Abstract:
OBJECT:At present, the administration of prophylactic antiepileptic medication following aneurysmal subarachnoid hemorrhage (SAH) is controversial, and the practice is heterogeneous. Here, the authors sought to inform clinical decision making by identifying factors associated with the occurrence of seizures following aneurysm rupture. METHODS:Exploratory analysis was performed on 413 patients enrolled in CONSCIOUS-1 (Clazosentan to Overcome Neurological Ischemia and Infarction Occurring after Subarachnoid Hemorrhage), a prospective randomized trial of clazosentan for the prevention of angiographic vasospasm. The association among clinical, laboratory, and radiographic covariates and the occurrence of seizures following SAH were determined. Covariates with a significance level of p < 0.20 on univariate analysis were entered into a multivariate logistic regression model. Receiver operating characteristic (ROC) curve analysis was used to define optimal predictive thresholds. RESULTS:Of the 413 patients enrolled in the study, 57 (13.8%) had at least 1 seizure following SAH. On univariate analysis, a World Federation of Neurosurgical Societies grade of IV-V, a greater subarachnoid clot burden, and the presence of midline shift and subdural hematomas were associated with seizure activity. On multivariate analysis, only a subarachnoid clot burden (OR 2.76, 95% CI 1.39-5.49) and subdural hematoma (OR 5.67, 95% CI 1.56-20.57) were associated with seizures following SAH. Using ROC curve analysis, the optimal predictive cutoff for subarachnoid clot burden was determined to be 21 (of a possible 30) on the Hijdra scale (area under the curve 0.63). CONCLUSIONS:A greater subarachnoid clot burden and subdural hematoma are associated with the occurrence of seizures after aneurysm rupture. These findings may help to identify patients at greatest risk for seizures and guide informed decisions regarding the prescription of prophylactic anticonvulsive therapy. Clinical trial registration no.: NCT00111085 (ClinicalTrials.gov).
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Ibrahim GM,Fallah A,Macdonald RLdoi
10.3171/2013.3.JNS122097subject
Has Abstractpub_date
2013-08-01 00:00:00pages
347-52issue
2eissn
0022-3085issn
1933-0693journal_volume
119pub_type
杂志文章,随机对照试验abstract::Although image-based human stereotaxis began with Spiegel and Wycis in 1947, the major principles of radiographic stereotaxis were formulated 50 years earlier by the French scientific photographer Gaston Contremoulins. In 1897, frustrated by the high morbidity of bullet extraction from the brain, the Parisian surgeon ...
journal_title:Journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.3171/2016.10.JNS161966
更新日期:2017-12-01 00:00:00
abstract::The authors report five cases of surgically treated giant vertebral artery aneurysm. Two giant serpentine aneurysms were managed with aneurysmectomy, a giant semifusiform aneurysm with trapping and partial aneurysmectomy, and the other two saccular giant aneurysms with clipping. Surgical results were satisfactory in a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.68.6.0960
更新日期:1988-06-01 00:00:00
abstract::Surgical sacrifice of the carotid artery is a frequently anticipated event during the treatment of certain aneurysms and tumors. The ability to predict tolerance to carotid artery occlusion is therefore of benefit when planning procedures in which the carotid artery is at risk. A trial of carotid artery occlusion usin...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.1.0015
更新日期:1994-07-01 00:00:00
abstract::OBJECTIVEThe authors' aim in this study was to evaluate placement accuracy and clinical outcomes in patients who underwent implantation of deep brain stimulation devices with the aid of frame-based stereotaxy and intraoperative MRI after induction of general anesthesia.METHODSThirty-three patients with movement disord...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.7.JNS171166
更新日期:2018-12-01 00:00:00
abstract:OBJECT:Middle cerebral artery (MCA) aneurysms can be difficult to detect and characterize. The authors describe the utility and impact of helical computerized tomography (CT) angiography for the evaluation of aneurysms in this location, and compare this modality with digital subtraction (DS) angiography and intraoperat...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.2002.97.6.1322
更新日期:2002-12-01 00:00:00
abstract:OBJECT:Traumatic parenchymal mass lesions are common sequelae of traumatic brain injuries (TBIs). They occur in up to 8.2% of all TBI cases and 13%-35% of severe TBI cases, and they account for up to 20% of surgical intracranial lesions. Controversy exists concerning the association between radiological and clinical ev...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.3171/2013.12.JNS131090
更新日期:2014-04-01 00:00:00
abstract::A patient with a posttraumatic leptomeningeal cyst is described. The cyst simulated an occipital encephalocele and communicated with an epidural cerebrospinal fluid collection in the posterior fossa. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.65.5.0704
更新日期:1986-11-01 00:00:00
abstract::Desmoplastic small round cell tumors (DSRCTs) are rare, aggressive neoplasms that typically arise from abdominal and pelvic peritoneum in young adults. Other primary sites are uncommon, and an intracranial origin is exceptionally rare. Here the authors report the first case of a DSRCT presenting as a primary suprasell...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.10.JNS132490
更新日期:2015-04-01 00:00:00
abstract::Melanocytomas are rare tumors of the central nervous system that are believed to arise from leptomeningeal melanocytes. A young girl presented with a contrast-enhancing cystic mass in the temporal horn of the left lateral ventricle. Microsurgical resection of a black-colored vascular tumor supplied by the anterior cho...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/109/9/0480
更新日期:2008-09-01 00:00:00
abstract:OBJECT:Quantitative and qualitative alterations in the epidermal growth factor receptor (EGFR) commonly occur in many cancers in humans, including malignant gliomas. The aim of the current study was to evaluate molecular and cellular effects of OSI-774, a novel EGFR tyrosine kinase inhibitor, on nine glioblastoma multi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.100.3.0523
更新日期:2004-03-01 00:00:00
abstract:OBJECT:In this prospective multicenter study the authors hypothesized that investigational epidural cortical stimulation (CS) delivered concurrently with rehabilitation therapy may enhance motor recovery following stroke. METHODS:Patients who had suffered their index stroke >or= 4 months previously were randomized int...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.3171/JNS/2008/108/4/0707
更新日期:2008-04-01 00:00:00
abstract::Between 1925 and 1945, Walter Dandy and Kenneth McKenzie performed more than 700 posterior fossa eighth nerve sections and vestibular neurectomies to treat the intractable vertigo accompanying Ménière's disease. During the past 10 years, with the aid of microsurgical techniques and the approach to the posterior fossa ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.72.4.0533
更新日期:1990-04-01 00:00:00
abstract::The authors present a case in which dysembryoplastic neuroepithelial tumors (DNETs) occurred in the cerebellum and brainstem of a 44-year-old woman. A magnetic resonance image of the brain revealed multiple cystic lesions in the right cerebellar hemisphere, vermis, tonsil, and brainstem. Partial removal of the tumors ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.93.3.0487
更新日期:2000-09-01 00:00:00
abstract::In this study, the authors performed deep brain stimulation (DBS) of the subgenual anterior cingulate cortex (SACC) in a patient with a history of bipolar disorder. After a right thalamic stroke, intractable depression without mood elevation or a mixed state developed in this patient. He underwent bilateral SACC DBS a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.2.JNS081299
更新日期:2009-10-01 00:00:00
abstract::The authors describe a case of intracranial heterotopic brain located on the medial one-third of the left sphenoid ridge, and enveloped in a huge cystic cavity. The heterotopic brain was resected successfully with satisfactory clinical results. The resected brain was 8 X 4 X 3 cm in diameter, of 7 or 8 months gestatio...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.48.3.0470
更新日期:1978-03-01 00:00:00
abstract::Sixteen dogs were entered into a study of the double subarachnoid hemorrhage (SAH) model of cerebral vasospasm. Six animals were sacrificed 72 hours after the first experimental SAH, and the remaining 10 animals were killed 72 hours after the second experimental SAH; ten additional animals served as controls. Basilar ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.5.0834
更新日期:1995-05-01 00:00:00
abstract:OBJECT:Due to the complex and variable nature of brachial plexus injury, outcome analysis can be cumbersome and imprecise. Many scales have been devised, but no single scale is used uniformly. Moreover, despite several studies in which the authors have reported brachial plexus surgical data, no highly predictive clinic...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2007.106.4.276
更新日期:2007-04-01 00:00:00
abstract::Despite diagnostic advances, it remains difficult to identify intrasellar and ectopic parasellar adrenocorticotropic hormone (ACTH)-secreting microadenomas. The authors present the case of a 61-year-old woman with Cushing disease in whom a significant central-to-peripheral and lateralized right-sided ACTH gradient was...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.98.6.1312
更新日期:2003-06-01 00:00:00
abstract::Secondary operations for the removal of retained bone fragments have been performed in 116 of the 1133 casualties with craniocerebral missile wounds incurred in the war in Vietnam, 1967 to 1970. Various complications developed in 19 of these 116 casualties. Dehiscence of the wound occurred in eight patients, five of w...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1982.57.5.0617
更新日期:1982-11-01 00:00:00
abstract::A randomized double-blind placebo-controlled study was carried out to determine whether phenytoin administered soon after injury lessens the incidence of epilepsy in the 1st week after severe head trauma. In this study, 244 patients were randomized into either a phenytoin or placebo group. The patients in the phenytoi...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.3171/jns.1983.58.2.0231
更新日期:1983-02-01 00:00:00
abstract:OBJECT:Botulinum toxin injections are the best therapeutic option in patients with spasmodic torticollis. Although a small number of patients do not benefit from such therapy, the majority respond well but may develop antibodies to the toxin after repeated applications. In those termed primary nonresponders, no improve...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.97.2.0207
更新日期:2002-09-01 00:00:00
abstract:OBJECT:Delayed vasospasm is a significant cause of morbidity and mortality after subarachnoid hemorrhage (SAH). Proteomic therapeutics offers a new modality in which biologically active proteins or peptides are transduced into cells via covalent linkage to cell permeant peptides (CPPs). The hypothesis of this study was...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.7.JNS09730
更新日期:2010-03-01 00:00:00
abstract::To evaluate microcirculatory disturbance and cerebral edema associated with subarachnoid hemorrhage (SAH), both stereological morphometry on the intraparenchymal capillary network and microgravimetry were performed on a rabbit SAH model. Autologous arterial blood (5 ml) was injected into the cisterna magna, and the an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.73.3.0410
更新日期:1990-09-01 00:00:00
abstract:OBJECT:The prevalence of deformational, or positional, plagiocephaly has increased during the last decade. Treatments vary among centers, ranging from expectant management to orthotic helmet therapy to craniofacial remodeling. This management variability is partially due to a lack of objective methods with which to mea...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2004.100.5.0537
更新日期:2004-05-01 00:00:00
abstract::The authors present the case of a 68-year-old man who experienced acute obstructive hydrocephalus after having suffered an infarction in the occipital lobe. Histopathological and serial neuroimaging examinations revealed that portions of a large disintegrating occipital infarct had entered the lateral ventricle and ob...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.95.1.0119
更新日期:2001-07-01 00:00:00
abstract::To investigate the alteration of endothelium-dependent responses in chronic vasospasm after subarachnoid hemorrhage (SAH), experiments were carried out in the double-hemorrhage canine model. After the presence of vasospasm was confirmed by cerebral angiography on Days 0 and 7, pharmacological studies on the basilar ar...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.69.2.0239
更新日期:1988-08-01 00:00:00
abstract::Tissue acidosis is believed to be a key element in ischemic injury of neural tissue. The goal of this study was to determine whether persisting postischemic acidosis or the extent of acidosis would affect metabolic recovery following an ischemic event. Intracellular pH (pHi), adenosine triphosphate, phosphocreatine, a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.4.0567
更新日期:1994-10-01 00:00:00
abstract::The present study describes the usefulness of blood vessel allografts to repair gaps in rat peripheral nerve after immunosuppression with cyclosporine. Isogeneic strains of rats with known histoincompatibility were used for this study. A 10-mm gap was created in the peroneal nerve of host Fischer rats. The gap was bri...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.70.1.0115
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:The brainstem is a compact, delicate structure. The surgeon must have good anatomical knowledge of the safe entry points to safely resect intrinsic lesions. Lesions located at the lateral midbrain surface are better approached through the lateral mesencephalic sulcus (LMS). The goal of this study was to compa...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.1.JNS182036
更新日期:2019-04-12 00:00:00
abstract::The authors report a series of 71 patients with intracerebral hemorrhage: 57 underwent surgery and 14, although suitable candidates for surgery, refused operation. The results are assessed in relation to the site of the hemorrhage, mode of onset, and interval between accident and operation. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.43.5.0590
更新日期:1975-11-01 00:00:00