Abstract:
INTRODUCTION:Stereotactic radiosurgery (SRS), particularly Gamma Knife radiosurgery (GKRS) is an established treatment option for residual and recurrent pituitary adenoma tumors. It helps in the preservation of surrounding normal neuronal, vascular, and hormone-producing structures and causes fewer neurologic deficits. The aim of this research was to evaluate the efficacy and define the role of GKRS in the treatment of nonfunctioning (NFA) and hormonal active (HAA) pituitary adenoma. METHODS:A retrospective analysis of 111 patients with histologically proven pituitary adenoma who underwent GKRS treatment at Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA, over a 17-year period was conducted presented. The clinical and radiologic data were collected from the database. The tumors were categorized into NFA and HAA based on the endocrinology profile. The relevant statistical analysis was conducted with SPSS software, version 22.0. RESULTS:The median age of the patients was 58 years. The study comprised 87 patients with NFA and 24 patients with HAA tumors. Thirty-eight patients (34.2%) had hypopituitarism symptoms, and 8 patients (7%) had panhypopituitarism symptoms. The mean tumor volume before to GKRS was 3.8 cm3. Suprasellar and cavernous extension of the tumor was noted in 28 patients (25.2%) and 34 (30.6%) patients, respectively. We observed >70% reduction in the size of tumors in the shrinkage cohort after GKRS; the median time for shrinkage was 48.4 months. However, increase in tumor size was noted in the progression cohort (pre-GKRS 3.8 cm3 vs. post-GKRS 6.5 cm3). Seventy patients (63.1%) had neurologic improvement, and 26 patients (23.4%) had endocrinologic worsening after GKRS. CONCLUSIONS:GKRS plays a significant role in the treatment of NFA and HAA. It affords a high rate of tumor control and offers a low risk of collateral neurologic or endocrine axis injury. Our study shows that control of tumor growth was achieved in 90% of patients, shrinkage of tumor in 54%, and arrest of progression in 36% after GKRS treatment. The biochemical remission rate in growth hormone secreting adenoma was 57%, in adrenocorticotropic hormone adenoma 67%, and prolactinoma 40%. Age below 50 years and tumor volume less than 5 cm3 were associated with a favorable radiosurgical outcome.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Narayan V,Mohammed N,Bir SC,Savardekar AR,Patra DP,Bollam P,Nanda Adoi
10.1016/j.wneu.2018.03.094subject
Has Abstractpub_date
2018-06-01 00:00:00pages
e824-e832eissn
1878-8750issn
1878-8769pii
S1878-8750(18)30576-Xjournal_volume
114pub_type
杂志文章abstract::This paper uses a neural network model to study the protective effect of dexmedetomidine on the anesthesia recovery period and neurocognitive function in elderly patients undergoing radical resection of colorectal cancer. Eighty-eight patients with colorectal cancer who underwent radical surgery in our hospital from J...
journal_title:World neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.wneu.2020.01.012
更新日期:2020-06-01 00:00:00
abstract::This case Video 1 demonstrates a microsurgical technique for trapping and excision of 2 ruptured mycotic aneurysms. The patient was a 64-year-old man with severe mitral regurgitation and valvular vegetations suggestive of endocarditis. On examination, the patient presented with speech difficulty. Preoperative imaging ...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.01.145
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Postoperative hemorrhagic or ischemic complications cause significant morbidity and mortality after craniotomy. High altitude creates a state of relative hypoxia, resulting in increased cerebral blood flow for compensation. This potentially creates an increased risk at high altitude of having increased morbi...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.186
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:It was believed that Chiari type II malformation (CM-II) was always present in a myelomeningocele (MMC). In fact, it is associated in about 80% of cases. Improvement of the hindbrain herniation after prenatal closure of MMC has challenged the idea that this condition was irreversible. Only 2 studies report as...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.08.152
更新日期:2017-12-01 00:00:00
abstract::The innominate artery, also known as the brachiocephalic artery, is the first vessel off the aortic arch and provides blood to the right arm, neck, and head. Occlusion of the innominate artery can be treated with endarterectomy, angioplasty, stenting, and bypass grafting. Bypass grafting describes a surgical procedure...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.05.134
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To report our experience of endoscopic disc removal by anterior approach for management of cervical myelopathy in 210 patients. METHODS:A retrospective study of 187 cases of single- and 23 cases of double-level disc disease was performed. Cases of myelopathy with or without unilateral or bilateral radiculopa...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.107
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND AND IMPORTANCE:Aneurysms of the anterior choroidal artery are uncommon, and distal anterior choroidal artery aneurysms are even rarer, with only 34 cases reported in the medical literature. These lesions have been most commonly reported in association with moyamoya disease or arteriovenous malformations. Mos...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.05.176
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:The blood-brain barrier (BBB) of patients with moyamoya angiopathy (MMA) is unstable, which may contribute to transient neurologic symptoms (TNS) after direct bypass surgery. However, BBB-related proteins have never been investigated. The purpose of this study was to evaluate the perioperative serum levels of...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.08.134
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Patients with neurofibromatosis type 2 and bilateral vestibular schwannoma (VS) are frequently treated surgically for any tumor progression, and often repeated surgery or radiation treatment is even considered. Some VS progression occurs without the development of new clinical symptoms, or it does not progre...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.02.075
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:We describe a rare case of a sphenoid sinus myxoma that was resected via an endoscopic endonasal skull base approach. We review the literature regarding these rare tumors of the paranasal sinuses. CASE DESCRIPTION:A 72-year-old woman was diagnosed with an incidental sphenoid sinus tumor and left sphenoid wi...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2017.04.019
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:The goal of this study was to assess the indications of revision for vagal nerve stimulation at a single institution in an adult population with drug-resistant epilepsy. METHODS:This was a retrospective review of a prospectively collected database who underwent vagal nerve stimulator implantation for drug-re...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.09.008
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:This study aimed to evaluate the technical details, clinical effectiveness, and complications of oblique lateral interbody fusion supplemented with anterolateral screw-rod instrumentation in managing degenerative lumbar diseases. METHODS:The clinical data of 14 patients with lumbar degenerative diseases who ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.11.046
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:Well-defined risk factors for the identification of patients with meningioma who might benefit from preoperative or early postoperative seizure prophylaxis are unknown. We investigated and quantified risk factors to determine individual risks of seizure occurrence in patients with meningioma. METHODS:A total...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.10.062
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Schwannomas not related to cranial nerves are very rare. Here, we present a case of a schwannoma that originated from the falx cerebri and review reported cases in the literature. CASE DESCRIPTION:A 36-year-old male experienced generalized seizures following right hemiparesis predominantly in his lower extr...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2018.12.122
更新日期:2019-01-03 00:00:00
abstract:OBJECTIVE:The authors analyze 124 cases with fracture of odontoid process. All patients were surgically treated by posterior atlantoaxial fixation. METHODS:There were 96 male and 28 female patients. The ages of the patients ranged from 12 to 80 years. Apart from Anderson and D'Alonzo type I (6 cases), type II (93 case...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.08.192
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:Spinal metastases represent the most common site of bony metastases and frequently reduce quality of life. A beneficial effect of surgery and radiotherapy versus radiotherapy alone has been demonstrated in symptomatic patients. The goal of our study was to perform a cost-utility analysis of surgery for spinal...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.01.130
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:To describe the incidence of and characterize risk factors for cerebrospinal fluid leak and symptomatic pseudomeningocele (CSFL/SP) after intradural spine surgery. METHODS:A retrospective analysis of a prospectively collected and consecutive series of patients undergoing intradural spine surgery by the senio...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.08.112
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:Patients with diffuse low-grade gliomas (DLGGs) typically present with seizures. We sought to review the neurosurgical literature for seizure outcome after resection of these tumors. METHODS:Using PubMed, we identified surgical series reporting seizure freedom rates for grade II astrocytoma, oligoastrocytoma...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2017.06.144
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:During the coronavirus disease 2019 (COVID-19) pandemic, a rapid screening method for COVID-19 detection is needed to decide the appropriate strategy to treat stroke patients. In acute ischemic stroke treatment, the efficacy and safety of emergent carotid artery stenting (eCAS) for hyperacute ischemic stroke...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.09.166
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Intraoperative neuromonitoring (ION) signal changes during spine surgery may portend a potentially catastrophic neurologic injury that, if identified and addressed expediently, may allow the surgeon to take correction actively and prevent permanent neurologic injury. CASE DESCRIPTION:We report a case of tra...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.06.116
更新日期:2018-09-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.058
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:The coexistence of a gangliocytoma and a pituitary adenoma is a rare event that has been reported in only case reports. The knowledge of its diagnosis and treatment is extremely limited. CASE DESCRIPTION:We present a rare case of intrasellar-suprasellar gangliocytoma and nonfunctioning pituitary adenoma. Th...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.05.064
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Collision tumors are often difficult to distinguish from intratumoral heterogeneity in diffuse gliomas. CASE DESCRIPTION:We report the case of a 44-year-old woman admitted for intracranial hypertension. Magnetic resonance imaging revealed a right intra-axial frontal mass, composed of a hypervascular nodular...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.05.156
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Carcinoid tumors are neuroendocrine neoplasms derived from enterochromaffin cells. Central nervous system involvement is rare. The reported cases include metastases to brain or spinal cord, and primary skeletal or extradural disease resulting in compressive myeloradiculopathy. There are 2 previously reported...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.06.179
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:To assess the efficacy of the combined use of a gasket seal closure and a vascularized pedicle nasoseptal flap (VP-NSF) multilayered reconstruction technique for high-flow cerebrospinal fluid (CSF) leaks resulting from endonasal endoscopic skull base surgery. METHODS:From October 2009-June 2011, a VP-NSF mul...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2014.06.004
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Burst fractures account for more than half of all thoracolumbar fractures and are frequently associated with spine instability and neurological deficit. The anterior approach is favored when decompression of the spinal canal is necessary. We compare two commonly available struts used for anterior approach af...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2010.09.018
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Posterior fixation and fusion is the primary treatment for thoracolumbar fractures, although this treatment may sacrifice range of motion (ROM) to achieve stability, rather than treating the fracture itself. Two issues addressed when treating thoracolumbar fractures are 1) replacing the fractured vertebrae, ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.08.093
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Inflammatory demyelinating changes in the absence of malignant cells can sometimes be found on initial biopsies preceding the diagnosis of primary central nervous system lymphoma (PCNSL), resulting in the term "sentinel" lesion. Sentinel lesions have been reported sporadically in literature, resulting in man...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.09.064
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Focal cortical dysplasias (FCDs) are highly epileptogenic and frequently associated with medically refractory focal epilepsy. FCDs are frequently located in the frontal lobe, making its complete resection highly challenging when in proximity to the motor cortex. CASE DESCRIPTION:We report a case of a 25-yea...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.08.181
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:Treatment of unruptured intracranial arteriovenous malformations (AVMs) has become controversial since the ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations) study was published in 2014. We sought to analyze changes in the demographics, clinical presentation, and treatment strategies i...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.05.094
更新日期:2020-09-01 00:00:00