Abstract:
OBJECT:The authors conducted a retrospective review to examine and document the frequency, degree, and timing of the radiologically confirmed response to radiotherapy of low-grade gliomas in children. METHODS:Between 1963 and 1995, 80 patients 17 years of age or younger were referred to the London Regional Cancer Centre in London, Ontario after diagnosis of a low-grade glioma. All patients underwent surgical resection or biopsy procedures and 47 underwent radiotherapy (40 postoperatively and seven at the time of tumor progression). Nineteen patients with residual measurable lesions who received radiation therapy were selected for volumetric analysis of tumor response to this treatment. The extent and timing of response to radiation were determined by the process of comparing postoperative, preirradiation computerized tomography (CT) scans with postirradiation, follow-up CT scans. For one patient the comparison was made by using serial magnetic resonance images. Residual tumor was found on postoperative CT scans in all cases. The mean preradiotherapy tumor volume was 17.1 cm3, and the postradiotherapy volume was reduced to a mean of 11.5 cm3. A reduction in tumor volume was demonstrated in eight patients by the time of their first postirradiation follow-up CT scan and in two patients a slower reduction in volume over time was shown, bringing the total number of "responders" to 10. In five of these 10 patients the tumor had shown a maximum response by the time of the first postirradiation CT scan; the median time to response was 3.3 months. A 25% or greater reduction in tumor volume was seen in eight (42%) of the 19 patients. A 50% or greater reduction was noted in five (26%) of the patients. A complete response was demonstrated at 7, 12, and 15 months, and 5 years, respectively, in four patients (21%). One responder's tumor eventually increased in size after radiotherapy and he died of his disease. The magnitude of the radiographically demonstrated response to radiation did not correlate significantly with clinical outcome (that is, survival or symptom improvement). CONCLUSIONS:On the basis of this CT scan analysis of the response of low-grade gliomas in children to radiotherapy, the authors suggest that these lesions respond to radiation, as demonstrated by tumor shrinkage on serial imaging. Major or complete responses occur occasionally. However, low-grade gliomas in children mimic other benign brain tumors such as pituitary adenomas and meningiomas in that, although growth is frequently arrested after radiotherapy, residual tumor can persist for many years, illustrating that tumor shrinkage may not be a good measure of treatment efficacy. Nevertheless, radiation therapy can result in improvement of clinical symptomatology in association with or independent of visible tumor reduction. As radiation treatment techniques become increasingly conformal and because studies indicate that lower doses of radiation may be equally effective, improvement of symptoms may be an important consideration when weighing treatment options, particularly in patients with residual or unresectable disease.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Fisher BJ,Bauman GS,Leighton CE,Stitt L,Cairncross JG,Macdonald DRdoi
10.3171/jns.1998.88.6.0969subject
Has Abstractpub_date
1998-06-01 00:00:00pages
969-74issue
6eissn
0022-3085issn
1933-0693journal_volume
88pub_type
杂志文章abstract::The authors report on the case of a 28-year-old woman presenting with an intraosseous arteriovenous fistula (AVF) located in the left parietal bone. The fistula was formed by direct arteriovenous shunts connecting branches of the left middle meningeal and superficial temporal arteries with a parietal diploic vein. Dra...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.103.1.0179
更新日期:2005-07-01 00:00:00
abstract:OBJECT:To provide greater accuracy in determining the epileptogenic zone during preoperative evaluation, the authors retrospectively examined 123I-iomazenil single-photon emission computed tomography (IMZ SPECT) studies obtained in patients with temporal lobe epilepsy (TLE) in whom there was no evidence of an abnormali...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/08/0352
更新日期:2007-08-01 00:00:00
abstract::The known cytoprotective properties of MgSO4 led the authors to study its effects on infarct size in rats when administered intraarterially before reversible focal ischemia. Following an intracarotid infusion of MgSO4 in the amount of 30 mg/kg (24 animals), 90 mg/kg (18 animals), or an equal volume of vehicle (23 anim...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.1.0117
更新日期:1996-07-01 00:00:00
abstract:OBJECT:Recent observations indicate that traumatic brain injury (TBI) may be associated with mitochondrial dysfunction. This, along with growing use of brain tissue PO2 monitors, has led to considerable interest in the potential use of ventilation with 100% oxygen to treat patients who have suffered a TBI. To date, the...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.2007.106.4.526
更新日期:2007-04-01 00:00:00
abstract::Intracranial extraaxial cavernous angiomas are rare vascular malformations. Their occurrence at the geniculate ganglion of the facial nerve within the temporal bone is exceptional. The authors describe a 35-year-old man who developed a slowly progressing facial palsy. Initial cranial MR imaging showed no pathological ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/109/11/0893
更新日期:2008-11-01 00:00:00
abstract::This review was undertaken to determine the efficacy of using dorsal root entry zone (DREZ) lesions to treat intractable pain caused by trauma to the conus medullaris and cauda equina. Traumatic lesions of this area are unique in that both the spinal cord and the peripheral nerve roots are injured. Although DREZ lesio...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.1.0028
更新日期:1995-01-01 00:00:00
abstract::OBJECTIVE Electrical motor cortex stimulation can relieve neuropathic pain (NP), but its use requires patients to undergo an invasive procedure. Repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex (M1) using a figure-8 coil can relieve NP noninvasively, but its ability to relieve lower limb...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.3171/2016.9.JNS16815
更新日期:2017-11-01 00:00:00
abstract::The purpose of this report was to review the results of stereotactic radiosurgery in the management of patients with residual neurocytomas after initial resection or biopsy procedures. Four patients underwent stereotactic radiosurgery for histologically proven neurocytoma. Clinical and imaging studies were performed t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.95.5.0879
更新日期:2001-11-01 00:00:00
abstract:OBJECT:It is unclear if there is a relationship between Chiari malformation Type I (CM-I) and body mass index (BMI). The aim of this study was to identify the relationship between BMI and cerebellar tonsil position in a random sample of people. METHODS:Cerebellar tonsil position in 2400 subjects from a cohort of patie...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.10.JNS141317
更新日期:2015-07-01 00:00:00
abstract:OBJECT:Following resection of a brain metastasis, stereotactic radiosurgery (SRS) to the cavity is an emerging alternative to postoperative whole-brain radiation therapy (WBRT). This approach attempts to achieve local control without the neurocognitive risks associated with WBRT. The authors aimed to report the outcome...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.6.GKS14708
更新日期:2014-12-01 00:00:00
abstract:OBJECT:A growing number of published studies have recently demonstrated the role of resection in overall survival (OS) for patients with gliomas. In this retrospective study, the authors objectively investigated the role of the extent of resection (EOR) in OS in patients with low-grade gliomas (LGGs). METHODS:Between ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.8.JNS12393
更新日期:2012-12-01 00:00:00
abstract::A modification of the transseptal, transsphenoidal appraoch to the sella turcica is described; it consists of a unilateral separation of the nasal mucosa from the nasal septum. Experience with the technique in 215 cases has indicated that it is a useful, practical appraoch. The advantages are that the septum is spared...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.1.0138
更新日期:1978-07-01 00:00:00
abstract:OBJECTIVE:Tumor proximity to the ventricle and ventricular entry (VE) during surgery have both been associated with worse prognoses; however, the interaction between these two factors is poorly understood. Given the benefit of maximal tumor resection, it is imperative for surgical planning and technique to know if VE h...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.7.JNS201362
更新日期:2021-01-08 00:00:00
abstract::In a previous study, the authors demonstrated that meningioma cells secrete platelet-derived growth factor (PDGF)-like molecules that stimulate their own growth in an autocrine manner. Based on that finding, a study was undertaken to examine the effect of trapidil, a drug known to have an antagonistic action against P...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.78.3.0463
更新日期:1993-03-01 00:00:00
abstract::The incidence of extracranial internal carotid artery (ICA) abnormalities, namely kinks, coils, and stenoses, was evaluated in a consecutive unselected series of 76 cases of single supratentorial saccular aneurysms submitted to bilateral carotid angiography. These patients were compared with a control group of 120 pat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.55.5.0693
更新日期:1981-11-01 00:00:00
abstract::Two patients with large vascular carotid body tumors underwent preoperative intravascular embolization of the major arterial feeders. The tumor vascularity was reduced markedly, and complete surgical extirpation was accomplished without difficulty. The literature on carotid body tumors is briefly reviewed. The role of...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.5.0867
更新日期:1983-11-01 00:00:00
abstract:OBJECTIVE:Convexity meningiomas are commonly managed with resection. Motor outcomes and predictors of new deficits after surgery are poorly studied. The objective of this study was to determine whether postoperative diffusion-weighted imaging (DWI) was associated with neurological deficits after convexity meningioma re...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.8.JNS193537
更新日期:2021-01-29 00:00:00
abstract::Because of his exceptional and pioneering contributions to the understanding and treatment of neurosurgical conditions, Walter Dandy is considered to be one of the founders of both neurosurgery and neuroradiology. In the field of hydrocephalus, Dandy developed revolutionary research models, imaging modalities, and ope...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.4.JNS172316
更新日期:2018-10-01 00:00:00
abstract:OBJECT:Subthalamotomy is a stereotactic surgery performed in patients with disabling dyskinesias due to Parkinson disease. The authors set out to model this human condition in MPTP monkeys and determine if subthalamotomy allowed a reduction of levodopa for similar benefit. METHODS:The authors performed unilateral subt...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.9.JNS12295
更新日期:2013-01-01 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:OBJECT:Intrasylvian hematoma (ISH) is a subtype of intracranial hematoma caused by aneurysmal rupture and often presents with a poor initial neurological grade; it is not well studied. The aim of this study was to elucidate outcomes of aneurysmal subarachnoid hemorrhage (SAH) with ISH. METHODS:Data for 97 patients wit...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.10.JNS141658
更新日期:2015-09-01 00:00:00
abstract::The authors have analyzed retrospectively a series of 288 consecutive patients with severe head injury observed between January, 1977, and May, 1980. Seventy-three patients were excluded as not being compatible with those of the International Data Bank. The remaining 215 patients complied with the definition of coma g...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1982.57.6.0779
更新日期:1982-12-01 00:00:00
abstract:OBJECT:The gold-standard surgical approach to the odontoid is via the transoral route. This approach necessitates opening of the oropharynx and is associated with risks of infection, and swallowing and breathing complications. The endoscopic endonasal approach has the potential to reduce these complications as the oral...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.9.JNS14733
更新日期:2015-03-01 00:00:00
abstract::Post-herpetic pain was treated in 12 patients using dorsal root entry zone ( DREZ ) lesions. All patients had failed to receive adequate pain relief from conservative therapy consisting of transcutaneous nerve stimulation, carbamazepine, and/or amitriptyline. Dorsal root entry zone lesions were made to include the inv...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.6.1258
更新日期:1984-06-01 00:00:00
abstract:OBJECT:Control of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) is the foundation of traumatic brain injury (TBI) management. In this study, the authors examined whether conventional ICP- and CPP-guided neurocritical care ensures adequate brain tissue O2 in the first 6 hours after resuscitation. ME...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2006.105.4.568
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:Cavernous sinus meningiomas are complex tumors that offer a perpetual challenge to skull base surgeons. The senior author has employed a management strategy for these lesions aimed at maximizing tumor control while minimizing neurological morbidity. This approach emphasizes combining "safe" tumor resection an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.10.JNS181480
更新日期:2020-02-01 00:00:00
abstract:OBJECT:This Phase II study was performed to determine the safety, tolerability, and efficacy of combining nimustine (ACNU)-carboplatin-vincristine-Interferon-beta (IFNbeta) chemotherapy. METHODS:Ninety-seven patients with Karnofsky Performance Scale scores of 50 or greater were enrolled in the study. Nimustine (60 mg/...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2006.105.3.385
更新日期:2006-09-01 00:00:00
abstract::The authors have created an experimental model of regional cerebral ischemia in gerbils that is reproducible and has a low mortality rate. In gerbils, either the posterior communicating artery (PCoA) or the middle cerebral artery (MCA) was occluded, and the distribution of cerebral ischemia from each surgical procedur...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.58.3.0362
更新日期:1983-03-01 00:00:00
abstract:OBJECT:Intracranial stenting has improved the ability to treat wide-neck aneurysms via endovascular techniques. However, stent placement necessitates the use of antiplatelet agents, and the latter may complicate the treatment of patients with acutely ruptured aneurysms who demonstrate hydrocephalus and require ventricu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.9.JNS10445
更新日期:2011-04-01 00:00:00
abstract:OBJECT:Several methods are used for stereotactically guided implantation of electrodes into the subthalamic nucleus (STN) for continuous high-frequency stimulation in the treatment of Parkinson's disease (PD). The authors present a stereotactic magnetic resonance (MR) method relying on three-dimensional (3D) T1-weighte...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.92.4.0615
更新日期:2000-04-01 00:00:00