Abstract:
:A 12-year operative experience with 171 consecutive patients with severe brachial plexus lesions who had at least 1 1/2 years of follow-up review is analyzed. Selection for and timing of operation was helped by categorization of each individual plexus element as "completely" or "incompletely" injured and as "in continuity" or "not in continuity." Results for each element could be given a single grade by a system which defined that element's proximal and distal input. For most lesions in continuity, an operative delay of several months is advocated so that intraoperative electrical evaluation can be used. Thus, in 282 gunshot wounded and stretch-injured elements of which 210 were thought to be clinically complete, 63 were spared resection because of nerve action potentials (NAP's) found at intraoperative testing, and 57 recovered function with only neurolysis. Elements resected (120) were confirmed as neurotmetic both by intraoperative electrical and subsequent histological studies. Acceptable results were achieved in 16 of 24 sutures, in 43 of 89 grafts, and in each of seven split repairs. Upper trunk and lateral and posterior cord elements fared better than lower trunk and medial cord lesions unless the latter were shown, with evidence of NAP's, to be regenerating and could be spared resection. Some stretched elements could, however, not be repaired, even though an attempt was made to exclude such cases from operation. Lacerations to the brachial plexus where continuity is lost are best repaired primarily if the injury is sharp; in this series, 14 of 18 elements having such repair recovered, whereas in 37 elements with secondary repair, grafts were often necessary and only 50% recovered function. Although associated with skin lacerations, 17 elements with complete loss were in continuity, and six of these were shown to be regenerating and were not resected. Despite intraneural location, large size, and prior operation, many benign tumors (including neurofibromas) can be removed without significant loss by use of the surgical loupes or microscope and repetitive NAP recording. Surgery for selected brachial plexus lesions is worthwhile.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Kline DG,Judice DJdoi
10.3171/jns.1983.58.5.0631subject
Has Abstractpub_date
1983-05-01 00:00:00pages
631-49issue
5eissn
0022-3085issn
1933-0693journal_volume
58pub_type
杂志文章abstract::The authors describe cerebrovascular and cerebral metabolic changes in monkeys, subjected to cerebral missile injury. After injury with BB pellet at 90 m/sec, there is a rapid rise in intracranial pressure (ICP), which reaches a peak 2 to 5 minutes posttrauma, and then falls to about 20 to 30 mm Hg. This, with a fall ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.46.6.0784
更新日期:1977-06-01 00:00:00
abstract:OBJECT:The purpose of this study was to examine patterns of diagnosis and relative survival rates in individuals in whom a primary malignant brain tumor was diagnosed between 1973 and 1997; follow-up review of these patients continued through the end of 1999. METHODS:The study population was composed of 21,493 patient...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.99.3.0458
更新日期:2003-09-01 00:00:00
abstract::A prospective study of 100 patients undergoing discectomy was carried out. The neurological findings were documented preoperatively and at 1 month and 1 year postoperatively. The clinical and radiological data were analyzed with respect to significant associations. There were no complications. At a minimum of 1 year p...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.3.0283
更新日期:1979-03-01 00:00:00
abstract::OBJECTIVE Because of its huge clinical potential, the importance of premotor areas for motor function itself and plastic reshaping due to tumors or ischemic brain lesions has received increased attention. Thus, in this study the authors used navigated transcranial magnetic stimulation (nTMS) to investigate whether tum...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.11.JNS152103
更新日期:2016-12-01 00:00:00
abstract::The authors present three patients who, after excision and irradiation of their brain tumors, were treated with BCNU for recurrence. All three patients responded well and now are without evidence of tumor, 37, 30, and 36 months after BCNU was stopped. Although these patients represent only a small fraction of those tr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.43.2.0191
更新日期:1975-08-01 00:00:00
abstract::The authors describe the technique of a transantral transsphenoidal approach to the sella turcica. The advantages and potential complications are discussed. This procedure may also be applicable when dealing with tumors of the skull base and orbits. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.6.1102
更新日期:1983-12-01 00:00:00
abstract::The authors have presented 81 children with intraspinal tumors, all less than 16 years of age. The clinical features indicated that gait disturbance, pain, and sphincter disturbance are the most prominent complaints. Reflex changes, paralysis, and sensory impairment are the most frequent physical findings. Cerebrospin...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.51.4.0437
更新日期:1979-10-01 00:00:00
abstract:OBJECT:The object of this study was to mathematically model the prognosis of a newly inserted shunt in pediatric or adult patients with hydrocephalus. METHODS:A structured search was performed of the English-language literature for case series reporting shunt failure, patient mortality, and shunt removal rates after s...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.3171/PED-07/12/448
更新日期:2007-12-01 00:00:00
abstract::In clinical follow-up studies after radiosurgery, imaging modalities such as computerized tomography (CT) and magnetic resonance (MR) imaging are used. Accurate determination of the residual lesion volume is necessary for realistic assessment of the effects of treatment. Usually, the diameters rather than the volume o...
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::Fifty-seven patients with acute cervical spine injuries and associated major neurological deficit were examined within 2 weeks of injury by magnetic resonance (MR) imaging. All patients had abnormal scans, indicating intramedullary lesions. This study was undertaken to determine if the early MR imaging pattern had a p...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.76.2.0218
更新日期:1992-02-01 00:00:00
abstract::A case of cerebral metastasis of chorioepithelioma with an occlusion of the angular artery is presented. The occlusion was verified angiographically, surgically, and microscopically. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.51.2.0247
更新日期:1979-08-01 00:00:00
abstract::Meralgia paresthetica is a syndrome of pain or dysesthesia, or both, in the anterolateral thigh caused by entrapment or neurinoma formation of the lateral femoral cutaneous nerve. Conservative treatment was successful in relieving symptoms in 91% of 277 patients with this syndrome; however, 24 patients required surgic...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.74.1.0076
更新日期:1991-01-01 00:00:00
abstract:OBJECT:A blinded evaluation of the effects of subthalamic nucleus (STN) stimulation was performed in levodopa-intolerant patients with Parkinson disease (PD). These patients (Group I, seven patients) were moderately or severely disabled (Hoehn and Yahr Stages III-V during the off period), but were receiving only a smal...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.2001.95.2.0213
更新日期:2001-08-01 00:00:00
abstract::In a previous study, the authors demonstrated that meningioma cells secrete platelet-derived growth factor (PDGF)-like molecules that stimulate their own growth in an autocrine manner. Based on that finding, a study was undertaken to examine the effect of trapidil, a drug known to have an antagonistic action against P...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.78.3.0463
更新日期:1993-03-01 00:00:00
abstract::Tumors of the cranial nerves are uncommon, and are usually schwannomas or neurofibromas. The authors describe a case of a fibroblastic tumor involving the sixth cranial nerve. Based upon electron microscopy and immunohistochemistry, the tumor was not of nerve-sheath origin, but was comprised of fibroblasts. Clinical, ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.2.0296
更新日期:1985-02-01 00:00:00
abstract::The lower brainstem and cervical spinal cord from an ordinarily treated case of Chiari Type I hindbrain hernia associated with syringomyelia was examined using high-resolution magnetic resonance microscopy and standard neuropathological techniques. Magnetic resonance microscopy allows total screening and visualizes th...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.4.0701
更新日期:1996-10-01 00:00:00
abstract:OBJECT:Sellar lesions with suprasellar extension may cause loss of visual acuity and visual field damage due to compression of the optic chiasm. Using intraoperative MR (iMR) imaging to detect symptomatic lesion remnants adjacent to the optic chiasm (that may be resected in the same procedure) may positively affect the...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.4.JNS101568
更新日期:2011-09-01 00:00:00
abstract::In 10 patients with supratentorial ependymomas, the tumors exhibited hyperdensity on computerized tomography (CT) scanning prior to contrast infusion and, with one exception, all tumors were mixed lesions with the low densities suggesting cystic or necrotic portions. Eighty percent of the tumors contained small calcif...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.2.0209
更新日期:1986-02-01 00:00:00
abstract:OBJECT:It is assumed that the observed increase in brain tumor incidence may at least partially be explained by increased use of MRI. However, to date no direct estimate of this effect is available. The authors undertook this registry-based study to examine whether regional frequencies of cerebral MRI use correlate to ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.12.JNS131312
更新日期:2014-04-01 00:00:00
abstract::Four cases of spontaneous intracranial hematomas caused by unsuspected meningiomas are reported. Nine previous cases were found in the literature and the entire series of 13 cases is reviewed. Because of their unusual clinical presentation, these cases were not diagnosed correctly prior to radiological studies. Hypert...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.45.4.0437
更新日期:1976-10-01 00:00:00
abstract:OBJECT:Brain tissue acidosis is known to mediate neuronal death. Therefore the authors measured the main parameters of cerebral acid-base homeostasis, as well as their interrelations, shortly after severe traumatic brain injury (TBI) in humans. METHODS:Brain tissue pH, PCO2, PO2, and/or lactate were measured in 151 pa...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.103.4.0597
更新日期:2005-10-01 00:00:00
abstract::Forty-two cats were subjected to decerebration, thoracic and lumbar laminectomies, and isolation of the sciatic nerves. Spinal evoked potentials in response to bilateral sciatic nerve stimulation were recorded at L-3, and the spinal cord blood flow (SCBF) was measured by the hydrogen clearance technique. Thoracic cord...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.71.5.0747
更新日期:1989-11-01 00:00:00
abstract::Forty-five children harboring brain-stem tumors were treated at the University of California, San Francisco, between 1969 and 1979. Pathological diagnoses were made in 19 patients. All patients received radiation therapy (RT). Thirteen patients received chemotherapy before, during, or immediately after RT. Twenty-four...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.6.0721
更新日期:1981-06-01 00:00:00
abstract::Unusual pathological findings were encountered in a temporal lobectomy specimen from a 9-year-old boy with intractable complex partial seizures. Magnetic resonance imaging revealed an enlarged left temporal lobe, with diffuse high signal intensity over the cortex and poor gray-white differentiation on T2-weighted imag...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.78.4.0654
更新日期:1993-04-01 00:00:00
abstract::OBJECTIVEParaclinoid aneurysms represent approximately 5% of intracranial aneurysms (Drake et al. [1968]). Visual impairment, which occurs in 16%-40% of patients, is among the most common presentations of these aneurysms (Day [1990], Lai and Morgan [2013], Sahlein et al. [2015], and Silva et al. [2017]). Flow-divertin...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.1.JNS171774
更新日期:2018-06-01 00:00:00
abstract::The presence of pneumocephalus in a patient without a history of undergoing intracranial or intrathecal procedures is a significant radiographic finding that portends a violation of the dural barrier or the presence of infection. The authors report a case of iatrogenic pneumocephalus that confounded the evaluation of ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.91.5.0878
更新日期:1999-11-01 00:00:00
abstract::A method of lateral orbital rim advancement is described for periorbital deformities associated with coronal and metopic synostosis in infants. The technique offers the advantages of a smooth lateral rim contour and improvement in accompanying malar recession. In 13 patients with follow-up periods of up to 2 years fol...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.72.1.0022
更新日期:1990-01-01 00:00:00
abstract:OBJECT:Disturbance of cerebral phosphorus-containing metabolites occurs in many disease entities and has not been widely studied in patients with subarachnoid hemorrhage (SAH). Pilot studies have indicated that hypermagnesemic treatment may improve outcome in patients with aneurysmal SAH, but the precise mechanism is n...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.10.JNS09915
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:Decision-making for intracranial tumor surgery requires balancing the oncological benefit against the risk for resection-related impairment. Risk estimates are commonly based on subjective experience and generalized numbers from the literature, but even experienced surgeons overestimate functional outcome aft...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.4.JNS20643
更新日期:2020-06-12 00:00:00
abstract::OBJECTIVE Outpatient craniotomy has many advantages to the psychological and physical well-being of patients, as well as benefits to the health care system. Its efficacy and safety have been well demonstrated, but barriers to its widespread adoption remain. Among the challenges is a perception that its application is ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.11.JNS152151
更新日期:2016-11-01 00:00:00