Abstract:
OBJECTIVE:The use of Gamma Knife stereotactic radiosurgery (GKSRS) for the treatment of extensive intracranial metastases has been expanding due to its superior dosimetry and efficacy. However, there remains a dearth of data regarding the dose parameters in actual clinical scenarios. The authors endeavored to calculate the radiation dose to the brain when treating ≥ 15 brain metastases with GKSRS. METHODS:This retrospective analysis reviewed dosage characteristics for patients requiring single-session GKSRS for the treatment of ≥ 15 brain metastases. Forty-two patients met the inclusion criteria between 2008 and 2017. The median number of tumors at the initial GKSRS procedure was 20 (range 15-39 tumors), accounting for 865 tumors in this study. The median aggregate tumor volume was 3.1 cm3 (range 0.13-13.26 cm3), and the median marginal dose was 16 Gy (range 14-19 Gy). RESULTS:The median of the mean brain dose was 2.58 Gy (range 0.95-3.67 Gy), and 79% of patients had a dose < 3 Gy. The 12-Gy dose volume was a median of 12.45 cm3, which was equivalent to 0.9% of the brain volume. The median percentages of brain receiving 5 Gy and 3 Gy were 6.7% and 20.4%, respectively. There was no correlation between the number of metastases and the mean dose to the brain (p = 0.8). A greater tumor volume was significantly associated with an increased mean brain dose (p < 0.001). The median of the mean dose to the bilateral hippocampi was 2.3 Gy. Sixteen patients had supplementary GKSRS, resulting in an additional mean dose of 1.4 Gy (range 0.2-3.8 Gy) to the brain. CONCLUSIONS:GKSRS is a viable means of managing extensive brain metastases. This procedure provides a relatively low dose of radiation to the brain, especially when compared with traditional whole-brain radiation protocols.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Bowden GN,Kim JO,Faramand A,Fallon K,Flickinger J,Lunsford LDdoi
10.3171/2020.3.JNS193369subject
Has Abstractpub_date
2020-05-08 00:00:00pages
1-5eissn
0022-3085issn
1933-0693pii
2020.3.JNS193369pub_type
杂志文章abstract::The purpose of this prospective study was twofold: 1) to determine the sensitivity and specificity of computer-derived density spectral array in detecting analog electroencephalographic (EEG) ischemic pattern changes during carotid artery cross-clamping in patients undergoing carotid endarterectomy; and 2) to assess t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.78.6.0884
更新日期:1993-06-01 00:00:00
abstract:OBJECT:Appropriate management of hemorrhage after Gamma Knife surgery (GKS) for arteriovenous malformations (AVMs) of the brain is poorly understood, although a certain proportion of patients suffer from hemorrhage. METHODS:Among 500 patients observed for 1 to 183 months (median 70 months) after GKS, 32 patients (6.4%...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/sup.2006.105.7.52
更新日期:2006-12-01 00:00:00
abstract::OBJECTIVEThe aim of this study was to describe the current state of epilepsy surgery and establish estimates of seizure outcomes following surgery for medically intractable epilepsy (MIE) in low- and middle-income countries (LMICs).METHODSThe MEDLINE and Embase databases were searched without publication date restrict...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2018.5.JNS18599
更新日期:2018-11-01 00:00:00
abstract::The metabolic rate was determined in the rat brain during the immediate concussive response to standardized impact accelerations of 7 and 9 m/sec velocity. In one series, the metabolic state was determined in freeze-clamped cortical and brain-stem tissue 20 seconds after the impact. The metabolic rate was calculated f...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.2.0274
更新日期:1977-08-01 00:00:00
abstract::The authors have reviewed the clinical records of 110 patients with intracranial cavernous malformations diagnosed by histological examination and/or magnetic resonance imaging over a mean follow-up period of 4.71 years. These cases were divided, based on their presentation, into a hemorrhage group, a seizure group, a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.83.1.0056
更新日期:1995-07-01 00:00:00
abstract::The case of a 30-year-old man with a spinal extradural meningeal cyst in the thoracolumbar region is reported. Operative findings revealed a dural defect that allowed communication between the extradural cyst cavity and the subarachnoid space. Application of the Valsalva maneuver made the cerebrospinal fluid flow into...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.2.0354
更新日期:1996-08-01 00:00:00
abstract:OBJECT:The aim of this study was to describe six variations of the extreme-lateral craniocervical approach, their application, and treatment results. METHODS:During a 4-year period 69 patients underwent surgery in which six variations of the extreme-lateral craniocervical approach were performed. The variations includ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.1999.90.2.0206
更新日期:1999-04-01 00:00:00
abstract::Clinical studies with transcranial Doppler suggest that the pulsatility of the flow velocity (FV) waveform increases when the distal cerebrovascular resistance (CVR) increases. To clarify this relationship, the authors studied animal models in which the resistance may be decreased in a controlled manner by an increase...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.84.1.0079
更新日期:1996-01-01 00:00:00
abstract::Acute cerebellar hemorrhages, treated medically with subsequent complete recovery, have been designated "benign cerebellar hemorrhages." Ordinarily, acute cerebellar hemorrhage does require early surgical intervention and reported surgical mortality is relatively low (17%) in awake patients with this lesion. Clinical ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.3.0374
更新日期:1979-03-01 00:00:00
abstract:OBJECT:The authors describe the use of a systemic approach to treat dural arteriovenous fistulas (DAVFs) in the lateral sinus and the confluence of sinuses in 17 patients who presented with signs and symptoms related to intracranial hemorrhage, infarction, and diffuse brain swelling. METHODS:Angiographic examination r...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.90.2.0289
更新日期:1999-02-01 00:00:00
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
doi:10.3171/2012.1.JNS111729
更新日期:2012-05-01 00:00:00
abstract::This is a report of five cases in which a bullet penetrated the vertex of the skull and brain, apparently during its vertical descent after having been fired into the air. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1971.34.2part1.0222
更新日期:1971-02-01 00:00:00
abstract:OBJECTIVE:It is well known that larger aneurysm size is a risk factor for poor outcome after surgical treatment of unruptured saccular intracranial aneurysms (USIAs). However, the authors have occasionally observed poor outcome in the surgical treatment of small USIAs and hypothesized that size ratio has a negative imp...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.4.JNS173221
更新日期:2018-09-21 00:00:00
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
doi:10.3171/2016.9.JNS161119
更新日期:2017-12-01 00:00:00
abstract::Considerable difference of opinion has arisen as to whether intravenously administered steroids affect cerebrospinal fluid (CSF) production in the acute laboratory animal undergoing ventriculocisternal perfusion. Our experiments with ventriculocisternal perfusion in dogs indicate that, when given intravenously, neithe...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.4.0477
更新日期:1979-04-01 00:00:00
abstract:OBJECT:Intracranial aneurysms of the anterior circulation might become symptomatic by causing visual deficits. The influence of treatment modality on improvement is still unclear. The objective of this study was to analyze the recovery of visual deficits caused by the mass effect of intracranial aneurysms after surgica...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2011.5.JNS101983
更新日期:2011-10-01 00:00:00
abstract:OBJECT:The treatment of solitary vestibular schwannomas by performing Gamma Knife surgery is well established. It has been reported that decreasing the surface dose reduces patient morbidity, especially facial weakness and numbness. The authors of this retrospective study examine patient data from a single center to de...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/sup.2006.105.7.154
更新日期:2006-12-01 00:00:00
abstract:OBJECT:Subarachnoid hemorrhage (SAH) with simultaneous acute subdural hematoma (SDH) is a severe disease. The authors' objective was to analyze the incidence, prognosis, and clinical outcome of patients suffering from aneurysm-related SAH and space-occupying acute SDH. METHODS:Between June 1999 and June 2011, data fro...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2012.11.JNS121435
更新日期:2013-05-01 00:00:00
abstract::OBJECTIVEThe clinical relevance of high-sensitivity troponin T (HsTnT) in trauma patients is not well explored. In this study, the authors aimed to study the predictive value of serum HsTnT in intubated patients who had sustained traumatic brain injury (TBI).METHODSA retrospective analysis was conducted for all intuba...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.7.JNS17675
更新日期:2018-12-01 00:00:00
abstract::Retrovirus-mediated herpes simplex virus-thymidine kinase (HSV-tk) gene therapy is a promising approach in the treatment of brain tumors. Previous in vitro and in vivo studies have demonstrated a bystander effect in which nonmodified tumor cells in proximity to HSV-tk-modified tumor cells are killed with the modified ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.83.4.0698
更新日期:1995-10-01 00:00:00
abstract::To evaluate the biology of thyrotropin (TSH)-producing pituitary adenomas, the authors reviewed the charts of 19 patients who underwent transsphenoidal surgery within a 15-year period at the University of California, San Francisco (UCSF). Between 1989 and 1991, the period during which immunostaining techniques were us...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.79.4.0521
更新日期:1993-10-01 00:00:00
abstract::Magnetic resonance (MR) angiography offers a safe, noninvasive alternative to conventional angiography in patients with suspected carotid stenosis; however, it tends to overestimate the severity of stenosis. Loss of the MR signal with a resulting flow gap is a frequent finding in cases of high-grade stenosis. The auth...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.3.0384
更新日期:1996-09-01 00:00:00
abstract::Cerebral blood flow (CBF) was measured at different times during the first 150 minutes following an experimental space-occupying lesion produced with a 50-microliter microballoon in rats. Local CBF was measured with the carbon-14-labeled iodoantipyrine quantitative autoradiographic technique. A region of local ischemi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.67.5.0732
更新日期:1987-11-01 00:00:00
abstract:OBJECT:Delayed cerebral ischemia is a major cause of morbidity and death following aneurysmal subarachnoid hemorrhage and requires timely intervention for a successful outcome to be achieved. In this study the investigators compared the commonly used Fisher scale with 2 newer radiographic scales for the prediction of v...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/109/8/0199
更新日期:2008-08-01 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::Post-herpetic pain was treated in 12 patients using dorsal root entry zone ( DREZ ) lesions. All patients had failed to receive adequate pain relief from conservative therapy consisting of transcutaneous nerve stimulation, carbamazepine, and/or amitriptyline. Dorsal root entry zone lesions were made to include the inv...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.6.1258
更新日期:1984-06-01 00:00:00
abstract::The key to the successful microvascular decompression of the trigeminal nerve is the maintenance of the separation between the trigeminal nerve and the offending vessel. The authors describe a technique whereby a dural sling is fashioned from the tentorium cerebelli (the anatomy of which is briefly reviewed), which is...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.84.1.0127
更新日期:1996-01-01 00:00:00
abstract::Intracranial occurrence of follicular dendritic cell (FDC) sarcoma, a rare tumor derived from dendritic cells of the lymphoid follicle, has not yet been described. Therefore, the case of a 53-year-old man presenting with an intracranial mass invading the clivus is reported. The diagnosis of FDC sarcoma was confirmed b...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.99.6.1089
更新日期:2003-12-01 00:00:00
abstract::Local cortical cooling for termination of epileptic discharges (EDs) has recently become a focus of research. The authors report on a newly devised cooling system that uses a thermoelectric (Peltier) chip and examine the system's performance in experimental neocortical seizures. Experiments were performed in adult mal...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2006.104.1.150
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:Delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) may result in focal neurological deficits and cerebral infarction, believed to result from critical regional rather than global impairments in cerebral blood flow (CBF). However, the burden of such regional hypoperfusion has not been evaluate...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.3.JNS183041
更新日期:2019-05-31 00:00:00