Abstract:
OBJECTIVE:Stereotactic radiosurgery (SRS) is a commonly employed treatment modality for brain arteriovenous malformations (AVMs). However, due to the low frequency of delayed cyst formation after AVM SRS, as well as the prolonged time interval between treatment and its occurrence, the characteristics of post-SRS cyst formation are not well defined. Therefore, the aims of this retrospective cohort study are to determine the rate of cyst formation after SRS for AVMs, identify predictive factors, and evaluate the clinical sequelae of post-SRS cysts. METHODS:The authors analyzed an SRS database for AVM patients who underwent SRS at the University of Virginia and identified those who developed post-SRS cysts. Statistical analyses were performed to determine predictors of post-SRS cyst formation and the effect of cyst formation on new or worsening seizures after SRS. RESULTS:The study cohort comprised 1159 AVM patients treated with SRS; cyst formation occurred in 17 patients (post-SRS cyst rate of 1.5%). Compared with patients who did not develop post-SRS cysts, those with cyst formation were treated with a greater number of radiosurgical isocenters (mean 3.8 vs 2.8, p = 0.047), had a longer follow-up (mean 132 vs 71 months, p < 0.001), were more likely to develop radiological radiation-induced changes (RIC) (64.7% vs 36.1%, p = 0.021), and had a longer duration of RIC (57 vs 21 months, p < 0.001). A higher number of isocenters (p = 0.014), radiological RIC (p = 0.002), and longer follow-up (p = 0.034) were found to be independent predictors of post-SRS cyst formation in the multivariate analysis. There was a trend toward a significant association between cyst formation and new or worsening seizures in univariate analysis (p = 0.054). CONCLUSIONS:Patients with greater nidal complexity appear to be more prone to post-SRS cyst formation. The findings of this study emphasize the importance of long-term follow-up for patients who have undergone AVM SRS, even after nidal obliteration is achieved. Post-SRS cysts may be epileptogenic, although seizure outcomes after AVM SRS are multifactorial.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Pomeraniec IJ,Ding D,Starke RM,Liu KC,Mrachek EK,Lopes MB,Sheehan JPdoi
10.3171/2017.6.JNS17559subject
Has Abstractpub_date
2018-10-01 00:00:00pages
937-946issue
4eissn
0022-3085issn
1933-0693pii
2017.6.JNS17559journal_volume
129pub_type
杂志文章abstract:OBJECT:This study was conducted to evaluate the value of postoperative CT scans in determining the probability of return to the operating room (OR) and the optimal time to obtain such scans to determine the effects of surgery. METHODS:Between January and December 2006 (12 months), all postoperative head CT scans obtai...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.11.JNS081048
更新日期:2010-11-01 00:00:00
abstract:OBJECT:The aim of this study was to investigate the incidence of elevated (> or = 75%) jugular venous oxygen saturation (SjvO2) and its relationship to cerebral hemodynamic and metabolic parameters and to outcome after severe head injury. METHODS:Data from 450 severely head injured patients admitted to the Neurosurgic...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.90.1.0009
更新日期:1999-01-01 00:00:00
abstract::The authors present the oldest historical case of a so-called beaten-copper cranium. The typical pattern was identified on a skull from a child, probably a boy, who died at approximately 6 years of age and was buried in a provisional cemetery used during the siege of Hanau, Germany, in 1635 and 1636. Morphological and...
journal_title:Journal of neurosurgery
pub_type: 历史文章,杂志文章
doi:10.3171/ped.2007.106.1.71
更新日期:2007-01-01 00:00:00
abstract:OBJECT:The prognosis of recurrent glioblastoma multiforme (GBM) remains unsatisfactory. The authors conducted a Phase II study of ifosfamide, carboplatin, and etoposide (ICE) for a first recurrence of GBM to determine whether it prolonged a patient's good-quality life. METHODS:This trial was an open-label, single-cent...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.5.JNS081738
更新日期:2010-01-01 00:00:00
abstract::Proper ventricular catheter placements are associated with improved shunt performance. When placing ventricular catheters via the posterior approach, the surgeon must determine an optimum trajectory and then pass a catheter along that trajectory. The incidence of optimal posterior catheter placements is increased by u...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.89.1.0157
更新日期:1998-07-01 00:00:00
abstract:OBJECT:Sedation regimens for head-injured patients are quite variable. The short-acting sedative-anesthetic agent propofol is being increasingly used in such patients, yet little is known regarding its safety and efficacy. In this multicenter double-blind trial, a titratable infusion of 2% propofol accompanied by low-d...
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.1999.90.6.1042
更新日期:1999-06-01 00:00:00
abstract::The authors report outcomes in 18 patients with arteriovenous malformations (AVMs) who were treated with gamma knife radiosurgery and in whom magnetic resonance (MR) imaging was obtained a mean of 14 years (range 8-23 years) after treatment and 10 years (range 4-17 years) after confirmed obliteration of the AVM. All p...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.86.4.0589
更新日期:1997-04-01 00:00:00
abstract:OBJECT:The purpose of this study was to examine the widely held assumption that early-onset symptoms after gamma knife radiosurgery (GKS) are uncommon. The study was designed to include all types of morbidity and not just those that lead to neurological dysfunction. It was hoped that the results of the study could lead...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.supplement
更新日期:2002-12-01 00:00:00
abstract:OBJECT:The aim of this prospective study was to evaluate the phagocytic, humoral, and cellular arms of the immune system in comatose patients shortly after severe brain injury and to compare the findings with those reported earlier in patients in a persistent vegetative state. The study was conducted in intensive care ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.94.5.0706
更新日期:2001-05-01 00:00:00
abstract::OBJECTIVE Of the intracranial schwannomas, those arising from the vestibular nerves are the most common. Abducens nerve (AN) schwannomas are very rare, and there is limited literature on their optimal management. Therapeutic options include surgery and/or stereotactic radiosurgery. The aim of this study was to evaluat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.8.JNS151140
更新日期:2016-10-01 00:00:00
abstract::Lymphomatoid granulomatosis is of uncertain etiology and poses problems with diagnosis and treatment. A case with involvement of the right temporal lobe, but associated with cystoid macular edema of the retina, is described. The unusual mode of presentation, the radiographic, operative, and pathological findings, the ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.67.4.0612
更新日期:1987-10-01 00:00:00
abstract::The authors report a case of myxochondrosarcoma of the fourth ventricle. The tumor was heavily calcified and proved impossible to remove at surgery. Histological examination revealed areas of loose fibroblastic tissue, hyaline cartilage, osteoid, and bone. It is postulated that the tumor arose from the stroma of the c...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.44.3.0386
更新日期:1976-03-01 00:00:00
abstract:OBJECT:Surgical indications for patients with pineal cysts are controversial. While the majority of patients harboring a pineal cyst require no treatment, surgery is a well-accepted option for a subset of those patients with secondary hydrocephalus or Parinaud's syndrome. The majority of pineal cysts are identified inc...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.9.JNS141081
更新日期:2015-08-01 00:00:00
abstract::A case is reported of a 63-year-old woman with thalamic syndrome as the presenting feature of an unruptured cerebral aneurysm. Unruptured aneurysm is a rare cause of thalamic syndrome; the possible mechanisms of production of the sensory disturbance are discussed. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.2.0291
更新日期:1995-02-01 00:00:00
abstract:OBJECT:Knowledge of the cranium projections of the gyral structures is essential to reduce the surgical complications and to perform minimally invasive interventions in daily neurosurgical practice. Thus, in this study the authors aimed to provide detailed information on cranial projections of the eloquent cortical are...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.10.JNS08159
更新日期:2009-08-01 00:00:00
abstract::The use of a pulsed echo Doppler technique during procedures for occlusion of intracranial aneurysms is described. Saccular aneurysms can be located with reference to probe position and depth setting. Tracings of intra-aneurysmal flow are presented, and the characteristic flow pattern is disucssed. Special emphasis ha...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.5.0570
更新日期:1979-05-01 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::The lower brainstem and cervical spinal cord from an ordinarily treated case of Chiari Type I hindbrain hernia associated with syringomyelia was examined using high-resolution magnetic resonance microscopy and standard neuropathological techniques. Magnetic resonance microscopy allows total screening and visualizes th...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.4.0701
更新日期:1996-10-01 00:00:00
abstract::The authors report a rare case of spontaneous left vertebrovertebral fistula associated with neurofibromatosis Type 1 in a young woman. The patient had undergone previous failed surgical attempts to close the fistula and presented to the authors with recurrence of the fistula and neurological deterioration. Successful...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.12.JNS081209
更新日期:2009-07-01 00:00:00
abstract:OBJECT:The objective of this study was to evaluate endovascular stent therapy for carotid artery dissections (CADs). METHODS:Retrospective review of data at Millard Fillmore Gates Hospital identified 43 patients with 44 CADs (intracranial and/or extracranial) treated with carotid artery (CA) stent placement between Ja...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.1.JNS091806
更新日期:2011-07-01 00:00:00
abstract:OBJECT:The authors discuss the indications for and timing of a diagnostic neurosurgical procedure in children with diabetes insipidus (DI) and a thickened pituitary stalk (TPS) on magnetic resonance (MR) imaging. METHODS:Seven children with a TPS who presented with DI eventually underwent surgery for diagnostic purpos...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2005.103.2.0142
更新日期:2005-08-01 00:00:00
abstract:OBJECT:Atorvastatin, a beta-hydroxy-beta-methylglutaryl coenzyme A reductase inhibitor, has pleiotropic effects, such as promoting angiogenesis, increasing fibrinolysis, and reducing inflammatory responses, and has shown promise in enhancing recovery in animals with traumatic brain injury (TBI) and stroke. The authors ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.101.5.0813
更新日期:2004-11-01 00:00:00
abstract::Fractures of the odontoid process are potentially serious injuries; Type II and III fractures, as described by Anderson and D'Alonzo, are seen in the emergency room especially in young adolescents and individuals over 60 years of age. The etiology of these fractures is still controversial. Malunion and nonunion in bot...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.83.2.0330
更新日期:1995-08-01 00:00:00
abstract:OBJECT:The development of endoscopic endonasal approaches, albeit in the early stages, represents part of the continuous evolution of skull base surgery. During this early period, it is important to determine the safety of these approaches by analyzing surgical complications to identify and eliminate their causes. MET...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.10.JNS09406
更新日期:2011-06-01 00:00:00
abstract::A 55-year-old man, who had previously had a left atrial myxoma excised, developed recurrent hematomas of the left occipital lobe. Microscopic examination revealed the presence of metastatic myxoma. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1990.72.2.0295
更新日期:1990-02-01 00:00:00
abstract:OBJECT:Bone morphogenetic proteins (BMPs) have been shown to have significant osteoinductive activity in numerous in vitro and in vivo assay systems, and BMP-2 and BMP-7 are currently being evaluated in human clinical studies. In the spinal region, BMPs have been shown to promote spinal arthrodesis at a higher rate tha...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2000.92.2.0191
更新日期:2000-04-01 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::Teratomas are neoplasms composed of tissues from all three germ layers with varying degrees of differentiation. They are most commonly found in the sacrococcygeal and gonadal regions and rarely occur in the head and neck region. A teratoma is termed "epignathus" when it arises from the skull base or hard palate and is...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/PED-07/09/266
更新日期:2007-09-01 00:00:00
abstract:OBJECT:At present, the administration of prophylactic antiepileptic medication following aneurysmal subarachnoid hemorrhage (SAH) is controversial, and the practice is heterogeneous. Here, the authors sought to inform clinical decision making by identifying factors associated with the occurrence of seizures following a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.3171/2013.3.JNS122097
更新日期:2013-08-01 00:00:00
abstract::The authors report the first case of vasogenic cerebral edema due to a cell-mediated hypersensitivity reaction to a nickel-containing aneurysm clip. The patient initially presented for elective clipping of a right middle cerebral artery aneurysm, and on long-term follow-up she demonstrated relapsing-remitting cerebral...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.6.JNS132405
更新日期:2014-10-01 00:00:00