Abstract:
:Stereotactic radiosurgery (SRS) for brain metastases has been carried out at the Leeds Gamma Knife Centre since March 2009. The aim of this study was to examine the outcomes and toxicity in our initial cohort of patients. The medical records of patients with brain metastases referred to the Leeds Gamma Knife Centre between March 2009 and July 2010 were retrospectively reviewed. Data on survival, primary tumour, Karnofsky performance status, time from diagnosis to identification of brain metastases, previous treatment for brain metastases and results of staging prior to SRS were recorded. Patients were followed up with regular magnetic resonance imaging of the brain for a minimum of 6 months and data on toxicity and oral steroid dose were recorded. Statistical analysis was carried out using SPSS v14.0. Survival curves were compared using the Log Rank test. Fifty eight patients (19 male) had a median survival of 50.4 weeks (95% CI, 32.6-68.2 weeks). Lung (36%) and breast (27%) were the most common primary tumours. Patients with a total volume of metastases treated < 5000 mm(3) (p = 0.007) or between 5000 mm(3) and 10,000 mm(3) (p = 0.01) had significantly improved survival compared with patients with a total treated volume > 10,000 mm(3). In addition, largest treated lesion < 5000 mm(3) was a positive prognostic factor. Patients with a single metastasis did not survive significantly longer than those with multiple metastases. Steroid dose dropped significantly after SRS (p < 0.01) and was the same or less in 91% of patients. There were only three cases of grade 3 toxicity. Our study reports survival comparable with other series on radiosurgery and demonstrates a significant decrease in steroid dose following treatment. It also shows that the size of the largest treated metastasis and total volume of metastatic disease seemed a better predictor of outcome than number of metastases treated.
journal_name
Br J Neurosurgjournal_title
British journal of neurosurgeryauthors
Banfill KE,Bownes PJ,St Clair SE,Loughrey C,Hatfield Pdoi
10.3109/02688697.2012.690913subject
Has Abstractpub_date
2012-10-01 00:00:00pages
674-8issue
5eissn
0268-8697issn
1360-046Xjournal_volume
26pub_type
杂志文章abstract::Use of transcranial Doppler (TCD) to diagnose vasospasm has been criticised. We examined reproducibility of TCD middle cerebral artery (MCA) velocity measurements. Thirty-six healthy adult volunteers were recruited. Four operators, two experienced and two inexperienced, participated. MCA velocity was measured twice by...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690701210539
更新日期:2007-02-01 00:00:00
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
更新日期:2020-05-15 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::The objective was to measure metabolic changes monitored by bedside microdialysis during impending and manifest hypoxia in traumatic brain injury. In 41 patients, a PtiO2-catheter (Licox; 1/min) was placed into non-lesioned frontal white matter together with a microdialysis catheter (CMA, hourly). Data were analysed f...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690310001601234
更新日期:2003-08-01 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::We describe the unique case of a 51-year-old lady who developed a contralateral lumbosacral plexopathy two days after a lumbar microdiscectomy. This is the first report to date of this complication occurring following this procedure. We review the literature regarding lumbosacral plexopathy and discuss the evidence ba...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1429568
更新日期:2020-08-01 00:00:00
abstract::A case report of a patient who developed cauda equina syndrome following pelvic traction for acute sciatica is presented. A good outcome was obtained with prompt surgical decompression. This case illustrates the potential dangers of traction, which is frequently employed in the management of acute back pain. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/0268869021000007696
更新日期:2002-08-01 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::The bursting pressure of samples of cerebral arteries was measured. Eighty-five samples of cerebral arteries were taken from 11 fresh cadavers. These samples were filled with saline under pressure to the point of bursting. The bursting pressures were recorded. The mean bursting pressure of all samples was 1.8 bar (137...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:
更新日期:2002-12-01 00:00:00
abstract:AIMS:To evaluate the efficacy of our methods for decreasing the incidence of post-operative central nervous system infections (PCNSI) and to assess the type of microbiology and risk factors associated with PCNSI. METHODS:This prospective study was performed at First Affiliated Hospital, College of Medicine, Zhejiang U...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1519112
更新日期:2019-02-01 00:00:00
abstract::We present a case of cervical intramedullary sarcoidosis. A 56 year old woman presented with progressive paraesthesia affecting the lower limbs. MRI revealed an intramedullar lesion from C4-C7. A laminectomy and subtotal resection was carried out for this presumed intramedullary tumour. Pathology revealed this to be a...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.1080/02688690400022920
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Glioblastoma multiforme (GBM) is the most aggressive type of primary brain tumor. It is a rapidly progressive, highly recurrent, fatal intracranial neoplasm, and the demand for novel treatment is urgent. Valproic acid (VPA) is a potential anticancer agent that belongs to a class of histone deacetylase (HDAC)...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2011.638996
更新日期:2012-06-01 00:00:00
abstract::We present two cases of symptomatic, post-lumbar surgery cauda equina compression due to formation of a dissecting subdural extra-arachnoid cerebrospinal fluid (CSF) collection (hygroma) under tension. In both cases, a small inadvertent durotomy was sustained during the initial surgery. Surgical re-exploration confirm...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2011.625063
更新日期:2012-06-01 00:00:00
abstract::We describe a patient who within 2 months of undergoing radio-chemotherapy for glioblastoma developed an Epstein-Barr virus-positive primary diffuse large B-cell CNS lymphoma. To our knowledge, this is the first such case reported in the literature showing that new tumefactions following aggressive treatment for gliob...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2013.829554
更新日期:2014-04-01 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::Microvascular decompression (MVD) is now recognized as an effective operation for the cure of trigeminal neuralgia (TN), and is far superior to the other surgical procedures utilized in the treatment of TN. TN is common in the elderly, but there is debate concerning MVD in 'elderly' patients. Some clinicians have a po...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690042861
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Solitary Fibrous Tumour (SFT) is a rare tumour occurring mainly in the pleural cavity, with less than 100 cases reported in the Central Nervous System, where it typically presents as a meningeal-based lesion. We describe the case of a SFT located in the fourth ventricle and briefly review the pertinent liter...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688691003675226
更新日期:2010-08-01 00:00:00
abstract::Tonsillar herniation is a rare and seldom reported complication after lumboperitoneal (LP) shunting. There have been only few reports that have presented possible options for treatment with varying degrees of success. In this report, we describe a rare case of tonsillar herniation after LP shunting and review related ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1538481
更新日期:2018-12-06 00:00:00
abstract::Neurolymphomatosis typically appears as a diffuse lesion with thickening of the affected nerves on magnetic resonance imaging (MRI). MRI in the present case revealed a well-defined, solitary lesion showing continuity with brachial plexus nerves. Findings including clinical symptoms resembled benign nerve sheath tumour...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2012.737959
更新日期:2013-06-01 00:00:00
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
更新日期:1996-12-01 00:00:00
abstract::Neuroendoscopy is increasingly used in the management of brain tumours and tumour related hydrocephalus and this study reviews the efficacy of neuroendoscopic interventions in this unit in patients with brain tumours. A series of 87 neuroendoscopic operations carried out in 77 patients with brain tumours over a 6-year...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/0268869021000030276
更新日期:2002-10-01 00:00:00
abstract::Our aim is to present a typical case of IgG4-related hypophysitis, which will offer insight into the aetiology and pathogenesis of this relatively newly described disease. IgG4 Related Disease is a protean systemic condition that mimics inflammatory, infectious, and malignant processes. Biopsy of affected organs will ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2017.1416061
更新日期:2020-02-01 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::A case is described where a reconstruction of a complex defect in the floor of anterior cranial fossa was successfully carried out using multiple layers of vascularised pedicle flaps. The 42-year-old male patient had previously undergone multiple surgical procedures for persistent cerebrospinal fluid (CSF) rhinorrhoea...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688699845096
更新日期:1998-06-01 00:00:00
abstract::Object: Intercellular adhesion molecule 1 (ICAM-1) is an adhesive protein involved in inflammatory responses and endothelial dysfunction. ICAM-1 expression is upregulated in cerebrovascular tissue affected by stroke. We investigated whether serum soluble ICAM-1 (sICAM-1) levels are associated with cerebral microbleeds...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1518515
更新日期:2018-12-01 00:00:00
abstract::Two patients with histologically benign pituitary adenomas subsequently underwent resections of a frontal and a cerebellar tumour each of which had histological appearances identical to those of classic pituitary adenomas. The frontal tumour was immunoreactive for prolactin, and the cerebellar metastasis was immunorea...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688699550041584
更新日期:1995-04-01 00:00:00
abstract::A series of 510 patients with proven aneurysmal subarachnoid haemorrhage (SAH) is reported. The incidence of recurrent haemorrhage during the period awaiting surgery was 13.7%. There was no significant difference in incidence between good and poor grade patients. Following rebleeding there was an immediate mortality o...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688698808999657
更新日期:1988-01-01 00:00:00
abstract::Total excision is usually the recommended treatment for central neurocytomas. The role of radiation therapy in their management is controversial, and is usually reserved for partially resected or recurrent tumours. Long-term outcome was studied in patients with central neurocytoma who were treated with radiation thera...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690220131714
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Aneurysms at nonbranching sites in the supraclinoid internal carotid artery (ICA), known as blood blister-like aneurysms (BBAs), are rare entities and differ from saccular aneurysms. In this study, we attempt to describe our clinical experience and the outcome of treatments for BBAs. METHOD:Thirteen of 745 ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2011.631617
更新日期:2012-06-01 00:00:00
abstract::We present a surgical series of 74 patients (30 males and 44 females) with pathologically verified cavernous angiomas of the intracranial and orbital compartments. Patients were admitted between 1975 and 1991; six had a family history of cerebral cavernomas, and two had multiple (two) lesions. The 76 malformations wer...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699308995075
更新日期:1993-01-01 00:00:00