Abstract:
OBJECT:In large vestibular schwannoma (VS), microsurgery is the main treatment option, and complete resection is considered the primary goal. However, previous studies have documented suboptimal facial nerve outcomes in patients who undergo complete resection of large VSs. Subtotal resection is likely to reduce the risk of facial nerve injury but increases the risk of lesion regrowth. Gamma Knife surgery (GKS) can be performed to achieve long-term growth control of residual VS after incomplete resection. In this study the authors report on the results in patients treated using planned subtotal resection followed by GKS with special attention to volumetric growth, control rate, and symptoms. METHODS:Fifty consecutive patients who underwent the combined treatment strategy of subtotal microsurgical removal and GKS for large VSs between 2002 and 2009 were retrospectively analyzed. Patients with neurofibromatosis Type 2 were excluded. Patient charts were reviewed for clinical symptoms. Audiograms were evaluated to classify hearing pre- and postoperatively. Preoperative and follow-up contrast-enhanced T1-weighted MR images were analyzed using volume-measuring software. RESULTS:Surgery was performed via a translabyrinthine (25 patients) or retrosigmoid (25 patients) approach. The median follow-up was 33.8 months. Clinical control was achieved in 92% of the cases and radiological control in 90%. One year after radiosurgery, facial nerve function was good (House-Brackmann Grade I or II) in 94% of the patients. One of the two patients who underwent surgery to preserve hearing maintained serviceable hearing after resection followed by GKS. CONCLUSIONS:Considering the good tumor growth control and facial nerve function preservation as well as the possibility of preserving serviceable hearing and the low number of complications, subtotal resection followed by GKS can be the treatment option of choice for large VSs.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
van de Langenberg R,Hanssens PE,van Overbeeke JJ,Verheul JB,Nelemans PJ,de Bondt BJ,Stokroos RJdoi
10.3171/2011.6.JNS101958subject
Has Abstractpub_date
2011-11-01 00:00:00pages
875-84issue
5eissn
0022-3085issn
1933-0693journal_volume
115pub_type
杂志文章abstract::Pituitary apoplexy has not been reported in the setting of lymphocytic hypophysitis. The authors present the case of a woman with sudden vision loss and headache. Magnetic resonance imaging revealed focal hemorrhages in a sellar lesion with suprasellar extension. The results of histopathological analysis were consiste...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.98.1.0183
更新日期:2003-01-01 00:00:00
abstract::Mean hemispheric cerebral blood flow (CBF) and intracranial pressure (ICP) were measured in 19 severely head-injured patients treated with barbiturate coma. The CBF was calculated from the clearance of tracer substance monitored by extracranial scintillation detectors after intravenous administration of xenon-133. In ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.68.3.0424
更新日期:1988-03-01 00:00:00
abstract::Thirteen patients underwent an anastomosis of the superficial temporal artery (STA) or a saphenous vein graft to one of the secondary trunks of the middle cerebral artery (MCA). They included five patients with giant MCA trifurcation aneurysms, four patients in whom an earlier conventional STA-MCA anastomosis had beco...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.1.0021
更新日期:1985-07-01 00:00:00
abstract:OBJECT:Continuous intracranial pressure (ICP) monitoring using an epidural sensor is a common technique used in selected neurosurgical patients. The aim of this study was to assess the safety and accuracy of the Neurodur-P epidural sensor in the clinical setting. METHODS:The zero drift, as well as the medical and tech...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/108/5/0934
更新日期:2008-05-01 00:00:00
abstract:OBJECT:In this study the authors compare the clinical outcomes after particle embolization of hemangioblastomas in the cerebellum and spinal cord. They also review the literature of similar cases. METHODS:Seven patients with hemangioblastomas in the spinal cord (four patients) and cerebellum (three patients) underwent...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2007.106.6.994
更新日期:2007-06-01 00:00:00
abstract::Pial artery constriction following fluid-percussion injury to the brain is associated with elevated cerebrospinal fluid (CSF) vasopressin concentration in newborn pigs. It has also been observed that fluid-percussion injury reverses the function of vasopressin from that of a dilator to a constrictor. Endothelin-1 (ET-...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.5.0901
更新日期:1996-11-01 00:00:00
abstract::This report describes a new and reliable technique for producing experimental noncommunicating syringomyelia. In 30 rats, 1.2 to 1.6 microliters of kaolin was microinjected into the dorsal columns and central gray matter of the spinal cord at C-6. The inoculations caused transient neurological deficits in four animals...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.78.2.0274
更新日期:1993-02-01 00:00:00
abstract::George J. Heuer was a pioneer in neurosurgery at The Johns Hopkins Hospital in the early 20th century; he trained under Harvey Cushing and acted as a mentor to Walter Dandy. In his early career, Heuer focused on research and clinical work in the field of neurosurgery and temporarily led the neurosurgery section at Joh...
journal_title:Journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.3171/jns.2002.96.6.1139
更新日期:2002-06-01 00:00:00
abstract::The authors report a case of craniopharyngioma presenting in the right cerebellopontine angle. The tumor was removed totally. The purpose of this report is to record this very unusual localization of a craniopharyngioma. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.4.0842
更新日期:1984-04-01 00:00:00
abstract::The authors present a surgical case of a lipoma of the cerebellopontine angle in a 28-year-old woman. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.46.4.0544
更新日期:1977-04-01 00:00:00
abstract:OBJECT:Although the gray matter of the spinal cord has been thought to be softer than the white matter, there is no evidence to support this belief. Because the spinal cord is extremely soft, it has been difficult to measure the mechanical properties of the gray and white matter. The modulis of elasticity of the gray a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2001.95.2.0221
更新日期:2001-10-01 00:00:00
abstract:OBJECT:Surgical intervention may be required if endovascular embolization is insufficient to completely obliterate intracranial dural arteriovenous fistulas (DAVFs). The authors report their 14-year experience with 23 patients harboring diverse intracranial DAVFs that required surgical intervention. METHODS:Between 19...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.9.JNS08733
更新日期:2009-05-01 00:00:00
abstract::OBJECTIVEMeralgia paresthetica causes pain, burning, and loss of sensation in the anterolateral thigh. Surgical treatment traditionally involves neurolysis or neurectomy of the lateral femoral cutaneous nerve (LFCN). After studying and publishing data on the anatomical feasibility of LFCN transposition, the author pre...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.8.JNS171120
更新日期:2018-04-13 00:00:00
abstract:OBJECT:Galectin-1 is highly expressed in motile cell lines. The authors investigated whether galectin-1 actually modulates the migration and invasion of human glioblastoma multiforme (GBM) cell lines, and whether its expression with respect to invasion and prognosis is attributable to certain glioma subgroups. METHODS...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/109/8/0273
更新日期:2008-08-01 00:00:00
abstract:OBJECT:The authors compared and characterized several new classes of camptothecin (CPT) analogs (a total of 22 drugs) directed against human and murine glioma cell lines in vitro, trying to identify CPT analogs that can be used for local therapy in future clinical trials. Camptothecin is a naturally occurring alkaloid ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.98.3.0570
更新日期:2003-03-01 00:00:00
abstract::Secure fixation of the sacrum is technically challenging. The bone of the dorsal sacral surface is often thin, making hook fixation tenuous. The use of bone screws in the sacral pedicles has gained popularity, but rigidity is often not achieved and screw pullout is common. Solid constructs have been achieved using ang...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.2.0313
更新日期:1994-08-01 00:00:00
abstract::Increasing evidence suggests that disturbances in the modulatory influence of the vasoactive peptide, calcitonin gene-related peptide (CGRP), contribute to the pathogenesis of cerebral vasospasm after subarachnoid hemorrhage (SAH). However, only limited success has been achieved in trials attempting to ameliorate vaso...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.1.0091
更新日期:1995-01-01 00:00:00
abstract::The authors describe the technique of a transantral transsphenoidal approach to the sella turcica. The advantages and potential complications are discussed. This procedure may also be applicable when dealing with tumors of the skull base and orbits. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.6.1102
更新日期:1983-12-01 00:00:00
abstract::To evaluate the reported benefit of ipsilateral single-application ophthalmic anesthetic eyedrops in patients with typical trigeminal neuralgia, a randomized double-blind placebo-controlled trial was performed. Forty-seven patients were randomly assigned to receive two drops of either proparacaine (25 cases) or saline...
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.1994.80.6.0993
更新日期:1994-06-01 00:00:00
abstract::Cerebral sinus thrombosis, although uncommon, can be lethal if not recognized and treated quickly. Systemic heparin has become the treatment standard of care; however, some patients' conditions continue to deteriorate even while taking heparin. Endovascular techniques for thrombolysis have continued to evolve. The aut...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.2.JNS09685
更新日期:2011-01-01 00:00:00
abstract::Toxoplasma gondii has been reported to be the most common cause of focal brain lesions in patients with acquired immunodeficiency syndrome (AIDS). A case of intramedullary toxoplasmosis of the conus medullaris is reported in a patient with hemophilia A-associated AIDS. The diagnosis is discussed, with particular empha...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.73.6.0951
更新日期:1990-12-01 00:00:00
abstract::The authors report seven cases of thoracic spinal stenosis caused by thickening of the laminar arch and facet joints. Claudication was a prominent clinical feature of this disorder. Motor and sensory abnormalities were found in all cases with either segmental or peripheral distribution. Diagnosis was best made from th...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.68.1.0037
更新日期:1988-01-01 00:00:00
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
doi:10.3171/jns.1976.45.1.0104
更新日期:1976-07-01 00:00:00
abstract::The authors report the case of a 6-year-old boy with cerebral sparganosis due to infection with a plerocercoid tapeworm larva of Spirometra mansoni. Magnetic resonance imaging revealed an area of irregular long T2 signal in the right frontal lobe. When compared with images obtained 2 years earlier, the lesion appeared...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2006.105.6.470
更新日期:2006-12-01 00:00:00
abstract::Metrizamide computerized tomographic cisternography (MCTC) has proved 100% successful in documenting the precise anatomic location of the dural osseous defect in three patients with sphenoethmoidal rhinorrhea. In each patient, direct surgical approach to the site indicated by MCTC terminated the leakage in a single pr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.2.0222
更新日期:1980-08-01 00:00:00
abstract::A reversible and presumably neurogenic form of myocardial dysfunction may occur following subarachnoid hemorrhage (SAH), but the relationship of this finding to electrocardiographic abnormalities remains unclear. To clarify this issue, serial electrocardiograms (ECGs, mean 6.2 per patient) and echocardiograms (mean 3....
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.1995.83.5.0889
更新日期:1995-11-01 00:00:00
abstract::The authors report the successful staged stenting and coil embolization of a large vertebral artery-posterior inferior cerebellar artery (VA-PICA) aneurysm using the contralateral VA for access. A 67-year-old woman presented with a large ruptured VA-PICA aneurysm. Initial attempts to stent the wide-necked aneurysm fro...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/12/1214
更新日期:2007-12-01 00:00:00
abstract:OBJECT:Glial cell line-derived neurotrophic factor (GDNF) has been shown to confer neuroprotective effects on dopaminergic neurons. The authors investigated the effects of GDNF on 6-hydroxydopamine (6-OHDA)-treated dopaminergic neurons in vitro and in vivo. METHODS:First, the authors examined how 1, 10, or 100 ng/ml o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.102.1.0080
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:Herein, the authors report their experience with intraoperative stimulation mapping to locate the descending subcortical motor pathways in patients undergoing surgery for hemispheric gliomas within or adjacent to the rolandic cortex, with particular description of the morbidity and functional outcomes associa...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.3.JNS172494
更新日期:2018-08-17 00:00:00
abstract:OBJECT:The aim of the study was to assess retrospectively the clinical efficacy and possible adverse effects of electrical spinal cord stimulation (SCS) for the treatment of patients with reflex sympathetic dystrophy (RSD). METHODS:Twenty-three patients who suffered severe pain due to RSD were included in the study. T...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.1999.90.1.0079
更新日期:1999-01-01 00:00:00