Abstract:
OBJECTIVES:The objective in the present study was to evaluate the usefulness of cortico-cortical evoked potentials (CCEP) monitoring for the intraoperative assessment of speech function during resection of brain tumors. METHODS:Intraoperative monitoring of CCEP was applied in 13 patients (mean age 34 ± 14 years) during the removal of neoplasms located within or close to language-related structures in the dominant cerebral hemisphere. For this purpose strip electrodes were positioned above the frontal language area (FLA) and temporal language area (TLA), which were identified with direct cortical stimulation and/or preliminary mapping with the use of implanted chronic subdural grid electrodes. The CCEP response was defined as the highest observed negative peak in either direction of stimulation. In 12 cases the tumor was resected during awake craniotomy. RESULTS:An intraoperative CCEP response was not obtained in one case because of technical problems. In the other patients it was identified from the FLA during stimulation of the TLA (7 cases) and from the TLA during stimulation of the FLA (5 cases), with a mean peak latency of 83 ± 15 msec. During tumor resection the CCEP response was unchanged in 5 cases, decreased in 4, and disappeared in 3. Postoperatively, all 7 patients with a decreased or absent CCEP response after lesion removal experienced deterioration in speech function. In contrast, in 5 cases with an unchanged intraoperative CCEP response, speaking abilities after surgery were preserved at the preoperative level, except in one patient who experienced not dysphasia, but dysarthria due to pyramidal tract injury. This difference was statistically significant (p < 0.01). The time required to recover speech function was also significantly associated with the type of intraoperative change in CCEP recordings (p < 0.01) and was, on average, 1.8 ± 1.0, 5.5 ± 1.0, and 11.0 ± 3.6 months, respectively, if the response was unchanged, was decreased, or had disappeared. CONCLUSIONS:Monitoring CCEP is feasible during the resection of brain tumors affecting language-related cerebral structures. In the intraoperative evaluation of speech function, it can be a helpful adjunct or can be used in its direct assessment with cortical and subcortical mapping during awake craniotomy. It can also be used to predict the prognosis of language disorders after surgery and decide on the optimal resection of a neoplasm.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Saito T,Tamura M,Muragaki Y,Maruyama T,Kubota Y,Fukuchi S,Nitta M,Chernov M,Okamoto S,Sugiyama K,Kurisu K,Sakai KL,Okada Y,Iseki Hdoi
10.3171/2014.4.JNS131195subject
Has Abstractpub_date
2014-10-01 00:00:00pages
827-38issue
4eissn
0022-3085issn
1933-0693journal_volume
121pub_type
杂志文章abstract::A technique of "frameless" stereotaxy that allows real-time intraoperative neurosurgical localization is described. The system is composed of four components: a hand-held probe containing two ultrasonic emitters, a microphone array that is rigidly affixed to the operating table in proximity to the surgical field, hard...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.78.3.0510
更新日期:1993-03-01 00:00:00
abstract::This 4 1-year-old man presented with a 2-year history of symptoms and signs of sciatic nerve compression. Imaging studies revealed a large ossified fragment within the biceps muscle of the thigh abutting the sciatic nerve at the level of the lesser trochanter. The bony fragment resulted from an unrecognized apophyseal...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.89.5.0819
更新日期:1998-11-01 00:00:00
abstract::Diagnosis of piriformis syndrome is difficult and its precise definition is highly controversial. In this article, the authors present the case of a patient who had clinical features suggestive of piriformis syndrome. During surgery the patient was found to have a rare variation in anatomical structures, in which the ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.94.4.0652
更新日期:2001-04-01 00:00:00
abstract::Mongrel dogs with experimental spinal cord injury were treated with the carotenoid compound crocetin. It has been shown that crocetin increases the diffusion speed of oxygen through plasma, and should provide a net increase in oxygen at the level of the capillary endothelial cell. The treated animals showed a signific...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.46.3.0358
更新日期:1977-03-01 00:00:00
abstract:OBJECT:Disturbance of cerebral phosphorus-containing metabolites occurs in many disease entities and has not been widely studied in patients with subarachnoid hemorrhage (SAH). Pilot studies have indicated that hypermagnesemic treatment may improve outcome in patients with aneurysmal SAH, but the precise mechanism is n...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.10.JNS09915
更新日期:2010-10-01 00:00:00
abstract:OBJECT:The authors tested the hypothesis in a porcine model that inhibition of nitric oxide synthesis during reduced cerebral perfusion pressure (CPP) affected the relative cerebral blood flow (CBF) and the cerebrovascular resistance. METHODS:The CPP was reduced by inducing high cerebrospinal fluid pressure and hemorr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.89.3.0448
更新日期:1998-09-01 00:00:00
abstract::Atretic cephalocele appears as an unimportant and benign lesion. This malformation consists of meningeal and vestigial tissues (arachnoid, glial, or central nervous system rests). The authors report the findings in 16 cases (seven parietal and nine occipital) of rudimentary cephaloceles. Twelve patients presented with...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.77.2.0230
更新日期:1992-08-01 00:00:00
abstract:OBJECT:The aim of this study was to evaluate the spatial accuracy of interictal magnetoencephalography (MEG) in localizing the primary epileptogenic focus in comparison with alternative MEG-derived estimates such as ictal onset recording or sensory mapping of the periphery where seizures manifest. METHODS:During this ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.98.4.0837
更新日期:2003-04-01 00:00:00
abstract::OBJECTIVE Blunt traumatic cerebrovascular injury (TCVI) represents structural injury to a vessel due to high-energy trauma. The Biffl Scale is a widely accepted grading scheme for these injuries that was developed using digital subtraction angiography. In recent years, screening CT angiography (CTA) has been used to i...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.7.JNS16849
更新日期:2017-07-01 00:00:00
abstract::To test the hypothesis that concussive brain injury interferes with the normal vasodilator response of the cerebral circulation to hypoxemia, 30 cats were subjected to mild (PaO2 50 mm Hg) and severe (PaO2 30 mm Hg) hypoxemia while measurements were made of arterial and intracranial pressure, regional cerebral blood f...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1982.56.3.0332
更新日期:1982-03-01 00:00:00
abstract::The authors studied 31 comatose head-injured patients to assess the clinical usefulness of laser Doppler flowmetry (LDF) in continuous autoregulation monitoring. The LDF probes were placed on the surface of the cerebral cortex. Data on LDF, intracranial pressure (ICP), and arterial blood pressure (ABP) were recorded a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.86.3.0438
更新日期:1997-03-01 00:00:00
abstract::OBJECTIVE Disposable supplies constitute a large portion of operating room (OR) costs and are often left over at the end of a surgical case. Despite financial and environmental implications of such waste, there has been little evaluation of OR supply utilization. The goal of this study was to quantify the utilization ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.2.JNS152442
更新日期:2017-02-01 00:00:00
abstract::The authors report the rare case of a patient with neurocutaneous vascular hamartomas mimicking Cobb syndrome. An 8-year-old boy was admitted to the authors' hospital with progressive urinary disturbance and upper back pain. Multiple skin nevi had been noted at the child's birth. Radiological examination revealed mult...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2000.93.1.0133
更新日期:2000-07-01 00:00:00
abstract::The translabyrinthine route or an extension of it was used to remove 150 acoustic nerve tumors. The mortality was 2% and the morbidity low. Preservation of the facial nerve was achieved in 100% of the small and 80% of the medium-sized tumors, but in only 20% of the large growths. The complications encountered are disc...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.52.2.0210
更新日期:1980-02-01 00:00:00
abstract::The key to the successful microvascular decompression of the trigeminal nerve is the maintenance of the separation between the trigeminal nerve and the offending vessel. The authors describe a technique whereby a dural sling is fashioned from the tentorium cerebelli (the anatomy of which is briefly reviewed), which is...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.84.1.0127
更新日期:1996-01-01 00:00:00
abstract::The authors present the case of an intraneural ganglion cyst of the peroneal nerve. The cyst was diagnosed by means of ultrasound, which also gave an exact definition of its size and location, confirmed at operation. Some controversial aspects of these lesions are discussed. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.76.3.0538
更新日期:1992-03-01 00:00:00
abstract:OBJECTIVE:This study aimed to assess longitudinal changes in the collateral channels originating from the lenticulostriate artery (LSA), posterior communicating artery (PCoA), and anterior and posterior choroidal arteries (AChA and PChA, respectively) during disease progression and/or aging. The impact of collateral ch...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.9.JNS172231
更新日期:2018-03-23 00:00:00
abstract::The clinical and angiographic findings of 55 patients with a spinal dural arteriovenous malformation (AVM) are reviewed, and the results of surgery assessed. The symptoms of dural AVM are usually gradual in onset, and hemorrhage from this type of AVM is less common than in true spinal cord angiomas. Other clinical fea...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.2.0238
更新日期:1984-02-01 00:00:00
abstract:OBJECT:A clearer understanding of the cellular mechanisms involved in the response to ionizing radiation is pivotal to the development of new therapeutic strategies for glioblastoma multiforme (GBM). To gain insight into dynamic functional aspects of cell cycle regulation and the control of apoptosis in GBMs, the autho...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.93.5.0863
更新日期:2000-11-01 00:00:00
abstract::Fifty-seven patients with acute cervical spine injuries and associated major neurological deficit were examined within 2 weeks of injury by magnetic resonance (MR) imaging. All patients had abnormal scans, indicating intramedullary lesions. This study was undertaken to determine if the early MR imaging pattern had a p...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.76.2.0218
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVE:Endoscopic surgery is an effective treatment strategy for pituitary adenomas; however, intrinsic tumor properties such as tumor consistency can challenge or preclude gross-total resection. Preoperative characterization of tumor consistency may help to guide the surgical approach and to predict the extent of r...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.12.JNS192940
更新日期:2020-02-28 00:00:00
abstract:OBJECT:Aneurysms located on the distal portion of the posterior inferior cerebellar artery (PICA) are uncommon, and their underlying pathology, natural history, and clinical management are poorly understood. To clarify these lesions more fully, the authors undertook a retrospective analysis of the clinical features and...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.4.0756
更新日期:2002-10-01 00:00:00
abstract:OBJECT:Studies on risk factors for subarachnoid hemorrhage (SAH) show heterogeneity. For example, hypertension has been found to be a significant risk factor in some studies but not in others. The authors hypothesized that differences in the ethnicity of the populations studied could account for these findings. METHOD...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,meta分析
doi:10.3171/JNS-07/09/0522
更新日期:2007-09-01 00:00:00
abstract::The authors reviewed 70 publications on MR imaging-based targeting techniques for identifying the subthalamic nucleus (STN) for deep brain stimulation in patients with Parkinson disease. Of these 70 publications, 33 presented quantitatively validated results. There is still no consensus on which targeting technique ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2011.6.JNS101571
更新日期:2011-11-01 00:00:00
abstract::The author describes the syndrome of suprascapular nerve entrapment neuropathy that occurs as that nerve passes beneath the transverse scapular ligament, and discusses the anatomy, comparative anatomy, and five case histories. The cardinal findings include pain in the shoulder, weakness, and wasting of spinati muscles...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.43.3.0337
更新日期:1975-09-01 00:00:00
abstract::The authors describe a case of subarachnoid hemorrhage from moyamoya-like vessels associated with an arteriovenous malformation (AVM) in a 44-year-old Hispanic man who presented with severe headache. The AVM was located in the left parietal lobe and the ipsilateral middle cerebral artery was occluded. Although the pat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.101.5.0869
更新日期:2004-11-01 00:00:00
abstract:OBJECT:Chronic pulmonary diseases (CPDs) are common causes of morbidity. However, their effects on the outcome of the neurosurgical patient population are unknown. In this study, the impact of CPD on length of stay (LOS) and cost of hospitalization (COH) in neurosurgical patients was evaluated. METHODS:This was a retr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.3.JNS101608
更新日期:2011-08-01 00:00:00
abstract::The intracranial vertebral artery and its branches are a common site of aneurysms in the posterior fossa. Ninety-four aneurysms in 86 patients were analyzed for their clinical manifestation, diagnosis, and treatment. There were three distinct varieties of aneurysm in this group: 56 (60%) saccular aneurysms, 26 (28%) d...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.69.3.0345
更新日期:1988-09-01 00:00:00
abstract::Selective cochlear neurotomy for intractable tinnitus is quite difficult to perform because there is no way to approach the cochlear nerve without interfering with other neural structures. The authors successfully performed selective cochlear neurotomy in the cerebellopontine cistern in a patient with persistent intra...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.86.6.1053
更新日期:1997-06-01 00:00:00
abstract:OBJECT:Stilbazulenyl nitrone (STAZN) is a second-generation azulenyl nitrone that has markedly enhanced antioxidant properties compared with those of conventional alpha-phenyl nitrones. In this study, the authors assessed the potential efficacy of STAZN in a rodent model of fluid-percussion brain injury, which results ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.96.6.1077
更新日期:2002-06-01 00:00:00