Abstract:
:OBJECT The authors assessed the feasibility of the dynamic decompressive craniotomy technique using a novel cranial fixation plate with a telescopic component. Following a craniotomy in human cadaver skulls, the telescopic plates were placed to cover the bur holes. The plates allow constrained outward movement of the bone flap upon an increase in intracranial pressure (ICP) and also prevent the bone flap from sinking once the ICP normalizes. The authors compared the extent of postcraniotomy ICP control after an abrupt increase in intracranial volume using the dynamic craniotomy technique versus the standard craniotomy or hinge craniotomy techniques. METHODS Fixation of the bone flap after craniotomy was performed in 5 cadaver skulls using 3 techniques: 1) dynamic telescopic craniotomy, 2) hinge craniotomy, and 3) standard craniotomy with fixed plates. The ability of each technique to allow for expansion during intracranial hypertension was evaluated by progressively increasing intracranial volume. Biomechanical evaluation of the telescopic plates with load-bearing tests was also undertaken. RESULTS Both the dynamic craniotomy and the hinge craniotomy techniques provided significant control of ICP during increases in intracranial volume as compared with the standard craniotomy technique. With the standard craniotomy, ICP increased from a mean of 11.4 to 100.1 mm Hg with the addition of 120 ml of intracranial volume. However, with the dynamic craniotomy, the addition of 120 ml of intracranial volume increased the ICP from a mean of 2.8 to 13.4 mm Hg, maintaining ICP within the normal range as compared with the standard craniotomy (p = 0.04). The dynamic craniotomy was also superior in controlling ICP as compared with the hinge craniotomy, providing expansion for an additional 40 ml of intracranial volume while maintaining ICP within a normal range (p = 0.008). Biomechanical load-bearing tests for the dynamic telescopic plates revealed rigid restriction of bone-flap sinking as compared with standard fixation plates and clamps. CONCLUSIONS The dynamic telescopic craniotomy technique with the novel cranial fixation plate provides superior control of ICP after an abrupt increase in intracranial volume as compared with the standard craniotomy and hinge craniotomy techniques.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Khanna R,Ferrara Ldoi
10.3171/2015.6.JNS15706subject
Has Abstractpub_date
2016-09-01 00:00:00pages
674-82issue
3eissn
0022-3085issn
1933-0693journal_volume
125pub_type
杂志文章abstract:OBJECTIVE:Tumor proximity to the ventricle and ventricular entry (VE) during surgery have both been associated with worse prognoses; however, the interaction between these two factors is poorly understood. Given the benefit of maximal tumor resection, it is imperative for surgical planning and technique to know if VE h...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.7.JNS201362
更新日期:2021-01-08 00:00:00
abstract::The commonest initial computerized tomography (CT) finding in head-injured children is bilateral diffuse cerebral swelling. Cerebral blood flow and CT density studies suggest that this swelling is due to cerebral hyperemia and increased blood volume, not to edema. The clinical history, course, and outcome of 63 childr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.2.0170
更新日期:1981-02-01 00:00:00
abstract::Two groups of rats with induced arterial hypertension were studied. One group underwent section of the left common carotid artery with an end-to-side anastomosis of the proximal segment to the right common carotid artery. The second group was subjected to ligation of the left common carotid artery. The number of aneur...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.65.3.0398
更新日期:1986-09-01 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:Convection-enhanced delivery (CED) can be used safely to perfuse regions of the central nervous system (CNS) with therapeutic agents in a manner that bypasses the blood-brain barrier (BBB). These features make CED a potentially ideal method for the distribution of potent chemotherapeutic agents with certain phar...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.99.5.0893
更新日期:2003-11-01 00:00:00
abstract::The criteria by which acromegalic patients are considered "cured" after surgical therapy are still controversial. Since the abnormal growth hormone (GH) increase after the administration of some agents has been demonstrated to be characteristic of the tumoral somatotrophs, its disappearance after surgery may be taken ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.3.0402
更新日期:1983-09-01 00:00:00
abstract:OBJECT:The hypogastric nerve (HGN) plays a crucial role in the primary functions of ejaculation: sperm transport through the vas deferens, secretion of prostatic fluid, and bladder neck closure. This study was undertaken to explore the possibility of restoring HGN function to the seminal tract and preserving its cross-...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.88.4.0726
更新日期:1998-04-01 00:00:00
abstract::Electrocortical stimulation mapping (ESM) is the clinical standard for localizing critical sensorimotor and language functions, but other functions can be assessed with this technique as well. The authors describe an 8-year-old girl with a left frontal desmoplastic gangliocytoma and medically intractable epilepsy who ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2007.106.6.501
更新日期:2007-06-01 00:00:00
abstract::Toxoplasma gondii has been reported to be the most common cause of focal brain lesions in patients with acquired immunodeficiency syndrome (AIDS). A case of intramedullary toxoplasmosis of the conus medullaris is reported in a patient with hemophilia A-associated AIDS. The diagnosis is discussed, with particular empha...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.73.6.0951
更新日期:1990-12-01 00:00:00
abstract::In order to elucidate some of the signal transduction processes in human meningioma cells, the authors studied the effect of epidermal growth factor (EGF) and bromocriptine on inositol phospholipid hydrolysis, using low-passage human meningioma cells in culture. Epidermal growth factor is a well-studied mitogenic fact...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.80.5.0890
更新日期:1994-05-01 00:00:00
abstract::To evaluate the biology of thyrotropin (TSH)-producing pituitary adenomas, the authors reviewed the charts of 19 patients who underwent transsphenoidal surgery within a 15-year period at the University of California, San Francisco (UCSF). Between 1989 and 1991, the period during which immunostaining techniques were us...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.79.4.0521
更新日期:1993-10-01 00:00:00
abstract:OBJECT:Oxidative stress may play a role in spontaneous intracerebral hemorrhage (ICH), but data on oxidative burden in cerebral hemorrhage are limited, and it is not clear whether oxidative markers add predictive power regarding ICH outcome beyond that of traditional factors. The authors therefore examined redox status...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.7.JNS11718
更新日期:2011-12-01 00:00:00
abstract:OBJECT:Mitoxantrone is a drug with potent in vitro activity against malignant brain tumor cell lines; however, its effectiveness as a systemic agent has been hampered by poor central nervous system penetration and dose-limiting myelosuppression. To avoid these problems, we incorporated mitoxantrone into biodegradable p...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.5.1173
更新日期:2002-11-01 00:00:00
abstract::The authors report on a 17-year-old boy with cervical myelopathy from dilated epidural veins due to cerebrospinal fluid (CSF) overdrainage. The patient had a long-standing subdural-peritoneal shunt and presented with incapacitating spastic tetraparesis. Magnetic resonance imaging revealed significant cervical spinal c...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2007.106.3.227
更新日期:2007-03-01 00:00:00
abstract:OBJECT:Improved neuroimaging techniques have led to an increase in the reported cases of intramedullary cavernomas. The purpose of this study was to define the spectrum of presenting signs and symptoms in patients with spinal intramedullary cavernomas and to analyze the role of surgery as a treatment for these lesions....
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2000.93.1.0065
更新日期:2000-07-01 00:00:00
abstract::A case-control analysis was performed to evaluate the association of 15 potential risk factors with postoperative infection in neurosurgical patients. All infections that developed postoperatively on the neurosurgical service at the University of Minnesota from January, 1970, to March, 1984, were identified. Among the...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.6.0902
更新日期:1986-06-01 00:00:00
abstract:OBJECT:In many new clinical trials of patients with malignant gliomas surgical intervention is incorporated as an integral part of tumor-directed interstitial therapies such as gene therapy, biodegradable wafer placement, and immunotherapy. Assessment of toxicity is a major component of evaluating these novel therapeut...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.98.6.1175
更新日期:2003-06-01 00:00:00
abstract::A 54-year-old man experienced a right occipital headache accompanied by a roaring sound, nausea, vomiting, right facial weakness, and stiff neck. Vertebral angiography revealed an aneurysm of the right anterior inferior cerebellar artery (AICA) at the internal acoustic meatus which was later excised with favorable res...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.48.3.0455
更新日期:1978-03-01 00:00:00
abstract::Carcinoembryonic antigen (CEA) in plasma, cerebrospinal fluid (CSF), and tumor cyst fluid obtained from patients with a variety of intracranial tumors was determined by radioimmunoassay Slightly elevated levels of plasma CEA, ranging from 2.6 to 3.8 ng/ml, were noted in six (4%) of 161 patients with primary brain tumo...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.3.0355
更新日期:1980-09-01 00:00:00
abstract::Moyamoya disease is a chronic occlusive cerebrovascular disease of unknown etiology for which no effective treatment has been found. The authors report the result of 23 superficial temporal-middle cerebral artery (STA-MCA) anastomoses and seven encephalomyosynangioses, performed on 13 cases with moyamoya disease and o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.5.0679
更新日期:1978-11-01 00:00:00
abstract::This case illustrates the potential growth rate of an atypical meningioma in a pediatric patient, emphasizes one of the potential risks after therapeutic radiation, and underscores the importance of clinical evaluation and follow up of the symptomatic patient after tumor resection and radiation therapy. The authors re...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2004.100.5.0488
更新日期:2004-05-01 00:00:00
abstract::OBJECT In patients with hydrocephalus and shunts, lasting symptoms such as headache and dizziness may be indicative of shunt failure, which may necessitate shunt revision. In cases of doubt, the authors monitor intracranial pressure (ICP) to determine the presence of over- or underdrainage of CSF to tailor management....
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.12.JNS141029
更新日期:2015-05-01 00:00:00
abstract:OBJECT:The purpose of this study was to evaluate the incidence of seizures or epileptiform abnormalities on electroencephalography (EEG) studies in patients undergoing surgical treatment for acute subdural hematoma (SDH). METHODS:This was a retrospective study of 134 consecutive patients with acute or acute-on-chronic...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.7.JNS09392
更新日期:2010-02-01 00:00:00
abstract::The authors describe a new headframe system, by which a variety of instruments, such as brain retractors, suction tubes, mirrors, forks, armrests, and cotton-sheet trays, can be simultaneously supported. This frame enables neurosurgeons to perform operations with greater ease and fewer problems. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.71.6.0945
更新日期:1989-12-01 00:00:00
abstract::The authors investigated the outcome of stereotactic biopsy and radiotherapy in 35 consecutive adult patients with nonanaplastic, nonpilocytic astrocytomas who were diagnosed between 1982 and 1992. The median patient age at presentation was 32 years. All received fractionated external-beam radiation therapy (median do...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.1995.82.4.0523
更新日期:1995-04-01 00:00:00
abstract:OBJECT:The goal in this study was to compare flat-panel detector (FD) CT with multislice (MS) CT in the visualization of intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), intraventricular hemorrhage, and external ventricular drains (EVDs) to evaluate the diagnostic quality and limitations of the new FD CT ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.2.JNS091054
更新日期:2010-10-01 00:00:00
abstract::Physiological variables were monitored in dogs and sheep after exposure of the brain to a pressure wave produced by a fluid-percussion device. Mean systemic arterial pressure (SAP), mean pulmonary arterial pressure (PAP), and pulmonary wedge pressure (PWP) were recorded prior to and following trauma. Lung lymph flows ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.4.0587
更新日期:1985-04-01 00:00:00
abstract::An intraventricular glioma occupying all four ventricles of the brain in children is very uncommon. The authors report a unique case of a tetraventricular Grade II astrocytoma with evidence of extension into the basal cisterns in a 5-year-old boy who had a 1-month history of headache. There was no neurological deficit...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2007.106.2.134
更新日期:2007-02-01 00:00:00
abstract::The authors describe a simple technique that reduces the incidence of retained ventricular catheters and minimizes the risk of life-threatening intraventricular hemorrhage during the removal of an obstructed, adherent ventricular catheter in patients with hydrocephalus. The technique requires no special equipment and ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.83.6.1101
更新日期:1995-12-01 00:00:00
abstract::Clinical results of an extra-intracranial arterial bypass (EIAB) procedure for cerebral ischemia are assessed in 65 patients. The 5-year-study suggests that the EIAB procedure has a protective effect against further clinically significant cerebrovascular accidents in properly selected patients. Correlation with angiog...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.44.3.0313
更新日期:1976-03-01 00:00:00