Abstract:
:OBJECTIVE. To effectively combine functional MRI (fMRI), diffusion tensor tractography (both guided by neuronavigation) along with cortical stimulation (CS) for surgery of eloquent cortex (EC) lesions. MATERIALS AND METHOds. Fifteen patients with lesions adjacent to the eloquent motor and sensory cortex were included. Preoperative fMRI and diffusion tensor imaging were performed and then integrated into the neuronavigation system. Intraoperative CS of sensory/motor cortex was performed to localize the EC under awake condition and this was correlated with areas active on fMRI utilizing neuronavigation. For excision of the deeper structures, CS, and tractography guided by neuronavigation were utilized. RESULTS. A total of 127 cortical sites were evaluated with CS in 15 patients. The overall sensitivity, specificity, and accuracy of fMRI were 79%, 85%, and 82%, respectively, keeping the areas positive on CS as a referential parameter. Tractography helped in resecting the deeper areas of the tumor, but was not very accurate due to brain shift. However, it was useful in roughly assessing the deeper areas close to the long tracts. The risk of developing persistent neurological deficits was 6%. Pathologies included gliomas in ten patients, cavernous malformation in two patients, meningioma in one patient, and focal cortical dysplasia and Dysembryonic neuroepithelial tumor in one patient each. Near total excision was achieved in 7/10 (> 95% excision) gliomas and a total excision in all others lesions. CONCLUSIONS. Lesions directly over the EC present a special surgical challenge. The challenge lies in excising these lesions without producing any deficits. These goals may be achieved better by combined use of multimodal neuronavigation (fMRI and tractography) and intraoperative mapping with CS under awake conditions.
journal_name
Br J Neurosurgjournal_title
British journal of neurosurgeryauthors
Kumar A,Chandra PS,Sharma BS,Garg A,Rath GK,Bithal PK,Tripathi Mdoi
10.3109/02688697.2013.835370subject
Has Abstractpub_date
2014-04-01 00:00:00pages
226-33issue
2eissn
0268-8697issn
1360-046Xjournal_volume
28pub_type
杂志文章abstract::The authors report their experience in the treatment of childhood hydrocephalus by endoscopic choroid plexus coagulation and post-operative ventricular perfusion with artificial CSF. The procedure was carried out on 23 children without mortality. In 12 cases (52%) the procedure was successful in controlling the hydroc...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699008992706
更新日期:1990-01-01 00:00:00
abstract::Attempts at radical excision of craniopharyngioma have been made increasingly possible by progress in neuroradiological imaging and the use of microscopic technique. Between 1977 and 1990, 50 patients of The National Hospital for Neurology and Neurosurgery, London, have undergone radical surgical excision of craniopha...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699109002877
更新日期:1991-01-01 00:00:00
abstract::Objective: To evaluate the clinical efficacy, practicability, and safety of an ultrasonic osteotome for percutaneous transforaminal endoscopic discectomy (PTED) in patients with calcified lumbar disc herniation (CLDH).Methods: A total of 25 CLDH patients who underwent PTED at our department between December 2017 and A...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2019.1687850
更新日期:2020-02-01 00:00:00
abstract::Subarachnoid haemorrhage (SAH) of the posterior fossa in cases of acoustic neurinoma is very rare. The authors present the clinical, neuroradiological and histological findings of an acoustic neurinoma presenting with SAH. The literature regarding this subject is reviewed and the pathogenesis of haemorrhage from neuri...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3109/02688690903506085
更新日期:2010-02-01 00:00:00
abstract::Two patients presented with nocardial brain abscesses, one as secondary to overwhelming pulmonary infection following a thoracic empyema, the second as a primary abscess. Both patients had immunopression. Such an infection should be considered early in any patient who is immunocompromised. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699408995123
更新日期:1994-01-01 00:00:00
abstract::Until recently, warfarin, clopidogrel and aspirin have provided the mainstay for prevention of thrombotic disease in cardiac patients. However, new classes of drugs have recently emerged that promise better clinical outcomes and lower risks. Use of such agents has increased, but increased risk and severity of intra-cr...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3109/02688697.2015.1029433
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:The aim of our study is to investigate the influence of caspase-9 and tumour necrosis factor alpha (TNFα) in the grade of lumbar disc herniation. We determined the strength of different predictors such as age, gender, disc grading, caspase-9 and TNFα. METHODS:We retrospectively reviewed 84 patients who had d...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1817314
更新日期:2020-09-14 00:00:00
abstract::Introduction: Adipose tissue acts as an active endocrine organ and may be involved in the biological mechanism of stroke. Adipokines can serve as key messenger of central energy and metabolic homeostasis and can contribute to the crosstalk between adipose tissue and brain. Recent research has offered vague data on the...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2019.1578862
更新日期:2019-10-01 00:00:00
abstract::Objective: Meta-analysis to evaluate complications in the use of autogenous bone and bone substitutes and to compare bone substitutes, specifically HA, polyetheretherketone (PEEK) and titanium materials.Methods: Search of PubMed, Cochrane, Embase and Google scholar to identify all citations from 2010 to 2019 reporting...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,meta分析
doi:10.1080/02688697.2020.1742291
更新日期:2020-08-01 00:00:00
abstract::Cortical thermal clearance was used during surgery for clipping of a giant middle cerebral artery (MCA) aneurysm. During prolonged continuous proximal MCA occlusion thermal clearance remained normal, indicating sufficient collateral blood supply. Postoperatively the patient had no neurological deficit. This monitoring...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699308995097
更新日期:1993-01-01 00:00:00
abstract::The objective of this study was to investigate if there are possible gender differences in relation to outcome following closed severe traumatic brain injury (TBI) in a predominantly Asian population. A study was conducted using our prospectively maintained TBI database of 672 patients with severe TBI admitted into ou...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690600682259
更新日期:2006-04-01 00:00:00
abstract:OBJECT:Animal models provide a basis for clarifying the complex pathogenesis of delayed cerebral vasospasm (DCVS) and for screening of potential therapeutic approaches. Arbitrary use of experimental parameters in current models can lead to results of uncertain relevance. The aim of this work was to identify and analyze...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3109/02688691003746274
更新日期:2010-08-01 00:00:00
abstract::A 48-year-old man with a cystic craniopharyngioma developed hypersomnia, personality changes, memory impairment and thermal dysfunction following intracystic administration of bleomycin through an Ommaya reservoir after partial removal of the tumour. The patient's neurological deterioration was thought to be related t...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699409101192
更新日期:1994-01-01 00:00:00
abstract::Silver-Russell syndrome is a rare genetically heterogeneous disorder in which patients demonstrate intrauterine and postnatal growth retardation, triangular facies, excessive sweating during early childhood, late closure of the anterior fontanelle and skeletal asymmetry. An association with malignancy exists and only ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690802044076
更新日期:2008-12-01 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::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
更新日期:2011-08-01 00:00:00
abstract::A case where the administration of intrathecal gentamycin, used to treat a ventriculitis consequent upon a ventriculoperitoneal shunt infection, with a persistent elevation of the CSF leucocyte count is described. In a situation where the number of white cells in the CSF is taken to indicate resolution of infection, i...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688698909002840
更新日期:1989-01-01 00:00:00
abstract::Incapacitating and drug-resistant posttraumatic movement disorders have successfully been treated by stereotactic thalamotomy. We describe the case of a young man with a posttraumatic hemiballismoid type movement disorder of the left arm, persistent for 2 years, who was selected for treatment with a thalamic deep brai...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690120082468
更新日期:2001-10-01 00:00:00
abstract::Background: Indications and clinical outcomes of percutaneous endoscopic thoracic discectomy(PETD) in treating thoracic disc herniation is rarely reported and still controversial. We reported an unsatisfied recovery of thoracic disc herniation with PETD, treated by a second posterior thoracic laminectomy and Ponte ost...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1751069
更新日期:2020-04-11 00:00:00
abstract::Intracerebral metastasis in osteosarcoma is extremely rare. A 14-year-old girl who had previously been operated upon for osteosarcoma of the femur presented with seizures and left hemiparesis. A right parietal lesion with calcification and brain oedema was found. After resection of the mass, pathology revealed an oste...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2011.581771
更新日期:2012-02-01 00:00:00
abstract::We report on a symptomatic case in which the whole intracranial blood supply was provided by a single vertebral artery as both internal carotid arteries were occluded and the contralateral vertebral artery was severely hypoplasic. The patient was treated by a flow-augmentation extracranial-intracranial bypass. Preoper...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2015.1023779
更新日期:2015-01-01 00:00:00
abstract::Endosaccular packing of inoperable aneurysms with electrolytic platinum coils was performed in 50 patients. Complete embolization of the aneurysms was achieved in 100% of small, 95% of large and 85% of giant aneurysms, with combined procedural and periprocedural morbidity and mortality rates of 6 and 4%, respectively....
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688699550040864
更新日期:1995-01-01 00:00:00
abstract::Epidermoid cyst may rarely arise within the lateral wall of the cavernous sinus (CS) and produce clinical symptoms mimicking the Tolosa-Hunt syndrome. Pathogenically, it is suggested that some of the subpopulation of cells arising from the neural crest which give rise to skin, may remain entrapped in the meninges arou...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.1080/02688690050206747
更新日期:2000-12-01 00:00:00
abstract::The debate regarding whether to perform an interbody fusion after anterior cervical discectomy (ACD) has been going on for the last 50 years. Several prospective randomized clinical trials have been performed to evaluate the clinical outcome following anterior cervical discectomy with and without interbody fusion. Non...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690802610249
更新日期:2009-02-01 00:00:00
abstract::This report details an additional case of the very rare instance of a respiratory epithelium-lined intracerebral cyst without communication with the ventricular system. Immunohistologic analysis supports an epithelial rather than neuroectodermal origin. Management using endoneurosurgical techniques is described. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688698909002838
更新日期:1989-01-01 00:00:00
abstract:PURPOSE:There is an abundance of articles published on low-grade glioma. The aim of this study was to identify and review the 50 most-cited articles on low-grade glioma, and to perform a bibliometric analysis. METHODS:In June 2017, we performed a basic search of the Web of Science database using "low-grade glioma mana...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1549314
更新日期:2019-04-01 00:00:00
abstract::Over a 2-year period, 22 consecutive comatose patients (Glasgow Coma Score of less than or equal to 8) with intraventricular haematomas were managed with prolonged external ventricular drainage via an external one-way valve regulated system. The mean duration of drainage was 12 days. The overall mortality was 23%. Acc...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688698809029600
更新日期:1988-01-01 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
pub_type: 杂志文章
doi:10.1080/02688697.2020.1789556
更新日期:2020-07-10 00:00:00
abstract::A woman with hypertension and hyperglycemia was diagnosed a metastatic brain carotid body paraganglioma. Her blood pressure, glucose, and norepinephrine were normal after craniotomy. Although most carotid body tumors are benign, a few show distant metastasis. This is the first reported case of intracerebral metastases...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2017.1328042
更新日期:2019-06-01 00:00:00
abstract::Primary melanocytic tumors of the central nervous system (CNS) are rare lesions, but primary sellar tumors are rarer. Only 10 cases have been reported, and they are often misdiagnosed as pituitary macroadenoma. We report the case of a 54-year-old Chinese man who developed progressive bitemporal hemianopsia and visual ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3109/02688697.2014.967752
更新日期:2015-04-01 00:00:00