Abstract:
OBJECT:Prior attempts to define normal cerebellar tonsil position have been limited by small numbers of patients precluding analysis of normal distribution by age group. The authors' objective in the present study was to analyze cerebellar tonsil location in every age range. METHODS:Two thousand four hundred patients were randomly selected from a database of 62,533 consecutive patients undergoing MRI and were organized into 8 age groups. Magnetic resonance images were directly examined for tonsil location, morphology, and other features. Patients with a history or imaging findings of posterior fossa abnormalities unrelated to Chiari malformation (CM) were excluded from analysis. The caudal extent of the cerebellar tonsils was measured at the midsagittal and lowest parasagittal positions. RESULTS:The mean tonsil height decreased slightly with advancing age into young adulthood and increased with advancing age in the adult age range. An increasing age in the adult age range was associated with a decreased likelihood of a tonsil position 5 mm or more below the foramen magnum (p = 0.0004). In general, the lowest tonsil position in each age group was normally distributed. Patients with pegged morphology were more likely to have a tonsil location at least 5 mm below the foramen magnum (85%), as compared with those having intermediate (38%) or rounded (2%) morphology (p < 0.0001). Female sex was associated with a lower mean tonsil position (p < 0.0001). Patients with a lower tonsil position also tended to have an asymmetrical tonsil position, usually lower on the right (p < 0.0001). CONCLUSIONS:Cerebellar tonsil position follows an essentially normal distribution and varies significantly by age. This finding has implications for advancing our understanding of CM.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Smith BW,Strahle J,Bapuraj JR,Muraszko KM,Garton HJ,Maher COdoi
10.3171/2013.5.JNS121825subject
Has Abstractpub_date
2013-09-01 00:00:00pages
812-9issue
3eissn
0022-3085issn
1933-0693journal_volume
119pub_type
杂志文章abstract::OBJECTIVE Results of radial nerve grafting are largely unknown for lesions of the radial nerve that occur proximal to the humerus, including those within the posterior cord. METHODS The authors describe 13 patients with proximal radial nerve injuries who were surgically treated and then followed for at least 24 months...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.12.JNS141944.test
更新日期:2016-01-01 00:00:00
abstract::A retrospective series of 12,478 patients with breast cancer included 2467 patients with spinal metastases. Local treatment was not necessary in 688 patients. Neurological dificit did not develop in 1735 patients who underwent radiotherapy. Forty-four patients developed myelopathy due to spinal cord compression as dem...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.5.0653
更新日期:1977-11-01 00:00:00
abstract::The fourth Editor of the Journal of Neurosurgery offers short vignettes on the Editors who preceded and succeeded him. He recounts some of the challenges that were faced and changes that were made during his time as Editor. One of the major changes was production of the Journal via computer. ...
journal_title:Journal of neurosurgery
pub_type: 历史文章,杂志文章
doi:10.3171/jns.1994.81.1.0147
更新日期:1994-07-01 00:00:00
abstract::Since the discovery of melatonin approximately 25 years ago, there has been intense study regarding the details of the structure and function of the pineal gland. This work is reviewed, with particular emphasis on those aspects of importance to human physiology and disease. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1985.63.3.0321
更新日期:1985-09-01 00:00:00
abstract::The authors report outcomes in 18 patients with arteriovenous malformations (AVMs) who were treated with gamma knife radiosurgery and in whom magnetic resonance (MR) imaging was obtained a mean of 14 years (range 8-23 years) after treatment and 10 years (range 4-17 years) after confirmed obliteration of the AVM. All p...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.86.4.0589
更新日期:1997-04-01 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::In a series of 32 surgical cases of carotid-ophthalmic artery aneurysm, seven of the lesions were located in the "carotid cave." This special type of aneurysm is usually small and projects medially on the anteroposterior view of the angiogram. At surgery, it is located intradurally at the dural penetration of the inte...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.70.2.0216
更新日期:1989-02-01 00:00:00
abstract:OBJECT:Chordomas have a high propensity for local recurrence and progression, as well as for systemic and cerebrospinal fluid metastasis. The authors identified and analyzed a series of patients with chordomas, focusing on an underrecognized pathological entity-surgical seeding of tumor cells. METHODS:In a retrospecti...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.95.5.0798
更新日期:2001-11-01 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::Delayed cerebral vasospasm is an important determinant of the clinical outcome after subarachnoid hemorrhage, but its prevention and treatment has met with limited success. Since cerebral arteries were found to be sensitive to the vasoconstrictor effect of angiotensin II, the possibility of angiotensin's contribution ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.55.6.0884
更新日期:1981-12-01 00:00:00
abstract:OBJECTIVE:The optimal margin size in postoperative stereotactic radiosurgery (SRS) for brain metastases is unknown. Herein, the authors investigated the effect of SRS planning target volume (PTV) margin on local recurrence and symptomatic radiation necrosis postoperatively. METHODS:Records of patients who received pos...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.9.JNS171735
更新日期:2018-04-20 00:00:00
abstract::In the central nervous system, recurrence of intracranial Masson's vegetant intravascular hemangioendothelioma (MVIH) is rare. To the authors' knowledge, only three recurrent intracranial cases have been reported. The authors report the case of a 75-year-old woman with a recurrent left-sided cerebellopontine angle and...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1999.91.2.0308
更新日期:1999-08-01 00:00:00
abstract::A computer-based system has been developed for the integration and display of computerized tomography (CT) image data in the operating microscope in the correct perspective without requiring a stereotaxic frame. Spatial registration of the CT image data is accomplished by determination of the position of the operating...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.65.4.0545
更新日期:1986-10-01 00:00:00
abstract::A case is reported of severe unilateral hemispheric edema and localized hemorrhage associated with seizures following endarterectomy of an ipsilateral high-grade carotid stenosis. Imaging studies including angiography, computerized tomography (CT), magnetic resonance imaging/angiography, and xenon-CT, suggested postop...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.83.1.0133
更新日期:1995-07-01 00:00:00
abstract::In 10 patients with supratentorial ependymomas, the tumors exhibited hyperdensity on computerized tomography (CT) scanning prior to contrast infusion and, with one exception, all tumors were mixed lesions with the low densities suggesting cystic or necrotic portions. Eighty percent of the tumors contained small calcif...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.2.0209
更新日期:1986-02-01 00:00:00
abstract:OBJECT:Cellular density is a major factor for change in the apparent diffusion coefficient (ADC). The authors hypothesized that loss of tumor cells after Gamma Knife surgery (GKS) may alter the ADC value and used diffusion weighted MR imaging (DW imaging) to evaluate cellular changes in brain tumors to detect their tre...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:
更新日期:2010-12-01 00:00:00
abstract::The case is reported of a patient with progressive left hemiparesis due to vascular compression of the medulla oblongata. Metrizamide computerized tomography cisternography revealed that the left vertebral artery was compressing and distorting the left lateral surface of the medulla. Compression was surgically relieve...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.3.0425
更新日期:1985-03-01 00:00:00
abstract::Forty-five children harboring brain-stem tumors were treated at the University of California, San Francisco, between 1969 and 1979. Pathological diagnoses were made in 19 patients. All patients received radiation therapy (RT). Thirteen patients received chemotherapy before, during, or immediately after RT. Twenty-four...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.6.0721
更新日期:1981-06-01 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::The author describes a woman in whom an S1-2 fracture developed after L4-S1 decompression and fusion. Osteoporosis was not present, but the lesion failed to respond to conservative therapy, necessitating surgical extension of the spinal fusion. Although biomechanical complications of lumbosacral fusion are uncommon, p...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2003.99.3.0310
更新日期:2003-10-01 00:00:00
abstract::Endolymphatic sac tumors (ELSTs) are locally invasive neoplasms that arise in the posterior petrous bone and are associated with von Hippel-Lindau (VHL) disease. These tumors cause symptoms even when microscopic in size (below the threshold for detectability on imaging studies) and can lead to symptoms such as hearing...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/08/0421
更新日期:2007-08-01 00:00:00
abstract:OBJECT:Expression of matrix metalloproteinases (MMPs) has been postulated to play a central role in brain tumor invasion; however, its underlying mechanism is not yet fully understood. In the present study, by assessing the effect of a specific p38 mitogen-activated protein kinase (MAPK) inhibitor, SB203580, on the sec...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.1.0112
更新日期:2002-07-01 00:00:00
abstract:OBJECT:The authors report their experience with the use of the Neuroform Microdelivery System for intravascular reconstruction. They assess the technical feasibility of the system, the efficacy of the combined application of stent and detachable coils, and the follow-up findings. METHODS:Fifty patients found to harbor...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.102.2.0235
更新日期:2005-02-01 00:00:00
abstract:OBJECT:The aim of this study was to determine the anatomical limitations of the transcallosal transchoroidal approach to the third ventricle. METHODS:Twenty-six formalin-fixed specimens were studied. Sagittal dissections were used to determine the anatomical relationships of the foramen of Monro, the angle of approach...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.7.JNS08124
更新日期:2009-09-01 00:00:00
abstract::Bilateral trigeminal neuralgia occurred in 32 (11.9%) of 269 consecutive patients who were treated with radiofrequency electrocoagulation (RFE). This is a higher incidence than has been reported before and may be explained by the prospective nature of the present study, the long follow-up period, and the inclusion of ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.67.1.0044
更新日期:1987-07-01 00:00:00
abstract::Neurosurgery has played an important role in the development of neuroscience and the science of consciousness. In this paper, the authors reflect on some of the historical contributions of neurosurgeons to the science of consciousness and discuss the ways in which clinical neurosurgery can contribute to the science of...
journal_title:Journal of neurosurgery
pub_type: 历史文章,杂志文章
doi:10.3171/2012.6.JNS112136
更新日期:2012-09-01 00:00:00
abstract::Forty-two cats were subjected to decerebration, thoracic and lumbar laminectomies, and isolation of the sciatic nerves. Spinal evoked potentials in response to bilateral sciatic nerve stimulation were recorded at L-3, and the spinal cord blood flow (SCBF) was measured by the hydrogen clearance technique. Thoracic cord...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.71.5.0747
更新日期:1989-11-01 00:00:00
abstract:OBJECT:Changes in cortical representation in patients with cerebral lesions may alter the correlation between cortical anatomy and function. This is of potential clinical significance when the extent of cortical resection is based on surface anatomical landmarks. METHODS:Fifty-one patients with supratentorial lesions ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.92.2.0242
更新日期:2000-02-01 00:00:00
abstract::OBJECT This study explored whether there were differences between the autoimmune disease prevalence rates in unilateral and bilateral moyamoya disease (MMD). METHODS The authors performed a retrospective review of data obtained from the medical records of their hospital, analyzing and comparing the clinical characteri...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.4.JNS142936
更新日期:2016-05-01 00:00:00
abstract:OBJECT:Functional results after surgery for acoustic neuromas that have little or no growth within the internal auditory canal are controversial, because these medial tumors can grow to a considerable size within the cerebellopontine angle (CPA) before symptoms occur. METHODS:A prospective study was designed to evalua...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.5.1083
更新日期:2002-11-01 00:00:00