion-gap metabolic acidosis (pH 6.71, HCO3-4.2 mmol/l, K + 6.5mmol/l) because of severe methanol intoxication (450 mg/L, reference level <2.9 mg/L) who presented with atypical symptoms ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2020.1765977

    authors: Chen J

    更新日期:2020-05-18 00:00:00

  • Brainstem gliomas: surgical indications and technical considerations in a series of 58 cases.

    abstract::OBJECTIVES. To analyze the indications of surgical treatment, surgical management strategies and post-surgical outcome in patients with brainstem glioma (BSG). METHODS. In this retrospective study conducted from 1998 to 2012, 58 patients of surgically treated intrinsic BSG, meeting the inclusion criterion were enrolle...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2013.829562

    authors: Sinha S,Kale SS,Chandra SP,Suri A,Mehta VS,Sharma BS

    更新日期:2014-04-01 00:00:00

  • Thrombosis of the straight sinus complicating hormone replacement therapy.

    abstract::Oral contraceptives have been implicated in the pathogenesis of dural venous thrombosis. No similar association has been confirmed between postmenopausal hormone replacement therapy and cerebral venous thrombosis, although one previous report in the literature has identified such a case. We present a further case of t...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688699550040819

    authors: Strachan R,Hughes D,Cowie R

    更新日期:1995-01-01 00:00:00

  • A new microsurgical instrument--a suction tube combined with a microdissector.

    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

    authors: Boström S,Milos P,Theodorsson A,Bobinski L

    更新日期:2011-06-01 00:00:00

  • Primary central nervous system malignant lymphoma in a patient with rheumatoid arthritis receiving low-dose methotrexate treatment.

    abstract::We report the first case of primary central nervous system lymphoma (PCNSL) developing in a patient with rheumatoid arthritis (RA) undergoing low-dose methotrexate therapy (LD-MTX). The characteristic clinical management and course in our experience of the present case illustrate the important points about PCNSL in me...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2013.798857

    authors: Fukushima M,Katayama Y,Yokose N,Kura Y,Sawada U,Kotani A,Yoshino A

    更新日期:2013-12-01 00:00:00

  • Thoracic spine ossified ligamentum flavum: single-surgeon experience of fifteen cases and a new MRI finding for preoperative diagnosis of dural ossification.

    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

    authors: Prasad GL

    更新日期:2020-12-01 00:00:00

  • A CD99+ primary spinal central PNET in a pregnant patient- therapeutic concerns and issues.

    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

    authors: Soni AJ,Modi G,Soni Z,Kotzen J,Soni Z,Goolab V

    更新日期:2019-06-01 00:00:00

  • A comparison of the efficacy, safety, and duration of frame-based and Remebot robot-assisted frameless stereotactic biopsy.

    abstract:OBJECTIVE:The aim of this study was to compare the efficacy, safety, and duration of Remebot robot-assisted frameless brain biopsy with those of standard frame-based stereotactic biopsy. PATIENTS AND METHODS:A retrospective analysis of 66 patients undergoing stereotactic brain biopsy in our department from January 201...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2020.1812519

    authors: Wu S,Wang J,Gao P,Liu W,Hu F,Jiang W,Lei T,Shu K

    更新日期:2020-09-17 00:00:00

  • Posterior fossa ICP monitoring: a tale of two compartments.

    abstract::Aim: Measuring the intracranial pressure (ICP) of the infra-tentorial, posterior fossa compartment has long been avoided due to a lack of precedent and interpretability, as well as concern of damage to the underlying vital structures. In cases of posterior fossa insults however, the supra-tentorial compartment ICPs ca...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2020.1765974

    authors: Khan A,Borg N,Shenouda E

    更新日期:2020-05-15 00:00:00

  • Posteroventrolateral pallidotomy through implanted DBS electrodes monitored by recording local field potentials.

    abstract::This paper describes the use of globus pallidus internus (Gpi) local field potentials recorded through pre-implanted deep brain stimulation (DBS) electrodes on a patient affected by generalized dystonia. The recordings were made both before and after radiofrequency-induced posteroventrolateral bilateral stereotactic p...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2015.1054363

    authors: Franzini A,Cordella R,Penner F,Rosa M,Messina G,Rizzi M,Nardocci N,Priori A

    更新日期:2015-01-01 00:00:00

  • Cavernous malformation of the optic chiasm: case report.

    abstract::We report a 14-year-old boy with cavernous malformation of the optic chiasm. He had a 2-year history of gradually worsening visual disturbance. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a suprasellar mass, findings compatible with craniopharyngioma. The mass was biopsied and histological e...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690601000238

    authors: Muta D,Nishi T,Koga K,Yamashiro S,Fujioka S,Kuratsu J

    更新日期:2006-10-01 00:00:00

  • Acoustic neuroma surgery: results of translabyrinthine tumour removal in 300 patients. Discussion of choice of approach in relation to overall results and possibility of hearing preservation.

    abstract::The results from the Danish model of acoustic neuroma surgery are presented. In the period from 1976 to 1985, 300 patients with acoustic neuromas were operated upon using the translabyrinthine procedure. Only one small intrameatal tumour was encountered; 96 tumours were medium sized and 203 were larger than 25 mm. Of ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688698909002815

    authors: Thomsen J,Tos M,Harmsen A

    更新日期:1989-01-01 00:00:00

  • Chlorpromazine in combination with nitrosourea inhibits experimental glioma growth.

    abstract::Modern cancer therapy has improved the prognosis for several tumour types. This, however, does not apply to the largest group of brain tumours, the malignant astrocytomas grades III-IV. Hence, there is need for new ideas to improve treatment. Ca2+ and the Ca(2+)-binding protein calmodulin have been shown to be involve...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688699409027965

    authors: Aas AT,Brun A,Pero RW,Salford LG

    更新日期:1994-01-01 00:00:00

  • Neuromas of the facial nerve: a report of 12 cases.

    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

    authors: Symon L,Cheesman AD,Kawauchi M,Bordi L

    更新日期:1993-01-01 00:00:00

  • An evaluation of the epileptogenic properties of a rifampicin/clindamycin-impregnated shunt catheter.

    abstract::A process has been developed by which ventriculoperitoneal hydrocephalus shunts, which are prone to bacterial colonisation, can be impregnated with antimicrobials in order to confer antibacterial activity. Concern that their use might be associated with an increased risk of postoperative seizures has been addressed he...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688699409101187

    authors: Abed WT,Alavijeh MS,Bayston R,Shorvon SD,Patsalos PN

    更新日期:1994-01-01 00:00:00

  • Craniometrical imaging and clinical findings of adult Chiari malformation type 1 before and after posterior fossa decompression surgery with duraplasty.

    abstract::Background: Posterior fossa decompression both with and without duraplasty are accepted treatments for symptomatic adult patients with Chiari Malformations Type 1 (CM-1). There is still debate of the superiority of one technique over the other. The purpose of this study was to determine the clinical and craniometrical...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2019.1617407

    authors: Nikoobakht M,Shojaei H,Gerszten PC,Shojaei SF,Mollahoseini R,Azar M

    更新日期:2019-10-01 00:00:00