Abstract:
OBJECTIVE:The impact of FDA approval of flow-diversion technology for the treatment of supraclinoid internal carotid artery aneurysms and the publication of the Carotid Occlusion Surgery Study, both of which occurred in 2011, on the utilization of extracranial-intracranial (EC-IC) bypasses is not known. METHODS:The National Inpatient Sample (NIS) was queried for hospitalizations for EC-IC bypass performed from 2008 to 2016. Diagnoses of interest included an unruptured intracranial aneurysm (UIA), subarachnoid hemorrhage (SAH), carotid occlusive disease (COD), and moyamoya disease. The authors assessed trends in EC-IC bypass utilization for these diagnoses and the incidence of adverse discharges, defined as discharge to locations other than home, and the rate of mortality. RESULTS:A total of 1640 EC-IC bypass procedures were performed at 558 hospitals during the study period, with 1148 procedures at 448 hospitals performed for a diagnosis of interest. The most frequent surgical indication was moyamoya disease (65.7%, n = 754), followed by COD (23.2%, n = 266), SAH (3.2%, n = 37), and a UIA (7.9%, n = 91). EC-IC bypass utilization for COD decreased from 0.21 per 100 admissions of COD in 2010 to 0.09 per 100 admissions in 2016 (p = 0.023). The frequency of adverse discharges increased during the study period from 22.3% of annual admissions in 2008 to 31.2% in 2016 (p = 0.030) when analysis was limited to procedures performed for a diagnosis of interest. Per volume, the top 5th percentile of hospitals, on average, performed 18.4 procedures (SD 13.2) per hospital during the study period, compared to 1.3 procedures (SD 1.3) that were performed in hospitals within the bottom 95th percentile. The rate of adverse discharges was higher at low-volume institutions when compared to that at high-volume institutions (33.8% vs 28.7%; p = 0.029). Over the study period, the authors noted a trend toward a reduced percentage of total surgical volume performed at high-volume hospitals (p < 0.001). CONCLUSIONS:The authors observed a decrease in the utilization of EC-IC bypass for COD during the study period. An increase in the rate of adverse discharges was also noted, coinciding with more procedures being performed at lower-volume centers.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Alvi MA,Rinaldo L,Kerezoudis P,Rangel-Castilla L,Bydon M,Cloft H,Lanzino Gdoi
10.3171/2019.8.JNS191401subject
Has Abstractpub_date
2019-11-15 00:00:00pages
1-9eissn
0022-3085issn
1933-0693pii
2019.8.JNS191401pub_type
杂志文章abstract:OBJECT:The aim of this study was to describe the similarity of configuration between the arachnoid complex in the posterior half of the incisural space and the Liliequist membrane. METHODS:Microsurgical dissection and anatomical observation were performed in 20 formalin-fixed adult cadaver heads. The origin, distribut...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.3.JNS132206
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:The optimal margin size in postoperative stereotactic radiosurgery (SRS) for brain metastases is unknown. Herein, the authors investigated the effect of SRS planning target volume (PTV) margin on local recurrence and symptomatic radiation necrosis postoperatively. METHODS:Records of patients who received pos...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.9.JNS171735
更新日期:2018-04-20 00:00:00
abstract::Of 410 patients with refractory herniated lumbar disc disease treated with intradiscal collagenase, 82 (20%) did not respond to enzyme treatment and subsequently underwent surgery. Failure to improve in 6 to 8 weeks was the predominant cause for surgical intervention (53 patients). Increased pain (18 patients), progre...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.4.0613
更新日期:1986-04-01 00:00:00
abstract::Clinical results of an extra-intracranial arterial bypass (EIAB) procedure for cerebral ischemia are assessed in 65 patients. The 5-year-study suggests that the EIAB procedure has a protective effect against further clinically significant cerebrovascular accidents in properly selected patients. Correlation with angiog...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.44.3.0313
更新日期:1976-03-01 00:00:00
abstract::Obstructive hydrocephalus complicating foramen magnum decompression (FMD) for a Chiari malformation (CM) Type I is rare. Two female patients (17 and 55 years old) presented with strain-related headaches. In both cases magnetic resonance (MR) imaging studies confirmed a CM Type I, which was accompanied by syringomyelia...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.2005.103.4.0752
更新日期:2005-10-01 00:00:00
abstract:OBJECT:The authors retrospectively analyzed data on brainstem gangliogliomas treated in their department and reviewed the pertinent literature to foster understanding of the preoperative characteristics, management, and clinical outcomes of this disease. METHODS:In 2006, the authors established a database of treated l...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.1.JNS121323
更新日期:2013-04-01 00:00:00
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
doi:10.3171/jns.2003.99.6.1018
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:Safety-net hospitals deliver care to a substantial share of vulnerable patient populations and are disproportionately impacted by hospital payment reform policies. Complex elective procedures performed at safety-net facilities are associated with worse outcomes and higher costs. The effects of hospital safety...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.10.JNS18103
更新日期:2019-02-22 00:00:00
abstract::OBJECTIVE Different surgical routes have been used over the years to achieve adequate decompression of the optic nerve in its canal including, more recently, endoscopic approaches performed either through the endonasal corridor or the transorbital one. The present study aimed to detail and quantify the amount of bone ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.8.JNS16566
更新日期:2017-07-01 00:00:00
abstract::In preparing this paper, the authors reviewed their experiences with four cases of T1-2 disc herniation as well as the medical literature on the subject. Intervertebral thoracic disc herniations are uncommon and high thoracic disc herniations are rare. In the upper third of the thoracic spine, T1-2 is the most common ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1998.88.1.0148
更新日期:1998-01-01 00:00:00
abstract::The variability of reflex responses during selective dorsal rhizotomy was studied in eight children between the ages of 3 and 7 years. For a given dorsal root or rootlet, the electrical reflex threshold and response varied considerably when observed over several minutes. Changes in electrode pressure, mechanical disse...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.79.3.0346
更新日期:1993-09-01 00:00:00
abstract::Coccidioidomycosis is an infection originating in the San Joaquim Valley of southern California, but now seen with increasing frequency throughout southern California and the southwestern United States. Central nervous system involvement is usually manifested as meningitis. The authors present the case of a young man ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.80.1.0140
更新日期:1994-01-01 00:00:00
abstract:OBJECT:The prognostic significance of tumor grade and resection and the efficacy of prophylactic radiation remain controversial in the management of intracranial ependymoma. The outcomes in patients with intracranial ependymoma treated at the Kyoto University Hospital were reviewed retrospectively, and prognostic signi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.103.1.0031
更新日期:2005-07-01 00:00:00
abstract::The acquired immune deficiency syndrome (AIDS) is a recently described T-cell deficiency predisposing patients to a spectrum of opportunistic infections. Kaposi's sarcoma, and other neoplasms. It appears primarily among homosexual males and intravenous drug abusers, but is now being observed in other groups as well. T...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.6.0994
更新日期:1983-12-01 00:00:00
abstract:OBJECT:There is no description of the change in the posterior cerebral artery (PCA) in the diagnostic criteria of moyamoya disease (MMD). However, PCAs are often involved in the clinical setting, and an understanding of the significance of PCA lesions is therefore of great importance when evaluating the disease progres...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.6.JNS122099
更新日期:2013-10-01 00:00:00
abstract:OBJECT:Brainstem hemangioblastomas are frequently encountered in patients with von Hippel-Lindau (VHL) disease. These tumors can cause significant morbidity, and their optimal management has not been defined. To better define the outcome and management of these tumors, the authors analyzed the long-term results in pati...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.9.JNS10839
更新日期:2011-05-01 00:00:00
abstract::Intraventricular rupture of a colloid cyst is a rare phenomenon and has been proposed as a mechanism for sudden death in patients with colloid cysts. Imaging of a colloid cyst during rupture has been described in only one other instance. The authors report a highly unusual case of a 53-year-old man who presented with ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.5.JNS153015
更新日期:2017-06-01 00:00:00
abstract::Moment-to-moment control of blood pressure is important in the management of the neurosurgical patient. The ideal agent to control blood pressure or induce hypotension should be non-toxic, maintain cerebrovascular autoregulation, and not alter cardiac output or change intracranial pressure. Intravenous nitroglycerin h...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.48.5.0704
更新日期:1978-05-01 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:Assessing academic productivity through simple quantification may overlook key information, and the use of statistical enumeration of academic output is growing. The h index, which incorporates both the total number of publications and the citations of those publications, has been recently proposed as an objecti...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.10.JNS08978
更新日期:2009-08-01 00:00:00
abstract::Pilomyxoid astrocytomas have been identified as a more aggressive variant of pilocytic astrocytomas that occur in infants and in young children. These tumors are characterized by a perivascular arrangement of pilocytic cells that has a monomorphous architecture with uniform, elongated bipolar cells loosely ranged with...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.2003.99.2.0416
更新日期:2003-08-01 00:00:00
abstract::In the central nervous system, recurrence of intracranial Masson's vegetant intravascular hemangioendothelioma (MVIH) is rare. To the authors' knowledge, only three recurrent intracranial cases have been reported. The authors report the case of a 75-year-old woman with a recurrent left-sided cerebellopontine angle and...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1999.91.2.0308
更新日期:1999-08-01 00:00:00
abstract::A new method was developed for the clinical assessment of motor function in rats after experimental spinal cord injury. The method consists of placing the animal on an inclined plane which can be adjusted to provide a slope of varying grade, and then assessing the maximum angle of the plane at which the animal can mai...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.4.0577
更新日期:1977-10-01 00:00:00
abstract::OBJECTIVE Improvement in treatment outcome for patients with glioblastoma multiforme (GBM) requires a multifaceted approach due to dysregulation of numerous signaling pathways. The murine double minute 2 (MDM2) protein may fulfill this requirement because it is involved in the regulation of growth, survival, and invas...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.1.JNS152513
更新日期:2017-02-01 00:00:00
abstract:OBJECT:Surgical or endovascular occlusion of the parent artery proximal to an aneurysm has been recommended for treatment of dissecting aneurysms of the intracranial posterior circulation. However, dissecting aneurysms may rupture even after proximal occlusion because distal progression of thrombus is necessary to occl...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.90.5.0853
更新日期:1999-05-01 00:00:00
abstract:OBJECT:A growing number of published studies have recently demonstrated the role of resection in overall survival (OS) for patients with gliomas. In this retrospective study, the authors objectively investigated the role of the extent of resection (EOR) in OS in patients with low-grade gliomas (LGGs). METHODS:Between ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.8.JNS12393
更新日期:2012-12-01 00:00:00
abstract::The authors describe a new headframe system, by which a variety of instruments, such as brain retractors, suction tubes, mirrors, forks, armrests, and cotton-sheet trays, can be simultaneously supported. This frame enables neurosurgeons to perform operations with greater ease and fewer problems. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.71.6.0945
更新日期:1989-12-01 00:00:00
abstract:OBJECT:The goal of this study was to determine whether the late neuromagnetic field elicited by simple speech sounds, which is detected by magnetoencephalography, may be used to estimate hemispheric dominance for language and to guide or constrain the intraoperative search for essential language sites. If sufficiently ...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.2001.94.3.0445
更新日期:2001-03-01 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::A consecutive series of 32 adult patients with chronic subdural hematoma was studied in respect to postoperative cerebral reexpansion (reduction in diameter of the subdural space) after burr-hole craniostomy and closed-system drainage. Patients with high subdural pressure showed the most rapid brain expansion and clin...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.55.3.0390
更新日期:1981-09-01 00:00:00