Abstract:
:Although the development of tonsillar herniation (acquired Chiari malformation) in association with lumboperitoneal (LP) shunting is well recognized, it has previously been considered rare. In order to ascertain the incidence of this complication after LP shunting, the authors undertook a retrospective study of all patients in whom this form of shunt had been inserted between 1974 and 1991 at The Hospital for Sick Children, Toronto. In the 143 patients, the mean age at insertion was 3.3 years and the indications for shunt placement were hydrocephalus (81%), pseudotumor cerebri (7%), cerebrospinal fluid fistula (6%), and posterior fossa pseudomeningocele (6%). The mean follow-up period was 5.7 years, during which time there was one shunt-related death due to unsuspected tonsillar herniation. Five other patients developed symptomatic tonsillar herniation treated by suboccipital decompression. Review of all computerized tomography (CT) scans not degraded by artifact showed evidence of excess soft tissue at the level of the foramen magnum in 38 (70%) of 54 patients so studied. In order to confirm that this CT finding represented hindbrain herniation, sagittal and axial magnetic resonance (MR) images were obtained for 17 asymptomatic patients and revealed tonsillar herniation (range 2 to 21 mm) in 12 (70.6%). In addition, some of these asymptomatic patients had evidence of uncal herniation and mesencephalic distortion. Similarities and distinctions are drawn between the morphological changes occurring after LP shunting and those seen in association with the Chiari I and II malformations. Although less than 5% of this study population required treatment for tonsillar herniation, the incidence of this complication was high in asymptomatic patients; MR imaging surveillance for patients with LP shunts is therefore recommended.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Chumas PD,Armstrong DC,Drake JM,Kulkarni AV,Hoffman HJ,Humphreys RP,Rutka JT,Hendrick EBdoi
10.3171/jns.1993.78.4.0568subject
Has Abstractpub_date
1993-04-01 00:00:00pages
568-73issue
4eissn
0022-3085issn
1933-0693journal_volume
78pub_type
杂志文章abstract::The effect of intrathecal fibrinolysis on cerebrospinal fluid (CSF) absorption was investigated after experimental subarachnoid hemorrhage (SAH). In 11 cats, SAH was induced by intracisternal application of 1 to 4 ml of fresh autologous blood. Thirty minutes after the experimental SAH, the CSF outflow resistance was f...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.74.5.0789
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVE:Although intravenous indocyanine green (ICG) videoangiography has been reported to be useful when applied to cerebral arteriovenous malformation (AVM) surgery, the ICG that remains after the procedure makes it difficult to understand the anatomy, to evaluate nidus blood flow changes, and to repeat ICG videoan...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.3.JNS20319
更新日期:2020-05-22 00:00:00
abstract:OBJECT:Selective dorsal rhizotomy (SDR) has been shown to provide considerable benefit to children with spastic cerebral palsy (CP). The authors sought to evaluate the risks of postoperative spinal deformities in patients following SDR. METHODS:All patients who underwent SDR at McGill University between 1991 and 2001 ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2007.106.6.441
更新日期:2007-06-01 00:00:00
abstract:OBJECT:Aneurysms located on the distal portion of the posterior inferior cerebellar artery (PICA) are uncommon, and their underlying pathology, natural history, and clinical management are poorly understood. To clarify these lesions more fully, the authors undertook a retrospective analysis of the clinical features and...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.4.0756
更新日期:2002-10-01 00:00:00
abstract:OBJECT:Scar formation in the carotid sheath is often identified during carotid endarterectomy (CEA) in patients with previous cardiac surgery, and dissection of the carotid sheath and exposure of the carotid arteries in such patients are difficult. The purpose of the present study was to investigate factors related to ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.4.JNS091819
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:Reliable animal models are an important aspect of translational research, especially for relatively uncommon clinical entities such as fusiform aneurysms. While several animal models exist, very few are tailored to cerebral fusiform aneurysms, which have unique attributes compared to abdominal fusiform aneury...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.2.JNS173168
更新日期:2018-07-27 00:00:00
abstract:OBJECT:The goal of this study was to quantify volumetrically cement fill and leakage in patients with osteoporotic and metastatic vertebral lesions undergoing percutaneous vertebroplasty and to establish whether these factors have any clinical significance at follow up. METHODS:Digital computerized tomography data wer...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2003.99.1.0056
更新日期:2003-07-01 00:00:00
abstract::Saccular intracranial aneurysms are a common and often fatal lesion. Whereas surgical treatment of these aneurysms continues to be the gold standard of care, certain situations arise for which surgery may not be the best option. In some of these cases, electrolytically detachable coils have been proven to provide outc...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.86.4.0724
更新日期:1997-04-01 00:00:00
abstract::Intracranial pressure (ICP) and continuous transcranial Doppler ultrasound signals were monitored in 20 head-injured patients and simultaneous synchronous fluctuations of middle cerebral artery (MCA) velocity and B waves of the ICP were observed. Continuous simultaneous monitoring of MCA velocity, ICP, arterial blood ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.76.3.0415
更新日期:1992-03-01 00:00:00
abstract::The authors present a retrospective analysis of the management of deep vein thrombosis (DVT) and pulmonary embolism (PE) in neurosurgical patients at the Massachusetts General Hospital from January, 1978, through June, 1982. There were 44 cases of DVT and 13 cases of PE. Management modalities included observation only...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.4.0563
更新日期:1986-04-01 00:00:00
abstract::The authors report the first case of vasogenic cerebral edema due to a cell-mediated hypersensitivity reaction to a nickel-containing aneurysm clip. The patient initially presented for elective clipping of a right middle cerebral artery aneurysm, and on long-term follow-up she demonstrated relapsing-remitting cerebral...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.6.JNS132405
更新日期:2014-10-01 00:00:00
abstract::The authors report on a 17-year-old boy who suffered from slowly progressive and long-standing symptoms of ataxia, neck pain, and headache. Computerized tomography (CT) and magnetic resonance (MR) imaging revealed a tumor arising from the floor of the fourth ventricle that resulted in a moderate hydrocephalus. A parti...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.91.3.0506
更新日期:1999-09-01 00:00:00
abstract:OBJECT:Because little is known about the molecular mechanisms underlying the process of spondylosis, the authors examined the extent of genetic localization of several members of bone morphogenetic protein (BMP) and BMP receptors in chondrogenesis during the process of inducing spondylosis in their previously establish...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2001.94.1.0068
更新日期:2001-01-01 00:00:00
abstract::In this study of 110 cranial cavities from adult cadavers, the superior sagittal sinus was found to divide into two channels. In most cases, the division was associated with a dural partition. Essentially, the variations as observed in this study could be grouped into three types: Type 1 includes those specimens in wh...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.1.0090
更新日期:1985-01-01 00:00:00
abstract:OBJECT:The authors investigated whether skull base resection and primary free-flap reconstruction in a single-stage surgery is oncologically effective for treating advanced stages of recurrent skin cancer (RSC) of the head. METHODS:Eighteen consecutive patients were surgically treated. Twelve of them underwent an ante...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.2004.100.4.0652
更新日期:2004-04-01 00:00:00
abstract::The authors describe three patients with expanding hemorrhagic mass lesions who presented 13 to 18 years after undergoing Silastic duraplasty. In all patients, results of bacteriological cultures of the masses obtained intraoperatively were positive, revealing low-virulence bacteria. Two of the patients were treated w...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.90.3.0559
更新日期:1999-03-01 00:00:00
abstract::The authors report a unique case of subarachnoid hemorrhage caused by a traumatic pseudoaneurysm of the ophthalmic artery, which was successfully treated with coil embolization. Clinical and imaging features, as well as the relevant literature, are described. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/11/1043
更新日期:2007-11-01 00:00:00
abstract::Studies in 28 traumatized cats showed the following acute changes after spinal cord compression in the cord segment below the trauma: 1) increase in size of the spinal cord evoked potential; 2) increase in size of the electrospinogram; and 3) increase in frequency of the electrospinogram. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.43.6.0737
更新日期:1975-12-01 00:00:00
abstract::Meningiomas have been reported to have associated areas of surrounding low density on computerized tomography (CT). These low-density areas may represent edema, widened subarachnoid spaces, loculated cerebrospinal fluid, demyelination, or adjacent tumor. Two cases are presented in which this adjacent area of low densi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.1.0103
更新日期:1979-01-01 00:00:00
abstract:OBJECT:Stereotactic radiosurgery (SRS) is an important treatment option for patients with cavernous sinus meningiomas (CSM). To analyze factors associated with local tumor control and complications after single-fraction SRS, the authors reviewed cases involving patients treated with Gamma Knife SRS between 1990 and 200...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.5.JNS13206
更新日期:2013-09-01 00:00:00
abstract:OBJECT:The literature on abdominal and general surgery-related complications following anterior lumbar interbody fusion (ALIF) is scant. In this retrospective review of 60 patients in whom ALIF was performed at their institutions between 1996 and 1998, the authors detail the associated complications and their correlati...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.1999.91.1.0060
更新日期:1999-07-01 00:00:00
abstract:OBJECT:The aim of this study was to evaluate different types of sensory stimulation used to distinguish between microvasculature and venous drainage on functional magnetic resonance (fMR) images with blood oxygen level-dependent (BOLD) contrast. METHODS:Seven volunteers received three sensory stimulations. One consist...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.93.3.0427
更新日期:2000-09-01 00:00:00
abstract:OBJECT:Historically, destructive procedures for cancer pain were the main line of treatment therapy. However, the use of high-dose opioids has essentially replaced such procedures. Recognition of the limits of medical therapy to treat cancer pain effectively is growing, while conversely, in regions with limited access ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2010.6.JNS10119
更新日期:2011-01-01 00:00:00
abstract::The commonest initial computerized tomography (CT) finding in head-injured children is bilateral diffuse cerebral swelling. Cerebral blood flow and CT density studies suggest that this swelling is due to cerebral hyperemia and increased blood volume, not to edema. The clinical history, course, and outcome of 63 childr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.2.0170
更新日期:1981-02-01 00:00:00
abstract::The authors report their investigation of the effects of high-dose barbiturates on the multimodality evoked response in 9 cats. After baseline evoked responses were obtained, boluses of pentobarbital were infused intravenously at regular intervals, amounting to cumulative total doses of 9, 18, 27, 45, 63, 123, and 183...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1982.57.2.0178
更新日期:1982-08-01 00:00:00
abstract::Bow hunter stroke, which is characterized by transient vertebrobasilar ischemia brought on by head turning, is an unusual condition usually caused by structural abnormalities at the craniocervical junction. The authors present a case in which compression of the left vertebral artery (VA) at the C4-5 level was caused b...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.96.1.0090
更新日期:2002-01-01 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::Retrochiasmatic craniopharyngiomas are formidable cranial base tumors to resect because of their intimate relationship with neighboring critical neurovascular structures, particularly the undersurface of the optic chiasm and hypothalamus. Radical resection offers the best chance of minimizing tumor recurrence, althoug...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:OBJECT:Neck clipping or coil embolization cannot always achieve complete neck obstruction in wide-necked basilar artery (BA) bifurcation aneurysms. Clipping of the aneurysm body, leaving a small aneurysm rest, is one clipping method used for this kind of aneurysm to maintain the patency of the posterior cerebral arteri...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.93.2.0169
更新日期:2000-08-01 00:00:00
abstract::The authors describe the first reported case of dissecting aneurysm presenting with hemifacial spasm. The patient was a 58-year-old woman with left hemifacial spasm of 2 years' duration. Cranial nerve examination was otherwise normal and no other clinical symptoms were observed. Vertebral angiography revealed a fusifo...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.74.4.0650
更新日期:1991-04-01 00:00:00