Effects of ventricular entry on patient outcome during glioblastoma resection.


OBJECTIVE:Tumor proximity to the ventricle and ventricular entry (VE) during surgery have both been associated with worse prognoses; however, the interaction between these two factors is poorly understood. Given the benefit of maximal tumor resection, it is imperative for surgical planning and technique to know if VE has negative consequences for patient survival and tumor dissemination. METHODS:The University of California, San Francisco tumor registry was searched for patients with newly diagnosed and recurrent supratentorial glioblastoma (GBM) who underwent resection by the senior author between 2013 and 2018. Tumor location with respect to the subventricular zone (SVZ), size, and extent of resection were assessed using pre- and postoperative imaging. VE was determined by postoperative imaging and/or the operative report. RESULTS:In this 200-patient cohort of newly diagnosed and recurrent GBM, 26.5% of patients had VE during resection. Patients with VE were more likely to have preexisting subependymal disease (41.5% vs 15.0%, p < 0.001). Comparing patients with VE to those without VE, there was no difference in the rates of postoperative hydrocephalus (1.9% vs 4.8%, p = 0.36), ventriculoperitoneal shunting (0% vs 3.4%, p = 0.17), pseudomeningoceles (7.5% vs 5.4%, p = 0.58), or subdural hematomas (11.3% vs 3.4%, p = 0.07). Importantly, rates of subsequent leptomeningeal disease (7.5% vs 10.2%, p = 0.57) and distant parenchymal recurrence (17.0% vs 23.1%, p = 0.35) were not different between the groups. Newly diagnosed patients with tumors contacting the SVZ (type I or II) had worse survival than patients with tumors that did not contact the SVZ (type III or IV) (1.27 vs 1.84 years, p = 0.014, HR 1.8, 95% CI 1.08-3.03), but VE was not associated with worse survival in these patients with high-risk SVZ type I and II tumors (1.15 vs 1.68 years, p = 0.151, HR 0.59, 95% CI 0.26-1.34). CONCLUSIONS:VE was well tolerated, with postoperative complications being rare events. There was no increase in leptomeningeal spread or distant parenchymal recurrence in patients with VE. Finally, although survival was worse for patients with preoperative subependymal disease, VE did not change survival for patients with tumors contacting the ventricle. Therefore, VE during GBM resection is not associated with adverse patient outcomes and should be used by surgeons to enhance extent of resection.■ CLASSIFICATION OF EVIDENCE Type of question: therapeutic; study design: retrospective cohort; evidence: class II.


J Neurosurg


Journal of neurosurgery


Young JS,Gogos AJ,Pereira MP,Morshed RA,Li J,Barkovich MJ,Hervey-Jumper SL,Berger MS




Has Abstract


2021-01-08 00:00:00










  • Reinforcement with gauze wrapping for ruptured aneurysms of the middle cerebral artery.

    abstract::A 2- to 15-year follow-up study is presented of a series of 35 consecutive patients treated for ruptured aneurysms of the middle cerebral artery by reinforcement with gauze wrapping. Only one patient suffered early recurrent hemorrhage in the postoperative period, and none had a late hemorrhage. The procedure carried ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Taylor JC,Choudhury AR

    更新日期:1977-12-01 00:00:00

  • Carotid body tumors managed with preoperative embolization. Report of two cases.

    abstract::Two patients with large vascular carotid body tumors underwent preoperative intravascular embolization of the major arterial feeders. The tumor vascularity was reduced markedly, and complete surgical extirpation was accomplished without difficulty. The literature on carotid body tumors is briefly reviewed. The role of...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Borges LF,Heros RC,DeBrun G

    更新日期:1983-11-01 00:00:00

  • Neurological and neuropsychological outcome after resection of craniopharyngiomas.

    abstract:OBJECTIVE:Craniopharyngiomas are rare and benign tumors of the sellar and/or parasellar region. Primary treatment involves resection followed by adjuvant radiotherapy. While the grade of resection was frequently analyzed following surgery, the neurological outcome and especially neuropsychological deficits and quality ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Giese H,Haenig B,Haenig A,Unterberg A,Zweckberger K

    更新日期:2019-04-19 00:00:00

  • Transient cerebellar mutism caused by bilateral damage to the dentate nuclei after the second posterior fossa surgery. Case report.

    abstract::The authors report on the case of a 6-year-old boy who underwent resection of a midline cerebellar tumor. The boy was able to speak fluently after the operation. Magnetic resonance (MR) imaging showed that the right dentate nucleus had been partially removed along with the tumor, but that the left dentate nucleus rema...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Kusano Y,Tanaka Y,Takasuna H,Wada N,Tada T,Kakizawa Y,Hongo K

    更新日期:2006-02-01 00:00:00

  • Comparison of effects of socioeconomic and geographic variations on survival for adults and children with glioma.

    abstract:OBJECT:The authors analyzed the effects of socioeconomic status (SES) and geographic variations on survival rates for adults and children with glioma, studying the data of 30,489 adults and 2940 children from the Cancer Registry in England and Wales. METHODS:The median survival time and crude survival rates for eight ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Tseng MY,Tseng JH,Merchant E

    更新日期:2006-10-01 00:00:00

  • New approach to cervical flexion deformity in ankylosing spondylitis. Case report.

    abstract::The treatment of cervical fixed flexion deformity in ankylosing spondylitis presents a challenging problem that is traditionally managed by a corrective cervicothoracic osteotomy. The authors report a new approach to this problem that involves performing a two-level osteotomy at the level of maximum spinal curvature, ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Duff SE,Grundy PL,Gill SS

    更新日期:2000-10-01 00:00:00

  • Computerized tomography findings in dural arteriovenous malformations. Report of three cases.

    abstract::Changes in the brain parenchyma and cerebrospinal fluid spaces were demonstrated in three cases of dural arteriovenous malformations by computerized tomography (CT). In various combinations, there were 1) vermiform or patchy enhancement after intravenous contrast infusion, 2) abnormal decreased density mainly in the w...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Miyasaka K,Takei H,Nomura M,Sugimoto S,Aida T,Abe H,Tsuru M

    更新日期:1980-11-01 00:00:00

  • New York City at the dawn of neurological surgery.

    abstract::Although there are many cities that can claim to have been the incubator of modern neurological surgery, the rise of this surgical subspecialty in New York City in the late 19th and early 20th century mirrors what was occurring around the world. The first confirmed brain tumor operation in the US was performed there i...

    journal_title:Journal of neurosurgery

    pub_type: 历史文章,杂志文章


    authors: Solomon RA

    更新日期:2016-11-01 00:00:00

  • Neurosurgical decision making: personal and professional preferences.

    abstract:OBJECT:Physicians are often solicited by patients or colleagues for clinical recommendations they would make for themselves if faced by a clinical situation. The act of making a recommendation can alter the clinical course being taken. The authors sought to understand this dynamic across different neurosurgical scenari...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Tanweer O,Wilson TA,Kalhorn SP,Golfinos JG,Huang PP,Kondziolka D

    更新日期:2015-03-01 00:00:00

  • Transparaspinal exposure of dumbbell tumors of the spine. Report of two cases.

    abstract::The authors present a surgical technique for resection of dumbbell tumors of the spine. The transparaspinal exposure combines laminectomy and sectioning of the paraspinal muscles through a transverse incision. The procedure allows total tumor resection by means of a single posterior approach in selected patients, thus...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Onesti ST,Ashkenazi E,Michelsen WJ

    更新日期:1998-01-01 00:00:00

  • Risk factors and analysis of long-term headache in sporadic vestibular schwannoma: a multicenter cross-sectional study.

    abstract:OBJECT:The primary goals of this study were: 1) to examine the influence of disease and treatment on headache in patients with sporadic vestibular schwannoma (VS); and 2) to identify clinical predictors of long-term headache disability. METHODS:This was a cross-sectional observational study with international multicen...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,多中心研究


    authors: Carlson ML,Tveiten ØV,Driscoll CL,Boes CJ,Sullan MJ,Goplen FK,Lund-Johansen M,Link MJ

    更新日期:2015-11-01 00:00:00

  • Treatment of nontraumatic atlantoaxial dislocation and fibrous fusion. Case report.

    abstract::The authors describe a case of nontraumatic atlantoaxial dislocation secondary to acute rheumatic fever, in which there appeared to be fibrous fusion between the axis and the atlas in the subluxed position. The dislocation was reduced by means of combined traction and steroid therapy. Fibrous fusion occurred in the re...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Lucas JT,Hungerford GD,Perot PL Jr

    更新日期:1982-01-01 00:00:00

  • The role of extracranial carotid abnormalities in the genesis of cerebral aneurysms.

    abstract::The incidence of extracranial internal carotid artery (ICA) abnormalities, namely kinks, coils, and stenoses, was evaluated in a consecutive unselected series of 76 cases of single supratentorial saccular aneurysms submitted to bilateral carotid angiography. These patients were compared with a control group of 120 pat...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Spallone A,Cantore G

    更新日期:1981-11-01 00:00:00

  • A novel, low-cost, reusable, high-fidelity neurosurgical training simulator for cerebrovascular bypass surgery.

    abstract::OBJECTIVECerebrovascular bypass surgery is a challenging yet important neurosurgical procedure that is performed to restore circulation in the treatment of carotid occlusive diseases, giant/complex aneurysms, and skull base tumors. It requires advanced microsurgical skills and dedicated training in microsurgical techn...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Cikla U,Sahin B,Hanalioglu S,Ahmed AS,Niemann D,Baskaya MK

    更新日期:2018-05-11 00:00:00

  • Panventriculomegaly with a wide foramen of Magendie and large cisterna magna.

    abstract::OBJECT The authors' goal in this paper is to provide the first clinical, radiological, and genetic studies of panventriculomegaly (PaVM) defined by a wide foramen of Magendie and large cisterna magna. METHODS Clinical and brain imaging data from 28 PaVM patients (including 10 patients from 5 families) were retrospecti...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Kageyama H,Miyajima M,Ogino I,Nakajima M,Shimoji K,Fukai R,Miyake N,Nishiyama K,Matsumoto N,Arai H

    更新日期:2016-06-01 00:00:00

  • Intracellular free magnesium of brain and cerebral phosphorus-containing metabolites after subarachnoid hemorrhage and hypermagnesemic treatment: a ³¹P–magnetic resonance spectroscopy study. Clinical article.

    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


    authors: Wong GK,Yeung DK,Ahuja AT,King AD,Lam CW,Chan MT,Gin T,Poon WS

    更新日期:2010-10-01 00:00:00

  • Use of a wedged microcatheter for curative transarterial embolization of complex intracranial dural arteriovenous fistulas: indications, endovascular technique, and outcome in 21 patients.

    abstract:OBJECT:The aim of this study was to describe the application of a novel transarterial approach to curative embolization of complex intracranial dural arteriovenous fistulas (DAVFs). This technique is particularly useful in patients harboring high-grade DAVFs with direct cortical venous drainage or for whom transvenous ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Nelson PK,Russell SM,Woo HH,Alastra AJ,Vidovich DV

    更新日期:2003-03-01 00:00:00

  • The effects of deep barbiturate coma on multimodality evoked potentials.

    abstract::The authors report their investigation of the effects of high-dose barbiturates on the multimodality evoked response in 9 cats. After baseline evoked responses were obtained, boluses of pentobarbital were infused intravenously at regular intervals, amounting to cumulative total doses of 9, 18, 27, 45, 63, 123, and 183...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Sutton LN,Frewen T,Marsh R,Jaggi J,Bruce DA

    更新日期:1982-08-01 00:00:00

  • Vitamin D status and 3-month Glasgow Outcome Scale scores in patients in neurocritical care: prospective analysis of 497 patients.

    abstract::OBJECTIVE Vitamin D deficiency has been associated with a variety of negative outcomes in critically ill patients, but little focused study on the effects of hypovitaminosis D has been performed in the neurocritical care population. In this study, the authors examined the effect of vitamin D deficiency on 3-month outc...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Guan J,Karsy M,Brock AA,Eli IM,Manton GM,Ledyard HK,Hawryluk GWJ,Park MS

    更新日期:2018-06-01 00:00:00

  • Carcinoembryonic antigen in patients with intracranial tumors.

    abstract::Carcinoembryonic antigen (CEA) in plasma, cerebrospinal fluid (CSF), and tumor cyst fluid obtained from patients with a variety of intracranial tumors was determined by radioimmunoassay Slightly elevated levels of plasma CEA, ranging from 2.6 to 3.8 ng/ml, were noted in six (4%) of 161 patients with primary brain tumo...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Suzuki Y,Tanaka R

    更新日期:1980-09-01 00:00:00

  • Extramedullary hemangioblastoma of the spinal cord. Case report.

    abstract::A case of hemangioblastoma of the spinal cord is described in which the tumor presented in an intradural extramedullary location. The patient did not have von Hippel-Lindau's disease or metastatic seeding. It is assumed that the tumor arose in the pia, and its direction of growth was purely extramedullary. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Wisoff HS,Suzuki Y,Llena JF,Fine DI

    更新日期:1978-03-01 00:00:00

  • Tremor cells in the human thalamus: differences among neurological disorders.

    abstract:OBJECT:Thalamic neurons firing at frequencies synchronous with tremor are thought to play a critical role in the generation and maintenance of tremor. The authors studied the incidence and locations of neurons with tremor-related activity (TRA) in the thalamus of patients with varied pathological conditions-including P...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Brodkey JA,Tasker RR,Hamani C,McAndrews MP,Dostrovsky JO,Lozano AM

    更新日期:2004-07-01 00:00:00

  • Detection of unanticipated intracranial hemorrhage during intraoperative magnetic resonance image-guided neurosurgery. Report of two cases.

    abstract::The authors report unanticipated intraoperative intracranial hemorrhaging in two pediatric neurosurgical patients. Both children were undergoing elective craniotomies with the aid of intraoperative magnetic resonance (iMR) imaging. In both cases, the ability of iMR imaging to aid in diagnosis allowed prompt and defini...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: McClain CD,Soriano SG,Goumnerova LC,Black PM,Rockoff MA

    更新日期:2007-05-01 00:00:00

  • Motor areas of the frontal cortex in patients with motor eloquent brain lesions.

    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


    authors: Bulubas L,Sabih J,Wohlschlaeger A,Sollmann N,Hauck T,Ille S,Ringel F,Meyer B,Krieg SM

    更新日期:2016-12-01 00:00:00

  • Nonhyperemic blood flow restoration and brain edema in experimental focal cerebral ischemia.

    abstract::The effect of suppression of postischemic reactive hyperemia on the blood-brain barrier (BBB) and ischemic brain edema after temporary focal cerebral ischemia was studied in cats under ketamine and alpha-chloralose anesthesia. Regional cerebral blood flow (rCBF) was measured by a thermal diffusion method and a hydroge...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Kuroiwa T,Shibutani M,Okeda R

    更新日期:1989-01-01 00:00:00

  • Safety of perioperative minidose heparin in patients undergoing brain tumor surgery: a prospective, randomized, double-blind study.

    abstract:OBJECT:Thromboembolic phenomena (TEPs) continue to be a significant source of morbidity and mortality in patients undergoing neurosurgery. Although the efficacy of low-dose heparin in preventing TEPs in neurosurgical patients is well established, neurosurgeons are reluctant to use it perioperatively because of concern ...

    journal_title:Journal of neurosurgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Constantini S,Kanner A,Friedman A,Shoshan Y,Israel Z,Ashkenazi E,Gertel M,Even A,Shevach Y,Shalit M,Umansky F,Rappaport ZH

    更新日期:2001-06-01 00:00:00

  • Inhibition of angiogenesis induced by cerebral arteriovenous malformations using gamma knife irradiation.

    abstract:OBJECT:The authors studied the effect of Gamma Knife irradiation on angiogenesis induced by cerebral arteriovenous malformation (AVM) tissues implanted in the corneas of rats. METHODS:Ten AVM specimens obtained from tissue resections performed at Marmara University between 1998 and 2004 were used. A uniform amount of ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Kiliç K,Konya D,Kurtkaya O,Sav A,Pamir MN,Kiliç T

    更新日期:2007-03-01 00:00:00

  • Delineating gray and white matter involvement in brain lesions: three-dimensional alignment of functional magnetic resonance and diffusion-tensor imaging.

    abstract:OBJECT:The role of functional magnetic resonance (fMR) imaging has become increasingly important in the presurgical mapping of gray matter. Neurosurgical interventions often involve fiber bundles that connect critical functional areas. Recently, diffusion-tensor (DT) imaging has enabled the visualization of fiber bundl...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Hendler T,Pianka P,Sigal M,Kafri M,Ben-Bashat D,Constantini S,Graif M,Fried I,Assaf Y

    更新日期:2003-12-01 00:00:00

  • Residency training in neurological surgery, 1934-1984: evolution over 50 years of trial and tribulation. The 1984 AANS presidential address.

    abstract::The President of the American Association of Neurological Surgeons (AANS) reviews formal neurosurgical training in the United States from its inception with one program in 1934 to 1984, with 94 programs and 650 residents. He reports on the 1st year's experience with a national neurosurgical residency matching plan. He...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Pevehouse BC

    更新日期:1984-12-01 00:00:00

  • A new technique for exposure of the cervical spine laminae. Technical note.

    abstract::The author describes a new technique for exposure of the cervical spine laminae in which the attachments of the semispinalis cervicis and multifidus muscles to the spinous processes are left untouched. It provides a conservative exposure through which a diverse range of posterior cervical surgeries can be performed. I...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Shiraishi T

    更新日期:2002-01-01 00:00:00