Abstract:
:Protection of the brain and spinal cord against ischemia is a goal of vast clinical importance. One approach to this objective is to reduce the tissue's functional activity in order to preserve energy for the metabolic processes that are essential to viability. Experiments to explore ways of reducing function-related energy demands were performed on isolated rabbit retina, a well-characterized model of organized adult mammalian central nervous system (CNS) tissue. The retina was maintained in a nearly physiological state in a miniature "heart-lung" apparatus. Energy metabolism (oxygen consumption and glycolysis) and electrophysiological function (determined by electroretinogram) of the in vitro retina were monitored, and their responses to a series of agents that may reduce energy requirements were determined. Large reversible reductions in O2 consumption, glycolysis, and electrophysiological function were seen in response to mild hypothermia (-3 degrees to -6 degrees C), phenytoin (Dilantin, 100 to 200 mg/kg), chlordiazepoxide (Librium, 200 microM), lithium (1 to 4 mM), Mg++ (6 to 20 mM), strophanthidin (0.15 to 0.25 microM), CO2 (25% to 30%), 2-amino-5-phosphonovaleric acid (APV, 500 microM), amiloride (1 mM), and dantrolene (1 mM). One retina was exposed simultaneously to a combination of six of these agents, which reduced its oxidative and glycolytic metabolism to less than 50% of the control level. The retina recovered metabolic and electrophysiological function after a 2 1/2-hour exposure period. Other agents tested (diphenhydramine, midazolam, nifedipine, nimodipine, and quercetin) had effects on energy metabolism and electrophysiological function that were poorly reversible. Surprisingly little effect was seen in response to general anesthetic agents (thiopental and Althesin) and other CNS depressants (chlorpromazine, ethanol, lidocaine, paraldehyde, valproic acid, and baclofen). The presumed mechanisms through which these agents reduce cellular energy requirements, as well as their potential roles in the treatment of CNS ischemia, are discussed.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Zager EL,Ames A 3rddoi
10.3171/jns.1988.69.4.0568subject
Has Abstractpub_date
1988-10-01 00:00:00pages
568-79issue
4eissn
0022-3085issn
1933-0693journal_volume
69pub_type
杂志文章abstract::The author describes the history of neurosurgery in Manitoba, with particular emphasis on events that occurred after his arrival there in 1950. Highlights of global neurosurgery are spliced into the author's reminiscences to anchor the local history with that of neurosurgery as a whole. ...
journal_title:Journal of neurosurgery
pub_type: 历史文章,杂志文章
doi:10.3171/jns.1995.82.5.0900
更新日期:1995-05-01 00:00:00
abstract:OBJECT:Botulinum toxin injections are the best therapeutic option in patients with spasmodic torticollis. Although a small number of patients do not benefit from such therapy, the majority respond well but may develop antibodies to the toxin after repeated applications. In those termed primary nonresponders, no improve...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.97.2.0207
更新日期:2002-09-01 00:00:00
abstract::Giant serpentine aneurysms (GSAs) are defined as partially thrombosed giant aneurysms with persistent serpentine vascular channels. Surgical management of these rare lesions is difficult because of their large size, complex structure, and unique hemodynamics. The authors report two cases of patients harboring GSAs wit...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.94.5.0836
更新日期:2001-05-01 00:00:00
abstract:OBJECT:The objectives of this study were to: 1) describe the incidence and clinical features of intravertebral vacuum phenomenon (IVVP) in a relatively large number of cases; 2) quantitatively evaluate intravertebral instability and determine the factors affecting instability; and 3) evaluate the efficacy of percutaneo...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2004.100.1.0024
更新日期:2004-01-01 00:00:00
abstract::Spontaneous intracranial hypotension due to a cerebrospinal fluid (CSF) leak in the spine is an important cause of new, daily persistent headaches. Most patients respond well to conservative treatments including epidural blood patching. Limited options for effective treatment are available for patients in whom these t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.100.6.1098
更新日期:2004-06-01 00:00:00
abstract:OBJECT:Most patients with preganglionic lesions after brachial plexus injuries suffer pain that is hard to control through medication or neuromodulation. Lesioning in the dorsal root entry zone (DREZ) is undeniably effective. Fifty-five patients who had undergone the so-called microsurgical DREZotomy (MDT) procedure we...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.2005.102.6.1018
更新日期:2005-06-01 00:00:00
abstract::The hydrogen clearance method was used to measure total and focal cerebral blood flow (CBF) in the monkey before and for 5 hours after a simulated subarachnoid hemorrhage (SAH). Some monkeys also received 0.2 to 1.0 mg/kg phentolamine intracisternally 3 hours after SAH. Results show that SAH did not change cerebrovasc...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.44.3.0353
更新日期:1976-03-01 00:00:00
abstract::Tail-like caudal appendages may be associated with spinal dysraphism, particularly with spinal lipomas or lipomyelomeningoceles. An unusual case is presented of a patient with a myelomeningocele and a thick filum terminale with tethered spinal cord, which presented with the external appearance of a human tail. A revie...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.78.6.0966
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVE:The object of this retrospective study was to investigate the impact of targeted therapies on overall survival (OS), distant intracranial failure, local failure, and radiation necrosis among patients treated with radiation therapy for renal cell carcinoma (RCC) metastases to the brain. METHODS:All patients d...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.8.JNS182100
更新日期:2019-01-18 00:00:00
abstract:OBJECT:The authors conducted a retrospective review to examine and document the frequency, degree, and timing of the radiologically confirmed response to radiotherapy of low-grade gliomas in children. METHODS:Between 1963 and 1995, 80 patients 17 years of age or younger were referred to the London Regional Cancer Cent...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.88.6.0969
更新日期:1998-06-01 00:00:00
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
doi:10.3171/2011.1.JNS091806
更新日期:2011-07-01 00:00:00
abstract::Thirteen patients underwent an anastomosis of the superficial temporal artery (STA) or a saphenous vein graft to one of the secondary trunks of the middle cerebral artery (MCA). They included five patients with giant MCA trifurcation aneurysms, four patients in whom an earlier conventional STA-MCA anastomosis had beco...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.1.0021
更新日期:1985-07-01 00:00:00
abstract::OBJECTIVEThe aim of this study was to derive a clinically applicable decision rule using clinical, radiological, and laboratory data to predict the development of delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (aSAH) patients.METHODSPatients presenting over a consecutive 9-year period with subar...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.1.JNS172715
更新日期:2018-06-01 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::Intracranial gas may be epidural, subdural, subarachnoid, parenchymal, or intraventricular. Intracranial air can be easily diagnosed and its location correctly assessed by computerized tomography. Potentially serious complications of intracranial air, such as tension pneumocephalus, can be rapidly and accurately ident...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.48.3.0355
更新日期:1978-03-01 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:OBJECT:The authors describe their initial results obtained using a skull-mounted trajectory guide for intraoperative magnetic resonance (MR) imaging-guided brain biopsy sampling. The device was used in conjunction with a new methodology known as prospective stereotaxis for surgical trajectory alignment. METHODS:Betwee...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.94.1.0067
更新日期:2001-01-01 00:00:00
abstract::The relationship among cerebral blood flow (CBF), blood volume, cardiac output (CO), and mean arterial blood pressure (MABP) at varying levels of arterial CO2 tensions (PaCO2) were studied in 70 normal cats. The CBF was measured from the clearance curve of xenon-133 and CO with a thermal dilution catheter placed in th...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.52.6.0745
更新日期:1980-06-01 00:00:00
abstract:OBJECT:In this study the authors' goal was to identify the complication rate of subduroperitoneal (SDP) shunts for the treatment of subdural hematomas (SDHs) in infants and to determine the influences on and predictive factors for these complications. METHODS:The authors present a case series spanning the years 1994 t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2007.106.3.172
更新日期:2007-03-01 00:00:00
abstract::OBJECT The frontal and insular fiber network in humans remains largely unknown. This study investigated the connectivity of the frontal and anterior insular network in humans using cortico-cortical evoked potential (CCEP). METHODS This retrospective analysis included 18 patients with medically intractable focal epilep...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.6.JNS15622
更新日期:2016-07-01 00:00:00
abstract::In this report, the authors describe three patients with malignant gliomas who experienced paroxysmal neurological symptoms triggered by standing. The symptoms were attributed to acute elevations of intracranial pressure, an uncommon phenomenon called "plateau waves." In each instance, the attacks occurred despite the...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.1.0224
更新日期:2002-07-01 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:OBJECT:Deep brain stimulation (DBS) of the ventral [anterior internal] capsule/ventral striatum (VC/VS) is under investigation as an alternative to anterior capsulotomy for severe obsessive-compulsive disorder (OCD). In neuroimaging studies of patients with OCD, dysfunction in the orbitofrontal and anterior cingulate c...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.3171/jns.2006.104.4.558
更新日期:2006-04-01 00:00:00
abstract:OBJECT:The objective of the present study was to perform a prospective evaluation of the potential efficacy and safety of intraoperative photodynamic therapy (PDT) using talaporfin sodium and irradiation using a 664-nm semiconductor laser in patients with primary malignant parenchymal brain tumors. METHODS:In 27 patie...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.3171/2013.7.JNS13415
更新日期:2013-10-01 00:00:00
abstract::The CANS supports the concept of organized neurological trauma care consisting of an appropriate amalgamation of prepared communities, institutions, and adequate numbers of committed neurosurgeons. It further supports the guidelines of the ACS regarding institutions designated to receive trauma cases. It opposes manda...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:
更新日期:1986-10-01 00:00:00
abstract::The object of this study was to analyze the pathology of collateral vessels newly induced by indirect bypass surgery for moyamoya disease (MMD). An autopsy analysis was conducted on a 39-year-old woman with MMD who had died of a brainstem infarction. The patient had undergone bilateral indirect bypass surgeries 22 yea...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.4.JNS15155
更新日期:2016-05-01 00:00:00
abstract::Melanocytomas are rare tumors of the central nervous system that are believed to arise from leptomeningeal melanocytes. A young girl presented with a contrast-enhancing cystic mass in the temporal horn of the left lateral ventricle. Microsurgical resection of a black-colored vascular tumor supplied by the anterior cho...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/109/9/0480
更新日期:2008-09-01 00:00:00
abstract::A case is reported of eosinophilic granuloma at the cervicothoracic junction presenting with profound quadriparesis preoperatively. The patient underwent excision via an anterior approach, with splitting of the sternum to gain access to the T-1 vertebra. Postoperatively, he has had an excellent return of function. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1989.71.6.0942
更新日期:1989-12-01 00:00:00
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
doi:10.3171/jns.2000.92.4.0615
更新日期:2000-04-01 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