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 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
doi:10.3171/jns.2007.106.1.142
更新日期:2007-01-01 00:00:00
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
doi:10.3171/2012.5.JNS112102
更新日期:2012-08-01 00:00:00
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
doi:10.3171/jns.1991.75.6.0911
更新日期:1991-12-01 00:00:00
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
doi:10.3171/2014.1.JNS131534
更新日期:2014-06-01 00:00:00
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
doi:10.3171/2011.1.JNS10782
更新日期:2011-06-01 00:00:00
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
doi:10.3171/jns.1980.53.5.0600
更新日期:1980-11-01 00:00:00
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
doi:10.3171/jns.1985.63.5.0704
更新日期:1985-11-01 00:00:00
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
doi:10.3171/jns.2005.103.6.0949
更新日期:2005-12-01 00:00:00
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
doi:10.3171/jns.1986.65.4.0545
更新日期:1986-10-01 00:00:00
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
pub_type: 杂志文章
doi:10.3171/2010.3.JNS091057
更新日期:2010-10-01 00:00:00
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
doi:10.3171/jns.2003.98.6.1235
更新日期:2003-06-01 00:00:00
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
doi:10.3171/jns.1989.70.1.0073
更新日期:1989-01-01 00:00:00
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
doi:10.3171/jns.2005.102.4.0738
更新日期:2005-04-01 00:00:00
abstract:OBJECT:After complete resection and radiation therapy, the 10-year overall survival rates for adult patients with posterior fossa ependymomas approach 85%. This favorable outcome profile emphasizes the critical importance of functional preservation to this patient population. Here, the authors identify predictors of fu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.1.JNS131590
更新日期:2014-05-01 00:00:00
abstract::OBJECT Spontaneous intracranial hypotension is an increasingly recognized cause of headaches. Pituitary enlargement and brain sagging are common findings on MRI in patients with this disorder. The authors therefore investigated pituitary function in patients with spontaneous intracranial hypotension. METHODS Pituitary...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.9.JNS132687
更新日期:2015-05-01 00:00:00
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
doi:10.3171/2015.2.JNS132686
更新日期:2015-06-01 00:00:00
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
pub_type: 杂志文章
doi:10.3171/jns.1987.67.2.0291
更新日期:1987-08-01 00:00:00
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
doi:
更新日期:2001-04-01 00:00:00
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
doi:10.3171/2015.2.JNS142088
更新日期:2016-01-01 00:00:00
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
doi:10.3171/jns.1994.80.4.0756
更新日期:1994-04-01 00:00:00
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
doi:10.3171/jns.1994.81.1.0078
更新日期:1994-07-01 00:00:00
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 ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.4.JNS08785
更新日期:2009-12-01 00:00:00
abstract:OBJECT:Stereotactic radiosurgery (SRS) is an important treatment option for patients with cavernous sinus meningiomas (CSM). To analyze factors associated with local tumor control and complications after single-fraction SRS, the authors reviewed cases involving patients treated with Gamma Knife SRS between 1990 and 200...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.5.JNS13206
更新日期:2013-09-01 00:00:00
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
doi:10.3171/2018.11.JNS182908
更新日期:2019-03-01 00:00:00
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
doi:10.3171/jns.1983.58.6.0932
更新日期:1983-06-01 00:00:00
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
doi:10.3171/jns.1980.52.2.0266
更新日期:1980-02-01 00:00:00
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
pub_type: 杂志文章
doi:10.3171/jns.1997.86.2.0203
更新日期:1997-02-01 00:00:00
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
doi:10.3171/jns.2002.96.5.0918
更新日期:2002-05-01 00:00:00
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
doi:10.3171/jns.1983.58.3.0362
更新日期:1983-03-01 00:00:00
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
doi:10.3171/jns.1980.52.3.0346
更新日期:1980-03-01 00:00:00