Abstract:
OBJECT:The purpose of this study was to analyze patient outcomes and to define the role of radiosurgery in patients who have undergone prior microsurgical resection of their vestibular schwannoma. METHODS:The authors evaluated the pre- and postoperative clinical and neuroimaging characteristics of 76 consecutive patients with 78 vestibular schwannomas who underwent radiosurgery after previous surgical resection. Twenty-nine patients (37% of tumors) had undergone more than one prior resection. Forty-three patients (55% of tumors) had significant impairment of facial nerve function (House-Brackmann Grades III-VI) after their microsurgical procedure; 50% had trigeminal sensory loss, and 96% had poor speech discrimination (< 50%). The median evaluation period following radiosurgery was 43 months (range 12-101 months). Tumor growth control after radiosurgery was achieved in 73 tumors (94%). Six patients underwent additional surgical resection despite radiosurgery (median of 32 months after radiosurgery), and one patient underwent repeated radiosurgery for tumor progression outside the irradiated volume. Eleven (23%) of 47 patients with Grades I to III facial function before radiosurgery developed increased facial weakness after radiosurgery. Eleven patients (14%) developed new trigeminal symptoms. CONCLUSIONS:Radiosurgery proved to be a safe and effective alternative to additional microsurgery in patients in whom the initial microsurgical removal failed. Stereotactic radiosurgery should be considered for all patients who have regrowth or progression of previously surgically treated vestibular schwannomas.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Pollock BE,Lunsford LD,Flickinger JC,Clyde BL,Kondziolka Ddoi
10.3171/jns.1998.89.6.0944subject
Has Abstractpub_date
1998-12-01 00:00:00pages
944-8issue
6eissn
0022-3085issn
1933-0693journal_volume
89pub_type
杂志文章abstract:OBJECT:The use of nicardipine prolonged-release implants (NPRIs) is associated with a significant improvement in the therapy of patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) regarding the occurrence and severity of cerebral vasospasm, new infarcts, and functional outcome (FO). Because quality of lif...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.3171/2008.2.17670
更新日期:2009-05-01 00:00:00
abstract:OBJECT:The authors have treated intractable pain, particularly cancer pain related to bone metastasis, with various protocols. Cancer pain has been treated by gamma knife radiosurgery (GKS), targeted to the pituitary gland-stalk, as an alternative new pain control method. The purpose of this study was to investigate a ...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.3171/jns.2002.97.supplement
更新日期:2002-12-01 00:00:00
abstract::By the time Harvey Cushing entered medical school, nerve reconstruction techniques had been developed, but peripheral nerve surgery was still in its infancy. As an assistant surgical resident influenced by Dr. William Halsted, Cushing wrote a series of reports on the use of cocaine for nerve blocks. Following his resi...
journal_title:Journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.3171/2010.11.JNS10804
更新日期:2011-05-01 00:00:00
abstract::A follow-up study was performed on 41 hydrocephalic children with primary (10 patients) or secondary (31 patients) placement of an anti-siphon device (ASD) connected to their shunt. The clinical course before and after ASD implantation was compared in these two groups, including studies of the head circumference, the ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.61.1.0156
更新日期:1984-07-01 00:00:00
abstract::A case is reported of a patient in whom an intracranial extracerebral melanoma developed in association with a life-long nevus of Ota. Melanotic pigmentation of the skull, periosteum, and meninges beneath the nevus was found at operation. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.58.2.0280
更新日期:1983-02-01 00:00:00
abstract::An intraventricular glioma occupying all four ventricles of the brain in children is very uncommon. The authors report a unique case of a tetraventricular Grade II astrocytoma with evidence of extension into the basal cisterns in a 5-year-old boy who had a 1-month history of headache. There was no neurological deficit...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2007.106.2.134
更新日期:2007-02-01 00:00:00
abstract:OBJECT:It is known that the spinal cord can sustain traumatic injury without associated injury of the spinal column in some conditions, such as a flexible spinal column or preexisting narrowed spinal canal. The purpose of this study was to characterize the clinical features and to understand the mechanisms in cases of ...
journal_title:Journal of neurosurgery
pub_type: 评论,信件
doi:
更新日期:2001-04-01 00:00:00
abstract:OBJECT:A relationship has been found between peripheral thermal injury and cerebral complications leading to injury and death. In the present study, the authors examined whether tumor necrosis factor-alpha (TNF-alpha) and matrix metalloproteinase-9 (MMP-9) play a causative role in blood-brain barrier (BBB) disruption a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.8.JNS08382
更新日期:2009-06-01 00:00:00
abstract:OBJECT:Ventricular infection after ventriculostomy placement carries a high mortality rate. Responding to ventriculostomy infection rates, a multidisciplinary performance improvement team was formed, a comprehensive protocol for ventriculostomy placement was developed, and the efficacy was evaluated. METHODS:A best-pr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.11.JNS121336
更新日期:2013-03-01 00:00:00
abstract::The present study describes the usefulness of blood vessel allografts to repair gaps in rat peripheral nerve after immunosuppression with cyclosporine. Isogeneic strains of rats with known histoincompatibility were used for this study. A 10-mm gap was created in the peroneal nerve of host Fischer rats. The gap was bri...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.70.1.0115
更新日期:1989-01-01 00:00:00
abstract::This series of 228 patients with infantile non-neoplastic hydrocephalus who received either a ventriculoatrial (VA) or a ventriculoperitoneal (VP) shunt before 2 years of age was followed for an average of 7 years, and the results with the two types of shunt were compared. Mortality and infection rates were similar fo...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.2.0179
更新日期:1979-02-01 00:00:00
abstract::OBJECTIVE: Intravenous infusion of mesenchymal stem cells (MSCs) derived from adult bone marrow improves behavioral function in rat models of cerebral infarction. Although clinical studies are ongoing, most studies have focused on the acute or subacute phase of stroke. In the present study, MSCs derived from bone marr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.5.JNS18140
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:Corpus callosotomy is a palliative procedure that is effective at reducing seizure burden in patients with medically refractory epilepsy. The procedure is traditionally performed via open craniotomy with interhemispheric microdissection to divide the corpus callosum. Concerns for morbidity associated with cra...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.9.JNS191769
更新日期:2019-12-13 00:00:00
abstract::The majority of cutaneous squamous cell carcinoma (SCC) are diagnosed early and cured using local treatment, although a minority of cases metastasize to regional structures. In this report the authors describe an unknown feature of skin SCC, namely, distant brain metastasis. This 54-year-old man, who had undergone sur...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.102.6.1155
更新日期:2005-06-01 00:00:00
abstract:OBJECT:Patients with gliomas frequently have cognitive deficits, and surgery can exacerbate these deficits. Preoperative assessment is therefore crucial in patients undergoing surgery for glioma in eloquent areas, because the proximity of functional areas increases the risk of permanent postoperative cognitive disturba...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.7.JNS12263
更新日期:2012-11-01 00:00:00
abstract::Total parenteral nutrition (TPN) has been shown to decrease mortality and to increase the rate of recovery in head-injured patients. However, a recent short-term animal experiment has raised concern over the potential enhancement of vasogenic edema by TPN. The experiment described here was undertaken to examine longer...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.70.4.0623
更新日期:1989-04-01 00:00:00
abstract::OBJECTIVE The Agency of Healthcare Research and Quality (AHRQ) has defined Patient Safety Indicators (PSIs) for assessments in quality of inpatient care. The hypothesis of this study is that, in the treatment of unruptured cerebral aneurysms (UCAs), PSI events are less likely to occur in hospitals meeting the volume t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.5.JNS162778
更新日期:2018-08-01 00:00:00
abstract::Changes in the brain parenchyma and cerebrospinal fluid spaces were demonstrated in three cases of dural arteriovenous malformations by computerized tomography (CT). In various combinations, there were 1) vermiform or patchy enhancement after intravenous contrast infusion, 2) abnormal decreased density mainly in the w...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.5.0698
更新日期:1980-11-01 00:00:00
abstract::This case of metastatic gestational choriocarcinoma presented as intracerebral hemorrhage from an atypical distal middle cerebral artery aneurysm. Operative evacuation of the intracerebral hematoma was undertaken and histopathological examination revealed choriocarcinoma invading the vessel wall. Neoplastic cerebral a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.4.0644
更新日期:1985-10-01 00:00:00
abstract::OBJECTIVE The middle clinoid process (MCP) is a bony projection that extends from the sphenoid bone near the lateral margin of the sella turcica. The varied prevalence and morphological features of the MCP in populations stratified by age, race, and sex are unknown; however, the knowledge of its anatomy and preoperati...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.2.JNS162114
更新日期:2018-07-01 00:00:00
abstract:OBJECT:The object of this study was to mathematically model the prognosis of a newly inserted shunt in pediatric or adult patients with hydrocephalus. METHODS:A structured search was performed of the English-language literature for case series reporting shunt failure, patient mortality, and shunt removal rates after s...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.3171/PED-07/12/448
更新日期:2007-12-01 00:00:00
abstract:OBJECT:Chronic sinusitis can be a debilitating disease with significant impact on quality of life. Frontal sinusitis has a relatively low prevalence, but complications can be severe due to its anatomical location. After failure of conservative measures, typically endoscopic procedures are performed to improve the drain...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2011.11.JNS101849
更新日期:2012-03-01 00:00:00
abstract::The authors report their experience in successfully treating a 15-week-old child who became comatose following a spontaneous intracerebral hemorrhage. It was initially believed that a tumor in the right frontal lobe caused the hemorrhage. Coagulation studies revealed abnormal results on presentation, and the problem w...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2006.104.3.202
更新日期:2006-03-01 00:00:00
abstract::OBJECTIVECerebrovascular bypass surgery is a challenging yet important neurosurgical procedure that is performed to restore circulation in the treatment of carotid occlusive diseases, giant/complex aneurysms, and skull base tumors. It requires advanced microsurgical skills and dedicated training in microsurgical techn...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.11.JNS17318
更新日期:2018-05-11 00:00:00
abstract::To investigate overcrowding in the posterior cranial fossa as the pathogenesis of adult-type Chiari malformation, the authors studied the morphology of the brainstem and cerebellum within the posterior cranial fossa (neural structures consisting of the midbrain, pons, cerebellum, and medulla oblongata) as well as the ...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.1997.86.1.0040
更新日期:1997-01-01 00:00:00
abstract::Tophaceous pseudogout is one of the rarest forms of crystal deposition disease, typically presenting as a destructive and invasive mass involving the temporomandibular joint or the infratemporal fossa region in the absence of any other articular manifestations. Previous cases have been assumed to be caused by calcium ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.90.1.0148
更新日期:1999-01-01 00:00:00
abstract:OBJECT:Grade 3 and 4 blunt vertebral artery (VA) injuries may carry a different natural course from that of lower-grade blunt VA injuries. Proper screening, management, and follow-up of these injuries remain controversial. Grade 3 and 4 blunt VA injuries were analyzed to define their natural history and establish a rat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.9.JNS1461
更新日期:2015-05-01 00:00:00
abstract::The criteria by which acromegalic patients are considered "cured" after surgical therapy are still controversial. Since the abnormal growth hormone (GH) increase after the administration of some agents has been demonstrated to be characteristic of the tumoral somatotrophs, its disappearance after surgery may be taken ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.3.0402
更新日期:1983-09-01 00:00:00
abstract::Seven patients with spasticity of spinal cord origin have been maintained for up to 2 years with continuous spinal intrathecal infusion of baclofen. Prior to treatment, all of the patients had severe rigidity in their lower limbs and most had frequent and extensive spontaneous spasms, all of which greatly interfered w...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.66.2.0181
更新日期:1987-02-01 00:00:00
abstract::Injury to the spinal column and spinal cord occurs relatively infrequently in the pediatric population. A review of 174 pediatric patients is presented, representing 5.4% of all patients admitted with spinal injury. Spinal cord injury was present in 45% of patients. A distinct injury profile, explained by anatomical a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.77.5.0700
更新日期:1992-11-01 00:00:00