Abstract:
:OBJECTIVEDifferent CSF diversion procedures (ventriculoperitoneal, ventriculoatrial, and lumboperitoneal shunting) have been utilized for the treatment of idiopathic normal pressure hydrocephalus. More recently, endoscopic third ventriculostomy has been suggested as a reasonable alternative in some studies. The purpose of this study was to perform a systematic review and meta-analysis to assess overall rates of favorable outcomes and adverse events for each of these treatments. An additional objective was to determine the outcomes and complication rates in relation to the type of valve utilized (fixed vs programmable).METHODSMultiple databases (PubMed, Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus) were searched for studies involving patients with idiopathic ventriculomegaly, no secondary cause of hydrocephalus, opening pressure < 25 mm Hg on high-volume tap or drainage trial, and age > 60 years. Outcomes included the proportion of patients who showed improvement in gait, cognition, and bladder function. Adverse events considered in the analysis included postoperative ischemic/hemorrhagic complications, subdural fluid collections, seizures, need for revision surgery, and infection.RESULTSA total of 33 studies, encompassing 2461 patients, were identified. More than 75% of patients experienced improvement after shunting, without significant differences among the different techniques utilized. Overall, gait improvement was observed in 75% of patients, cognitive function improvement in more than 60%, and improvement of incontinence in 55%. Adjustable valves were associated with a reduction in revisions (12% vs 32%) and subdural collections (9% vs 22%) as compared to fixed valves.CONCLUSIONSOutcomes did not differ significantly among different CSF diversion techniques, and overall improvement was reported in more than 75% of patients. The use of programmable valves decreased the incidence of revision surgery and of subdural collections after surgery, potentially justifying the higher initial cost associated with these valves.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Giordan E,Palandri G,Lanzino G,Murad MH,Elder BDdoi
10.3171/2018.5.JNS1875subject
Has Abstractpub_date
2018-11-01 00:00:00pages
1-13eissn
0022-3085issn
1933-0693pii
2018.5.JNS1875pub_type
杂志文章,评审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:This study was conducted to determine if there is a change in intracranial arterial diameters after papaverine infusion for vasospasm and to determine whether the change occurs in proximal, intermediate, and distal arteries. METHODS:The authors measured arterial diameters retrospectively in all patients who rec...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.88.1.0038
更新日期:1998-01-01 00:00:00
abstract::Precise intraoperative localization of retained bone fragments and foreign bodies avoids extensive brain disseciton, cerebral edema, damage to vital structures, incomplete debridement, and prolonged surgical procedures. Such localization after head trauma is often hampered by cerebral distortion, previous incomplete d...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.46.1.0065
更新日期:1977-01-01 00:00:00
abstract::OBJECTIVE The comparative effectiveness of the 2 treatment options-surgical clipping and endovascular coiling-for unruptured cerebral aneurysms remains an issue of debate and has not been studied in clinical trials. The authors investigated the association between treatment method for unruptured cerebral aneurysms and...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.1.JNS152028
更新日期:2017-03-01 00:00:00
abstract::A patient is presented who had neck pain and transient episodes of visual-field defect followed by unconsciousness when he hyperextended his neck. Radiographic examination revealed atlantooccipital instability on flexion and extension views. Treatment by fusion of the occiput to C-2 resulted in relief of symptoms. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.48.4.0636
更新日期:1978-04-01 00:00:00
abstract::The authors present the case history of a patient in whom the peritoneal catheter of a ventriculoperitoneal shunt system caused ureter obstruction. This is a rare complication of such a shunt procedure, and the patient's symptoms were relieved by shortening the peritoneal catheter. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.3.0542
更新日期:1983-09-01 00:00:00
abstract:OBJECT:The authors investigated the causes for surgical reexploration in patients with complex regional pain syndrome Type II who received initial relief of pain from implantation of a peripheral nerve stimulator (PNS). METHODS:The authors reviewed the charts of 11 consecutive patients who underwent a total of 27 PNS-...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2007.106.3.388
更新日期:2007-03-01 00:00:00
abstract:OBJECT:The authors undertook this study to identify predictors of persistent postoperative seizures in their group of 28 Dutch pediatric and adolescent patients with medically intractable epilepsy who underwent functional hemispherectomy. METHODS:The records of 28 pediatric and adolescent patients who underwent a func...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/PED-07/10/275
更新日期:2007-10-01 00:00:00
abstract::A prospective study of 100 patients undergoing discectomy was carried out. The neurological findings were documented preoperatively and at 1 month and 1 year postoperatively. The clinical and radiological data were analyzed with respect to significant associations. There were no complications. At a minimum of 1 year p...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.3.0283
更新日期:1979-03-01 00:00:00
abstract::Among 121 intracerebral aneurysms presenting at one institution between 1984 and 1989, 16 were treated by endovascular means. All 16 lesions were intradural and intracranial, and had failed either surgical or endovascular attempts at selective exclusion with parent vessel preservation. The lesions included four giant ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.75.5.0694
更新日期:1991-11-01 00:00:00
abstract::The present study investigates the hematological reaction to arterial injury during the first 10 minutes after endarterectomy in dogs to determine if heparin reversal during this early period predisposes to thrombus formation. Known platelet physiology would predict that heparinization during this early period would b...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.58.5.0708
更新日期:1983-05-01 00:00:00
abstract::A meningioma occurred 36 years after surgical removal of a craniopharyngioma. No radiation therapy was instituted after the initial surgery. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.58.6.0947
更新日期:1983-06-01 00:00:00
abstract::The first reported instance of identical twins with moyamoya disease is presented. The involved portions of the main intracranial arteries were similar, but the formation of the moyamoya vessels was somewhat different. The cause fo obstructive changes in large intracranial arteries remains obscure, but the frequent fa...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.1.0109
更新日期:1980-07-01 00:00:00
abstract:OBJECTIVE:The authors performed a study to evaluate the hemorrhagic rates of cerebral dural arteriovenous fistulas (dAVFs) and the risk factors of hemorrhage following Gamma Knife radiosurgery (GKRS). METHODS:Data from a cohort of patients undergoing GKRS for cerebral dAVFs were compiled from the International Radiosu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.12.JNS182208
更新日期:2019-03-15 00:00:00
abstract::Giant paraclinoidal carotid artery aneurysms frequently require temporary interruption of local circulation to facilitate safe occlusion. Due to brisk retrograde flow through the ophthalmic artery and cavernous branches, simple trapping of the aneurysm by cervical internal carotid artery clamping and intracranial dist...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.73.2.0305
更新日期:1990-08-01 00:00:00
abstract::OBJECT In patients with hydrocephalus and shunts, lasting symptoms such as headache and dizziness may be indicative of shunt failure, which may necessitate shunt revision. In cases of doubt, the authors monitor intracranial pressure (ICP) to determine the presence of over- or underdrainage of CSF to tailor management....
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.12.JNS141029
更新日期:2015-05-01 00:00:00
abstract::In this study the authors examine the historical tradition as well as current features of neurosurgery in Greece and compare the available data with international standards. In particular, they describe the organizational structure of neurosurgery with reference to manpower, unit distribution, training, and qualificat...
journal_title:Journal of neurosurgery
pub_type: 历史文章,杂志文章
doi:10.3171/jns.1998.88.4.0782
更新日期:1998-04-01 00:00:00
abstract::The purpose of this report was to review the results of stereotactic radiosurgery in the management of patients with residual neurocytomas after initial resection or biopsy procedures. Four patients underwent stereotactic radiosurgery for histologically proven neurocytoma. Clinical and imaging studies were performed t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.95.5.0879
更新日期:2001-11-01 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::Sixteen patients referred for atlantoaxial fixation failures were treated surgically with revision procedures during the past decade. Of these 16 patients, atlantoaxial instability occurred because of rheumatoid arthritis in five, as odontoideum in seven, transverse ligament disruption in two, and odontoid fracture no...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.83.2.0248
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:The authors aimed to determine whether differences exist in presentation and natural history when comparing Asian patients with moyamoya disease (MMD) to those of other ethnicities in North America. METHODS:A database of 137 patients with MMD presenting to their institution between 1994 and 2015 was reviewed...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.7.JNS191507
更新日期:2019-10-04 00:00:00
abstract::Thalamic, pallidal, and hypothalamic targets were determined in 16 patients by a stereotactic computerized tomography (CT) study using a noninvasive technique with Laitinen's Stereoadapter. At surgery, the Stereoadapter was remounted to the head and the stereotactic CT coordinates were transferred to the Stereoguide w...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.73.4.0565
更新日期:1990-10-01 00:00:00
abstract::The treatment of primary central nervous system lymphoma with chemotherapy prior to whole-brain radiation therapy (WBRT) has improved outcome considerably in this previously fatal disease. Complete or partial responses to intravenous methotrexate (3.5 gm/sq m with leucovorin rescue every 3 weeks for two to four cycles...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.2.0188
更新日期:1994-08-01 00:00:00
abstract:OBJECT:The aim of this study was to describe six variations of the extreme-lateral craniocervical approach, their application, and treatment results. METHODS:During a 4-year period 69 patients underwent surgery in which six variations of the extreme-lateral craniocervical approach were performed. The variations includ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.1999.90.2.0206
更新日期:1999-04-01 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:OBJECTIVE:Although it is known that intersurgeon variability in offering elective surgery can have major consequences for patient morbidity and healthcare spending, data addressing variability within neurosurgery are scarce. The authors performed a prospective peer review study of randomly selected neurosurgery cases i...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.2.JNS182658
更新日期:2019-05-31 00:00:00
abstract::Cerebrospinal fluid (CSF) leaks are relatively common following spinal surgery. A midline dural tear in the spine is readily repaired by direct application of sutures; however, far-lateral or ventral dural tears are problematic. Fat is an ideal sealant because it is impermeable to water. In this paper the author repor...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.96.2.0250
更新日期:2002-03-01 00:00:00
abstract::The authors have developed a stereotactic device for use in rabbits that uses the plane at the base of the mandible combined with cranial sutures as an anatomical reference. The device was developed for a study designed to evaluate catheters for infection prophylaxis, and this required the implantation of silicone cat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/108/3/0601
更新日期:2008-03-01 00:00:00
abstract::OBJECTIVE: This study was performed to identify the angiographic features of hemorrhagic-onset moyamoya disease (MMD) in comparison with those of patients with ischemic-onset MMD. METHODS: This case-control study compared the data set of the Japan Adult Moyamoya (JAM) Trial with the angiographic data of adult patients...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.11.JNS171990
更新日期:2019-05-01 00:00:00
abstract:OBJECT:Little information is available on staged Gamma Knife surgery (GKS) with an interval of 3 years or more when used to treat arteriovenous malformations (AVMs) with volumes larger than 10 cm(3). The goal of this study was to increase knowledge in this area by reporting the authors' experience. METHODS:The authors...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.6.GKS12757
更新日期:2012-12-01 00:00:00