Abstract:
OBJECT:Brainstem cavernous malformations (CMs) are challenging due to a higher symptomatic hemorrhage rate and potential morbidity associated with their resection. The authors aimed to preoperatively define the relationship of CMs to the perilesional corticospinal tracts (CSTs) by obtaining qualitative and quantitative data using high-definition fiber tractography. These data were examined postoperatively by using longitudinal scans and in relation to patients' symptomatology. The extent of involvement of the CST was further evaluated longitudinally using the automated "diffusion connectometry" analysis. METHODS:Fiber tractography was performed with DSI Studio using a quantitative anisotropy (QA)-based generalized deterministic tracking algorithm. Qualitatively, CST was classified as being "disrupted" and/or "displaced." Quantitative analysis involved obtaining mean QA values for the CST and its perilesional and nonperilesional segments. The contralateral CST was used for comparison. Diffusion connectometry analysis included comparison of patients' data with a template from 90 normal subjects. RESULTS:Three patients (mean age 22 years) with symptomatic pontomesencephalic hemorrhagic CMs and varying degrees of hemiparesis were identified. The mean follow-up period was 37.3 months. Qualitatively, CST was partially disrupted and displaced in all. Direction of the displacement was different in each case and progressively improved corresponding with the patient's neurological status. No patient experienced neurological decline related to the resection. The perilesional mean QA percentage decreases supported tract disruption and decreased further over the follow-up period (Case 1, 26%-49%; Case 2, 35%-66%; and Case 3, 63%-78%). Diffusion connectometry demonstrated rostrocaudal involvement of the CST consistent with the quantitative data. CONCLUSIONS:Hemorrhagic brainstem CMs can disrupt and displace perilesional white matter tracts with the latter occurring in unpredictable directions. This requires the use of tractography to accurately define their orientation to optimize surgical entry point, minimize morbidity, and enhance neurological outcomes. Observed anisotropy decreases in the perilesional segments are consistent with neural injury following hemorrhagic insults. A model using these values in different CST segments can be used to longitudinally monitor its craniocaudal integrity. Diffusion connectometry is a complementary approach providing longitudinal information on the rostrocaudal involvement of the CST.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Faraji AH,Abhinav K,Jarbo K,Yeh FC,Shin SS,Pathak S,Hirsch BE,Schneider W,Fernandez-Miranda JC,Friedlander RMdoi
10.3171/2014.12.JNS142169subject
Has Abstractpub_date
2015-11-01 00:00:00pages
1133-44issue
5eissn
0022-3085issn
1933-0693pii
10.3171/2014.12.JNS142169journal_volume
123pub_type
杂志文章abstract::Schwannomas of the brain parenchyma are extremely rare, occurring mostly in children and young adults. Fewer than 50 cases have been reported in the English-language literature. Isolated temporal lobe epilepsy is a rare presentation of intracerebral schwannomas, with only 2 reported cases. The authors present the case...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.3.JNS111043
更新日期:2012-07-01 00:00:00
abstract::OBJECT The objective of this study was to compare the cost of deep brain stimulation (DBS) performed awake versus asleep at a single US academic health center and to compare costs across the University HealthSystem Consortium (UHC) Clinical Database. METHODS Inpatient and outpatient demographic and hospital financial ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.5.JNS15433
更新日期:2016-05-01 00:00:00
abstract::Increasing evidence suggests that disturbances in the modulatory influence of the vasoactive peptide, calcitonin gene-related peptide (CGRP), contribute to the pathogenesis of cerebral vasospasm after subarachnoid hemorrhage (SAH). However, only limited success has been achieved in trials attempting to ameliorate vaso...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.1.0091
更新日期:1995-01-01 00:00:00
abstract:OBJECT:Recent advances in neuroradiology have made it possible to dilate vasospastic human cerebral arteries after aneurysmal subarachnoid hemorrhage (SAH), but the time window is short and the success rate for reversal of delayed ischemic neurological deficits (DINDs) varies between 31% and 77%. In a dog model of vaso...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.91.1.0051
更新日期:1999-07-01 00:00:00
abstract:OBJECT:There is little evidence addressing whether procedures requiring adjunctive devices lead to an increased frequency of thromboembolic complications. The authors report their experience with 155 aneurysms treated with and without adjunctive devices. METHODS:The authors retrospectively reviewed their last 155 aneu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/108/6/1095
更新日期:2008-06-01 00:00:00
abstract:OBJECT:Primary and metastatic neoplasms of the lumbosacral junction frequently pose a complex problem for the surgical management and stabilization of the spine because of the anatomical and biomechanical factors of this transition zone between spine and pelvis. The authors have used a modification of the Galveston tec...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2000.92.1.0061
更新日期:2000-01-01 00:00:00
abstract::The ocular complications of intracarotid infusion of drugs for brain-tumor chemotherapy may be eliminated by infusion of the chemotherapeutic agent into the carotid artery above the origin of the ophthalmic artery. The authors have developed a catheter that can negotiate the carotid siphon. This catheter is not balloo...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.58.4.0616
更新日期:1983-04-01 00:00:00
abstract::The supplementary motor area (SMA) is a region located within each cerebral hemisphere at the posterior mesial border of the frontal lobe adjacent to the falx. The functional significance of this area has been somewhat unclear, and information regarding its influence on motor output has largely been based on evoked re...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.75.1.0062
更新日期:1991-07-01 00:00:00
abstract::OBJECTIVE Arteriovenous malformations (AVMs) in the cerebellopontine angle cistern (CPAC) are specific lesions that can cause neurovascular compression syndromes as well as intracranial hemorrhage. Although case reports describing the CPAC AVMs, especially those presenting with trigeminal neuralgia (TN), have been acc...
journal_title:Journal of neurosurgery
pub_type: 评论,杂志文章
doi:10.3171/2015.12.JNS152190
更新日期:2017-01-01 00:00:00
abstract::The effect of concentrated conditioned medium from each of eight human malignant glioma cell lines on the growth of indicator cells (normal rat kidney fibroblasts (NRK), clone 14) was determined in monolayer and in soft agar assay systems. The conditioned medium from all cell lines was mitogenic in the monolayer assay...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.71.6.0875
更新日期:1989-12-01 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 transbasal approach (TBA) is an anterior skull base approach, which provides access to the anterior skull base, sellar-suprasellar region, and clivus. The TBA typically involves a bifrontal craniotomy with orbital bar and/or nasal bone osteotomies performed in 2 separate steps. The authors explored the feasi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.8.JNS132609
更新日期:2014-12-01 00:00:00
abstract:OBJECT:The goal of this study was to assess the accuracy of the routine clinical use of transcranial Doppler (TCD) ultrasonography and SPECT in predicting angiographically demonstrated vasospasm. METHODS:Following receipt of institutional review board approval, the authors reviewed the records of patients with subarac...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.4.17520
更新日期:2009-01-01 00:00:00
abstract::Thirty-seven patients harboring recurrent malignant primary or metastatic brain tumors were treated by 40 implantations of high-activity iodine-125 (125I) sources. All patients had been treated with irradiation and most had been treated with chemotherapeutic agents, primarily nitrosoureas. Implantations were performed...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.1.0061
更新日期:1984-01-01 00:00:00
abstract::The authors report the case of a young man who suffered multiple injuries in a motor vehicle accident, the most significant of which arose in the brain, creating an unusual clinical syndrome. After experiencing an initial coma for several days, the patient was found to have a right-sided homonymous hemianopsia and a r...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.94.2.0309
更新日期:2001-02-01 00:00:00
abstract::Liposomes have a variety of attributes as a drug delivery system. Targeting of liposomes to specific cells has been investigated by using appropriate cytophilic ligands such as monoclonal antibodies (MAb's). In the present study, liposomes with selective cytotoxicity toward glioma cells were obtained. An MAb which rea...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.71.3.0382
更新日期:1989-09-01 00:00:00
abstract::Primary intracerebral squamous cell carcinoma is a rare sequela of benign cerebral epidermoid cysts. A case of presumed malignant transformation in a lateral ventricular epidermoid cyst is described, in which squamous cell carcinoma arose 33 years after the surgical resection of a benign epidermoid cyst. Three years a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.66.4.0618
更新日期:1987-04-01 00:00:00
abstract::The authors report a case of ossification of the ligamentum flavum at T-10 and T-11 associated with compressive myelopathy. Metrizamide myelography with computerized tomography allowed precise preoperative diagnosis and anatomic localization of the lesion. The patient had satisfactory and prompt improvement after surg...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1982.56.3.0448
更新日期:1982-03-01 00:00:00
abstract:OBJECT:Noninvasive neuroimaging techniques are increasingly identifying unruptured intracranial arterial dissections (IADs) at examination for headache or ischemic symptoms. Approximately 3% of cases of aneurysmal subarachnoid hemorrhage (SAH) are caused by IADs in Japan, but the natural history of unruptured IADs is n...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.9.JNS10668
更新日期:2011-04-01 00:00:00
abstract::Gamma Knife surgery (GKS) is widely recognized as an effective, minimally invasive treatment for intractable trigeminal neuralgia, but the role of GKS in glossopharyngeal neuralgia (GPN) remains unclear. This study involved 2 patients with medically intractable GPN who were treated using GKS. One patient required 2 tr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.8.17641
更新日期:2009-03-01 00:00:00
abstract:OBJECT:The head-shaking method combined with cisternal irrigation has been proposed to be effective in preventing cerebral vasospasm after subarachnoid hemorrhage (SAH) by facilitating rapid washout of the clot from the subarachnoid space. This study was conducted to evaluate the effectiveness of this method. METHODS:...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.100.2.0236
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:Perioperative visual loss (POVL) is a rare but serious complication in surgical disciplines, especially in spine surgery. The exact pathophysiology of POVL remains unclear, but elevated intraocular pressure (IOP) is known to be part of it. As POVL is rarely described in patients undergoing intracranial or int...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.3.JNS173098
更新日期:2018-08-24 00:00:00
abstract:OBJECT:The risk of surgical site infection (SSI) after craniotomies or craniectomies in patients in whom contaminated bone flaps have been reimplanted has not been determined. The objectives of this study were to identify the prevalence of bone flaps with positive cultures--especially those contaminated with Propioniba...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.1.JNS10782
更新日期:2011-06-01 00:00:00
abstract::Protection of the brain and spinal cord against ischemia is a goal of vast clinical importance. One approach to this objective is to reduce the tissue's functional activity in order to preserve energy for the metabolic processes that are essential to viability. Experiments to explore ways of reducing function-related ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.69.4.0568
更新日期:1988-10-01 00:00:00
abstract::Heterotopic new bone formation, associated with head injuries, usually affects the shoulder, elbow, and hip joints. The authors present a case with an unusual involvement of the cervical spine, confirmed by bone scanning and computerized tomography. Although the etiology of heterotopic new bone formation is not well u...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.3.0513
更新日期:1986-03-01 00:00:00
abstract::A new aneurysm clip has been developed specifically for internal carotid artery (ICA) aneurysms. This fenestrated clip's occluding blades deviate laterally, since the majority of ICA aneurysms protrude posterolateral to the parent artery. The clip was applied safely in seven recent patients with ICA aneurysms. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.65.1.0122
更新日期:1986-07-01 00:00:00
abstract::A study of the overall management of ruptured posterior fossa aneurysms was conducted over a 1-year period (1993) in five neurosurgical centers in Sweden, serving a population of 6.93 million people. Forty-nine cases were identified and treated. One-third of the patients were in the seventh or eighth decade of life. G...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.1.0033
更新日期:1996-07-01 00:00:00
abstract::Intraventricular pressure (IVP) is increased in the early stages of acute hydrocephalus. Pressure falls, however, when compensatory routes for cerebrospinal fluid (CSF) absorption develop. In order to better understand the pathophysiology of acute hydrocephalus, the authors performed ventriculocisternal perfusions on ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.4.0606
更新日期:1983-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study is to present the authors' medium-term results, with special emphasis on complications, occlusion rate of the aneurysm sac (digital subtraction angiography [DSA] and MRI), and the fate of cortical branches and perforating arteries covered ("jailed") by the flow diverter (FD) stent. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.7.JNS18654
更新日期:2018-12-21 00:00:00
abstract::A method is described for determining stereotaxic coordinates using computerized tomographic scanning and intraoperative ventriculography of the third ventricle. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.6.0861
更新日期:1980-12-01 00:00:00