Abstract：
OBJECTIVE:Intraoperative distinction of brain tumor from surrounding brain is a crucial challenge in neuro-oncologic surgery. We directly compared confocal laser endomicroscopy (CLE) findings with intraoperative instantaneous sections by the neuropathologist in a blinded fashion. METHODS:The imaging device comprises a rigid endoscope with Hopkins rod lenses and a red wave length laser with a scanning depth of 80 μm. Brain tumor samples of 100 patients were investigated. Tissue samples were simultaneously investigated by the neuropathologist and with CLE. The tissue was not prepared or stained before CLE analysis. RESULTS:CLE could be performed in all cases. Sensitivity for detection of a correct final diagnosis by CLE on site was 82%-90% for high-grade gliomas (26/32), low-grade gliomas (9/10), schwannomas (7/8), and meningiomas (28/34). Sensitivity of only 37% (6/16) was achieved for metastasis (6/16). CONCLUSIONS:With intraoperative CLE, it is possible to obtain an on-site histologic diagnosis with a high sensitivity in many tumors. Although definitive histologic classification requires further neuropathologic investigation, these results show that CLE could fill the gap between tissue resection and microscopic analysis. This could ultimately help neurosurgeons to scan brain tissue for tumor remnants on a microscopic scale without having to resect it first. Further development of the device and further investigations are needed before this technique can become part of the neurosurgical routine in specific cases.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Breuskin D,Szczygielski J,Urbschat S,Kim YJ,Oertel Jdoi
10.1016/j.wneu.2016.12.128subject
Has Abstractpub_date
2017-04-01 00:00:00pages
180-185eissn
1878-8750issn
1878-8769pii
S1878-8750(16)31443-7journal_volume
100pub_type
杂志文章abstract：OBJECTIVE:This study looks at the various comorbidities and postoperative complications and their impact on readmission rates of patients undergoing outpatient versus inpatient 1- and 2-level anterior cervical discectomy and fusion (ACDF). With increasing costs within the United States medical system, one emerging cost...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2019.03.124
更新日期：2019-06-01 00:00:00
abstract：BACKGROUND:Sinus histiocytosis with massive lymphadenopathy, also known as Rosai-Dorfman disease, is a rare condition, classically characterized by painless, massive cervical lymphadenopathy. Histologically, the pathognomonic findings include a dense, mixed inflammatory infiltrate with areas of emperipolesis. Albeit in...
journal_title：World neurosurgery
pub_type： 杂志文章,评审
doi：10.1016/j.wneu.2016.02.121
更新日期：2016-06-01 00:00:00
abstract：BACKGROUND:Cavernous hemangiomas account for 5%-13% of central nervous system vascular lesions. They are usually found intra-axially but rarely involve extra-axial structures, most commonly the middle cranial fossa. A cavernous hemangioma manifesting as a clinoid meningioma is extremely rare. CASE DESCRIPTION:A 36-yea...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2017.02.029
更新日期：2017-04-01 00:00:00
abstract：BACKGROUND:Bilateral hemifacial spasm (HFS) is very rare. The literature contains only 32 clinical reports. Although microvascular decompression (MVD) is widely accepted as effective therapy for HFS, the etiology and surgical treatment of bilateral HFS are seldom addressed. We report our experience with MVD for patient...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2015.10.091
更新日期：2016-03-01 00:00:00
abstract：BACKGROUND:Paragangliomas are neuroendocrine tumors that originate from autonomic nervous system-associated paraganglia and are rare tumors accounting for only 0.3% of all neoplasms. Malignant paragangliomas frequently spread to the skeleton. The authors present a case of malignant paraganglioma with bone metastases to...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2015.09.102
更新日期：2016-06-01 00:00:00
abstract：OBJECTIVE:This study was undertaken to evaluate de novo aneurysm formation in the long-term follow-up of patients with clipped aneurysms. METHODS:Of 459 patients who underwent clipping of ruptured cerebral aneurysms at our institution between 1997 and 2008, 119 patients were available in good condition and agreed to u...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2013.06.008
更新日期：2014-11-01 00:00:00
abstract：BACKGROUND:Filum terminale arteriovenous fistula (FTAVF) with multiple shunt points has not been reported in the literature. In previous studies, the angioarchitecture of FTAVFs was always featured with only one single shunt point, and such a uniformity had established the preconceived and conventional understanding of...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.07.097
更新日期：2018-10-01 00:00:00
abstract：OBJECTIVE:To investigate the occurrence and progression of heterotopic ossification (HO) in patients treated by anterior cervical discectomy with arthroplasty. It was evaluated if HO affects clinical outcome and range of motion (ROM). Risk factors of HO was studied as well. METHODS:Patients who underwent anterior cerv...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2019.07.187
更新日期：2019-11-01 00:00:00
abstract：BACKGROUND:Major depressive disorder is a common and disabling illness and is the leading cause of disability worldwide. Despite aggressive medical, behavioral, and electroconvulsive therapies, a significant number of patients remain refractory to treatment. Deep brain stimulation (DBS) has proven efficacy in neurobeha...
journal_title：World neurosurgery
pub_type： 历史文章,杂志文章,评审
doi：10.1016/j.wneu.2012.10.068
更新日期：2013-09-01 00:00:00
abstract：INTRODUCTION:Ventriculitis is a serious infection associated with high mortality even when both intravenous (IV) and intrathecal (IT) antibiotics are administered. Poor outcome in patients with ventriculitis indicates the need to be more aggressive in our attempts to expeditiously eradicate the infection. The purpose o...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2016.06.022
更新日期：2016-09-01 00:00:00
abstract：BACKGROUND:Lack of risk stratification among patients with varying severities of compound head injury has resulted in too-inconsistent and conflicting results to support any management strategy over another. The purpose of this study was to validate a new clinico-radiological grading scheme with implications on outcome...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2015.05.058
更新日期：2015-11-01 00:00:00
abstract：BACKGROUND:Readmission and reoperation are used as hospital and surgeon quality metrics. Venous thromboembolic (VTE) events, including deep vein thrombosis and pulmonary embolism (PE), are a major cause of readmission, morbidity, and mortality after spine surgery. Specific procedural, perioperative, and patient charact...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2017.11.168
更新日期：2018-03-01 00:00:00
abstract：OBJECTIVES:In complex lumbosacral lipomatous malformation or retethering, 'crotch' dissection, an incision on the dura or lipoma at the site lateral to the lipoma-cord fusion line saving underlying roots, is often not easy. Attempts of this dissection in complex and obscured conditions may cause damage to the spinal co...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.12.137
更新日期：2019-01-04 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:Atherosclerotic stenosis of the extracranial internal carotid artery accounts for 15%-20% of ischemic strokes, depending on the population studied. Carotid endarterectomy (CEA) is the most frequently performed operation to prevent stroke. METHODS:Since the 1990s, several randomized controlled trials have be...
journal_title：World neurosurgery
pub_type： 杂志文章,评审
doi：10.1016/j.wneu.2011.05.037
更新日期：2011-12-01 00:00:00
abstract：BACKGROUND:Glioblastoma multiforme (GBM) is a rapid-growing central nervous system neoplasm. We report a case of GBM with extensive intramedullary lumbar drop metastasis and highly unusual osseous spine metastasis from a primary infratentorial GBM occurring 10 years after the initial diagnosis, which to our knowledge h...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2019.07.142
更新日期：2019-11-01 00:00:00
abstract：OBJECTIVE:To report on our experience with the Elekta Extend system, a relocatable frame system used in patients with brain metastases for single-session, hypofractionated, or staged hypofractionated Gamma Knife radiosurgery (GKRS); and the evaluation of its efficacy. METHODS:From March 2014 to September 2016, 856 pat...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.07.157
更新日期：2018-11-01 00:00:00
abstract：BACKGROUND:To retrospectively analyze our clinical data to determine the risk factors for thromboembolism, especially with unruptured posterior circulation coil embolization. METHODS:A total of 53 coil embolization procedures for unruptured posterior circulation aneurysms performed in 53 patients between October 2010 ...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2020.03.065
更新日期：2020-06-01 00:00:00
abstract：BACKGROUND:Osteoid osteomas (OOs) are benign bone forming tumors that, usually, occur in the extremities, with about 10% of them arising in the spine more commonly in the posterior elements. The aim of this study is to evaluate the long-term results of patients suffering from spinal OO treated with surgery and radiofre...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2020.10.050
更新日期：2021-01-01 00:00:00
abstract：BACKGROUND:Medical implications of 3-dimensional (3D) printing technology have evolved and are increasingly used. Surgical spine oncology involves at times complex resection using various surgical approaches and unique spinal reconstruction. As high general complication rates, including hardware failure, are reported, ...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2019.09.002
更新日期：2020-01-01 00:00:00
abstract：BACKGROUND:Departments of neurosurgery in the United States have had a long history of hosting international visitors for the advancement of their neurosurgical education. The goal of the present study was to determine the existence of a geographic profile of international visitors for education purposes, both students...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2020.04.105
更新日期：2020-07-01 00:00:00
abstract：BACKGROUND:The anterior surgical approach to the cervical spine is known to be safe, and damage to the hypoglossal nerve and trigeminal pathway after the surgery is uncommon. However, once damage to those nerves occurs, the patient's quality of life can be severely impaired by discomfort and disability. CASE DESCRIPTI...
journal_title：World neurosurgery
pub_type： 杂志文章,评审
doi：10.1016/j.wneu.2019.12.094
更新日期：2020-04-01 00:00:00
abstract：BACKGROUND:Intracranial hypotension (IH) is a recognized cause of coma; however, the diagnosis is often challenging, especially in patients with superimposed traumatic brain injury. CASE DESCRIPTION:A 67-year-old woman became comatose following evacuation of bilateral acute subdural hematomas with concurrent respirato...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2017.06.060
更新日期：2017-09-01 00:00:00
abstract：BACKGROUND:Microvascular anastomosis is an essential procedure in neurosurgery, but the opportunity to perform the surgery has gradually decreased for neurosurgeons. Therefore, training is necessary for obtaining and maintaining the skills required for the procedure. We describe the detailed anatomy of cervical and fem...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.09.071
更新日期：2018-12-01 00:00:00
abstract：BACKGROUND:We sought to analyze the clinical data and imaging features from a rare case presenting an intravertebral mobile nerve sheath tumor of the lumbar spine, review the relevant literature, discuss the imaging features and possible causes of the tumor, and propose preventive measures and solutions. CASE DESCRIPT...
journal_title：World neurosurgery
pub_type：
doi：10.1016/j.wneu.2020.07.166
更新日期：2020-11-01 00:00:00
abstract：OBJECTIVE:For adult patients undergoing surgical decompression for Chiari malformation type I (CM-I), the patient-level factors that influence extended length of stay (LOS) are relatively unknown. The aim of this study was to investigate the impact of patient-baseline comorbidities, demographics, and postoperative comp...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2020.02.158
更新日期：2020-06-01 00:00:00
abstract：BACKGROUND:Pseudoarthrosis after spinal fusion is an important cause of pain, neurologic decline, and reoperation. METHODS:The Healthcare Cost and Utilization Project State Inpatient Databases were queried in New York, California, Florida, and Washington for adult patients who had undergone new spinal fusion from 2009...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.08.026
更新日期：2018-12-01 00:00:00
abstract：BACKGROUND:The semi-sitting position is preferred in some surgeries of the posterior fossa and the cervical spine. At the same time, it is associated with a risk of air embolism. In the presence of a patent foramen ovale (PFO) with an intracardial right-to-left shunt, an air embolism can result in a paradoxical embolis...
journal_title：World neurosurgery
pub_type： 杂志文章,评审
doi：10.1016/j.wneu.2018.04.114
更新日期：2018-07-01 00:00:00
abstract：BACKGROUND:In his 1938 monograph, Cushing tabulated 313 meningioma cases treated throughout his career at the Johns Hopkins and the Peter Bent Brigham Hospitals. Of these, 18 patients were treated at the Johns Hopkins Hospital. Cushing provided basic demographic, perioperative, and outcomes data in his tables, but the ...
journal_title：World neurosurgery
pub_type： 传,历史文章,杂志文章
doi：10.1016/j.wneu.2011.08.021
更新日期：2013-07-01 00:00:00
abstract：OBJECTIVE:To report the establishment of a new center for deep brain stimulation (DBS) as a surgical treatment for Parkinson disease and the surgical outcomes, from 2014 to 2017 in Shiraz, Southern Iran. METHODS:A new treatment program was established in Shiraz through a multidisciplinary team in 2014. Thirty-four pat...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.09.035
更新日期：2019-01-01 00:00:00
