Abstract:
OBJECTIVE:Stereotactic biopsy is an everyday procedure implemented in numerous neurosurgical departments. The procedure is performed to obtain tumor tissue of unclear diagnosis. Going in hand with low complication rates and high diagnostic yield, stereotactic biopsies can be performed in adults and children likewise for histopathologic evaluation of lesions in eloquent localizations. However, little is known about whether aged patients do benefit from stereotactic biopsy or rather the therapy that is derived from histopathologic results. In this study, we therefore focused on old (80-84 years) and very old patients (85 years and older) to evaluate whether stereotactic biopsy should be performed leading to further therapy. We also assessed the complication rates of the procedure in this aged population. METHODS:We performed a retrospective analysis of our database and included all patients older than 80 years who underwent stereotactic biopsy at our department from October 2005 until May 2016. Forty-seven patients were included in this study. These patients were divided into 2 subgroups: group 1 consisted of patients from 80 to 84 years old and group 2 of patients aged 85 years and older. All patients underwent stereotactic biopsy to establish histopathologic diagnosis. We excluded patients who underwent cyst puncture or puncture of a hemorrhage because the procedure was not performed for diagnostic purposes. We assessed gender, neuroradiologic diagnosis, Karnofsky Performance Score (KPS), number of tissue samples taken, histopathologic diagnosis, localization, postoperative hemorrhage, modality of anesthesia anticoagulation, and further therapy. RESULTS:Group 1 consisted of 34 patients and group 2 of 13 patients. KPS was 80 and 70, respectively. A histopathologic diagnosis was possible in all but 1 patient. In group 1, 61.8% of the patients agreed to further postoperative therapy (radiation, 35.3%; chemotherapy, 11.8%; combined radiochemotherapy, 11.8%; complication that prevented therapy, 2.9%), as did 53.8% of the patients in group 2 (resection, 7.7%; radiation, 15.4%; combined radiochemotherapy, 30.7%). In group 1, 38.2% declined further therapy, as did 64.1% in group 2. CONCLUSIONS:Also in old and very old patients, a final histopathologic diagnosis should be established to provide adequate therapy. Our data show that most of these aged patients want to be treated.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Quick-Weller J,Tichy J,Dinc N,Tritt S,Won SY,Behmanesh B,Bruder M,Seifert V,Weise LM,Marquardt Gdoi
10.1016/j.wneu.2017.03.059subject
Has Abstractpub_date
2017-06-01 00:00:00pages
442-448eissn
1878-8750issn
1878-8769pii
S1878-8750(17)30382-0journal_volume
102pub_type
杂志文章abstract:BACKGROUND:Intracranial hematomas associated with abnormal collateral vessels are observed in certain populations of adult patients with moyamoya disease (MMD). Of these, intraventricular hematomas resulting from rupture of intraventricular aneurysms, which are formed along an abnormal peripheral choroidal artery, are ...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.05.222
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Dysplastic gangliocytoma is a sporadic cerebellar benign tumor with the characteristics of hamartoma and true tumor, also known as Lhermitte-Duclos disease (LDD). Bone fibrous dysplasia (FD) is a slowly progressive self-limited benign bone tissue disease. Cowden syndrome, an autosomal dominant genetic disord...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2020.06.071
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:This study sought to show and analyze the main authors' experience (P.R. and J.M.C.) in previously coiled aneurysm surgery as an emerging challenge in today's neurosurgical practice. METHODS:Twelve female and 8 male patients, whose ages ranged from 32 to 56 years (average 43.5), underwent surgery between Apr...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2013.09.016
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Currently, polylactide is the most popular material used to made bioabsorbable cages but too-quick degradation and osteolysis around the cage have been reported in the literature. This study evaluated the fusion effect, biomechanical stability, and histologic characteristics of a novel bioabsorbable multiami...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.04.005
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:Hemangioblastomas remain a surgical challenge because of their arteriovenous malformation-like character. Recently, indocyanine green (ICG) videoangiography has been applied to neurosurgical vascular surgery. The aim of this study was to evaluate the usefulness of tumor blood flow imaging by intraoperative IC...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2013.02.009
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Fenestration of the basilar artery is a segmental duplication of the vessel due to nonfusion of the embryonal arteries and is the second most common vascular disjunction. Here, we present a single case example demonstrating the utility of the temporary bridging device Comaneci as a new option in the endovasc...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.08.047
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Nonlethal neural tube defects are developmental malformations with complex pathogenesis usually manifested at birth or in childhood. CASE DESCRIPTION:We report the case of a 61-year-old woman without significant previous clinical history presenting for neck pain and stiffness. An extensive workup detected m...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.02.164
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:To describe longitudinal image changes in supratentorial hemispheric meningiomas based on magnetic resonance imaging after preoperative embolization using calibrated microspheres. METHODS:A total of 14 patients with symptomatic supratentorial meningiomas were included in a prospective, mono-centric, mono-arm...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.08.078
更新日期:2018-12-01 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
abstract:BACKGROUND:Affective symptoms are frequent in patients with brain tumors. The origin of such symptoms is unknown; either focal brain injury or reactive emotional distress may be responsible. This cross-sectional pilot study linked depressive symptoms and anxiety to white matter integrity. The objective was to test the ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.05.031
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Cyclooxygenase 2 (COX-2) is a key enzyme in the synthesis of prostaglandins. Recent studies have shown that overexpression of COX-2 can reduce the antitumor effect of the immune system by inhibiting the proliferation of B and T lymphocytes. Programmed cell death ligand 1 (PD-L1) was the first functionally ch...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.09.031
更新日期:2020-12-01 00:00:00
abstract::Clinical neurosurgery is a complex specialty with multiple participants, including a variety of providers, patients, family members, and administrators, who interact in complex fashions. Modern-day patient care requires near-constant team communication of vital, detailed clinical information; any breakdown in this pro...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.08.134
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Global neurosurgery encompasses the social and surgical practices that effect the neurologic health of vulnerable and underserved populations in domestic and international resource-limited settings. Formal academic engagement in global neurosurgery is limited in residency programs. Here we explore the curren...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.06.039
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Melanocytic lesions of the nervous system are thought to arise from leptomeningeal melanocytes, which are derived from neural crest and include diffuse melanocytosis, melanocytomas, and malignant melanomas. Meningeal melanocytomas are extremely rare benign lesions. The usual treatment of intradural extramedu...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.03.122
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Lumbar arthrodesis is a surgical option for treatment of lumbar pathologies. Stability of the spinal construct partly depends on load-bearing support from back muscles. Despite the role of the psoas muscle in upright spinal stabilization, data describing its clinical significance are scarce. We evaluated the...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.11.022
更新日期:2016-03-01 00:00:00
abstract:CASE DESCRIPTION:A 20-year-old woman presented with a rare intracranial inflammatory myofibroblastic tumor (IMT) manifesting as headache and insomnia. Magnetic resonance imaging showed a tumorous lesion with heterogeneous enhancement at the right temporal lobe, as well as perifocal edema with midline shift. The tumor w...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.07.060
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:The chemoreceptor network, consisting of the glossopharyngeal nerve and carotid body (GPN-CB), is essential for the regulation of blood pH. Its ischemic insults after subarachnoid hemorrhage (SAH), which may contribute to acidosis, have not been investigated. METHODS:Twenty-three hybrid rabbits were used. Th...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.04.105
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To report a series of four patients with uterine sarcoma, including one with müllerian adenosarcoma (MA) and three with low-grade endometrial stromal sarcoma (LGESS), who developed intracranial meningiomas while receiving the progesterone agonist megestrol acetate. METHODS:The hospital records, imaging studi...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2011.03.035
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Most sellar gangliocytomas are discovered with a concurrent pituitary adenoma, also known as a mixed gangliocytoma-adenoma (MGA). MGAs are rare, with fewer than 100 cases reported in the literature to date and only 1 previously documented surgical series. Because MGAs are radiologically indistinguishable fro...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.08.174
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Altered mental status (AMS) has been associated with inferior surgical outcomes. The factors leading to AMS after spine surgery are unknown. The aim of this study is to determine the risk factors and independent predictors of 30-day readmission for AMS in patients with spine deformity after undergoing electi...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.02.001
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Motor evoked potential (MEP) monitoring has been widely used in brain or spine surgery to recognize potential damage of the pyramidal motor system. However, its ability to detect ischemic injury during middle cerebral artery (MCA) aneurysm surgery remains unclear. A prospective cohort study was designed to e...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2014.09.004
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Large calcified intrasellar masses, called pituitary stones, have been reported as calcified pituitary adenomas in the literature. Although relatively rare, calcified pituitary adenomas appear in various formations. Thus, whether the lesion is removable-and, if so, which approach is appropriate-mainly depend...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2018.11.255
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVES:To prospectively evaluate the diagnostic value of 3.0 Tesla magnetic resonance 3-dimensional sampling perfection with application-optimized contrast using different flip angle evolution (3D-SPACE) in the detection of sinus wall invasion and sinus patency in parasinus meningiomas. METHODS:In this study, 28 p...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.07.223
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Although a subdural fluid collection frequently is observed, diagnostic methods that differentiate between the subdural collection caused by external hydrocephalus and that caused by subdural hygroma have not been established. Here, we report a case of external hydrocephalus caused by Gliadel-induced eosinop...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.09.175
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Heterotopic ossification (HO) and anterior bone loss (ABL) are 2 complications in cervical disc replacement (CDR), which have impacts on the clinical outcomes. Physiologically, bone formation (HO) and bone loss are 2 sides of bone remodeling. However, clinically, some patients experienced anterior HO (AHO) a...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.01.022
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Abnormalities of the posterior arches of the upper and middle cervical spine that can cause myelopathy are rare, and no reports of such defects at the thoracic spinal level have been published. CASE DESCRIPTION:A 29-year-old male patient reported right arm weakness and pain for 1 year. Magnetic resonance im...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.06.088
更新日期:2016-09-01 00:00:00
abstract::Foramen magnum meningiomas represent a challenge for neurosurgeons. These tumors require careful surgical manipulation as they are often located in proximity to critical neurovascular structures and the cranial nerves. The far lateral approach is considered the safest neurosurgical approach for excising foramen magnum...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2017.07.029
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:To investigate potential health care discrepancies in patients with ruptured cerebral aneurysms undergoing microsurgical intervention. METHODS:We retrospectively reviewed patients with ruptured intracranial aneurysms treated at our tertiary referral university hospital (UH) and safety net county hospital (CH...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.03.087
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:Simulation models enable trainees to master microsurgical skills before performing surgeries. Vascular bypass is a critical component of cerebrovascular and many nonneurologic procedures. However, most available bypass training models lack important spatial, tactile, and physiologic aspects of real surgery. A...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.02.107
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Hiccups are a well-known short-term phenomenon in daily life. If they persist or become intractable, they may be a primary symptom of a disease. Recent studies identified the medulla oblongata as the neuroanatomic center of the hiccup reflex arc. In previous cases, an isolated lesion at the dorsal side of th...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.06.013
更新日期:2020-09-01 00:00:00