Abstract:
BACKGROUND:Distal middle cerebral artery (MCA) aneurysms frequently have nonsaccular morphology that necessitates trapping and bypass. Bypasses can be difficult because efferent arteries lie deep in the opercular cleft and may not be easily identifiable. OBJECTIVE:We introduce the "flash fluorescence" technique, which uses videoangiography with indocyanine green (ICG) dye to identify an appropriate recipient artery on the cortical surface for the bypass, enabling a more superficial and easier anastomosis. METHODS:Flash fluorescence requires 3 steps: (1) temporary clip occlusion of the involved afferent artery; (2) videoangiography demonstrating fluorescence in uninvolved arteries on the cortical surface; and (3) removal of the temporary clip with flash fluorescence in the involved efferent arteries on the cortical surface, thereby identifying a recipient. Alternatively, temporary clips can occlude uninvolved arteries, and videoangiography will demonstrate initial fluorescence in efferent arteries during temporary occlusion and flash fluorescence in uninvolved arteries during reperfusion. RESULTS:From a consecutive series of 604 MCA aneurysms treated microsurgically, 22 (3.6%) were distal aneurysms and 11 required a bypass. The flash fluorescence technique was used in 3 patients to select the recipient artery for 2 superficial temporal artery-to-MCA bypasses and 1 MCA-MCA bypass. The correct recipient was selected in all cases. CONCLUSION:The flash fluorescence technique provides quick, reliable localization of an appropriate recipient artery for bypass when revascularization is needed for a distal MCA aneurysm. This technique eliminates the need for extensive dissection of the efferent artery and enables a superficial recipient site that makes the anastomosis safer, faster, and less demanding.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Rodríguez-Hernández A,Lawton MTdoi
10.1227/NEU.0b013e31823158f3subject
Has Abstractpub_date
2012-06-01 00:00:00pages
209-20issue
2 Suppl Operativeeissn
0148-396Xissn
1524-4040journal_volume
70pub_type
杂志文章,评审相关文献
NEUROSURGERY文献大全abstract:OBJECTIVE:Hypomania accounts for approximately 4% to 13% of psychotropic adverse events during subthalamic nucleus (STN) deep brain stimulation (DBS) for Parkinson's disease. Diffusion of current into the inferior and medial "limbic" STN is often reported to be the cause. We suggest a different explanation, in which th...
journal_title:Neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1227/01.NEU.0000345631.54446.06
更新日期:2009-06-01 00:00:00
abstract::Magnetic resonance can visualize the vertebral bodies, discs, neural structures, cerebrospinal fluid (CSF), neural foramina, and extradural structures in the sagittal, axial, and coronal planes. The normal nucleus pulposus can be differentiated from the anulus and changes associated with degeneration. Infection, traum...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198410000-00022
更新日期:1984-10-01 00:00:00
abstract:OBJECTIVE:Preoperative magnetic resonance imaging (MRI) myelography scans demonstrated a dural defect in a 50-year-old man with an epidural arachnoid cyst who had a 29-year history of untreated weakness and numbness both lower limbs. METHODS:MRI scans showed a dorsal intraspinal extradural cystic lesion at the level f...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000232659.56174.28
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:Cadaveric fibula with locking plate internal fixation has been reported to be associated with fewer complications and better long-term results, compared with autologous iliac crest. With the knowledge that cortically dense allografts collapse less with time, new machined femoral ring allografts were developed...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Approximately 20% of low-grade gliomas (LGG) display visible protoporphyrin fluorescence during surgery after 5-aminolevulinic acid (5-ALA) administration. OBJECTIVE:To determine if fluorescence represents a prognostic marker in LGG. METHODS:Seventy-four consecutive patients with LGG (World Health Organiza...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyy365
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Although injury to the lumbar arteries during anterior spinal approaches is often encountered, there are few published articles regarding the relationship between the lumbar arteries and spinal cord ischemia. OBJECTIVE:To examine the morphology of the lumbar arteries and to emphasize their clinical importan...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e318205e307
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:We describe a patient with a cavernous malformation within the trigeminal nerve at the nerve root entry zone who presented with trigeminal neuralgia. CLINICAL PRESENTATION:A 52-year-old woman sought treatment after experiencing dizziness and lancinating left facial pain for almost a year. Neur...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:To analyze the incidence and impact of an intracerebral hematoma (ICH) on treatment and outcome in patients with aneurysmal subarachnoid hemorrhage. METHODS:Data of 585 consecutive patients with subarachnoid hemorrhage from June 1999 to December 2005 were prospectively entered in a database. ICH was diagnose...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000335170.76722.B9
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:Meningiomas are the most common tumors occurring in the central nervous system, with variable recurrence rates depending on World Health Organization grading. Atypical (Grade II) meningioma has a higher rate of recurrence than benign (Grade I) meningioma. The efficacy of adjuvant radiotherapy (RT) to improve...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyaa348
更新日期:2020-12-15 00:00:00
abstract::Clinical decision analysis is applied to the treatment decisions for four patients with unruptured familial aneurysms. The surgical treatment was uneventful in all patients except one with mild mixed aphasia and facial weakness postoperatively; these deficits disappeared in less than 2 years. In the decision analysis,...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198809000-00007
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:Ten-year follow-up data from the US Food and Drug Administration investigational device exemption trial comparing BRYAN® Cervical Disc (Medtronic, Dublin, Ireland) arthroplasty to anterior cervical discectomy and fusion (ACDF) demonstrated that disc arthroplasty maintained range of motion and improvements in...
journal_title:Neurosurgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/neuros/nyy118
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:Wingspan (Boston Scientific, Fremont, CA) is a self-expanding stent designed specifically for the treatment of symptomatic intracranial atheromatous disease. The current series reports the observed incidence of in-stent restenosis (ISR) and thrombosis on angiographic follow-up. METHODS:A prospective, intent-...
journal_title:Neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1227/01.NEU.0000290914.24976.83
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Cerebral ischemia is the most worrisome perioperative complication of carotid endarterectomy (CEA). The stroke rate occurring with CEA is estimated to range from 2.3 to 6.3%. Numerous treatment options are available to the neurosurgeon in this scenario, although no "gold standard" exists. CLIN...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000134466.55733.3e
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:Calcific cerebral emboli are rare yet pose a difficult therapeutic challenge because of their lack of response to thrombolytic therapy and their propensity for fragmentation. CLINICAL PRESENTATION:A 75-year-old woman developed aphasia and hemiparesis after cardiac catheterization from a near-occlusive calcif...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000335088.85470.FC
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Venous thromboembolism is a common complication of traumatic brain injury with an estimated incidence of 25% when chemoprophylaxis is delayed. The timing of initiating prophylaxis is controversial given the concern for hemorrhage expansion. OBJECTIVE:To determine the safety of initiating venous thromboembol...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyx164
更新日期:2017-12-01 00:00:00
abstract::Intracranial epidermoid and dermoid tumors are unusual benign lesions that are potentially curable. Subtotal removal carries a high incidence of recurrence, plus the rare possibility of carcinomatous degeneration of the remnants. Aseptic meningitis from spillage of cyst contents into the subarachnoid space is frequent...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/00006123-198904000-00014
更新日期:1989-04-01 00:00:00
abstract::We studied the impairment of autoregulation of cerebral blood flow (CBF) and its effect on the electrical activity of the brain during the development of chronic cerebral vasospasm after subarachnoid hemorrhage, using a vasospasm model in primates. Fourteen animals were divided into two groups: a clot group (8) and a ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199101000-00007
更新日期:1991-01-01 00:00:00
abstract::There has been a renewed interest in manned spaceflight due to endeavors by private and government agencies. Publicized goals include manned trips to or colonization of Mars. These missions will likely be of long duration, exceeding existing records for human exposure to extra-terrestrial conditions. Participants will...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1093/neuros/nyy531
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Tractography based on diffusion tensor imaging has become a popular tool for delineating white matter tracts for neurosurgical procedures. OBJECTIVE:To explore whether navigated transcranial magnetic stimulation (nTMS) might increase the accuracy of fiber tracking. METHODS:Tractography was performed accord...
journal_title:Neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1227/NEU.0000000000000715
更新日期:2015-06-01 00:00:00
abstract::Intracranial cartilaginous tumors are unusual lesions, of which myxoid chondrosarcoma is the rarest. We describe this tumor arising from the falx in a 28-year-old woman treated at recurrence with a second operation and a radiation implant. The behavior of classic chondrosarcoma and mesenchymal chondrosarcoma is also r...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199208000-00021
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the role of transsphenoidal selective adenomectomy alone or in combination with adjuvant therapy in treatment of recurrent Cushing's disease. METHODS:A total of 16 patients with recurrent Cushing's disease underwent reoperation, 15 via a transsphenoidal approach and one ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000215945.26764.92
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Traumatic brain injuries remain a treatment enigma with devastating late results. As terminally differentiated tissue, the brain retains little capacity to regenerate, making early attempts to preserve brain cells after brain injury essential. OBJECTIVE:To resuscitate damaged tissue by modulating edema, sol...
journal_title:Neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1227/NEU.0b013e3182446760
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Brain magnetic resonance imaging scans occasionally reveal asymmetrical ventricles with no identifiable cause. A case is presented that highlights a possible connection between transient choroid plexus cysts and benign asymmetrical ventricles. CLINICAL PRESENTATION:The patient was a 2.5-week-o...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200301000-00027
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:Cerebral autoregulation maintains a relatively stable cerebral blood flow over a range of perfusion pressures. During exercise, regional cerebral blood flow may be elevated in particular areas of the brain. This case report presents the impact of aerobic exercise on intracranially measured pressure and brain ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000371976.21043.C8
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:The posterior meningeal artery (PMA) normally arises from the vertebral artery; however, its origin varies considerably as the result of its embryological development. This gains clinical significance when associated with vascular pathology. CLINICAL PRESENTATION:A 65-year-old man presented to his local hosp...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000325256.72308.AF
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Neuronavigation has become an intrinsic part of preoperative surgical planning and surgical procedures. However, many surgeons have the impression that accuracy decreases during surgery. OBJECTIVE:To quantify the decrease of neuronavigation accuracy and identify possible origins, we performed a retrospectiv...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e318287072d
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:A quantitative analysis of intraoperative cortical shift and deformation was performed to gain a better understanding of the nature and extent of this problem and the resultant loss of spatial accuracy in surgical procedures coregistered to preoperative imaging studies. METHODS:Three-dimensional feature trac...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199810000-00010
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Study of the corticosubcortical functional anatomy of reading and picture naming. OBJECTIVE:To study the role of the left basal occipitotemporal area and its white matter pathways. METHODS:Three patients underwent awake surgery for lesions in the left basal posterotemporal region with intraoperative electr...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e318282a361
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:Stereotactic radiosurgery is a commonly used treatment method in the management of metastatic brain tumors. When lesions enlarge after radiosurgery, it may represent tumor regrowth, radiation necrosis, or both. The purpose of this study was to determine whether standard magnetic resonance imaging (MRI) sequen...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000333263.31870.31
更新日期:2008-11-01 00:00:00
abstract::One hundred eighty patients affected by cerebral arteriovenous malformations (AVMs) underwent radiosurgical treatment in our department. One hundred fifty-three patients have been treated with complete irradiation of the entire AVM nidus. In 27 patients (with large and/or three-dimensional irregular target volumes), o...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00