Abstract:
Background and importance:Lesions in the corticospinal tract above the decussation at the medullary pyramids almost universally produce contralateral deficits. Rare cases of supratentorial lesions causing ipsilateral motor deficits have been reported previously, but only ever found secondary to stroke or congenital pyramidal tract malformations. Clinical presentation:Herein, we report a case of ipsilateral corticospinal tract innervation discovered incidentally with intraoperative monitoring during a microsurgical resection of a vestibular schwannoma. Intraoperative monitoring with electrical transcranial stimulation of the frontal scalp triggered motor-evoked potentials in the ipsilateral arms. The uncrossed pathways were later confirmed with MRI tractography using diffusion tensor imaging. Conclusion:To the best of our knowledge, this is the first case of isolated ipsilateral motor innervation of the corticospinal tract discovered incidentally during a neurosurgical procedure. Given the increasing use of intraoperative monitoring, this case underscores the importance of cautious interpretation of seemingly discordant neurophysiological findings. Once technical issues have been ruled out, ipsilateral motor innervation may be considered as a possible explanation and neurosurgeons should be aware of the existence of this rare anatomic variant.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Ku J,Mendelsohn D,Chew J,Shewchuk J,Dong C,Akagami Rdoi
10.1093/neuros/nyw074subject
Has Abstractpub_date
2017-03-01 00:00:00pages
E194-E200issue
3eissn
0148-396Xissn
1524-4040pii
2884535journal_volume
80pub_type
杂志文章相关文献
NEUROSURGERY文献大全abstract::The object of this investigation was to study the effects of dimethyl sulfoxide (DMSO) upon the evolution of cerebral infarction. Twenty adult cats anesthetized lightly with ketamine hydrochloride underwent right middle cerebral artery occlusion for 6 hours. Ten cats were not treated and 10 cats received DMSO (2.5 g/k...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198107000-00006
更新日期:1981-07-01 00:00:00
abstract::Fourteen patients with acoustic neurinomas varying in size from 7 to 30 mm were treated by stereotactic radiosurgery and then were followed for 4 years. The tumors of eight patients decreased 1 to 10 mm in diameter, no change was found in two, and the tumor increased slightly in three patients. Loss of the ability to ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198307000-00003
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVE:Treatment of 11 patients with aneurysms or arteriovenous fistulae of the craniocervical arteries with stent grafts. METHODS:Peripheral stent grafts were deployed in two extracranial internal carotid arteries. Coronary stent grafts were used to treat two giant aneurysms, five direct carotid-cavernous fistulae...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000134455.02947.1f
更新日期:2004-09-01 00:00:00
abstract::An 8-year-old boy presented with acute proptosis of the right eye. Examination revealed 8 mm of exophthalmos, limitation of upward gaze, optic disc swelling, and normal visual acuity, but an inferonasal quadrantic visual field defect. Orbital ultrasound and computed tomographic scanning demonstrated a superotemporal t...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::The development of new devices, especially controlled detachable coils, has made the endovascular approach one of the modalities for the treatment of intracranial aneurysms. We describe the treatment and present the results of 35 patients treated by selective occlusion of basilar artery aneurysms in our department dur...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199605000-00019
更新日期:1996-05-01 00:00:00
abstract::Intimal proliferation is thought to be initiated by the migration and proliferation of smooth muscle cells after endothelial damage. These changes may be induced, in part, by mitogenic growth factors such as insulin-like growth factor-1 (IGF-1). This study was designed to investigate the role of locally synthesized IG...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199407000-00015
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Middle cerebral artery (MCA) aneurysms are often considered unsuitable for endovascular coiling because of unfavorable morphological features. With improvements in endovascular techniques, several series have detailed the results and complications of endovascular treatment of MCA aneurysms. OBJECTIVE:We per...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/NEU.0b013e318201d7f4
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:Despite apparent gross total resection, olfactory groove meningiomas have a high rate of late recurrence (average, 23%). In this retrospective study, we confirmed that the sites of these recurrences are the cranial base and paranasal sinuses. We postulated that these recurrences stem from conservative handlin...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000079484.19821.4a
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Calcification of the ligamentum flavum is a rare disease that occurs almost exclusively in elderly Japanese people. We report the case of a young Caucasian woman who presented with a C5-C6 disc herniation associated with a cervical calcified ligamentum flavum. CLINICAL PRESENTATION:The patient...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200103000-00047
更新日期:2001-03-01 00:00:00
abstract::Even though neurosurgeons exercise these enormous and versatile skills, the COVID-19 pandemic has shaken the fabrics of the global neurosurgical family, jeopardizing human lives, and forcing the entire world to be locked down. We stand on the shoulders of the giants and will not forget their examples and their teachin...
journal_title:Neurosurgery
pub_type: 历史文章,杂志文章
doi:10.1093/neuros/nyaa314
更新日期:2020-09-15 00:00:00
abstract::The authors describe a new suction device with prehensile properties that has proved itself particularly useful in the removal of certain types of tumor, especially extramedullary. ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198710000-00031
更新日期:1987-10-01 00:00:00
abstract:BACKGROUND:Length of stay beyond medical readiness (LOS-BMR) leads to increased expenses and higher morbidity related to hospital-acquired conditions. OBJECTIVE:To determine the proportion of admitted neurosurgical patients who have LOS-BMR and associated risk factors and costs. METHODS:We performed a prospective, co...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyaa535
更新日期:2020-12-28 00:00:00
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
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:Gliomatosis cerebri is an enigmatic diffuse brain neoplasm whose prognosis is grim. We reviewed data for patients with gliomatosis who were treated at the University of California, San Francisco, during a 10-year period. Our focus was on presentation, radiological and pathological features, and outcomes. MET...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/01.neu.0000073527.20655.e6
更新日期:2003-08-01 00:00:00
abstract:OBJECTIVE:The majority of tumors of the cerebellopontine angle (CPA) are benign. We report the case of a primary malignant melanoma of the CPA that mimicked a vestibular schwannoma (acoustic neuroma). We discuss the differential diagnosis and prognosis of melanotic lesions at this location. CLINICAL PRESENTATION:A 49-...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000219236.48886.44
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:Anterior microforaminotomy for spondylotic cervical myelopathy is reported with surgical results. METHODS:A retrospective study was performed for 40 patients with spondylotic cervical myelopathy who had been surgically treated with anterior microforaminotomy at the University of Pittsburgh between April 1994...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:2002-11-01 00:00:00
abstract::The natural history of intracranial arteriovenous malformations (AVMs) was studied in 131 patients. The 83 patients managed nonsurgically and the 48 patients treated surgically were followed for an average of 8 years. Hemorrhage occurred in 61.8% of all patients. A second hemorrhage occurred in 67.4% of the survivors ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198411000-00003
更新日期:1984-11-01 00:00:00
abstract:BACKGROUND:Knowledge of the anatomic location of the deep brain stimulation (DBS) electrode in the brain is essential in quality control and judicious selection of stimulation parameters. Postoperative computed tomography (CT) imaging coregistered with preoperative magnetic resonance imaging (MRI) is commonly used to d...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e318218c7ae
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:Policies of regionalization and selective referral for a number of "high-risk" surgical procedures are being explored and implemented as a result of significant variation in postoperative mortality between high- and low-volume providers. The effect of provider volume on outcomes after intracranial tumor resec...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200301000-00005
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:We report the first example of an anaplastic meningioma arising from an intracranial arachnoid cyst and discuss the diagnostic challenges of this case, including the useful role of genetic markers. CLINICAL PRESENTATION:A 72-year-old man presented with transient episodes of expressive dysphasi...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000370013.55369.92
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Flow diversion is increasingly used to treat intracranial aneurysms. In previous reports, patients were pretreated with aspirin and clopidogrel before the intervention for the prevention of thromboembolic complications. OBJECTIVE:To assess the safety and efficacy of a new protocol for anticoagulation using ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000001071
更新日期:2016-05-01 00:00:00
abstract::Although thrombocytopenia occurs in approximately 10% of medical patients who receive heparin, this complication has not been described in neurosurgical patients. We report the clinical course of two patients who in the immediate postoperative period developed heparin-associated thrombocytopenia that resulted in signi...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198607000-00010
更新日期:1986-07-01 00:00:00
abstract:OBJECTIVE:An excruciating headache of instantaneous onset is known as a thunderclap headache. A subarachnoid hemorrhage is the prototypical cause, but other serious disorders may also present with a thunderclap headache, including cerebral venous sinus thrombosis, carotid artery dissection, and pituitary apoplexy. We r...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200103000-00009
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Surgical treatment of C2 tumors remains challenging. Because of the deep location and unique anatomical complexity, anterior exposure in this region is considered difficult and dangerous, and few reports concerning anterior tumor resection and reconstruction exist. OBJECTIVE:To describe a technique of seque...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e31821bc7f9
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:Interhemisperic lipomas are almost always associated with hypogenesis or agenesis of the corpus callosum. These lesions are stable. CLINICAL PRESENTATION:We report a case of an interhemispheric lipoma in a 72-year-old man who had undergone myelolipomatous differentiation. INTERVENTION:Gross total excision o...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000317326.09601.51
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Rugby is characterized by high-speed collisions among the players that predispose them to injuries, particularly to the head, neck, and spine. OBJECTIVE:To evaluate the effectiveness of current neurological injury prevention strategies in rugby union. METHODS:Systematic review in May 2010. We assessed the ...
journal_title:Neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1227/NEU.0b013e3181f209f1
更新日期:2010-11-01 00:00:00
abstract::HIPPOCRATIC WORKS LEND themselves still today to the modern physician for further analysis of his approach to the diagnosis and treatment of various pathological conditions. We present an attempt to systematize his methodology regarding the management of head trauma and present it in the format of a modern-era algorit...
journal_title:Neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.1227/01.neu.0000187321.13149.b9
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Preoperative diffusion tensor imaging (DTI) is used to demonstrate corticospinal tract (CST) position. Intraoperative brain shifts may limit preoperative DTI value, and studies characterizing such shifts are lacking. OBJECTIVE:To examine tumor characteristics that could predict intraoperative shift in tumor...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000338
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Deep brain stimulation (DBS) is commonly used in the treatment of movement disorders such as Parkinson disease (PD), dystonia, and other tremors. OBJECTIVE:To examine systematic errors in image-guided DBS electrode placement and to explore a calibration strategy for stereotactic targeting. METHODS:Pre- and...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e3181f7422a
更新日期:2010-12-01 00:00:00
abstract::Meningiomas have a wide range of biological potential and clinical behavior. Histological findings are helpful in recognizing the malignant potential of a given tumor, but often fail to correlate with gross features, liability of recurrence, and extent of associated cerebral edema. To find alternate approaches to impr...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198812000-00006
更新日期:1988-12-01 00:00:00