Fully endoscopic microvascular decompression for hemifacial spasm.


OBJECTIVE:Hemifacial spasm (HFS) is characterized by involuntary tonic and/or clonic contractions of facial nerve muscles. Fully endoscopic microvascular decompression (E-MVD) for HFS has not been widely adopted. This paper aims to illustrate the safety and efficacy of the fully endoscopic technique for HFS treatment. METHODS:The authors conducted a single-center retrospective study of 27 patients (28 separate E-MVD cases; 1 patient had bilateral E-MVD) diagnosed with HFS who underwent fully E-MVD from January 2013 to October 2016. Intraoperative brainstem auditory evoked potentials and lateral spread resolution were reviewed. Outcome was based on the clinical status of the patient at the last contact point with the senior author. Complications were categorized as facial weakness, hearing loss, ataxia, dysphagia, or any adverse event able to be attributed to the surgical procedure. RESULTS:HFS was relieved either completely or partially in the majority of cases (24 of 28, 85.7%). Of the 28 separate procedures, 17 (60.7%) resulted in complete resolution of symptoms, 4 (14.3%) resulted in near-complete resolution, 2 (7.1%) resulted in 50% reduction of symptoms, 1 (3.6%) resulted in minimal reduction, and 4 (14.3%) resulted in no relief. Of the 27 patients, 26 (96%) had no permanent postoperative complications. In multivariate logistic regression, the best predictor of greater than 50% resolution of spasm was resolution of intraoperative lateral spread response. CONCLUSIONS:A fully E-MVD for HFS provides a safe and comprehensive view of the neurovascular conflict. Exclusive use of the endoscope in MVD is both safe and feasible in the treatment of HFS. Attention to lateral spread response monitoring remains an integral part of comprehensive neurosurgical management.


J Neurosurg


Journal of neurosurgery


Flanders TM,Blue R,Roberts S,McShane BJ,Wilent B,Tambi V,Petrov D,Lee JYK




Has Abstract


2018-10-05 00:00:00














  • A microsurgical study of the anatomy and course of the ophthalmic artery and its possibly dangerous anastomoses.

    abstract:OBJECT:The authors studied the microsurgical anatomy of the ophthalmic artery (OphA), paying particular attention to its possibly dangerous anastomoses with the middle meningeal artery (MMA). METHODS:The microsurgical anatomy of the OphA and its anastomoses with the MMA were studied in 14 vessels from seven adult cada...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Perrini P,Cardia A,Fraser K,Lanzino G

    更新日期:2007-01-01 00:00:00

  • Long-term visual outcome after microsurgical removal of occipital lobe cavernomas.

    abstract:OBJECT:Cavernomas in the occipital lobe are relatively rare. Because of the proximity to the visual cortex and incoming subcortical tracts, microsurgical removal of occipital cavernomas may be associated with a risk of visual field defects. The goal of the study was to analyze long-term outcome after operative treatmen...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Kivelev J,Koskela E,Setälä K,Niemelä M,Hernesniemi J

    更新日期:2012-08-01 00:00:00

  • Histopathology of experimental hematomyelia.

    abstract::The pathology of hematomyelia was examined in 35 rats following the stereotactic injection of 2 microliters blood into the dorsal columns of the thoracic spinal cord. This experimental model produced a small ball-hemorrhage without associated neurological deficits or significant tissue injury. Histological sections of...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Milhorat TH,Adler DE,Heger IM,Miller JI,Hollenberg-Sher JR

    更新日期:1991-12-01 00:00:00

  • Enhanced expression of proapoptotic and autophagic proteins involved in the cell death of glioblastoma induced by synthetic glycans.

    abstract:OBJECT:Glioblastoma is the most aggressive malignant brain tumor, and overall patient survival has not been prolonged even by conventional therapies. Previously, the authors found that chemically synthesized glycans could be anticancer agents against growth of a series of cancer cells. In this study, the authors examin...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Faried A,Arifin MZ,Ishiuchi S,Kuwano H,Yazawa S

    更新日期:2014-06-01 00:00:00

  • Clinical significance of positive cranial bone flap cultures and associated risk of surgical site infection after craniotomies or craniectomies.

    abstract:OBJECT:The risk of surgical site infection (SSI) after craniotomies or craniectomies in patients in whom contaminated bone flaps have been reimplanted has not been determined. The objectives of this study were to identify the prevalence of bone flaps with positive cultures--especially those contaminated with Propioniba...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Chiang HY,Steelman VM,Pottinger JM,Schlueter AJ,Diekema DJ,Greenlee JD,Howard MA 3rd,Herwaldt LA

    更新日期:2011-06-01 00:00:00

  • Acquired hemophilia, meningioma, and diphenylhydantoin therapy.

    abstract::A patient is reported in whom a meningioma of the lateral one-third of the sphenoid ridge was completely removed and long-term prophylaxis for seizures with diphenylhydantoin was prescribed. One and a half years later, a powerful inhibitor developed that specifically neutralized Factor VIII, the antihemophilic factor,...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: O'Reilly RA,Hamilton RD

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  • Methylprednisolone and neurological function 1 year after spinal cord injury. Results of the National Acute Spinal Cord Injury Study.

    abstract::A multi-center double-blind randomized clinical trial was conducted by the National Acute Spinal Cord Injury Study Group to examine the efficacy of high-dose methylprednisolone (1000-mg bolus and 1000 mg daily thereafter for 10 days) compared with that of a standard dose (100-mg bolus and 100 mg daily for 10 days). No...

    journal_title:Journal of neurosurgery

    pub_type: 临床试验,杂志文章,随机对照试验


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  • Deep brain stimulation in movement disorders: stereotactic coregistration of two-dimensional electrical field modeling and magnetic resonance imaging.

    abstract:OBJECT:Adjusting electrical parameters used in deep brain stimulation (DBS) for dystonia remains time consuming and is currently based on clinical observation alone. The goal of this study was to visualize electrical parameters around the electrode, to correlate these parameters with the anatomy of the globus pallidus ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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  • A frameless stereotaxic integration of computerized tomographic imaging and the operating microscope.

    abstract::A computer-based system has been developed for the integration and display of computerized tomography (CT) image data in the operating microscope in the correct perspective without requiring a stereotaxic frame. Spatial registration of the CT image data is accomplished by determination of the position of the operating...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Roberts DW,Strohbehn JW,Hatch JF,Murray W,Kettenberger H

    更新日期:1986-10-01 00:00:00

  • Assessment of necrotic core with intraplaque hemorrhage in atherosclerotic carotid artery plaque by MR imaging with 3D gradient-echo sequence in patients with high-grade stenosis. Clinical article.

    abstract:OBJECT:The aim of this study was to assess the histopathological differences between advanced atherosclerotic carotid artery (CA) plaques with signal hyperintensity on T1-weighted MR images and those without, focusing on necrotic core size and intraplaque hemorrhage (IPH). METHODS:Thirty-five patients scheduled for ca...

    journal_title:Journal of neurosurgery

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    authors: Hishikawa T,Iihara K,Yamada N,Ishibashi-Ueda H,Miyamoto S

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    abstract:OBJECT:The aim of this study was to assess the diagnostic yield of imaging tests performed in patients in whom the cause of subarachnoid hemorrhage (SAH) had not been demonstrated on initial angiography. METHODS:By reviewing medical records of 806 patients with SAH who had been admitted during a 6.5-year period, the a...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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    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


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    abstract::Rapid growth and diffuse brain infiltration are hallmarks of malignant gliomas. The underlying molecular pathomechanisms of these tumors, however, remain to be determined. The authors present a novel glioma invasion model that allows researchers to monitor consecutively tumor cell proliferation and migration in an org...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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    abstract:OBJECT:Complete avulsion traumatic brachial plexus injuries (BPIs) can be treated using nerve and musculoskeletal reconstruction procedures. However, these interventions are most viable within certain timeframes, and even then they cannot restore all lost function. Little is known about how patients make decisions rega...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Franzblau LE,Maynard M,Chung KC,Yang LJ

    更新日期:2015-06-01 00:00:00

  • Reliability of left and right indicators in CT scanning of the head. Case report.

    abstract::A case is described in which incorrect preliminary programming of a computerized tomography (CT) machine caused transposition of the left- and right-side indicators in a CT scan, which led to craniotomy on the normal side. The possible mechanism for this is incorrect pre-scan programming of the CT scanner with respect...

    journal_title:Journal of neurosurgery

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    更新日期:1987-08-01 00:00:00

  • Spinal cord injury.

    abstract:OBJECT:It is known that the spinal cord can sustain traumatic injury without associated injury of the spinal column in some conditions, such as a flexible spinal column or preexisting narrowed spinal canal. The purpose of this study was to characterize the clinical features and to understand the mechanisms in cases of ...

    journal_title:Journal of neurosurgery

    pub_type: 评论,信件


    authors: Bhatoe HS

    更新日期:2001-04-01 00:00:00

  • Lateral supracerebellar infratentorial approach for microsurgical resection of large midline pineal region tumors: techniques to expand the operative corridor.

    abstract::Pineal region tumors pose certain challenges in regard to their resection: a deep surgical field, associated critical surrounding neurovascular structures, and narrow operative working corridor due to obstruction by the apex of the culmen. The authors describe a lateral supracerebellar infratentorial approach that was...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Kulwin C,Matsushima K,Malekpour M,Cohen-Gadol AA

    更新日期:2016-01-01 00:00:00

  • Intraoperative transdural functional mapping. Technical note.

    abstract::During craniotomy for supratentorial intraparenchymal space-occupying lesions, with the patient either under general anesthesia or awake, a smaller durotomy designed to expose only the region of resection may be desirable because of brain swelling. Similarly, during repeat craniotomy or craniotomy following cerebral i...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Silbergeld DL

    更新日期:1994-04-01 00:00:00

  • Transcranial approach to the orbit: microsurgical anatomy.

    abstract::An anatomical study of three microsurgical intraorbital routes to the optic nerve and orbital apex, which can be reached through a fronto-orbital craniotomy, was conducted on cadaver specimens. The structures that could be exposed via the medial, central, or lateral approaches directed through the orbital roof were de...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Natori Y,Rhoton AL Jr

    更新日期:1994-07-01 00:00:00

  • Poststroke fixed dystonia of the foot relieved by chronic stimulation of the posterior limb of the internal capsule.

    abstract::The authors report the case of an adult patient with irreducible fixed dystonia (inward rotation) of the right foot that arose after cardioembolic ischemia of the left putamen and globus pallidus externus. Given the resistance of such symptomatology to all of the attempted conservative treatments (including botulinum ...

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Pollock BE,Stafford SL,Link MJ,Garces YI,Foote RL

    更新日期:2013-09-01 00:00:00

  • Dorsal component of the superior longitudinal fasciculus revisited: novel insights from a focused fiber dissection study.

    abstract:OBJECTIVE:The aim of this study was to investigate the anatomical consistency, morphology, axonal connectivity, and correlative topography of the dorsal component of the superior longitudinal fasciculus (SLF-I) since the current literature is limited and ambiguous. METHODS:Fifteen normal, adult, formalin-fixed cerebra...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Komaitis S,Skandalakis GP,Kalyvas AV,Drosos E,Lani E,Emelifeonwu J,Liakos F,Piagkou M,Kalamatianos T,Stranjalis G,Koutsarnakis C

    更新日期:2019-03-01 00:00:00

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    abstract::A 13-year-old girl was referred for evaluation of the deceleration in her rate of linear growth, an arrest in the progression of her pubertal maturation, and bifrontal headaches. Detailed endocrinological and radiological studies revealed the following abnormalities: partial growth hormone deficiency, prepubertal lute...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Dempsey RJ,Chandler WF,Sauder SE

    更新日期:1983-06-01 00:00:00

  • Disseminated intravascular coagulation following cranial trauma. Case report.

    abstract::Cranial and spinal trauma resulted in disseminated intravascular coagulation (DIC) in a 78-year-old man, causing widespread bleeding and incoagulable blood. Traumatized brain tissue was found in the lumina of dural venous sinuses. The mechanisms of DIC are reviewed. It is suggested that intravascular release of potent...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Clark JA,Finelli RE,Netsky MG

    更新日期:1980-02-01 00:00:00

  • Hypoglossal-facial nerve side-to-end anastomosis for preservation of hypoglossal function: results of delayed treatment with a new technique.

    abstract::This report describes a new surgical technique to improve the results of conventional hypoglossal-facial nerve anastomosis that does not necessitate the use of nerve grafts or hemihypoglossal nerve splitting. Using this technique, the mastoid process is partially resected to open the stylomastoid foramen and the desce...

    journal_title:Journal of neurosurgery

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    authors: Sawamura Y,Abe H

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  • Real-time detection of vascular occlusion and reperfusion of the brain during surgery by using infrared imaging.

    abstract:OBJECT:Application of sensitive infrared imaging is ideally suited to observe blood vessels and blood flow in exposed organs, including the brain. Temporary vascular occlusion is an important part of neurosurgery, but the capacity to monitor the effects of these occlusions in real time is limited. In surgical procedure...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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    更新日期:2002-05-01 00:00:00

  • Regional cerebral ischemia by occlusion of the posterior communicating artery and the middle cerebral artery in gerbils.

    abstract::The authors have created an experimental model of regional cerebral ischemia in gerbils that is reproducible and has a low mortality rate. In gerbils, either the posterior communicating artery (PCoA) or the middle cerebral artery (MCA) was occluded, and the distribution of cerebral ischemia from each surgical procedur...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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    更新日期:1983-03-01 00:00:00

  • Pain reduction in amputees by long-term spinal cord stimulation. Long-term follow-up study over 5 years.

    abstract::This follow-up study analyzes the results of dorsal column stimulation instituted between 1972 and 1974 for the relief of pain in 84 patients, including 64 amputees. Good results decreased from 52.4% after 2 years of stimulation to 39% after 5 years. Special therapeutic problems in amputees are discussed. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Krainick JU,Thoden U,Riechert T

    更新日期:1980-03-01 00:00:00