Abstract:
BACKGROUND:Early detection of residual disease may benefit management strategies in patients undergoing transsphenoidal surgery for acromegaly. This requires establishing objective thresholds for early postoperative growth hormone (GH) assays, and incorporating these parameters into a scale for outcome prediction. METHOD:We analyzed a database containing the records of 86 patients who had undergone gross total transsphenoidal resection of GH-secreting pituitary adenomas. Early postoperative biochemical testing included a morning fasting basal GH assay on the first postoperative day (POD1) and a second GH assay following suppression with 100 g of oral glucose on the seventh postoperative day (POD7). Remission was defined as a normal IGF-1 with either a GH nadir <0.4 ng/ml following suppression with oral glucose or a basal fasting GH <1 ng/ml on follow-up dated >3 months after surgery. Receiver operator characteristic (ROC) curves identified optimal thresholds for all biochemical parameters. Logistic regression analysis assessed the statistical significance of factors associated with cure. A point system was developed, employing regression coefficients obtained from the multivariate statistical model to quantify the impact of each predictor on cure. RESULTS:Remission was achieved in 34.6 % of patients and was associated with smaller, non-invasive tumors with lower preoperative, POD1 and POD7 GH levels. Optimal thresholds obtained from the ROC analysis suggested that lower POD1 and POD7 GH values provided good sensitivity and specificity for cure, despite modest predictive values. The model with the best ability to predict outcome included size, POD1 GH and POD7 GH levels, with a score of ≥95 demonstrating high specificity for prediction of remission. CONCLUSION:Early postoperative GH assays are highly sensitivity and specific. The scoring system that we propose provided excellent predictive value and requires further validation in larger cohorts and in different populations. The model may help guide the intensity of follow-up and enable early identification of residual disease.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Sarkar S,Jacob KS,Pratheesh R,Chacko AGdoi
10.1007/s00701-014-2098-5subject
Has Abstractpub_date
2014-07-01 00:00:00pages
1379-87; discussion 1387issue
7eissn
0001-6268issn
0942-0940journal_volume
156pub_type
杂志文章abstract::Extensive large dumbbell-shaped hypoglossal schwannoma is extremely rare, and total resection is nearly impossible. We present a case of a 61-year-old male with a giant-size hypoglossal schwannoma with moderate tongue atrophy. The tumor extended from the enlarged hypoglossal canal to the brainstem intradurally and the...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3431-6
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:To prospectively compare the demonstration of the intracranial optic pathway in patients with sellar/juxtasellar tumours and with clinical evidence of visual disturbance using either spoiled gradient recalled acquisition in steady state (SPGR) or conventional spin echo (CSE) T1-weighted imaging. MATERIALS AN...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050138
更新日期:1998-01-01 00:00:00
abstract::Migration of the catheter tip of a ventriculoperitoneal shunt (VPS) through a patent processus vaginalis (PV) has seldom being reported. In this series, we analyzed all cases of inguinoscrotal migration of an VPS catheter at our center. Between 1975 and 2015, 295 VPS insertions were performed. In seven infants (2.3%),...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3243-8
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Scientific research can offer the joy of discovery. For many graduating neurosurgeons, often, a seminar, class, or instructional module is their first and only formal exposure to the world of conducting research responsibly, to write down and report the results of such research. The pressure to publish scien...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-020-04546-9
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:To evaluate the clinical presentation, diagnostic and therapeutic management and outcome of 27 cases of post-traumatic thoracic outlet syndrome (PT TOS). METHODS:Retrospective chart analysis. RESULTS:Nineteen women and eight men were included in this study. Involvement in a traffic accident was the most co...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-1269-x
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:The relationship of pain relief from a recently presented CT-guided indirect cervical nerve root injection with local anesthetics and steroids to surgical decompression as a treatment for single-level cervical radiculopathy is not clear. This retrospective study aimed to compare the immediate and 6-week post...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2933-y
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:Adjuvant systemic chemotherapy increases survival of primary malignant glioma patients beyond 12-18 months. The only interstitial chemotherapy treatment approved for malignant glioma is Gliadel wafer containing carmustine (BCNU) placed in the resection cavity at surgery. Analysis of a large trial by Westphal ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s00701-005-0707-z
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Brainstem cavernous malformations (CM) carry high risks of hemorrhage and neurologic morbidity. While much is published on physical effects of brainstem CM, very little is known about these patients' quality of life. This study aimed to assess the quality of life PROMIS-29 health domains of brainstem CM pati...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-04075-0
更新日期:2019-12-01 00:00:00
abstract:INTRODUCTION:Spontaneous posterior interosseous nerve palsy is a rare condition. Entrapment is mostly at level of the arcade of Frohse, and a few cases of distal entrapment have been described. METHODS:A case of entrapment distal to the arcade of Frohse is described here. Cases of distal entrapment have been reviewed ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-018-3615-8
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:Early repair of myelomeningocoele (MM) is associated with decreased morbidity and mortality. In sub-Saharan Africa, the peculiar harsh economic and social realities make late presentation, malnutrition and sepsis at presentation prevalent. As these factors may affect surgical repair, the aim of this study was...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-008-0002-x
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:The phrenic nerve can be transferred to the musculocutaneous nerve in patients with traumatic brachial plexus palsy in order to recover biceps strength, but the results are controversial. There is also a concern about pulmonary function after phrenic nerve transection. In this paper, we performed a qualitati...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-016-2855-8
更新日期:2016-09-01 00:00:00
abstract::The authors report a retrospective study of 15 patients with solitary vertebral plasmacytoma. 15 patients were considered in this study on the basis of the following characteristics: 1) histologically confirmed plasmacytoma following surgical removal; 2) existence of a single vertebral lesion, documented by skeletal a...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02187754
更新日期:1995-01-01 00:00:00
abstract::Maurice Ravel (1875-1937), the great impressionist-classicist composer of many popular compositions, such as the Boléro, suffered from a progressive disease and died following an exploratory craniotomy by Clovis Vincent. The history of his progressive dementia and the contribution of a car accident, following which he...
journal_title:Acta neurochirurgica
pub_type: 传,历史文章,杂志文章
doi:10.1007/s00701-009-0507-y
更新日期:2010-04-01 00:00:00
abstract::It is critical that traumatic intracranial pseudoaneurysms should be removed completely from the parent artery because there is a possibility of significant morbidity and mortality from the high risk of rebleeding from any remnants of the pseudoaneurysm. However, the deconstruction of the parent artery has the risk of...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-1251-7
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:Cardiopulmonary bypass with profound hypothermia and circulatory arrest has seen a resurgence as an adjunct technique in neurological surgery. We report our experience with this technique in treating seven complex vertebro-basilar aneurysms. METHODS:Skull base approaches were used in all cases, providing exc...
journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章
doi:10.1007/s007010050259
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:The effectiveness of pallidal deep brain stimulation (GPi DBS) for cervical dystonia has been extensively described, but controversies exist about which prognostic factor is clinically useful. We previously reported that classification of tonic- or phasic-type cervical dystonia is useful for predicting clini...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-04076-z
更新日期:2019-12-01 00:00:00
abstract::From a clinical standpoint recovery of spinal nerve roots is less likely than that of peripheral nerves, despite their identical structures. This may be due to several factors including the length of gap to be bridged, changes in the proximal stump or neuroma, and chromatolysis. In this paper we discuss the roles of s...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405874
更新日期:1976-01-01 00:00:00
abstract::The present study compares the clinical outcome, as expressed by the Glasgow outcome scale, of two groups of severely head injured patients treated before (49 patients) and after (72 patients) the establishment of a neurosurgical intensive care (NIC) unit at the department of neurosurgery. Uppsala University Hospital....
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01402049
更新日期:1991-01-01 00:00:00
abstract::Without mortality, 31 patients underwent conservative treatment for traumatic supratentorial acute subdural haematoma (SDH). Later on six of them had the haematoma surgically evacuated mainly because of a deterioration of the Glasgow Coma Scale (GCS) scores. It was found that patients with a midline shift of less than...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02307412
更新日期:1995-01-01 00:00:00
abstract::We retrospectively analysed 13 patients (pts.) treated at the University of Tübingen from 1985 to 1993 to evaluate the results of radiation therapy (XRT) given as an adjuvant to totally or subtotally resected meningiomas. The overall survival was 38% at five years with a probability of relapse of 50% at this time. Rec...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02187764
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Supratentorial intracerebral haemorrhage (ICH) carries an excessive mortality and morbidity. Although surgical ICH treatment can be life-saving, the indications for surgery in larger cohorts of ICH patients are controversial and not well defined. We hypothesised that surgical indications vary substantially a...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03853-0
更新日期:2019-05-01 00:00:00
abstract::We estimated the volume doubling time (Vd) of the ethyl-nitrosourea-induced rat glioma by serial magnetic resonance imaging, and the results were compared with potential doubling time (Tp) determined immunohistochemically. Vd ranged from 3.3 to 29.2 days (11.3 +/- 7.74) and Tp ranged from 2.3 to 13.3 days (6.81 +/- 3....
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050148
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Radiosurgical treatment of brain lesions near motor or language eloquent areas requires careful planning to achieve the optimal balance between effective dose prescription and preservation of function. Navigated brain stimulation (NBS) is the only non-invasive modality that allows the identification of funct...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2079-8
更新日期:2014-06-01 00:00:00
abstract::We present an extremely rare complication after ventriculoperitoneal shunting. The peritoneal tube migrated into the stomach 8 months after the operation and patient presented with gastric bleeding. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1413-9
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Successful deep brain stimulation is mostly dependent on accurate positioning of the leads at the optimal target points. We investigated whether the identification of the subthalamic nucleus in T2-weighted 3-T MRI, fluid-attenuated inversion recovery 3-T MRI and susceptibility-weighted 3-T MRI is confirmed b...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2328-x
更新日期:2015-03-01 00:00:00
abstract::Technological developments in neuroendoscopy are leading to an expansion of applications into the realm of microneurosurgical procedures. The new dimension that using an endoscope provides requires insight into different neuroanatomical aspects and a new kind of strategy in planning a microneurosurgical procedure. To ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01417688
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:An understanding of the present standing of surgery, surgical results and the role in altering the future morbidity and mortality of untreated brain arteriovenous malformations (bAVMs) is appropriate considering the myriad alternative management pathways (including radiosurgery, embolization or some combinat...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-017-3217-x
更新日期:2017-08-01 00:00:00
abstract:PURPOSE:The medial tentorial artery (MTA) of Bernasconi-Cassinari has been associated with many neurosurgical pathologies, including tentorial and petroclival meningiomas, dural arteriovenous fistulae, hemangioblastomas, moyamoya disease, arteriovenous malformations, trigeminal neuromas, and malignant gliomas. This ves...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-011-1195-y
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Our current understanding of the role of dequalinium chloride (DECA) in the progression of glioma remains very limited. This study was aimed to investigate the effect of DECA on human glioma cell lines in vitro and vivo. METHODS:The underlying molecular mechanism was analyzed for developing potential target...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04401-x
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:As the volume of scientific publications increases, the rate of retraction of published papers is also likely to increase. In the present study, we report the characteristics of retracted papers from clinical neurosurgery and allied clinical and basic science specialties. METHODS:Retracted papers were ident...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04615-z
更新日期:2021-01-01 00:00:00