Abstract：
INTRODUCTION:The main treatment modalities for single brain metastases are whole brain radiotherapy (WBRT), surgery and stereotactic radiosurgery. Current guidelines recommend complete surgical excision for single cerebral metastases and two randomised controlled trials (RCT) have also found survival benefit of surgery. However, a more recent RCT and a Cochrane review have challenged the effectiveness of surgery for cerebral metastases. This study aims to assess the effectiveness of surgery for cerebral metastases in current practice. MATERIALS AND METHODS:A retrospective review was performed for a single surgeon series of consecutive patients undergoing primary surgery for cerebral metastases between June 2005 and April 2010. The main outcome measure was the survival time after surgery. RESULTS:One hundred and twenty three patients (61 males, 62 females) were identified with a mean age of 58.4 years. Eighty three patients (67%) were under 65 years. The overall 30-day mortality rate was 2.4%. The overall median survival was 10 months. There were 26 (21%) breast cancers with median survival of 13.5 months, 32 (26%) NSCLC with 8.3 months, 24 (19%) melanomas with 6.7 months, 13 (11%) colorectal cancers with 6.4 months, and 11 (9%) renal cell cancers with 13.6 months. The differences were not significant (p > 0.05). However, when the breast cancer group was compared to the NSCLC group, the difference was significant (p = 0.005). The median survival differences were not significant (p > 0.05) with regard to the RPA class, the site (supratentorial or infratentorial) and the number of metastases (single or two). CONCLUSIONS:Median survival in this cohort was identical to those in the two RCTs that showed survival benefits from surgery. This was significantly longer than that (5.6 months) in the single series demonstrating no benefit. Therefore, our results support the previous evidence of improved outcomes with surgery.
journal_name
Br J Neurosurgjournal_title
British journal of neurosurgeryauthors
Lim CS,Grundy PLdoi
10.3109/02688697.2013.771729subject
Has Abstractpub_date
2013-10-01 00:00:00pages
654-7issue
5eissn
0268-8697issn
1360-046Xjournal_volume
27pub_type
杂志文章abstract：:A simple and inexpensive device is described for measurement of intracranial pressure over prolonged periods. ...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688698808992680
更新日期：1988-01-01 00:00:00
abstract：:Isolated intrasellar pituitary mucocele following transsphenoidal sinus surgery is extremely rare. The clinical features resemble a pituitary tumor, therefore careful radiological interpretation is crucial to reach the correct diagnosis. We report a case of intrasellar mucocele who had transsphenoidal sinus surgery pe...
journal_title：British journal of neurosurgery
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doi：10.3109/02688697.2013.817535
更新日期：2014-06-01 00:00:00
abstract：OBJECTIVES:The lumbar infusion test is an invasive technique for quantifying cerebrospinal dynamics in patients with hydrocephalus. However, some patients have difficulty tolerating the duration of this procedure. Therefore, we investigated the limits of shortening the test by examining the reliability of cerebrospinal...
journal_title：British journal of neurosurgery
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doi：10.3109/02688697.2011.591848
更新日期：2012-02-01 00:00:00
abstract：BACKGROUND:Deep brain stimulation (DBS) lead revision due to suboptimal therapy is common but there is no standardised protocol. We describe a novel technique using iMRI to perform concurrent new Globus Pallidus Internus (GPi) DBS lead implantation and old lead removal in a dystonia patient. Case-description: A 60-year...
journal_title：British journal of neurosurgery
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doi：10.1080/02688697.2020.1789556
更新日期：2020-07-10 00:00:00
abstract：:Sixty patients with borderline or frank insufficiency of their cerebrovascular reserve undergoing carotid endarterectomy were given enough short acting barbiturates, during cross clamping of the internal carotid artery, to cause EEG burst suppression. Arterial and venous concentrations of lactate were measured in bloo...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688698909002828
更新日期：1989-01-01 00:00:00
abstract：:Selecting patients who will benefit from a permanent CSF diversion procedure in benign intracranial hypertension (BIH) or communicating hydrocephalus due to normal pressure hydrocephalus (NPH) has inherent problems. The percutaneous introduction of a lumbar subcutaneous shunt (LSS) under local anaesthesia facilitates ...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688690802007883
更新日期：2008-10-01 00:00:00
abstract：:Cavernous angiomas affecting the optic pathway are rare. This report describes the case of a 12-year-old girl who presented with a 10-month history of right-sided blurred vision caused by a cavernous angioma affecting the right side of the optic chiasm. The computed tomography (CT) scan demonstrated a hyperdense image...
journal_title：British journal of neurosurgery
pub_type： 杂志文章,评审
doi：10.3109/02688697.2012.685820
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abstract：:Chordomas constitute <5% of vertebral column tumours and a third of these arise in the upper cervical spine and tend to be clival - usually midline, with occasional eccentric extension. We report a case of cervical chordoma presenting as a lateral neck mass and discuss its origin, diagnosis and management. ...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688697.2010.508959
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abstract：:Knowledge of post-traumatic cerebral haemodynamic disturbances might be beneficial for predicting the management outcome when measuring the basal cerebral arteries blood flow velocity by ultrasonic transcranial Doppler device immediately after severe head injury. Thirty patients who sustained severe brain injury under...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688690601048104
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abstract：:The history of chronic subdural haematoma (CSH), spanning from its possibly earliest beginnings throughout the centuries until the early 1980s, was investigated within the context of four different epochs. In the 'era of uncertainty', successful trephination, the modem method of choice for the treatment of CSH, was de...
journal_title：British journal of neurosurgery
pub_type： 传,历史文章,杂志文章
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更新日期：2004-02-01 00:00:00
abstract：:A 39-year-old lady presented with low back pain and neurogenic claudication. Magnetic resonance imagining revealed an intradural neoplasm in the cauda equina region. The patient underwent lumbar laminectomy and total excision of the neoplasm. Biopsy showed it to be a ganglioneuroblastoma, which is rare in the spinal c...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/026886900408513
更新日期：2000-06-01 00:00:00
abstract：:Background: When treating intracranial aneurysms with open microsurgery, rare cases arise in which an ipsilateral approach leads to poor visualization, lack of proximal control, or potential damage to nearby vital structures due to the anatomy of the aneurysm. Case Description: We describe a patient with a small, unru...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688697.2019.1648754
更新日期：2019-07-31 00:00:00
abstract：:Twenty unselected pituitary adenomas have been examined for proliferative indices (PIs), and anterior pituitary hormone expression. All but two of the tumours were non-functional with proliferative indices from less than 0.1 to 0.5%. Two tumours were null cell adenomas with PIs less than 0.1 and 0.2%. The PIs of the t...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688699209002899
更新日期：1992-01-01 00:00:00
abstract：:Purpose: Decompressive craniectomy (DC) is widely used to treat raised intracranial pressure (ICP) in cranial trauma and stroke. It is accompanied by numerous complications. The aim of our study is to assess the surgical treatment of infections related to the use of a dural substitute with concurrent CSF leakage perfo...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688697.2020.1735301
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journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688697.2012.703356
更新日期：2013-02-01 00:00:00
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journal_title：British journal of neurosurgery
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更新日期：2020-12-17 00:00:00
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journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688698909002815
更新日期：1989-01-01 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
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doi：
更新日期：2002-12-01 00:00:00
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journal_title：British journal of neurosurgery
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journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688699209002895
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journal_title：British journal of neurosurgery
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更新日期：1995-01-01 00:00:00
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journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688697.2010.551678
更新日期：2011-06-01 00:00:00
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journal_title：British journal of neurosurgery
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更新日期：2013-12-01 00:00:00
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journal_title：British journal of neurosurgery
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doi：10.1080/02688690802439110
更新日期：2009-04-01 00:00:00
abstract：:A subgaleal collection of blood or cerebrospinal fluid (CSF) is commonly encountered after craniotomy. In spite of the placement of subgaleal drains by many neurosurgeons, a collection at this site is frequent and occasionally can result in complications. 'Tenting' scalp stitches are described. Three to four (or more)...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688699209023795
更新日期：1992-01-01 00:00:00
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journal_title：British journal of neurosurgery
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更新日期：1995-01-01 00:00:00
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journal_title：British journal of neurosurgery
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更新日期：1990-01-01 00:00:00
abstract：:We describe the case of a 29-year-old farmer who developed upper limb radiculopathy followed by myelopathy in his lower limbs. MRI findings suggested cervical disc prolapse with cord changes. Despite a successful anterior cervical decompression and fusion his symptoms rapidly returned. Further investigations ultimatel...
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