Intended Near-Total Removal of Koos Grade IV Vestibular Schwannomas: Reconsidering the Treatment Paradigm.

Abstract:

BACKGROUND:The goals of treating Koos grade IV vestibular schwannomas are to relieve brainstem compression, preserve or restore neurological function, and achieve long-term tumor control while minimizing tumor- and treatment-related morbidity. OBJECTIVE:To propose a treatment paradigm involving the intentional near-total removal of Koos grade IV vestibular schwannomas, in which a small amount of residual tumor is not dissected off the cisternal portion of the facial nerve. Patients are then followed by a wait-and-scan approach. Any subsequent volumetric progression of the residual tumor is treated with radiosurgery. METHODS:This is a case series of 44 consecutive unselected patients who underwent intended near-total resection of a Koos grade IV vestibular schwannoma through a retrosigmoid approach from January 2009 to December 2015. Pre- and postoperative volumetric analyses were performed on routine magnetic resonance imaging sequences (constructive interference in steady state and gadolinium-enhanced T1-weighted sequence). RESULTS:The mean preoperative tumor volume was 10.9 cm3. The mean extent of resection was 89%. At the last clinical follow-up, facial nerve function was good [House and Brackmann (HB) I-II] in 89%, fair (HB III) in 9%, and poor (HB IV-VI) in 2% of the patients. At the last radiological follow-up, the residual tumor had become smaller or remained the same size in 84% of patients. Volumetric progression was negatively correlated with the original extent of resection and positively correlated with postoperative residual tumor volume (P = .01, P < .001, respectively). CONCLUSION:Intended near-total removal results in excellent preservation of facial nerve function and has a low recurrence rate. Any progressive residual tumor may be treated by radiosurgery.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Zumofen DW,Guffi T,Epple C,Westermann B,Krähenbühl AK,Zabka S,Taub E,Bodmer D,Mariani L

doi

10.1093/neuros/nyx143

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

202-210

issue

2

eissn

0148-396X

issn

1524-4040

pii

3104315

journal_volume

82

pub_type

杂志文章
  • Malignant optic glioma presenting radiologically as a "cystic" suprasellar mass: case report and review of the literature.

    abstract::The diagnosis of malignant glioma of the optic nerves and chiasm may be difficult because these rare lesions may mimic other suprasellar lesions. We report a case of glioblastoma multiforme of the optic chiasm in which the appearance of the lesion on computed tomographic (CT) scan was consistent with that of craniopha...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198212000-00011

    authors: Barbaro NM,Rosenblum ML,Maitland CG,Hoyt WF,Davis RL

    更新日期:1982-12-01 00:00:00

  • Evaluation of the Risk Assessment and Prediction Tool for Postoperative Disposition Needs After Cervical Spine Surgery.

    abstract:BACKGROUND:Bundled care payment models are becoming more prevalent in neurosurgery. Such systems place the cost of postsurgical facilities in the hands of the discharging health system. Opportunity exists to leverage prediction tools for discharge disposition by identifying patients who will not benefit from prolonged ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyz161

    authors: Berger I,Piazza M,Sharma N,Glauser G,Osiemo B,McClintock SD,Lee JYK,Schuster JM,Ali Z,Malhotra NR

    更新日期:2019-11-01 00:00:00

  • Radioguided improved resection of a cranial base meningioma.

    abstract:OBJECTIVE:In meningioma surgery, the completeness of resection is of great importance with regard to prognosis and recurrence. This is more difficult in meningiomas en plaque and cranial base meningiomas, which often involve the bone of the cranial base. We present a case in which radioguided resection of a meningioma ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000336309.14805.F5

    authors: Dammers R,Hsu SP,Krisht AF

    更新日期:2009-03-01 00:00:00

  • The role of intraoperative ultrasound imaging in the surgical removal of intramedullary cavernous angiomas.

    abstract::Five intramedullary cavernous angiomas were surgically removed after being localized by intraoperative ultrasound imaging. Two patients were men, and three were women; in three patients, the symptoms had an acute onset, whereas in the other two, it was gradual. The vascular malformation was localized in the dorsal tra...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199403000-00020

    authors: Lunardi P,Acqui M,Ferrante L,Fortuna A

    更新日期:1994-03-01 00:00:00

  • Juxtafacet cysts of the cervical spine.

    abstract:OBJECTIVE:We report a retrospective series of 13 patients who presented with symptoms and signs caused by cervical juxtafacet cysts. Clinical findings, radiographic features, surgical management strategies, and possible causes are reported and discussed. METHODS:We reviewed clinical histories, radiographic studies, su...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1097/00006123-199812000-00058

    authors: Krauss WE,Atkinson JL,Miller GM

    更新日期:1998-12-01 00:00:00

  • Elevation of brain norepinephrine concentration after experimental subarachnoid hemorrhage.

    abstract::Regional brain tissue catecholamine concentrations were measured in 5 control rats and in 10 rats 72 hours after experimental subarachnoid hemorrhage (SAH). Catecholamine levels were determined in the cerebral hemispheres, brain stem, and cerebellum of each animal using a radioenzymatic assay. Three days after SAH, th...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198609000-00005

    authors: Solomon RA,McCormack BM,Lovitz RN,Swift DM,Hegemann MT

    更新日期:1986-09-01 00:00:00

  • Carotid endarterectomy after noninvasive evaluation by duplex ultrasonography and magnetic resonance angiography.

    abstract::Recent studies documenting the efficacy of carotid endarterectomy (CEA) in selected patients provide further impetus for developing noninvasive techniques to evaluate carotid occlusive disease. Eliminating the morbidity due to preoperative angiography would further refine the treatment of this condition. Recent improv...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199404000-00007

    authors: Lustgarten JH,Solomon RA,Quest DO,Khanjdi AG,Mohr JP

    更新日期:1994-04-01 00:00:00

  • Should Levetiracetam or Phenytoin Be Used for Posttraumatic Seizure Prophylaxis? A Systematic Review of the Literature and Meta-analysis.

    abstract:BACKGROUND:Posttraumatic seizure (PTS) is a significant complication of traumatic brain injury (TBI). OBJECTIVE:To perform a systematic review and meta-analysis to compare levetiracetam with phenytoin for seizure prophylaxis in patients diagnosed with severe TBI. METHODS:An inclusive search of several electronic data...

    journal_title:Neurosurgery

    pub_type: 杂志文章,meta分析,评审

    doi:10.1227/NEU.0000000000001445

    authors: Khan NR,VanLandingham MA,Fierst TM,Hymel C,Hoes K,Evans LT,Mayer R,Barker F,Klimo P Jr

    更新日期:2016-12-01 00:00:00

  • Multifocal Intradural Extramedullary Pilocytic Astrocytomas of the Spinal Cord: A Case Report and Review of the Literature.

    abstract:Background and importance:Pilocytic astrocytoma (PA) is among the most common of the central nervous system gliomas in the pediatric population; however, it is uncommon in adults. PAs of the spinal cord in adults are even rarer, with only a few cases found in the literature. We report here the first case in the literat...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1093/neuros/nyw029

    authors: Basheer A,Rammo R,Kalkanis S,Felicella MM,Chedid M

    更新日期:2017-02-01 00:00:00

  • Accuracy of magnetic resonance imaging-directed frame-based stereotaxis.

    abstract:BACKGROUND:Accurate placement of a probe to the deep regions of the brain is an important part of neurosurgery. In the modern era, magnetic resonance image (MRI)-based target planning with frame-based stereotaxis is the most common technique. OBJECTIVE:To quantify the inaccuracy in MRI-guided frame-based stereotaxis a...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0b013e3182320bd6

    authors: Thani NB,Bala A,Lind CR

    更新日期:2012-03-01 00:00:00

  • Boron neutron capture therapy of brain tumors: an emerging therapeutic modality.

    abstract::Boron neutron capture therapy (BNCT) is based on the nuclear reaction that occurs when boron-10, a stable isotope, is irradiated with low-energy thermal neutrons to yield alpha particles and recoiling lithium-7 nuclei. For BNCT to be successful, a large number of 10B atoms must be localized on or preferably within neo...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1097/00006123-199903000-00001

    authors: Barth RF,Soloway AH,Goodman JH,Gahbauer RA,Gupta N,Blue TE,Yang W,Tjarks W

    更新日期:1999-03-01 00:00:00

  • Epithelial growth factor receptor tyrosine kinase inhibitor prevents infiltration and cerebrospinal fluid dissemination in malignant glioma: an experimental study.

    abstract:UNLABELLED:BAC1KGROUND: AG1478 is an epithelial growth factor receptor tyrosine kinase inhibitor. Epithelial growth factor receptor regulates the expression of cadherin in cells via its action on β-catenin, and N-cadherin downregulation promotes infiltration and cerebrospinal fluid (CSF) dissemination of glioma cells. ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0b013e318215a3d0

    authors: Asano K,Ohkuma H

    更新日期:2011-08-01 00:00:00

  • Low-Dose Intravenous Heparin Infusion After Aneurysmal Subarachnoid Hemorrhage is Associated With Decreased Risk of Delayed Neurological Deficit and Cerebral Infarction.

    abstract:BACKGROUND:Patients who survive aneurysmal subarachnoid hemorrhage (aSAH) are at risk for delayed neurological deficits (DND) and cerebral infarction. In this exploratory cohort comparison analysis, we compared in-hospital outcomes of aSAH patients administered a low-dose intravenous heparin (LDIVH) infusion (12 U/kg/h...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyaa473

    authors: Kole MJ,Wessell AP,Ugiliweneza B,Cannarsa GJ,Fortuny E,Stokum JA,Shea P,Chryssikos T,Khattar NK,Crabill GA,Schreibman DL,Badjatia N,Gandhi D,Aldrich EF,James RF,Simard JM

    更新日期:2020-12-02 00:00:00

  • Transdural approach to the anterior spinal canal in patients with cervical spondylotic myelopathy and superimposed central soft disc herniation.

    abstract::We present seven patients with multilevel cervical spondylotic myelopathy and superimposed midline soft disc herniation who were treated by decompressive laminectomies of the spondylotic segments followed by transdural excision of the anteriorly located disc extrusion. There was no perioperative neurological morbidity...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199404000-00010

    authors: Fox MW,Onofrio BM

    更新日期:1994-04-01 00:00:00

  • Tumors of the lateral ventricular wall, especially the septum pellucidum: clinical presentation and variations in pathological features.

    abstract::The clinical and histopathological features of 19 patients with tumors involving the septum pellucidum are presented. These tumors predominantly affected young adults, and the clinical manifestations were usually the results of raised intracranial pressure related to obstructive hydrocephalus, mental abnormality, epil...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199008000-00009

    authors: Nishio S,Fujiwara S,Tashima T,Takeshita I,Fujii K,Fukui M

    更新日期:1990-08-01 00:00:00

  • Nimodipine-induced acute hypoxemia: case report.

    abstract:OBJECTIVE AND IMPORTANCE:Nimodipine is commonly used to improve neurological outcomes after subarachnoid hemorrhage. Although nimodipine reportedly has high specificity for the cerebral vasculature, adverse systemic effects such as hypotension have been described. This case report describes a patient with traumatic sub...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200011000-00048

    authors: Devlin JW,Coplin WM,Murry KR,Rengachary SS,Wilson RF

    更新日期:2000-11-01 00:00:00

  • Late magnetic resonance imaging related to neurobehavioral functioning after aneurysmal subarachnoid hemorrhage.

    abstract::Twenty patients who underwent early aneurysm surgery--that is, surgery within 72 hours after rupture--underwent further follow-up examination including magnetic resonance imaging (MRI) of the brain and a comprehensive neuropsychological assessment. Significant statistical correlation between tissue loss as seen on a l...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-198909000-00012

    authors: Romner B,Sonesson B,Ljunggren B,Brandt L,Säveland H,Holtås S

    更新日期:1989-09-01 00:00:00

  • Intracranial head and neck tumors: endovascular considerations, present and future.

    abstract::To review the literature on endovascular therapies available to clinicians to aid in the management of head, neck, and intracranial tumors. Hypervascular tumors of the head and neck region, as well as the intracranial region, are associated with large amounts of blood loss intraoperatively. Preoperative embolization o...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000239249.65742.1C

    authors: Gupta R,Thomas AJ,Horowitz M

    更新日期:2006-11-01 00:00:00

  • Liposclerosing Myxofibrous Tumor of the Cranial Vault: A Case Report.

    abstract:BACKGROUND AND IMPORTANCE:Liposclerosing myxofibrous tumors (LSMFTs) are rare benign fibro-osseous tumors most frequently occurring in the proximal femur. We report the first case of this rare tumor occurring within the calvarium. CLINICAL PRESENTATION:Our patient presented with a 2-yr history of enlarging, painless, ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyy071

    authors: Ploof J,Shaikh H,Melli J,Jour G,Turtz A

    更新日期:2019-03-01 00:00:00

  • Predicting the Occurrence of Postoperative Distal Junctional Kyphosis in Cervical Deformity Patients.

    abstract:BACKGROUND:Distal junctional kyphosis (DJK) development after cervical deformity (CD)-corrective surgery is a growing concern for surgeons and patients. Few studies have investigated risk factors that predict the occurrence of DJK. OBJECTIVE:To predict DJK development after CD surgery using predictive modeling. METHO...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyz347

    authors: Passias PG,Horn SR,Oh C,Lafage R,Lafage V,Smith JS,Line B,Protopsaltis TS,Yagi M,Bortz CA,Segreto FA,Alas H,Diebo BG,Sciubba DM,Kelly MP,Daniels AH,Klineberg EO,Burton DC,Hart RA,Schwab FJ,Bess S,Shaffrey CI,A

    更新日期:2020-01-01 00:00:00

  • Estimating energy expenditure in traumatic brain injury: comparison of indirect calorimetry with predictive formulas.

    abstract::A high degree of variability in energy expenditure has characterized the metabolic response to traumatic brain injury. A goal of parenteral or enteral repletion in this population is the precise estimation of caloric requirement to avoid complications associated with overfeeding and underfeeding. The first aim of this...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199208000-00009

    authors: Sunderland PM,Heilbrun MP

    更新日期:1992-08-01 00:00:00

  • Polyamine and prostaglandin markers in focal cerebral ischemia.

    abstract::This study examines the pathophysiology of stroke secondary to focal cerebral ischemia. The interaction of arachidonic acid metabolites and polyamines, a class of ubiquitous ornithine-derived molecules with important membrane effects on edema, Ca++-dependent endocytosis, platelet function, and prostaglandin (PG) forma...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198510000-00017

    authors: Dempsey RJ,Roy MW,Meyer K,Tai HH,Olson JW

    更新日期:1985-10-01 00:00:00

  • Hemodynamic evaluation of basilar and vertebral artery angioplasty.

    abstract:OBJECTIVE:The postangioplasty evaluation of a stenotic vessel is often conducted by studying serial angiograms to determine the anatomic reduction in stenosis. In flow-limiting stenosis, the hemodynamic change that accompanies these anatomic changes is of great importance in evaluating the success of the angioplasty. T...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Guppy KH,Charbel FT,Corsten LA,Zhao M,Debrun G

    更新日期:2002-08-01 00:00:00

  • Facial palsy and its management in the Kitab al-Hawi of Rhazes.

    abstract::More than 1000 years ago, Rhazes practiced rudimentary neurology. This monumental physician wrote more than 200 books in his lifetime and died a blind pauper in the 10th century AD. His Kitab al-Hawi (Liber Continens) was one of the most famous and detailed medical texts of the ancient world. Here, we discuss the life...

    journal_title:Neurosurgery

    pub_type: 历史文章,杂志文章

    doi:10.1227/01.NEU.0000345639.46737.67

    authors: Shoja MM,Tubbs RS,Loukas M,Shokouhi G,Ardalan MR

    更新日期:2009-06-01 00:00:00

  • Chronic posttraumatic lumbar intradural arachnoid cyst with cauda equina compression: case report.

    abstract::An unusual case of a chronic posttraumatic lumbar intradural arachnoid cyst causing compression of the cauda equina is reported. The etiological, pathological, and clinical features are discussed. Emphasis is placed on the importance of a correct interpretation of radiological findings. ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198704000-00024

    authors: Zuccarello M,Powers G,Tobler WD,Sawaya R,Hakim SZ

    更新日期:1987-04-01 00:00:00

  • Biomechanical evaluation of Caspar cervical screws: comparative stability under cyclical loading.

    abstract::Anterior cervical instrumentation is used as an adjunct to bone fusion; however, definitive biomechanical data to support some applications and techniques are lacking. In the absence of supportive experimental data, posterior cortical penetration has been recommended with the Caspar system. Previously, we compared the...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199312000-00013

    authors: Gallagher MR,Maiman DJ,Reinartz J,Pintar F,Yoganandan N

    更新日期:1993-12-01 00:00:00

  • Intraventricular pneumocephalus secondary to subcutaneous emphysema: a case report.

    abstract::Intraventricular tension pneumocephalus is an unusual complication of surgically treated hydrocephalus. This is a life-threatening complication requiring prompt diagnosis and treatment. A case is presented wherein tension pneumocephalus developed as a result of cervicocranial subcutaneous emphysema in the presence of ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198410000-00016

    authors: Horton DD,Pollay M,Reynolds AF Jr

    更新日期:1984-10-01 00:00:00

  • Saccular intracranial aneurysm disease: distribution of site, size, and age suggests different etiologies for aneurysm formation and rupture in 316 familial and 1454 sporadic eastern Finnish patients.

    abstract:OBJECTIVE:Finnish saccular intracranial aneurysm (sIA) disease associates to 2q33, 8q11, and 9p21 loci and links to 19q13, Xp22, and kallikrein cluster in sIA families. Detailed phenotyping of familial and sporadic sIA disease is required for fine mapping of the Finnish sIA disease. METHODS:Eastern Finland, which is p...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000367634.89384.4B

    authors: Huttunen T,von und zu Fraunberg M,Frösen J,Lehecka M,Tromp G,Helin K,Koivisto T,Rinne J,Ronkainen A,Hernesniemi J,Jääskeläinen JE

    更新日期:2010-04-01 00:00:00

  • Spontaneous pneumocephalus in the posterior fossa in a patient with a ventriculoperitoneal shunt: case report.

    abstract:OBJECTIVE AND IMPORTANCE:A unique case of spontaneous pneumocephalus is described. It appeared a few years after the uneventful introduction of a cerebrospinal fluid shunt and was probably attributable to a defect of the posterior mastoid plate. CLINICAL PRESENTATION:A 65-year-old man presented with a subacute onset o...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-200004000-00048

    authors: Kanner AA,Nageris BI,Chaimoff M,Rappaport ZH

    更新日期:2000-04-01 00:00:00

  • Gamma knife surgery for low-grade gliomas.

    abstract:OBJECT:Data regarding the long-term efficacy of Gamma knife surgery on a large series of patients with low-grade gliomas is lacking. We aimed to review the outcome of patients with low-grade gliomas undergoing Gamma knife surgery at the Lars Leksell Gamma Knife Center at the University of Virginia to clarify its role i...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000316279.22371.b8

    authors: Heppner PA,Sheehan JP,Steiner LE

    更新日期:2008-02-01 00:00:00