Abstract:
:OBJECTIVE Idiopathic intracranial hypertension (IIH) may cause blindness due to elevated intracranial pressure (ICP). Venous sinus stenosis has been identified in select patients, leading to stenting as a potential treatment, but its effects on global ICP have not been completely defined. The purpose of this pilot study was to assess the effects of venous sinus stenting on ICP in a small group of patients with IIH. METHODS Ten patients for whom medical therapy had failed were prospectively followed. Ophthalmological examinations were assessed, and patients with venous sinus stenosis on MR angiography proceeded to catheter angiography, venography with assessment of pressure gradient, and ICP monitoring. Patients with elevated ICP measurements and an elevated pressure gradient across the stenosis were treated with stent placement. RESULTS All patients had elevated venous pressure (mean 39.5 ± 14.9 mm Hg), an elevated gradient across the venous sinus stenosis (30.0 ± 13.2 mm Hg), and elevated ICP (42.2 ± 15.9 mm Hg). Following stent placement, all patients had resolution of the stenosis and gradient (1 ± 1 mm Hg). The ICP values showed an immediate decrease (to a mean of 17.0 ± 8.3 mm Hg), and further decreased overnight (to a mean of 8 ± 4.2 mm Hg). All patients had subjective and objective improvement, and all but one improved during follow-up (median 23.4 months; range 15.7-31.6 months). Two patients developed stent-adjacent stenosis; retreatment abolished the stenosis and gradient in both cases. Patients presenting with papilledema had resolution on follow-up funduscopic imaging and optical coherence tomography (OCT) and improvement on visual field testing. Patients presenting with optic atrophy had optic nerve thinning on follow-up OCT, but improved visual fields. CONCLUSIONS For selected patients with IIH and venous sinus stenosis with an elevated pressure gradient and elevated ICP, venous sinus stenting results in resolution of the venous pressure gradient, reduction in ICP, and functional, neurological, and ophthalmological improvement. As patients are at risk for stent-adjacent stenosis, further follow-up is necessary to determine long-term outcomes and gain an understanding of venous sinus stenosis as a primary or secondary pathological process behind elevated ICP.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Liu KC,Starke RM,Durst CR,Wang TR,Ding D,Crowley RW,Newman SAdoi
10.3171/2016.8.JNS16879subject
Has Abstractpub_date
2017-11-01 00:00:00pages
1126-1133issue
5eissn
0022-3085issn
1933-0693journal_volume
127pub_type
杂志文章abstract:OBJECT:The aim of this anatomical study was to define more fully the three-dimensional (3D) relationships between the optic radiations and the temporal horn and superficial anatomy of the temporal lobe by using the Klingler white matter fiber dissection technique. These findings were correlated with established surgica...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.101.5.0739
更新日期:2004-11-01 00:00:00
abstract::An elevated serum carcinoembryonic antigen (CEA) without evidence of neoplasia was noted in an 84-year-old woman. She subsequently developed a lytic skull lesion, which at surgery proved to be an atypical meningioma. Immunohistochemical analysis demonstrated that this tumor was producing CEA. This aggressive meningiom...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.3.0489
更新日期:1995-03-01 00:00:00
abstract::Chordoid meningioma is a rare meningothelial tumor characterized by chordoma-like histological features with lymphoplasmacellular infiltration. This tumor is often seen in children, but not in adults, with a systemic inflammatory syndrome (iron-resistant microcytic anemia and/or dysgammaglobulinemia) and very rarely w...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.103.3.0555
更新日期:2005-09-01 00:00:00
abstract::One major risk of intraoperative stimulation mapping is the production of stimulation-evoked seizures. Cold Ringer's lactate solution was applied directly to the irritated cortex in 22 patients with stimulation-induced seizures that occurred during intraoperative brain mapping procedures. The irrigation rapidly and re...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.88.2.0349
更新日期:1998-02-01 00:00:00
abstract::The authors investigate whether there are any permeability changes in the endoneurial blood-nerve barrier and the perineurium-nerve barrier of surviving nerve allografts. In a normal nerve, the blood-nerve barrier regulates the passage of substances from endoneurial blood vessels into the endoneurium, whereas the peri...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.78.5.0794
更新日期:1993-05-01 00:00:00
abstract::Are spinal schwannomas as benign as we think? To what extent do patients recover? Are patients prone to develop late complications such as cystic myelopathy or symptomatic spinal deformity? Is their life expectancy compromised? In an effort to answer these questions, the authors analyzed the long-term outcome for 187 ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.83.4.0621
更新日期:1995-10-01 00:00:00
abstract:OBJECTIVE:Direct brain compression and secondary injury due to increased intracranial pressure are believed to be the pathognomic causes of a grave outcome in acute subdural hemorrhage (aSDH). However, ischemic damage from aSDH has received limited attention. The authors hypothesized that cerebral microcirculation is a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.5.JNS162579
更新日期:2018-10-01 00:00:00
abstract:OBJECT:Intraoperative bleeding often obscures the surgical field and may cause neurological damage. The irrigation fluids used during surgery might affect physiological hemostasis because they modulate the extracellular fluid composition of the bleeding area directly. The authors therefore investigated the influence of...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.7.JNS09561
更新日期:2010-04-01 00:00:00
abstract:OBJECT:Extracorporeal shock wave therapy (ESWT) is widely used for the clinical treatment of various human diseases. Recent studies have demonstrated that low-energy ESWT upregulates the expression of vascular endothelial growth factor (VEGF) and promotes angiogenesis and functional recovery in myocardial infarction an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.8.JNS132562
更新日期:2014-12-01 00:00:00
abstract:OBJECT:Schwannomas occupying the craniocervical junction (CCJ) are rare and usually originate from the jugular foramen, hypoglossal nerves, and C-1 and C-2 nerves. Although they may have different origins, they may share the same symptoms, surgical approaches, and complications. An extension of these lesions along the ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.5.JNS0966
更新日期:2011-05-01 00:00:00
abstract::OBJECTIVE Different surgical routes have been used over the years to achieve adequate decompression of the optic nerve in its canal including, more recently, endoscopic approaches performed either through the endonasal corridor or the transorbital one. The present study aimed to detail and quantify the amount of bone ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.8.JNS16566
更新日期:2017-07-01 00:00:00
abstract::Five patients were seen who described similar rapid shot-like pains that we have called "flashing pain syndrome" and whose pain was relieved by carbamazepine. The pathology of these conditions is not uniform, but the clinical description appears to be specific for an unpleasant condition that will respond dramatically...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.45.1.0049
更新日期:1976-07-01 00:00:00
abstract:OBJECT:The aim of this study was to investigate the role of S-100 proteins in the onset of vasospasm induced by subarachnoid hemorrhage (SAH), which leads to severe neurological morbidity and death. It has recently been argued that modifications in the levels of expression of some intracellular signaling elements contr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.2.0408
更新日期:2002-08-01 00:00:00
abstract:OBJECT:The authors conducted a study to determine the results of decompressive surgery without fusion in selected patients who presented with radicular compression syndromes caused by degenerative lumbar spondylolisthesis and in whom there was no evidence of hypermobility on flexion-extension radiographs. METHODS:The ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.97.3.0281
更新日期:2002-10-01 00:00:00
abstract::Endodermal sinus tumor (yolk sac carcinoma), a germinal neoplasm, is rarely primary in the cranial cavity. The authors add a third case with the tumor located in the anterior third ventricular (suprasellar) region to the literature. Seventeen previously reported intracranial cases, mostly in the pineal region, are bri...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.2.0246
更新日期:1979-02-01 00:00:00
abstract:OBJECT:Aneurysmal subarachnoid hemorrhage rarely occurs in young adults. The aim of this work was to clarify the clinical characteristics of ruptured aneurysms in young adults in the third and fourth decades of life and to compare these two age groups. METHODS:The authors retrospectively investigated 2493 patients who...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.99.2.0276
更新日期:2003-08-01 00:00:00
abstract::The surgical indication for spontaneous cerebellar hemorrhage is not as controversial as the operative management of intracranial hemorrhage. Timing of the operation is crucial: intervening too early can produce an additional strain on the patient and an increased risk, while waiting too long to evacuate the hematoma ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.73.2.0217
更新日期:1990-08-01 00:00:00
abstract::OBJECTIVEThe pathogenesis of dural arteriovenous fistulas (DAVFs) remains poorly defined. Prior studies on thrombophilia as a risk factor for DAVF development are limited by small sample sizes and poor generalizability.METHODSIn this longitudinal observational study, all patients with intracranial DAVFs evaluated at t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.10.JNS171987
更新日期:2018-04-01 00:00:00
abstract:OBJECT:The management issues of 106 cases of pituitary tumors with a fluid level within the fluid content of the cystic part of the tumor (a "fluid-fluid" level) were reviewed. METHODS:Between 2000 and March 2009, 1660 pituitary tumors were treated neurosurgically at K.E.M. Hospital. Investigations of 106 of these cas...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.11.JNS091083
更新日期:2010-06-01 00:00:00
abstract::OBJECTIVE Contrary to acute ischemic stroke involving the anterior circulation, no randomized trial has yet demonstrated the safety and effectiveness of endovascular management in acute basilar artery occlusion (BAO). Recently developed thrombectomy devices, such as stentrievers and aspiration systems, have helped in ...
journal_title:Journal of neurosurgery
pub_type: 评论,杂志文章
doi:10.3171/2016.2.JNS151983
更新日期:2017-05-01 00:00:00
abstract::Previously presented data showed that Vicryl mesh was a potentially effective dural grafting material. It is easily handled, relatively inexpensive, absorbed over time, and elicits a minimal inflammatory response. The present experimental project was conducted to investigate the effectiveness of a tightly woven versio...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.71.1.0124
更新日期:1989-07-01 00:00:00
abstract::Domestic violence leading to strangulation by an abusive spouse can cause carotid artery dissection. This phenomenon is rare and has been described in only three previous instances. The authors present their management strategies in three additional cases. Three young women aged 24 to 43 years were victims of manual s...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.92.3.0481
更新日期:2000-03-01 00:00:00
abstract::Spinal cord infarction in association with pneumococcal meningitis has not been previously recognized. The case is reported of a 5 1/2-year-old boy who had Streptococcus pneumoniae meningitis complicated by the sudden onset of flaccid paraplegia and loss of all sensory modalities below the level of T-2. At operation, ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.55.1.0121
更新日期:1981-07-01 00:00:00
abstract::An extraosseous extradural tumor of the lumbar region with the histological appearance of chordoma produced symptoms in a 58-year-old woman. The tumor occupied the epidural space and produced scalloping of the adjacent vertebral body and pedicle without associated bone destruction. The location of the tumor within Bat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.75.6.0980
更新日期:1991-12-01 00:00:00
abstract::Recent information regarding the nature of bulk cerebrospinal fluid formation and absorption is reviewed, integrated with previous knowledge, and applied to the clinical setting. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.3.0369
更新日期:1983-09-01 00:00:00
abstract::Microvascular end-to-end anastomoses of rat common carotid arteries measuring 0.6 to 0.7 mm in diameter were performed using an argon surgical laser system. Vascular bonding with the argon laser was accomplished in all cases. The anastomosed carotid artery segments were evaluated both angiographically and histological...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.5.0771
更新日期:1985-11-01 00:00:00
abstract::OBJECTIVE This study aimed to determine the trial discontinuation and publication rate of randomized controlled trials (RCTs) in neurosurgery. METHODS Trials registered from 2000 to 2012 were identified on the website clinicaltrials.gov using a range of key words related to neurosurgery. Any trials that were actively ...
journal_title:Journal of neurosurgery
pub_type: 评论,杂志文章
doi:10.3171/2016.8.JNS16765
更新日期:2017-10-01 00:00:00
abstract:OBJECT:Gliomatosis cerebri (GC), a rare entity characterized by a widespread infiltration of brain by tumor, lacks objective and quantitative diagnostic criteria. Single-voxel spectroscopy and chemical shift imaging (two-dimensional proton magnetic resonance [MR] spectroscopy) were performed using both short (20- or 22...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.98.2.0269
更新日期:2003-02-01 00:00:00
abstract::In a retrospective study of magnetic resonance (MR) images obtained in 289 neurosurgical patients, loss of signal intensity (signal-void phenomenon, SVP) of the cerebrospinal fluid (CSF) in the mesencephalic aqueduct was observed in 77 patients. This SVP was noted in the MR studies of 12 of 14 patients with communicat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.69.5.0675
更新日期:1988-11-01 00:00:00
abstract::The application of several recent advances in cell biology, brain implantation, and cell-mediated tumor immunotherapy requires successful and reproducible placement of viable cell suspensions into brain. Stereotaxic implantation is being used to inject cytotoxic lymphocytes into gliomas and to replace dopaminergic cel...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.69.2.0228
更新日期:1988-08-01 00:00:00