Structural heterogeneity within the axis: the main cause in the etiology of dens fractures. A histomorphometric analysis of 37 normal and osteoporotic autopsy cases.


:Fractures of the odontoid process are potentially serious injuries; Type II and III fractures, as described by Anderson and D'Alonzo, are seen in the emergency room especially in young adolescents and individuals over 60 years of age. The etiology of these fractures is still controversial. Malunion and nonunion in both types of fractures are presumed to be due to insufficient external or internal fixation, but this theory has not been fully explained. To examine these issues, the authors expanded their prior studies of the anatomy of the axis. For histomorphometric analysis of cancellous and cortical bone, the axis was removed in 37 autopsies (26 normal and 11 osteoporotic cases) and sectioned in the sagittal plane to a thickness of 1 mm using a surface-stained block-grinding technique. The base of the dens is the region of least resistance for fractures because of its reduced trabecular bone volume, a poorer trabecular interconnection, and a cortical thickness one-third that of the axis. In all cases, trabeculae were disconnected from the trabecular lattice, and in 30%, microcallus formations were demonstrated in the base of the dens. A special filigree type of trabeculae in the base of the dens is often seen in patients with osteoporosis; microarchitectural differences of cancellous bone between the base of the dens and the other regions of the axis are also markedly increased. The authors infer from the data that the bone structure of the axis is responsible for the location, distribution, and frequency of fractures of the odontoid process in normal healthy bone and this frequency is greatly increased in individuals with osteoporosis. The deficiency of bone mass within the base also suggests a new explanation for the occurrence of nonunions, even after treatment of fractures of the base of the dens.


J Neurosurg


Journal of neurosurgery


Amling M,Pösl M,Wening VJ,Ritzel H,Hahn M,Delling G




Has Abstract


1995-08-01 00:00:00












  • Decreasing ventricular infections through the use of a ventriculostomy placement bundle: experience at a single institution.

    abstract:OBJECT:Ventricular infection after ventriculostomy placement carries a high mortality rate. Responding to ventriculostomy infection rates, a multidisciplinary performance improvement team was formed, a comprehensive protocol for ventriculostomy placement was developed, and the efficacy was evaluated. METHODS:A best-pr...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Kubilay Z,Amini S,Fauerbach LL,Archibald L,Friedman WA,Layon AJ

    更新日期:2013-03-01 00:00:00

  • Combination therapy in a xenograft model of glioblastoma: enhancement of the antitumor activity of temozolomide by an MDM2 antagonist.

    abstract::OBJECTIVE Improvement in treatment outcome for patients with glioblastoma multiforme (GBM) requires a multifaceted approach due to dysregulation of numerous signaling pathways. The murine double minute 2 (MDM2) protein may fulfill this requirement because it is involved in the regulation of growth, survival, and invas...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Wang H,Cai S,Bailey BJ,Reza Saadatzadeh M,Ding J,Tonsing-Carter E,Georgiadis TM,Zachary Gunter T,Long EC,Minto RE,Gordon KR,Sen SE,Cai W,Eitel JA,Waning DL,Bringman LR,Wells CD,Murray ME,Sarkaria JN,Gelbert LM,Jon

    更新日期:2017-02-01 00:00:00

  • History of neurosurgery at University of Toronto: the St. Michael's story.

    abstract::In this paper, the authors describe the history of neurosurgery at St. Michael's Hospital, University of Toronto. St. Michael's has long been regarded as one of the top teaching and research hospitals in Canada. A detailed literature review of published and unpublished works was performed to formulate a succinct but i...

    journal_title:Journal of neurosurgery

    pub_type: 历史文章,杂志文章


    authors: Alotaibi NM,Guha D,Ahuja CS,Spears J,Muller PJ,Tucker WS,Hudson AR,Macdonald RL

    更新日期:2017-12-01 00:00:00

  • Accuracy of transcranial Doppler ultrasonography and single-photon emission computed tomography in the diagnosis of angiographically demonstrated cerebral vasospasm.

    abstract:OBJECT:The goal of this study was to assess the accuracy of the routine clinical use of transcranial Doppler (TCD) ultrasonography and SPECT in predicting angiographically demonstrated vasospasm. METHODS:Following receipt of institutional review board approval, the authors reviewed the records of patients with subarac...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Kincaid MS,Souter MJ,Treggiari MM,Yanez ND,Moore A,Lam AM

    更新日期:2009-01-01 00:00:00

  • Neurosurgical implications of mannitol accumulation within a meningioma and its peritumoral region demonstrated by magnetic resonance spectroscopy: case report.

    abstract::Mannitol is widely considered the hyperosmolar therapy of choice in routine neurosurgical practice for the reduction of intracranial pressure (ICP). The authors present a unique case of a patient with a large meningioma treated with mannitol, in which mannitol accumulation within the tumor and its surrounding parenchy...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Sankar T,Assina R,Karis JP,Theodore N,Preul MC

    更新日期:2008-05-01 00:00:00

  • Surgical treatment of falcotentorial meningiomas: a retrospective review of a single-institution experience.

    abstract:OBJECTIVE:Meningiomas at the falcotentorial junction represent a rare subgroup of complex meningiomas. Debate remains regarding the appropriate treatment strategy for and optimal surgical approach to these tumors, and surgical outcomes have not been well described in the literature. The authors reviewed their single-in...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Zhao X,Belykh E,Przybylowski CJ,Borba Moreira L,Gandhi S,Tayebi Meybodi A,Cavallo C,Valli D,Wicks RT,Nakaji P

    更新日期:2019-08-02 00:00:00

  • Toward better balance.

    abstract::The AANS was founded in 1931 as an educational and scientific organization whose principal purpose was to foster optimum neurosurgical care. Because socioeconomic and political pressures on medicine generally and neurosurgery specifically have escalated in recent years, the American Association of Neurological Surgeon...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Hoff JT

    更新日期:1994-11-01 00:00:00

  • Spontaneous intracerebral hematoma in carotid-cavernous fistula. Report of three cases.

    abstract::Spontaneous intracerebral hematoma associated with carotid-cavernous fistula is rare. Three new cases are presented. In each, the hemorrhage originated in the vicinity of localized intracranial venous engorgement, as demonstrated by cerebral angiography. Rupture of one or several of the distended venous channels from ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Turner DM,Vangilder JC,Mojtahedi S,Pierson EW

    更新日期:1983-10-01 00:00:00

  • Predictors of 30-day readmission after aneurysmal subarachnoid hemorrhage: a case-control study.

    abstract::OBJECTIVE Despite persisting questions regarding its appropriateness, 30-day readmission is an increasingly common quality metric used to influence hospital compensation in the United States. However, there is currently insufficient evidence to identify which patients are at highest risk for readmission after aneurysm...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Greenberg JK,Guniganti R,Arias EJ,Desai K,Washington CW,Yan Y,Weng H,Xiong C,Fondahn E,Cross DT,Moran CJ,Rich KM,Chicoine MR,Dhar R,Dacey RG Jr,Derdeyn CP,Zipfel GJ

    更新日期:2017-06-01 00:00:00

  • Long-term follow-up studies of Gamma Knife surgery with a low margin dose for vestibular schwannoma.

    abstract:OBJECT:The aim of this study was to assess long-term clinical outcomes in patients who underwent Gamma Knife surgery (GKS) with a low margin dose-14 Gy or less-to treat vestibular schwannoma (VS) unrelated to neurofibromatosis Type II. METHODS:Between December 1994 and December 2001, 200 patients with VSs underwent GK...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Sun S,Liu A

    更新日期:2012-12-01 00:00:00

  • Bilateral subthalamic stimulation for Parkinson's disease by using three-dimensional stereotactic magnetic resonance imaging and electrophysiological guidance.

    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


    authors: Bejjani BP,Dormont D,Pidoux B,Yelnik J,Damier P,Arnulf I,Bonnet AM,Marsault C,Agid Y,Philippon J,Cornu P

    更新日期:2000-04-01 00:00:00

  • Giant suprasellar aneurysm associated with optic stalk agenesis and unilateral anophthalmos. Case report.

    abstract::The authors report a patient with unilateral anophthalmos who had a large suprasellar aneurysm associated with aplasia of an optic nerve and the chiasmal commissure. The anatomical findings at craniotomy are described. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Hoff J,Winestock D,Hoyt WF

    更新日期:1975-10-01 00:00:00

  • Regional cerebrovascular and metabolic effects of hyperventilation after severe traumatic brain injury.

    abstract:OBJECT:Recently, concern has been raised that hyperventilation following severe traumatic brain injury (TBI) could lead to cerebral ischemia. In acute ischemic stroke, in which the baseline metabolic rate is normal, reduction in cerebral blood flow (CBF) below a threshold of 18 to 20 ml/100 g/min is associated with ene...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Diringer MN,Videen TO,Yundt K,Zazulia AR,Aiyagari V,Dacey RG Jr,Grubb RL,Powers WJ

    更新日期:2002-01-01 00:00:00

  • Failure of surgical decompression for a presumed case of piriformis syndrome. Case report.

    abstract::Diagnosis of piriformis syndrome is difficult and its precise definition is highly controversial. In this article, the authors present the case of a patient who had clinical features suggestive of piriformis syndrome. During surgery the patient was found to have a rare variation in anatomical structures, in which the ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Spinner RJ,Thomas NM,Kline DG

    更新日期:2001-04-01 00:00:00

  • Surgical treatment of multiple aneurysms and of incidentally-discovered unruptured aneurysms.

    abstract::Review of a series of 460 patients with spontaneous intracranial hemorrhage showed that 241 had demonstrable aneurysms and 38 had multiple aneurysms. The importance of demonstrating the entire circulation following ligation of one aneurysm is emphasized. Treatment of the 38 patients with multiple aneurysms is describe...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Moyes PD

    更新日期:1971-09-01 00:00:00

  • Neuroprotective and neurorestorative effects of thymosin β4 treatment initiated 6 hours after traumatic brain injury in rats.

    abstract:OBJECT:Thymosin β4 (Tβ4) is a regenerative multifunctional peptide. The aim of this study was to test the hypothesis that Tβ4 treatment initiated 6 hours postinjury reduces brain damage and improves functional recovery in rats subjected to traumatic brain injury (TBI). METHODS:Traumatic brain injury was induced by con...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Xiong Y,Zhang Y,Mahmood A,Meng Y,Zhang ZG,Morris DC,Chopp M

    更新日期:2012-05-01 00:00:00

  • The surgical treatment of metastatic spinal tumors within the intradural extramedullary compartment.

    abstract::The authors retrospectively reviewed the surgical outcomes in 10 cases of symptomatic intradural extramedullary spinal metastases of nonneurogenic origin because the collective experience in treating this rare manifestation of systemic cancer is limited. Pain and weakness were the presenting complaints in 70% of the p...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,评审


    authors: Chow TS,McCutcheon IE

    更新日期:1996-08-01 00:00:00

  • Radiographic absence of the posterior communicating arteries and the prediction of cognitive dysfunction after carotid endarterectomy.

    abstract:OBJECT:Approximately 25% of patients exhibit cognitive dysfunction 24 hours after carotid endarterectomy (CEA). One of the purported mechanisms of early cognitive dysfunction (eCD) is hypoperfusion due to inadequate collateral circulation during cross-clamping of the carotid artery. The authors assessed whether poor co...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Sussman ES,Kellner CP,Mergeche JL,Bruce SS,McDowell MM,Heyer EJ,Connolly ES

    更新日期:2014-09-01 00:00:00

  • Intraoperative subcortical mapping of a language-associated deep frontal tract connecting the superior frontal gyrus to Broca's area in the dominant hemisphere of patients with glioma.

    abstract:OBJECT:The deep frontal pathway connecting the superior frontal gyrus to Broca's area, recently named the frontal aslant tract (FAT), is assumed to be associated with language functions, especially speech initiation and spontaneity. Injury to the deep frontal lobe is known to cause aphasia that mimics the aphasia cause...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Fujii M,Maesawa S,Motomura K,Futamura M,Hayashi Y,Koba I,Wakabayashi T

    更新日期:2015-06-01 00:00:00

  • Cerebral hemispherectomy in pediatric patients with epilepsy: comparison of three techniques by pathological substrate in 115 patients.

    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


    authors: Cook SW,Nguyen ST,Hu B,Yudovin S,Shields WD,Vinters HV,Van de Wiele BM,Harrison RE,Mathern GW

    更新日期:2004-02-01 00:00:00

  • Age-related changes in expression of transforming growth factor-beta and receptors in cells of intervertebral discs.

    abstract:OBJECT:The authors conducted a study to determine age-related changes in expression of transforming growth factor (TGF)-beta1, -beta2, -beta3, and Type I and Type II receptors in various cells in the nucleus pulposus and anulus fibrosus. Immunolocalization of TGFbetas and Type I and II receptors was examined during the...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Matsunaga S,Nagano S,Onishi T,Morimoto N,Suzuki S,Komiya S

    更新日期:2003-01-01 00:00:00

  • Mechanisms of intracerebral hemorrhage after carotid endarterectomy.

    abstract:OBJECT:Intracerebral hemorrhage (ICH) is an uncommon complication of carotid endarterectomy (CEA), and carries a high rate of mortality and morbidity. Traditionally, attention has been focused on the cerebral hyperperfusion syndrome (HPS) as the leading cause of ICH after CEA. Other mechanisms, such as a perioperative ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Henderson RD,Phan TG,Piepgras DG,Wijdicks EF

    更新日期:2001-12-01 00:00:00

  • Effect of reduced cerebral perfusion pressure on cerebral blood flow following inhibition of nitric oxide synthesis.

    abstract:OBJECT:The authors tested the hypothesis in a porcine model that inhibition of nitric oxide synthesis during reduced cerebral perfusion pressure (CPP) affected the relative cerebral blood flow (CBF) and the cerebrovascular resistance. METHODS:The CPP was reduced by inducing high cerebrospinal fluid pressure and hemorr...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Rise IR,Kirkeby OJ

    更新日期:1998-09-01 00:00:00

  • Usefulness of inferior petrosal sinus venous endocrine markers in Cushing's disease.

    abstract::Bilateral and simultaneous sampling of the inferior petrosal sinuses in patients with Cushing's disease has been used to establish the presence and laterality of adrenocorticotropic hormone (ACTH)-producing microadenomas prior to transsphenoidal surgery. Successful preoperative lateralization depends upon equivalent d...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Zovickian J,Oldfield EH,Doppman JL,Cutler GB Jr,Loriaux DL

    更新日期:1988-02-01 00:00:00

  • Diffuse axonal injury in mild traumatic brain injury: a diffusion tensor imaging study.

    abstract:OBJECT:Diffuse axonal injury (DAI) is a major complication of traumatic brain injury (TBI) that leads to functional and psychological deficits. Although DAI is frequently underdiagnosed by conventional imaging modalities, it can be demonstrated using diffusion tensor imaging. The aim of this study was to assess the pre...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Inglese M,Makani S,Johnson G,Cohen BA,Silver JA,Gonen O,Grossman RI

    更新日期:2005-08-01 00:00:00

  • Enhanced expression of proapoptotic and autophagic proteins involved in the cell death of glioblastoma induced by synthetic glycans.

    abstract:OBJECT:Glioblastoma is the most aggressive malignant brain tumor, and overall patient survival has not been prolonged even by conventional therapies. Previously, the authors found that chemically synthesized glycans could be anticancer agents against growth of a series of cancer cells. In this study, the authors examin...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Faried A,Arifin MZ,Ishiuchi S,Kuwano H,Yazawa S

    更新日期:2014-06-01 00:00:00

  • Acquired hemophilia, meningioma, and diphenylhydantoin therapy.

    abstract::A patient is reported in whom a meningioma of the lateral one-third of the sphenoid ridge was completely removed and long-term prophylaxis for seizures with diphenylhydantoin was prescribed. One and a half years later, a powerful inhibitor developed that specifically neutralized Factor VIII, the antihemophilic factor,...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: O'Reilly RA,Hamilton RD

    更新日期:1980-11-01 00:00:00

  • Calcified cervical intervertebral discs in children. Report of three cases.

    abstract::Calcified cervical intervertebral discs in children are manifestations of an uncommon, distinct disease of unknown cause. Acute symptoms are usually followed by a benign course of spontaneous recovery, frequently culminating in resorption of the calcium. Rarely herniation of the disc may cause neurological complicatio...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Smith RA,Vohman MD,Dimon JH 3rd,Averett JE Jr,Milsap JH Jr

    更新日期:1977-02-01 00:00:00

  • Single-beam radiotherapy knife. A practical theoretical model.

    abstract::A feasibility study reveals that a standard linear accelerator, with only slight modification, can function in a manner similar to Leksell's multiple cobalt radiation device. A high radiation dose can be delivered to a 1-cm or 0.5-cm volume target with insignificant radiation effect on the surrounding tissue. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Heifetz MD,Wexler M,Thompson R

    更新日期:1984-04-01 00:00:00

  • Endovascular stent therapy for extracranial and intracranial carotid artery dissection: single-center experience.

    abstract:OBJECT:The objective of this study was to evaluate endovascular stent therapy for carotid artery dissections (CADs). METHODS:Retrospective review of data at Millard Fillmore Gates Hospital identified 43 patients with 44 CADs (intracranial and/or extracranial) treated with carotid artery (CA) stent placement between Ja...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Ohta H,Natarajan SK,Hauck EF,Khalessi AA,Siddiqui AH,Hopkins LN,Levy EI

    更新日期:2011-07-01 00:00:00