Abstract:
OBJECTIVE:Meningiomas at the falcotentorial junction represent a rare subgroup of complex meningiomas. Debate remains regarding the appropriate treatment strategy for and optimal surgical approach to these tumors, and surgical outcomes have not been well described in the literature. The authors reviewed their single-institution experience in the management, approach selection, and outcomes for patients with falcotentorial meningiomas. METHODS:From the medical records, the authors identified all patients with falcotentorial meningiomas treated with resection at the Barrow Neurological Institute between January 2007 and October 2017. Perioperative clinical, surgical, and radiographic data were retrospectively collected. For patients who underwent the supracerebellar infratentorial approach, the tentorial angle was defined as the angle between the line joining the nasion with the tuberculum sellae and the tentorium in the midsagittal plane. RESULTS:Falcotentorial meningiomas occurred in 0.97% (14/1441) of the patients with meningiomas. Most of the patients (13/14) were female, and the mean patient age was 59.8 ± 11.3 years. Of 17 total surgeries (20 procedures), 11 were single-stage primary surgeries, 3 were two-stage primary surgeries (6 procedures), 2 were reoperations for recurrence, and 1 was a reoperation after surgery had been aborted because of brain edema. Hydrocephalus was present in 5 of 17 cases, 4 of which required additional treatment. Various approaches were used, including the supracerebellar infratentorial (4/17), occipital transtentorial/transfalcine (4/17), anterior interhemispheric transsplenial (3/17), parietal transventricular (1/17), torcular (2/17), and staged supracerebellar infratentorial and occipital transtentorial/transfalcine (3/17) approaches. Of the 17 surgeries, 9 resulted in Simpson grade IV resection, and 3, 1, and 4 surgeries resulted in Simpson grades III, II, and I resection, respectively. The tentorial angle in cases with Simpson grade I resection was significantly smaller than in those with an unfavorable resection grade (43.3° ± 4.67° vs 54.0° ± 3.67°, p = 0.04). Complications occurred in 10 of 22 approaches (17 surgeries) and included visual field defects (6 cases, 2 permanent and 4 transient), hemiparesis (2 cases), hemidysesthesia (1 case), and cerebellar hematoma (1 case). CONCLUSIONS:Falcotentorial meningiomas are challenging lesions. A steep tentorial angle is an unfavorable preoperative radiographic factor for achieving maximal resection with the supracerebellar infratentorial approach. Collectively, the study findings show that versatility is required to treat patients with falcotentorial meningiomas and that treatment goals and surgical approach must be individualized to obtain optimal surgical results.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Zhao X,Belykh E,Przybylowski CJ,Borba Moreira L,Gandhi S,Tayebi Meybodi A,Cavallo C,Valli D,Wicks RT,Nakaji Pdoi
10.3171/2019.4.JNS19208subject
Has Abstractpub_date
2019-08-02 00:00:00pages
1-12eissn
0022-3085issn
1933-0693pii
2019.4.JNS19208pub_type
杂志文章abstract::This is the report of a case of vertebral sarcoidosis causing collapse of cervical vertebrae with resulting tetraplegia. The patient was successfully treated by decompression and subsequent anterior removal of the invaded three vertebral bodies, followed by an autologous bone graft. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.5.0665
更新日期:1979-05-01 00:00:00
abstract::Traction injury to the optic nerve and vasa nervorum is the suggested etiology for monocular blindness following trivial frontal trauma. Holographic interferometry was used on human skulls to demonstrate orbital deformation in response to nondestructive frontal loading. The findings suggest an additional mechanism for...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.55.6.0963
更新日期:1981-12-01 00:00:00
abstract::A previous undescribed cause of ventriculoperitoneal shunt malfunction is presented. Limitation of abdominal excursion by a spica cast used to correct congenital hip dislocation reduced cerebrospinal fluid flow through a shunt. This easily correctable cause of "shunt failure" nearly resulted in replacement of a workin...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.46.6.0830
更新日期:1977-06-01 00:00:00
abstract:OBJECTIVE:Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is known to reduce motor symptoms of Parkinson's disease (PD). The effects of DBS on various nonmotor symptoms often differ from patient to patient. The factors that determine whether or not a patient will respond to treatment have not been elucida...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.6.JNS201126
更新日期:2020-10-09 00:00:00
abstract::In this report, the authors describe a case in which the patient began to experience a supernumerary phantom arm after she received motor cortex stimulation for central pain. The patient had a history of right thalamocapsular stroke. It is speculated that the motor cortex activation triggered a response in the patient...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.91.1.0121
更新日期:1999-07-01 00:00:00
abstract::Patients with medically intractable temporal lobe epilepsy are potential candidates for anterior temporal lobectomy (ATL), in which epileptogenic temporal lobe tissue is localized and surgically removed. This surgical approach can eliminate or drastically reduce seizures in the majority of patients. The authors used a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.87.1.0020
更新日期:1997-07-01 00:00:00
abstract::OBJECT This study explored whether there were differences between the autoimmune disease prevalence rates in unilateral and bilateral moyamoya disease (MMD). METHODS The authors performed a retrospective review of data obtained from the medical records of their hospital, analyzing and comparing the clinical characteri...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.4.JNS142936
更新日期:2016-05-01 00:00:00
abstract::Up to now, navigated transcranial magnetic stimulation (nTMS) has been used for motor mapping in the vicinity of rolandic brain lesions. Recently, nTMS has also been suggested to be useful in mapping human language areas. The authors describe the case of a left-handed patient with a left-side glioblastoma within the...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.9.JNS121053
更新日期:2013-01-01 00:00:00
abstract::Mannitol is widely considered the hyperosmolar therapy of choice in routine neurosurgical practice for the reduction of intracranial pressure (ICP). The authors present a unique case of a patient with a large meningioma treated with mannitol, in which mannitol accumulation within the tumor and its surrounding parenchy...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/108/5/1010
更新日期:2008-05-01 00:00:00
abstract::Extensive histological and immunohistochemical studies were performed to elucidate the histopathogenesis of exencephaly induced in chick embryo as an experimental model. The findings were compared with those identified in a chick myeloschisis experimental model and in human autopsy cases. The experimental model of exe...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.72.3.0450
更新日期:1990-03-01 00:00:00
abstract:OBJECT:The authors have previously reported that the results of using cadaveric fibula and locking plate (CF/LP) fusion following anterior cervical discectomy (ACD) for cervical spondylotic radiculopathy and myelopathy are superior to those obtained using autologous iliac crest (AIC) grafts in the short term. The long-...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2001.95.1.0043
更新日期:2001-07-01 00:00:00
abstract::A number of reports have shown that epidural or intrathecal administration of morphine provides pain relief. Since February, 1981, the authors have used an implantable pump and epidural catheter for continuous epidural morphine infusion in patients with chronic pain. This system has functioned well, without respirator...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1982.56.6.0803
更新日期:1982-06-01 00:00:00
abstract::A patient with findings of bilateral cortical blindness and a unilateral carotid bruit is reported. A persistent trigeminal artery allowed emboli from a unilateral ulcerated internal carotid plaque to affect the visual cortex bilaterally. The angiographic findings and a brief discussion of this anomalous artery are pr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.52.5.0709
更新日期:1980-05-01 00:00:00
abstract:OBJECT:The authors analyzed the role of endoscopic third ventriculostomy (ETV) as a primary treatment for hydrocephalus and also as an alternative to shunt revision for malfunctioning and infected ventriculoperitoneal (VP) shunts. METHODS:A retrospective analysis of clinical notes, operation records, and magnetic reso...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2005.103.5.0393
更新日期:2005-11-01 00:00:00
abstract::A transoral, transsphenoidal microsurgical technique for exposing the pituitary stalk and gland of the rhesus monkey is described and illustrated. The technique has proved to be a safe and practical method for performing a variety of pituitary operations in a total of 37 animals. The procedures have included complete ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.5.0663
更新日期:1977-11-01 00:00:00
abstract::Cavernous hemangiomas of the orbit are benign vascular growths that commonly occur in adults and account for 6% of all intraorbital tumors. Multifocal intraorbital cavernous hemangiomas are quite rare. The reported incidence of arachnoid cysts accounts for only 1% of lesions that occupy intracranial space, and they ar...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2005.103.5.0454
更新日期:2005-11-01 00:00:00
abstract::With the goal of developing a practical method of performing noninvasive measurements of flow in cerebrospinal fluid (CSF) shunts, transcutaneous thermal convection CSF shunt flow measurement was investigated using dimensional analysis, numerical modeling, and bench testing. Using appropriate manufacturing practices a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2005.103.4.0366
更新日期:2005-10-01 00:00:00
abstract::The cases of 127 consecutive patients with subarachnoid hemorrhage (SAH), in whom cerebral panangiography revealed no cause for the bleeding nor any sign of an intraparenchymatous hemorrhage, were reviewed in a study of the long-term prognosis and the possible prognostic factors in this condition. Data for all 127 pat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.3.0349
更新日期:1985-09-01 00:00:00
abstract::To characterize the temporal course of radiosurgical lesions, 19 cats were irradiated in an animal linear accelerator radiosurgical device. The animals were followed clinically and, at 3.5, 6, 12, 18, 23, 29, and 63 weeks, were studied with gadolinium-enhanced magnetic resonance (MR) imaging. They were then sacrificed...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.80.6.1046
更新日期:1994-06-01 00:00:00
abstract:OBJECT:In this paper the authors introduce a novel use of magnetoencephalography (MEG) for noninvasive mapping of language-specific cortex in individual patients and in healthy volunteers. METHODS:The authors describe a series of six experiments in which normative MEG data were collected and the reliability, validity,...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.90.1.0085
更新日期:1999-01-01 00:00:00
abstract:OBJECT:Patients with fusiform aneurysms can present with subarachnoid hemorrhage (SAH), mass effect, ischemia, or unrelated symptoms. The absence of an aneurysm neck impedes the direct application of a clip and endovascular coil deployment. To evaluate the effects of their treatments, the authors retrospectively analyz...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2007.106.5.855
更新日期:2007-05-01 00:00:00
abstract::The putative mechanism of vagus nerve stimulation (VNS) for medically refractory epilepsy is desynchronization of hippocampal and thalamocortical circuitry; however, the nature of the dose-response relationship and temporal dynamics is poorly understood. For greater elucidation, a study in a nonepileptic rat model was...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.6.JNS18735
更新日期:2018-11-01 00:00:00
abstract:OBJECT:The authors conducted a study to determine the results of decompressive surgery without fusion in selected patients who presented with radicular compression syndromes caused by degenerative lumbar spondylolisthesis and in whom there was no evidence of hypermobility on flexion-extension radiographs. METHODS:The ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.97.3.0281
更新日期:2002-10-01 00:00:00
abstract::The intrasellar pressure has been studied in a consecutive series of 24 patients undergoing transsphenoidal surgery for pituitary adenoma. The mean intrasellar pressure for the group was 23 +/- 2.5 mm Hg (+/- standard error of the mean), with a mean pulse pressure of 3.5 +/- 1 mm Hg. The waveform partly resembled the ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.67.2.0192
更新日期:1987-08-01 00:00:00
abstract:OBJECT:Based on data from primate experiments it is known that rotational acceleration in the sagittal plane and in a forward direction is most likely to produce acute subdural hematomas due to bridging vein rupture. For protection against these lesions, knowledge of rotational acceleration tolerance levels in humans i...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2006.104.6.950
更新日期:2006-06-01 00:00:00
abstract:OBJECT:The authors describe a method that utilizes an image-guided robotic radiosurgical apparatus (the CyberKnife) for treatment of cerebral arteriovenous malformations (AVMs). This procedure required the development of an original technique that allows a high degree of automation. METHODS:Angiographic images were im...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.10.JNS08749
更新日期:2009-10-01 00:00:00
abstract:OBJECT:Irinotecan (CPT-11), a topoisomerase I inhibitor, is a cytotoxic agent with activity against malignant gliomas and other tumors. After systemic delivery, CPT-11 is converted to its active metabolite, SN-38, which displays significantly higher cytotoxic potency. However, the achievement of therapeutically effecti...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.2.JNS09719
更新日期:2011-03-01 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:OBJECT:The aim of this study was to identify patients likely to develop CSF leaks after vestibular schwannoma surgery using a retrospective analysis for the identification of risk factors. METHODS:Between January 2001 and December 2006, 420 patients underwent retrosigmoidal microsurgical tumor removal in a standardize...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2009.2.JNS081380
更新日期:2009-10-01 00:00:00
abstract:OBJECT:Ventricular infection after ventriculostomy placement carries a high mortality rate. Responding to ventriculostomy infection rates, a multidisciplinary performance improvement team was formed, a comprehensive protocol for ventriculostomy placement was developed, and the efficacy was evaluated. METHODS:A best-pr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.11.JNS121336
更新日期:2013-03-01 00:00:00