Abstract:
:A technique of "frameless" stereotaxy that allows real-time intraoperative neurosurgical localization is described. The system is composed of four components: a hand-held probe containing two ultrasonic emitters, a microphone array that is rigidly affixed to the operating table in proximity to the surgical field, hardware to control and detect timing of signal production and reception, and a color graphics computer workstation with software to calculate and present the location of the probe tip on reconstructed neuroimaging studies. Unlike previously reported mechanical or sonic navigational devices, this system is adaptable to a wide array of neurosurgical instruments, allows free movement of the operating table and conventional patient draping, and has accuracy in the hostile operating room environment that rivals that of frame stereotaxy. In the operating room environment, using four pulse pairs with the wand positioned optimally, reproducibility of a point in space is +/- 0.6 mm. The wand has a broad range of orientations that maintain error at or below 1.0 mm. The mean error when measuring distances within a 1000-cu cm cube is 1.1 +/- 1.0 mm (1.0% +/- 0.7%). The ability to localize a fourth point (a target) in space is typically within 1.5 mm (using computerized tomography scans with a 1-mm slice thickness) but is dependent on several variables. This technology provides a powerful yet flexible tool in the neurosurgical operating room.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Barnett GH,Kormos DW,Steiner CP,Weisenberger Jdoi
10.3171/jns.1993.78.3.0510subject
Has Abstractpub_date
1993-03-01 00:00:00pages
510-4issue
3eissn
0022-3085issn
1933-0693journal_volume
78pub_type
杂志文章abstract::Superior oblique myokymia (SOM) is a rare eye movement disorder presenting as uniocular rotatory microtremor due to intermittent contractions of the superior oblique muscle. Medical treatment usually fails to provide long-term benefit for the patient and has considerable side effects. Surgical alternatives including t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.89.6.1020
更新日期:1998-12-01 00:00:00
abstract::In a series of 75 patients with surgically treated lipomyelomeningoceles, the neurological condition of six patients deteriorated 6 months to 14 years after the operation due to repeat tethering of the spinal cord. The tethering resulted from postoperative dense adhesion between the cord and the overlying dura mater. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.74.5.0709
更新日期:1991-05-01 00:00:00
abstract::The ability of hemodilution to lower blood viscosity and increase cerebral blood flow has been proven experimentally; however, the optimum hematocrit for maximum oxygen delivery to ischemic brain tissue is not known, and a study was designed to determine this. Fifty dogs were selected for inclusion in the study using ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.80.3.0469
更新日期:1994-03-01 00:00:00
abstract::Thirteen cases of cerebral cavernous angiomas are reported, and their radiological and pathological features are reviewed. The clinical presentation was variable: 53.8% of patients had seizures, 30.8% intracerebral hemorrhage, and 15.4% focal neurological signs, including one unusual case that presented as a cerebello...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.5.0720
更新日期:1986-05-01 00:00:00
abstract::The pressure-volume index (PVI) was measured in six adult cats while cerebral perfusion pressure (CPP) was reduced from normal levels to below the autoregulatory range by a continuous infusion of adenosine triphosphate. Anesthesia was induced with methohexital and maintained with an N2O:O2 (70%:30%) mixture. Body temp...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.67.3.0377
更新日期:1987-09-01 00:00:00
abstract::A patient with a posttraumatic leptomeningeal cyst is described. The cyst simulated an occipital encephalocele and communicated with an epidural cerebrospinal fluid collection in the posterior fossa. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.65.5.0704
更新日期:1986-11-01 00:00:00
abstract::The neurological and neuroradiological manifestations of pediatric achondroplasia are analyzed on the basis of 10 cases. In addition to the classical symptomatology of an enlarging head, with or without increased intracranial pressure, several patients presented symptoms related to a small foramen magnum. Respiratory ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.1.0049
更新日期:1981-01-01 00:00:00
abstract:OBJECT:The authors experienced an intriguing phenomenon in 2 adult patients with moyamoya disease. Mouth opening caused reversible occlusion of the donor superficial temporal artery (STA), and the patients exhibited transient cerebral ischemic symptoms. The aim of this study was to assess the incidence of such occlusio...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.10.JNS141805
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:Perilesional edema is a predominant mechanism underlying secondary brain injury after traumatic brain injury (TBI). Perilesional edema is characterized by inflammation, production of proinflammatory cytokines, and migration of peripheral immune cells into the brain. The nucleotide-binding domain and leucine-r...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.6.JNS1954
更新日期:2019-09-27 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:The goal of this study was to determine whether the late neuromagnetic field elicited by simple speech sounds, which is detected by magnetoencephalography, may be used to estimate hemispheric dominance for language and to guide or constrain the intraoperative search for essential language sites. If sufficiently ...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.2001.94.3.0445
更新日期:2001-03-01 00:00:00
abstract:OBJECT:This investigation was performed to determine the tolerance and toxicities of split-course fractionated gamma knife radiosurgery (FSRS) given in combination with conventional external-beam radiation therapy (CEBRT). METHODS:Eighteen patients with previously unirradiated, gliomas treated between March 1995 and J...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.2000.93.supplement
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVE:Although the majority of patients with cerebral venous sinus thrombosis (CVST) will improve with anticoagulation therapy, a portion of patients will either present in a comatose state or continue to deteriorate clinically despite early anticoagulation. In these cases, along with treating the underlying thromb...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.6.JNS201795
更新日期:2020-10-30 00:00:00
abstract::Because it is often difficult to diagnose accurately the structurally intact cervical spine after acute trauma, a series of patients was evaluated with magnetic resonance (MR) imaging to assess its efficacy for the evaluation and clearance of the cervical spine in a trauma victim in the early posttrauma period. Ultral...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.5.0824
更新日期:1996-11-01 00:00:00
abstract:OBJECT:The authors analyzed the role of endoscopic third ventriculostomy (ETV) as a primary treatment for hydrocephalus and also as an alternative to shunt revision for malfunctioning and infected ventriculoperitoneal (VP) shunts. METHODS:A retrospective analysis of clinical notes, operation records, and magnetic reso...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2005.103.5.0393
更新日期:2005-11-01 00:00:00
abstract:OBJECT:The authors conducted a study to determine clinical, patient/family satisfaction, and financial outcomes following application of a management scheme that involves evaluation of computerized tomography (CT) scans and emergency department observation, rather than overnight admission, for children who have sustain...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2004.101.2.0038
更新日期:2004-08-01 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:OBJECT:In the course of their lives most patients with von Hippel-Lindau (VHL) disease require treatment for several symptom-producing hemangioblastomas of the cerebellum, brainstem, or spinal cord. However, many tumors never produce symptoms and do not require treatment. Detection at an early stage of lesions that wil...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2006.105.2.248
更新日期:2006-08-01 00:00:00
abstract::A serrated suction tip with a variety of diameters and serrations has been developed for the microsurgical removal of tumors. These tips can dissect and aspirate tumor tissue, cerebrospinal fluid, or blood simultaneously, and the degree of suction can be controlled by the pressure of the tip against the tumor. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.69.1.0140
更新日期:1988-07-01 00:00:00
abstract::To determine if dexamethasone administered by osmotic pump directly to brain tumors would control peritumoral edema and at the same time suppress tumor growth and prolong survival, the authors studied experimental brain tumors produced in 102 rabbits by implanting VX2 carcinoma cells. Of these, 58 animals were separat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.79.5.0716
更新日期:1993-11-01 00:00:00
abstract::Two episodes of massive bleeding from a sutured arteriotomy were observed within 30 hours after carotid endarterectomy. The patient had received anticoagulation therapy with heparin for 72 hours prior to surgery. A platelet count of 93,000/cu mm was demonstrated following the second hemorrhage. The potential problem o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.69.4.0632
更新日期:1988-10-01 00:00:00
abstract:OBJECT:Carotid artery (CA) angioplasty with stent placement has been proposed as an alternative technique for revascularization in cases of CA stenosis. In this report the authors review the results of a multicenter Phase I study in which they evaluated the safety and feasibility of using a new self-expanding nitinol s...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.3171/jns.2002.96.5.0830
更新日期:2002-05-01 00:00:00
abstract::Cerebral blood volume (CBV) was calculated in gerbils from specific-gravity (SG) changes between normal and saline-perfused brains. Furthermore, changes in CBV were investigated during ischemia using carbon-14-labeled dextran (MW 70,000) as an intravascular marker. Both data were used to evaluate the possible error du...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.5.0704
更新日期:1985-05-01 00:00:00
abstract:OBJECT:Intracranial germinomas commonly occur in the pineal region, the floor of the third ventricle (hypothalamus), or both, and they are often associated with diabetes insipidus (DI). The authors conducted a study to correlate preoperative DI with the endoscopic and magnetic resonance (MR) imaging evidence of tumor o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2004.100.5.0430
更新日期:2004-05-01 00:00:00
abstract::The authors describe a novel approach to the management of high-output heart failure secondary to an intracranial high-flow dural arteriovenous fistula (DAVF) by using extracorporeal membrane oxygenation (ECMO). To the best of the authors' knowledge, this represents the first report of an embolization performed in con...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2004.100.2.0197
更新日期:2004-02-01 00:00:00
abstract::By definition, the term "radiosurgery" refers to the delivery of a therapeutic radiation dose in a single fraction, not simply the use of stereotaxy. Multiple-fraction delivery is better termed "stereotactic radiotherapy." There are compelling radiobiological principles supporting the biological superiority of single-...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.93.supplement
更新日期:2000-12-01 00:00:00
abstract:OBJECT:Cerebral hemispherectomy for intractable seizures has evolved over the past 50 years, and current operations focus less on brain resection and more on disconnection. In addition, cases involving cortical dysplasia and Rasmussen encephalitis are being identified and surgically treated in younger individuals. Few ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2004.100.2.0125
更新日期:2004-02-01 00:00:00
abstract::The surgical resection of neoplasms involving the petrous bone and surrounding areas in 20 patients is reported. Technical advances described include the total resection of several tumors previously considered inoperable due to involvement of dura and brain, petrous internal carotid artery (ICA), the vein of Labbé, an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.76.4.0578
更新日期:1992-04-01 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:OBJECT:Despite the increasing use of immunotherapy in the treatment of metastatic melanoma, the effects of this therapy on the management of patients with associated brain metastases are not completely defined. The authors undertook this study to determine the effectiveness of resection and the effects of immunotherapy...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.3.JNS091107
更新日期:2011-07-01 00:00:00