Abstract:
OBJECTIVE:In daily practice, neurosurgeons face increasing numbers of patients using aspirin (acetylsalicylic acid, ASA). While many of these patients discontinue ASA 7-10 days prior to elective intracranial surgery, there are limited data to support whether or not perioperative ASA use heightens the risk of hemorrhagic complications. In this study the authors retrospectively evaluated the safety of perioperative ASA use in patients undergoing craniotomy for brain tumors in the largest elective cranial surgery cohort reported to date. METHODS:The authors retrospectively analyzed the medical records of 1291 patients who underwent elective intracranial tumor surgery by a single surgeon from 2007 to 2017. The patients were divided into three groups based on their perioperative ASA status: 1) group 1, no ASA; 2) group 2, stopped ASA (low cardiovascular risk); and 3) group 3, continued ASA (high cardiovascular risk). Data collected included demographic information, perioperative ASA status, tumor characteristics, extent of resection (EOR), operative blood loss, any hemorrhagic and thromboembolic complications, and any other complications. RESULTS:A total of 1291 patients underwent 1346 operations. The no-ASA group included 1068 patients (1112 operations), the stopped-ASA group had 104 patients (108 operations), and the continued-ASA group had 119 patients (126 operations). The no-ASA patients were significantly younger (mean age 53.3 years) than those in the stopped- and continued-ASA groups (mean 64.8 and 64.0 years, respectively; p < 0.001). Sex distribution was similar across all groups (p = 0.272). Tumor locations and pathologies were also similar across the groups, except for deep tumors and schwannomas that were relatively less frequent in the continued-ASA group. There were no differences in the EOR between groups. Operative blood loss was not significantly different between the stopped- (186 ml) and continued- (220 ml) ASA groups (p = 0.183). Most importantly, neither hemorrhagic (0.6%, 0.9%, and 0.8%, respectively; p = 0.921) nor thromboembolic (1.3%, 1.9%, and 0.8%; p = 0.779) complication rates were significantly different between the groups, respectively. In addition, the multivariate model revealed no statistically significant predictor of hemorrhagic complications, whereas male sex (odds ratio [OR] 5.9, 95% confidence interval [CI] 1.7-20.5, p = 0.005) and deep-extraaxial-benign ("skull base") tumors (OR 3.6, 95% CI 1.3-9.7, p = 0.011) were found to be independent predictors of thromboembolic complications. CONCLUSIONS:In this cohort, perioperative ASA use was not associated with the increased rate of hemorrhagic complications following intracranial tumor surgery. In patients at high cardiovascular risk, ASA can safely be continued during elective brain tumor surgery to prevent potential life-threatening thromboembolic complications. Randomized clinical trials with larger sample sizes are warranted to achieve a greater statistical power.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Hanalioglu S,Sahin B,Sahin OS,Kozan A,Ucer M,Cikla U,Goodman SL,Baskaya MKdoi
10.3171/2018.12.JNS182483subject
Has Abstractpub_date
2019-04-05 00:00:00pages
1529-1538issue
5eissn
0022-3085issn
1933-0693pii
2018.12.JNS182483journal_volume
132pub_type
杂志文章abstract::A study of the overall management of ruptured posterior fossa aneurysms was conducted over a 1-year period (1993) in five neurosurgical centers in Sweden, serving a population of 6.93 million people. Forty-nine cases were identified and treated. One-third of the patients were in the seventh or eighth decade of life. G...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.1.0033
更新日期:1996-07-01 00:00:00
abstract:OBJECT:The aim of this study was to clarify the clinical outcome of schwannomatosis, a rare condition characterized by multiple nonvestibular schwannomas in the absence of meningiomas, intraspinal ependymomas, and other clinical signs of neurofibromatosis type 2 (NF2). METHODS:Nine patients with schwannomatosis treate...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.89.1.0036
更新日期:1998-07-01 00:00:00
abstract:OBJECT:This study was undertaken to evaluate the association between age at diagnosis, patterns of care, and outcome among elderly individuals with anaplastic astrocytoma (AA) and glioblastoma multiforme (GBM). Methods Using the Surveillance, Epidemiology and End Results database, the authors identified 1753 individual...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/108/4/0642
更新日期:2008-04-01 00:00:00
abstract:OBJECT:Endothelial tight junction (TJ) expression is mostly absent in cerebral cavernous malformations (CMs), which causes increased perilesional erythrocyte and fluid oozing. However, in a subset of CM lesions, foci of preserved TJ staining are observed along endothelial cell contacts. The clinical relevance of this f...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.6.JNS132775
更新日期:2014-09-01 00:00:00
abstract::Excellent results from multiple burr-hole operations for adult moyamoya disease are reported in this study. Ten patients had between one and four burr holes (mean 2.1) drilled in each hemisphere. In four patients new burr holes were added on the opposite side after depression of cerebral blood flow (CBF) was detected ...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.1996.84.3.0468
更新日期:1996-03-01 00:00:00
abstract::Ten cases of meningioma of the pineal region were histologically verified at a single institution during an 8-year period. These represented 0.3% of 3061 intracranial meningiomas, as well as 6.2% of 164 pineal tumors. Patients were predominantly women. Symptoms and signs of increased intracranial pressure were most co...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.4.0586
更新日期:1996-10-01 00:00:00
abstract:OBJECT:During a 5-year period 317 patients presenting with aneurysmal subarachnoid hemorrhage were successfully treated by coil embolization within 30 days of hemorrhage. The authors followed patients to assess the stability of aneurysm occlusion and its longer-term efficacy in protecting patients against rebleeding. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.90.4.0656
更新日期:1999-04-01 00:00:00
abstract::The accuracy of high-resolution ultrasound scans in detecting foreign bodies and hemorrhage within the brain was evaluated by comparison with computerized tomography (CT) scans and gross pathology. The test lesions were blood and foreign bodies consisting of bone, wood, and metal placed in the brain of an experimental...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.3.0304
更新日期:1981-03-01 00:00:00
abstract::The authors reviewed the clinical findings, radiological evaluation, and operative therapy of 39 patients with syringomyelia. Syringoperitoneal (SP) shunting was used in 15 patients and other procedures were used in 24 patients. Follow-up periods ranged from 1 1/2 to 12 years. During the period of this study, metrizam...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.61.3.0531
更新日期:1984-09-01 00:00:00
abstract::The authors describe an intraoperative technique, in which oxycellulose is placed between an aneurysm and its surrounding arteries, allowing a space to be secured for inserting the clip blades without occlusion of the arteries. This method is useful in preserving the blood vessels, especially perforating arteries, aro...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.83.4.0748
更新日期:1995-10-01 00:00:00
abstract:OBJECT:Pure sylvian fissure arteriovenous malformations (AVMs) are vascular malformations confined to the sylvian fissure without parenchymal involvement. Because the branches of the middle cerebral artery are arteries of passage and the margins between the AVM and the insula cortex may be ill defined, many surgeons re...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.92.1.0039
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVES:The objective in the present study was to evaluate the usefulness of cortico-cortical evoked potentials (CCEP) monitoring for the intraoperative assessment of speech function during resection of brain tumors. METHODS:Intraoperative monitoring of CCEP was applied in 13 patients (mean age 34 ± 14 years) durin...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.4.JNS131195
更新日期:2014-10-01 00:00:00
abstract:OBJECT:Telomerase activity is responsible for cell immortality. To examine the role of telomerase in the carcinogenesis of human glioblastomas multiforme (GBMs), the authors studied telomerase activity, telomerase component expression, and telomere lengths in 42 GBM samples. METHODS:In all samples, EGFR and MDM2 ampli...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.93.4.0618
更新日期:2000-10-01 00:00:00
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
doi:10.3171/jns.1980.53.3.0355
更新日期:1980-09-01 00:00:00
abstract::A feasibility study reveals that a standard linear accelerator, with only slight modification, can function in a manner similar to Leksell's multiple cobalt radiation device. A high radiation dose can be delivered to a 1-cm or 0.5-cm volume target with insignificant radiation effect on the surrounding tissue. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.4.0814
更新日期:1984-04-01 00:00:00
abstract::The authors report a case of traumatic femoral nerve palsy caused by a pseudoaneurysm of the iliolumbar artery and a iliacus muscle hematoma. This case report details not only the classic history and physical findings seen in patients such as this one, but also illustrates an unusual source of the hematoma and a discu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.102.2.0382
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:Transsphenoidal surgery is advocated as the first-line management of growth hormone (GH)-secreting adenomas. Although disease control is defined by strict criteria for biochemical remission, the length of follow-up needed is not well defined in literature. In this report, the authors present their long-term r...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.6.JNS191187
更新日期:2019-10-11 00:00:00
abstract:OBJECT:Primary and metastatic neoplasms of the lumbosacral junction frequently pose a complex problem for the surgical management and stabilization of the spine because of the anatomical and biomechanical factors of this transition zone between spine and pelvis. The authors have used a modification of the Galveston tec...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2000.92.1.0061
更新日期:2000-01-01 00:00:00
abstract::Two patients with chronic spinal subdural hematomas are described. Both had a fluctuating clinical course, not previously documented in the literature. Surgical evacuation resulted in almost complete recovery. The pathogenesis of spinal subdural hematoma is discussed and the pertinent literature is reviewed. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.4.0636
更新日期:1985-10-01 00:00:00
abstract:OBJECT:A methodology for dosimetric verification of radiation therapy plans was developed and implemented. Dosimetric accuracy of clinically active intensity-modulated radiotherapy (IMRT) and intensity-modulated radiosurgery (IMRS) programs was assessed using this methodology. METHODS:The methodology included several ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.101.supplement 3.0356
更新日期:2004-11-01 00:00:00
abstract::Bilateral trigeminal neuralgia occurred in 32 (11.9%) of 269 consecutive patients who were treated with radiofrequency electrocoagulation (RFE). This is a higher incidence than has been reported before and may be explained by the prospective nature of the present study, the long follow-up period, and the inclusion of ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.67.1.0044
更新日期:1987-07-01 00:00:00
abstract:OBJECTIVE:Coverage of the anterior spinal artery (ASA) ostia is a source of considerable consternation regarding flow diversion (FD) in vertebral artery (VA) aneurysms due to cord supply. The authors sought to assess the association between coverage of the ASA, posterior spinal artery (PSA), or lateral spinal artery (L...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.1.JNS193293
更新日期:2020-03-27 00:00:00
abstract::Forty-five children harboring brain-stem tumors were treated at the University of California, San Francisco, between 1969 and 1979. Pathological diagnoses were made in 19 patients. All patients received radiation therapy (RT). Thirteen patients received chemotherapy before, during, or immediately after RT. Twenty-four...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.6.0721
更新日期:1981-06-01 00:00:00
abstract::OBJECTIVEAwake craniotomies have become a feasible tool over time to treat brain tumors located in eloquent regions. Different techniques have been applied in neurooncology centers. Both "asleep-awake-asleep" (asleep) and "conscious sedation" were used subsequently at the authors' neurosurgical department. Since 2013,...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.7.JNS171312
更新日期:2018-11-01 00:00:00
abstract::Verbal memory deficits remain a major complication of dominant hemisphere temporal lobectomy for epilepsy. The extent of this deficit was assessed preoperatively and 1 month and 1 year postoperatively with the Wechsler Verbal Memory Scale (WMSV) in 14 adults undergoing left temporal lobectomy. Intraoperative localizat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.1.0101
更新日期:1985-01-01 00:00:00
abstract::The authors report a case of transverse myelitis caused by Schistosoma mansoni. Although this is a treatable disease if diagnosed in the early stage, it is very rarely seen in developed countries and can result in complications if diagnosis is delayed. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.6.1065
更新日期:1995-06-01 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::Adults and children with low-grade gliomas often present with medically refractory epilepsy. Currently, controversy exists regarding the need for intraoperative electrocorticography (ECoG) to identify and, separately, resect seizure foci versus tumor removal alone to yield maximum seizure control in this patient popul...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.79.1.0062
更新日期:1993-07-01 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