Abstract:
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.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Flanders TM,Blue R,Roberts S,McShane BJ,Wilent B,Tambi V,Petrov D,Lee JYKdoi
10.3171/2018.4.JNS172631subject
Has Abstractpub_date
2018-10-05 00:00:00pages
813-819issue
3eissn
0022-3085issn
1933-0693pii
2018.4.JNS172631journal_volume
131pub_type
杂志文章abstract:OBJECT:The authors report their experience with the use of the Neuroform Microdelivery System for intravascular reconstruction. They assess the technical feasibility of the system, the efficacy of the combined application of stent and detachable coils, and the follow-up findings. METHODS:Fifty patients found to harbor...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.102.2.0235
更新日期:2005-02-01 00:00:00
abstract::A technique is described for using a clip-suture to expedite handling of the divided sympathetic chain in a deep, small upper-thoracic exposure. No late failures were experienced in 23 patients with hyperhydrosis surgically treated using this technique. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.3.0482
更新日期:1994-09-01 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::A case of hemangioblastoma of the spinal cord is described in which the tumor presented in an intradural extramedullary location. The patient did not have von Hippel-Lindau's disease or metastatic seeding. It is assumed that the tumor arose in the pia, and its direction of growth was purely extramedullary. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.48.3.0461
更新日期:1978-03-01 00:00:00
abstract:OBJECT:The authors provide a systematic analysis of electroclinical characteristics in patients with persistent seizures following temporal lobe epilepsy (TLE) surgery and identify ideal candidates for reoperation. METHODS:The authors retrospectively reviewed the records of 68 adult patients (mean follow-up 8.7 years)...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.8.JNS10180
更新日期:2010-12-01 00:00:00
abstract::The aim of this study was to determine whether positron emission tomography (PET) with fluorine-18 (18F)-2-deoxyglucose (FDG) can be used as a prognostic test in patients with high-grade cerebral gliomas, regardless of the treatment given. Forty-five patients with astrocytoma Grade III or IV were included in this anal...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.6.0816
更新日期:1985-06-01 00:00:00
abstract::In this report the authors describe the endovascular treatment of dural arteriovenous fistulas (DAVFs) through transcranial puncture of the feeding arteries. Four patients had DAVFs that were fed by occipital arteries (OAs) that supplied blood to the intracranial meningeal arteries via the transcranial branches and co...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2007.106.5.912
更新日期:2007-05-01 00:00:00
abstract::All patients who underwent decompressive lumbar laminectomy in the Washtenaw County, Michigan metropolitan area during a 7-year period were studied for the purpose of defining long-term outcome, clinical correlations, and the need for subsequent fusion. Outcome was determined by questionnaire and physical examination ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.5.0699
更新日期:1994-11-01 00:00:00
abstract:OBJECT:This study was undertaken to determine the outcomes in an unselected group of patients treated with semiurgent surgical clipping of aneurysms following subarachnoid hemorrhage (SAH). METHODS:A clinical management outcome audit was conducted to determine outcomes in a group of 391 consecutive patients who were t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.2.0250
更新日期:2002-08-01 00:00:00
abstract::The authors report four cases of primary intracranial choriocarcinoma, all in young males. There tumors occurred in the pineal region and one in the lateral ventricle. Besides the signs of increased intracranial pressure and ophthalmological disorders, skin pigmentation or eruption was observed in three cases and prec...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.3.0369
更新日期:1980-09-01 00:00:00
abstract::The fibrinolytic activity in cerebrospinal fluid has been monitored by determination of levels of fibrin split products (FSP) in 23 patients with ruptured intracranial aneurysms. In 20 of these 23, FSP was found in the cerebrospinal fluid (CSF), with levels ranging from 10 to 80 micrograms/ml. Eleven of the 23 patient...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.52.4.0453
更新日期:1980-04-01 00:00:00
abstract:OBJECTIVE:The brainstem is a compact, delicate structure. The surgeon must have good anatomical knowledge of the safe entry points to safely resect intrinsic lesions. Lesions located at the lateral midbrain surface are better approached through the lateral mesencephalic sulcus (LMS). The goal of this study was to compa...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.1.JNS182036
更新日期:2019-04-12 00:00:00
abstract:OBJECT:This outcome study was undertaken to investigate the long-term results obtained in surgically treated pediatric patients with lumbar disc disease by using standardized medical outcome scales and clinical follow-up examination. METHODS:Twenty nine patients 17 years of age or younger underwent surgery between 196...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2000.92.1.0001
更新日期:2000-01-01 00:00:00
abstract:OBJECT:The 201Tl uptake index was evaluated for its usefulness in formulating a diagnosis of hemangioblastoma. Thallium-201-single-photon emission computerized tomography (SPECT) studies were performed in nine patients harboring hemangioblastomas in the posterior fossa and in five patients (six lesions) with gliomas in...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.2001.95.2.0292
更新日期:2001-08-01 00:00:00
abstract::Cellular immune responses to brain antigens in patients with head injury were studied by applying the leukocyte adherence inhibition (LAI) assay. The investigation was conducted in three phases. 1) In the initial phase, evaluation of a series of 22 test and 25 control cases obtained at random during a 2- to 6-week tim...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.51.3.0317
更新日期:1979-09-01 00:00:00
abstract:OBJECT:Distal coil or stent migration is a rare, but potentially morbid complication of intracranial aneurysm embolization. At present, there is no established standard of surgical evacuation of displaced material-in particular, there is no consensus on the optimum time for such intervention. The authors report their p...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.1.JNS132788
更新日期:2015-10-01 00:00:00
abstract::The authors report on two patients in whom an increased signal on T1-weighted magnetic resonance images and a high-density signal on computerized tomography scans of the striatum were demonstrated, both of which were associated with nonketotic hyperglycemia. Involuntary movements, which have been present in all previo...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.101.2.0343
更新日期:2004-08-01 00:00:00
abstract::A case of brain-stem hemangioma calcificans is described. The few cases reported in the literature prove the rarity of this tumor, which is considered a benign variant of cerebral cavernous hemangioma. Diagnosis and treatment of these tumors are briefly discussed with a review of the literature including 11 previous c...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.1.0150
更新日期:1983-07-01 00:00:00
abstract::The commonest initial computerized tomography (CT) finding in head-injured children is bilateral diffuse cerebral swelling. Cerebral blood flow and CT density studies suggest that this swelling is due to cerebral hyperemia and increased blood volume, not to edema. The clinical history, course, and outcome of 63 childr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.2.0170
更新日期:1981-02-01 00:00:00
abstract::Neural foundations underlying visual agnosia are poorly understood. The authors present the case of a patient who underwent awake surgery for a right basal temporooccipital low-grade glioma in which direct electrostimulation was used both at the cortical and subcortical level. Brain mapping over the inferior longitudi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.10.JNS12527
更新日期:2013-01-01 00:00:00
abstract:OBJECT:The poor prognosis for traumatic acute subdural hematoma (ASDH) might be due to underlying primary brain damage, ischemia, or both. Ischemia in ASDH is likely caused by increased intracranial pressure (ICP) leading to decreased cerebral perfusion pressure (CPP), but the degree to which these phenomena occur is u...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.95.4.0569
更新日期:2001-10-01 00:00:00
abstract::The syndrome of spontaneous intracranial hypotension is characterized by orthostatic headaches in conjunction with reduced cerebrospinal fluid (CSF) pressure or CSF volume, and characteristic magnetic resonance (MR) imaging findings. A 50-year-old man presented with a 1-year history of paroxysmal ataxia of gait and sh...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.98.4.0903
更新日期:2003-04-01 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::Tissue acidosis is believed to be a key element in ischemic injury of neural tissue. The goal of this study was to determine whether persisting postischemic acidosis or the extent of acidosis would affect metabolic recovery following an ischemic event. Intracellular pH (pHi), adenosine triphosphate, phosphocreatine, a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.4.0567
更新日期:1994-10-01 00:00:00
abstract:OBJECT:Because little is known about the molecular mechanisms underlying the process of spondylosis, the authors examined the extent of genetic localization of several members of bone morphogenetic protein (BMP) and BMP receptors in chondrogenesis during the process of inducing spondylosis in their previously establish...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2001.94.1.0068
更新日期:2001-01-01 00:00:00
abstract::OBJECTIVE Neurosurgery is among the most competitive residencies, as evidenced by the high number of applicants for relatively few positions. Although it is important to recruit candidates who have the intellectual capacity and drive to succeed, traditional objective selection criteria, such as US Medical Licensing Ex...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.7.JNS15880
更新日期:2016-10-01 00:00:00
abstract::Blood flow for the whole spinal cord (SCBF), central cord (largely gray matter), and peripheral cord (largely white matter) has been measured at all segmental levels using radioactive microspheres in conscious sheep. Whole SCBF was greatest in the lower cervical and lumbar enlargements and least in the upper cervical ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.5.0620
更新日期:1981-05-01 00:00:00
abstract:OBJECTIVE:Although ventricular shunting is an effective therapy for idiopathic normal pressure hydrocephalus (iNPH), the effect of shunt valve type on the incidence of revision surgery is not well defined. To address this issue, shunt revision rates between patients with iNPH receiving a fixed-setting valve (FSV) versu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.3.JNS183077
更新日期:2019-06-07 00:00:00
abstract:OBJECT:The aim of the study was to assess retrospectively the clinical efficacy and possible adverse effects of electrical spinal cord stimulation (SCS) for the treatment of patients with reflex sympathetic dystrophy (RSD). METHODS:Twenty-three patients who suffered severe pain due to RSD were included in the study. T...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.1999.90.1.0079
更新日期:1999-01-01 00:00:00
abstract::An unusual case of complete anatomical compartmentalization of the cavernous sinus in a patient with bilateral Type D cavernous dural arteriovenous fistulae is described. This anatomical anomaly isolated the anterior cavernous sinus and orbital venous system, which was primarily responsible for the patient's clinical ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.79.4.0592
更新日期:1993-10-01 00:00:00