Massive cerebral involvement in fat embolism syndrome and intracranial pressure management.


:Fat embolism syndrome (FES) is a common clinical entity that can occasionally have significant neurological sequelae. The authors report a case of cerebral fat embolism and FES that required surgical management of intracranial pressure (ICP). They also discuss the literature as well as the potential need for neurosurgical management of this disease entity in select patients. A 58-year-old woman presented with a seizure episode and altered mental status after suffering a right femur fracture. Head CT studies demonstrated hypointense areas consistent with fat globules at the gray-white matter junction predominantly in the right hemisphere. This CT finding is unique in the literature, as other reports have not included imaging performed early enough to capture this finding. Brain MR images obtained 3 days later revealed T2-hyperintense areas with restricted diffusion within the same hemisphere, along with midline shift and subfalcine herniation. These findings steered the patient to the operating room for decompressive hemicraniectomy. A review of the literature from 1980 to 2012 disclosed 54 cases in 38 reports concerning cerebral fat embolism and FES. Analysis of all the cases revealed that 98% of the patients presented with mental status changes, whereas only 22% had focal signs and/or seizures. A good outcome was seen in 57.6% of patients with coma and/or abnormal posturing on presentation and in 90.5% of patients presenting with mild mental status changes, focal deficits, or seizure. In the majority of cases ICP was managed conservatively with no surgical intervention. One case featured the use of an ICP monitor, while none featured the use of hemicraniectomy.


J Neurosurg


Journal of neurosurgery


Kellogg RG,Fontes RB,Lopes DK




Has Abstract


2013-11-01 00:00:00












  • Spinal extradural meningeal cyst. Case report.

    abstract::The case of a 30-year-old man with a spinal extradural meningeal cyst in the thoracolumbar region is reported. Operative findings revealed a dural defect that allowed communication between the extradural cyst cavity and the subarachnoid space. Application of the Valsalva maneuver made the cerebrospinal fluid flow into...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Uemura K,Yoshizawa T,Matsumura A,Asakawa H,Nakamagoe K,Nose T

    更新日期:1996-08-01 00:00:00

  • CSF smooth-muscle constrictor activity associated with cerebral vasospasm and mortality in SAH patients.

    abstract::Cerebrospinal fluid (CSF) was collected preoperatively (by lumbar puncture) or perioperatively (by lumbar or ventricular drain) from 32 patients with subarachnoid hemorrhage (SAH) from ruptured intracranial aneurysms. Samples were also obtained from six control patients without evidence of subarachnoid blood. Smooth-m...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Kaye AH,Tagari PC,Teddy PJ,Adams CB,Blaso WP,Boullin DJ

    更新日期:1984-05-01 00:00:00

  • Traumatic aneurysms and arteriovenous fistulas of intracranial vessels associated with penetrating head injuries occurring during war: principles and pitfalls in diagnosis and management. A survey of 31 cases and review of the literature.

    abstract::In the early days of the war between Iran and Iraq, reports of the sudden deaths of soldiers who previously had survived a penetrating head injury suggested the possibility that a late complication, traumatic aneurysm (TA), could be the cause of this catastrophe. In response, the authors planned a prospective study to...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Amirjamshidi A,Rahmat H,Abbassioun K

    更新日期:1996-05-01 00:00:00

  • Impact of body mass index on cerebellar tonsil position in healthy subjects and patients with Chiari malformation.

    abstract:OBJECT:It is unclear if there is a relationship between Chiari malformation Type I (CM-I) and body mass index (BMI). The aim of this study was to identify the relationship between BMI and cerebellar tonsil position in a random sample of people. METHODS:Cerebellar tonsil position in 2400 subjects from a cohort of patie...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Smith BW,Strahle J,Kazarian E,Muraszko KM,Garton HJ,Maher CO

    更新日期:2015-07-01 00:00:00

  • Ventriculovesical shunt. Technical note.

    abstract::A patient is reported whose hydrocephalus was controlled by diverting the ventricular cerebrospinal fluid directly into the urinary bladder. This drainage route may have a useful place in the management of the adult pressure-sensitive patient whose more conventional shunt requires frequent revision for repeated obstru...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: West CG

    更新日期:1980-12-01 00:00:00

  • Reflex variability in selective dorsal rhizotomy.

    abstract::The variability of reflex responses during selective dorsal rhizotomy was studied in eight children between the ages of 3 and 7 years. For a given dorsal root or rootlet, the electrical reflex threshold and response varied considerably when observed over several minutes. Changes in electrode pressure, mechanical disse...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Weiss IP,Schiff SJ

    更新日期:1993-09-01 00:00:00

  • Recombinant vesicular stomatitis virus vectors as oncolytic agents in the treatment of high-grade gliomas in an organotypic brain tissue slice-glioma coculture model.

    abstract:OBJECT:The purpose of this study was to evaluate both replication-competent and replication-restricted recombinant vesicular stomatitis virus (VSV) vectors as therapeutic agents for high-grade gliomas by using an organotypic brain tissue slice-glioma coculture system. METHODS:The coculture system involved growing diff...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Duntsch CD,Zhou Q,Jayakar HR,Weimar JD,Robertson JH,Pfeffer LM,Wang L,Xiang Z,Whitt MA

    更新日期:2004-06-01 00:00:00

  • Results of volume-staged fractionated Gamma Knife radiosurgery for large complex arteriovenous malformations: obliteration rates and clinical outcomes of an evolving treatment paradigm.

    abstract::OBJECTIVE There are few reported series regarding volume-staged Gamma Knife radiosurgery (GKRS) for the treatment of large, complex, cerebral arteriovenous malformations (AVMs). The object of this study was to report the results of using volume-staged Gamma Knife radiosurgery for patients affected by large and complex...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Franzin A,Panni P,Spatola G,Del Vecchio A,Gallotti AL,Gigliotti CR,Cavalli A,Donofrio CA,Mortini P

    更新日期:2016-12-01 00:00:00

  • Myelomeningocele: long-term neurosurgical treatment and follow-up in 202 patients.

    abstract:OBJECT:In this paper the authors focus on the long-term management of myelomeningocele (MMC) and its associated conditions. METHODS:During a 25-year period, 220 consecutive patients with MMC underwent surgical repair. There were 203 cases (92%) of enlarged ventricles, but only 171 cases (78%) of hydrocephalus. Seven i...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Talamonti G,D'Aliberti G,Collice M

    更新日期:2007-11-01 00:00:00

  • Placental alkaline phosphatase as a tumor marker for primary intracranial germinoma.

    abstract::A sensitive enzyme-linked immunosorbent assay (ELISA) was used in a retrospective study of placental alkaline phosphatase (PLAP) levels in serum, cerebrospinal fluid (CSF), and intratumoral cyst fluid in primary intracranial germinoma. The ELISA showed no cross-reactivity with intestinal alkaline phosphatase except in...

    journal_title:Journal of neurosurgery

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    authors: Shinoda J,Yamada H,Sakai N,Ando T,Hirata T,Miwa Y

    更新日期:1988-05-01 00:00:00

  • Upregulation of neurogenesis and reduction in functional deficits following administration of DEtA/NONOate, a nitric oxide donor, after traumatic brain injury in rats.

    abstract:OBJECT:Neurogenesis, which is upregulated by neural injury in the adult mammalian brain, may be involved in the repair of the injured brain and functional recovery. Therefore, the authors sought to identify agents that can enhance neurogenesis after brain injury, and they report that (Z)-1-[N-(2-aminoethyl)-N-(2-ammoni...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Lu D,Mahmood A,Zhang R,Copp M

    更新日期:2003-08-01 00:00:00

  • Reversal of dementia in normotensive hydrocephalus after removal of a cauda equina tumor. Case report.

    abstract::An elderly man presented with signs of normotensive hydrocephalus. Elevated protein content in the spinal fluid led to the diagnosis of an "asymptomatic" cauda equine neurilemoma and its removal. Within 6 weeks the patient's mental status had dramatically improved. Chronic transudation of plasma proteins including fib...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Bamford CR,Labadie EL

    更新日期:1976-07-01 00:00:00

  • Vascular consequences of operculoinsular corticectomy for refractory epilepsy.

    abstract:OBJECT:Surgery in the insular region is considered challenging because of its vascular relationships, the proximity of functional structures, and its deep location in the sylvian fissure. The authors report the incidence and consequences of ischemic lesions after operculoinsular corticectomy for refractory epilepsy. M...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Finet P,Nguyen DK,Bouthillier A

    更新日期:2015-06-01 00:00:00

  • Barbiturate coma in focal cerebral ischemia. Relationship of protection to timing of therapy.

    abstract::The therapeutic application of barbiturate-induced coma was evaluated in a primate model of focal cerebral ischemia. A standardized regimen of pentobarbital was used, and the times of initiation of administration were varied following a 6-hour middle cerebral artery occlusion in baboons. Three groups of five animals w...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Selman WR,Spetzler RF,Roski RA,Roessmann U,Crumrine R,Macko R

    更新日期:1982-05-01 00:00:00

  • Angiographic frequency of saccular intracranial aneurysms in patients with spontaneous cervical artery dissection.

    abstract::The pathogenesis of intracranial aneurysms and spontaneous cervical artery dissection is incompletely understood but a primary arteriopathy, possibly similar in both disorders, may be of importance. To investigate the frequency of intracranial aneurysms in patients with spontaneous cervical artery dissection, the angi...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Schievink WI,Mokri B,Piepgras DG

    更新日期:1992-01-01 00:00:00

  • Morphometric and qualitative analysis of congenital occipitocervical instability in children: implications for patients with Down syndrome.

    abstract:OBJECT:Congenital occipitocervical (OC) instability is uncommon in healthy children but can occur in many children with Down syndrome. A simple morphometric method of evaluating the OC joint in children with OC instability is presented, supported by a qualitative image analysis based on computed tomography (CT). METHO...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Browd S,Healy LJ,Dobie G,Johnson JT 3rd,Jones GM,Rodriguez LF,Brockmeyer DL

    更新日期:2006-07-01 00:00:00

  • Influence of surgical or endovascular treatment on visual symptoms caused by intracranial aneurysms: single-center series and systematic review.

    abstract:OBJECT:Intracranial aneurysms of the anterior circulation might become symptomatic by causing visual deficits. The influence of treatment modality on improvement is still unclear. The objective of this study was to analyze the recovery of visual deficits caused by the mass effect of intracranial aneurysms after surgica...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,评审


    authors: Schuss P,Güresir E,Berkefeld J,Seifert V,Vatter H

    更新日期:2011-10-01 00:00:00

  • Improvement in intensive care unit outcomes in patients with subarachnoid hemorrhage after initiation of neurointensivist co-management.

    abstract:OBJECT:Neurointensivists are specialists trained to manage all aspects of the intensive care unit (ICU) stay of neurologically ill patients. No study to date has examined the role of neurointensivists specifically in subarachnoid hemorrhage (SAH) management. This study examined the use of a team-based neurointensivist ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Josephson SA,Douglas VC,Lawton MT,English JD,Smith WS,Ko NU

    更新日期:2010-03-01 00:00:00

  • Application of magnetic resonance neurography in the evaluation of patients with peripheral nerve pathology.

    abstract::Currently, diagnosis and management of disorders involving nerves are generally undertaken without images of the nerves themselves. The authors evaluated whether direct nerve images obtained using the new technique of magnetic resonance (MR) neurography could be used to make clinically important diagnostic distinction...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Filler AG,Kliot M,Howe FA,Hayes CE,Saunders DE,Goodkin R,Bell BA,Winn HR,Griffiths JR,Tsuruda JS

    更新日期:1996-08-01 00:00:00

  • Brain-stem hemangioma calcificans. Case report.

    abstract::A case of brain-stem hemangioma calcificans is described. The few cases reported in the literature prove the rarity of this tumor, which is considered a benign variant of cerebral cavernous hemangioma. Diagnosis and treatment of these tumors are briefly discussed with a review of the literature including 11 previous c...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Occhiogrosso M,Carella A,D'Aprile P,Vailati G

    更新日期:1983-07-01 00:00:00

  • Clinical tolerance of corticospinal tracts in convection-enhanced delivery to the brainstem.

    abstract:OBJECTIVE:Convection-enhanced delivery (CED) has been explored as a therapeutic strategy for diffuse intrinsic pontine glioma (DIPG). Variables that may affect tolerance include infusate volume, infusion rate, catheter trajectory, and target position. Supratentorial approaches for catheter placement and infusate distri...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Morgenstern PF,Zhou Z,Wembacher-Schröder E,Cina V,Tsiouris AJ,Souweidane MM

    更新日期:2018-12-21 00:00:00

  • Mononuclear leukocyte ADP-ribosylation as an indicator of immune function in malignant-glioma patients treated with betamethasone for cerebral edema.

    abstract::Glioma patients receiving corticosteroids (16 mg/day betamethasone) were examined for evidence of immune cell dysfunction by using quantitative estimates of adenosine diphosphate (ADP)-ribosylation in peripheral mononuclear leukocytes as the physiological indicator. The duration of daily treatment with corticosteroids...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Pero RW,Salford LG,Strömblad LG,Andersson C

    更新日期:1992-10-01 00:00:00

  • Effectiveness of staged angioplasty for avoidance of cerebral hyperperfusion syndrome after carotid revascularization.

    abstract::OBJECTIVECerebral hyperperfusion syndrome (CHS) is a serious complication after carotid artery stenting (CAS). Staged angioplasty (SAP)-i.e., angioplasty followed by delayed CAS-has been reported as a potential CHS-avoiding procedure. The purpose of this study was to clarify the effectiveness of SAP in avoiding CHS af...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Hayakawa M,Sugiu K,Yoshimura S,Hishikawa T,Yamagami H,Fukuda-Doi M,Sakai N,Iihara K,Ogasawara K,Oishi H,Ito Y,Matsumaru Y

    更新日期:2019-01-18 00:00:00

  • Microsurgical anatomy of the hippocampal arteries.

    abstract::An anatomical study of the vascularization of the hippocampus was performed on 30 hemispheres. There were a total of 140 arteries supplying the hippocampi, for an average of 4.7 arteries per hemisphere (range three to seven arteries). Based on the origin and caliber of the arteries supplying the hippocampus, the hemis...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Erdem A,Yaşargil G,Roth P

    更新日期:1993-08-01 00:00:00

  • Hand prehension recovery after brachial plexus avulsion injury by performing a full-length phrenic nerve transfer via endoscopic thoracic surgery.

    abstract:OBJECT:The functional recovery of hand prehension after complete brachial plexus avulsion injury (BPAI) remains an unsolved problem. The authors conducted a prospective study to elucidate a new method of resolving this injury. METHODS:Three patients with BPAI underwent a new procedure during which the full-length phre...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Xu WD,Lu JZ,Qiu YQ,Jiang S,Xu L,Xu JG,Gu YD

    更新日期:2008-06-01 00:00:00

  • Late seizures and morbidity after subdural empyema.

    abstract::A survey of 89 patients with subdural empyema was conducted to assess the incidence of late seizures and morbidity in this disease. Twenty-four patients died during the acute stage of the illness and, of the 65 survivors, 13 were lost or had incomplete follow-up review. Hemiparesis occurred in 48 of the survivors duri...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Cowie R,Williams B

    更新日期:1983-04-01 00:00:00

  • Prospective, randomized, double-blind trial of BQ-123 and bosentan for prevention of vasospasm following subarachnoid hemorrhage in monkeys.

    abstract::Thirty-one monkeys were randomly divided into three groups to undergo baseline cerebral angiography followed by induction of subarachnoid hemorrhage by placement of autologous blood clot along the right-sided arteries of the anterior circle of Willis (Day 0). The monkeys were then given drug vehicle or one of two endo...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Hino A,Weir BK,Macdonald RL,Thisted RA,Kim CJ,Johns LM

    更新日期:1995-09-01 00:00:00

  • Individual variations in the sulcal anatomy of the basal temporal lobe and its relevance for epilepsy surgery: an anatomical study performed using magnetic resonance imaging.

    abstract:OBJECT:The concept of selective amygdalohippocampectomy is based on pathophysiological insights into the epileptogenicity of the hippocampal region and the definition of the clinical syndrome of mesial temporal lobe epilepsy (TLE). High-resolution magnetic resonance (MR) imaging allows correlation of the site of histol...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Novak K,Czech T,Prayer D,Dietrich W,Serles W,Lehr S,Baumgartner C

    更新日期:2002-03-01 00:00:00

  • Phase I trial of caudate deep brain stimulation for treatment-resistant tinnitus.

    abstract:OBJECTIVE:The objective of this open-label, nonrandomized trial was to evaluate the efficacy and safety of bilateral caudate nucleus deep brain stimulation (DBS) for treatment-resistant tinnitus. METHODS:Six participants underwent DBS electrode implantation. One participant was removed from the study for suicidality u...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Cheung SW,Racine CA,Henderson-Sabes J,Demopoulos C,Molinaro AM,Heath S,Nagarajan SS,Bourne AL,Rietcheck JE,Wang SS,Larson PS

    更新日期:2019-09-24 00:00:00

  • Shunts in normal-pressure hydrocephalus: do we place too many or too few?

    abstract:OBJECT:The average 65-year-old patient with moderate dementia can look forward to only 1.4 quality-adjusted life years (QALYs), that is, longevity times quality of life. Some of these patients suffer from normal-pressure hydrocephalus (NPH) and respond dramatically to shunt insertion. Currently, however, NPH cannot be ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Stein SC,Burnett MG,Sonnad SS

    更新日期:2006-12-01 00:00:00