Abstract:
OBJECT:Sellar lesions with suprasellar extension may cause loss of visual acuity and visual field damage due to compression of the optic chiasm. Using intraoperative MR (iMR) imaging to detect symptomatic lesion remnants adjacent to the optic chiasm (that may be resected in the same procedure) may positively affect the functional outcome of patients with these lesions. The aim of this study was to evaluate the correlation between visual improvement and optic nerve decompression detected by iMR imaging in patients undergoing transsphenoidal resection of pituitary lesions. METHODS:A total of 32 patients (23 men and 9 women) who underwent transsphenoidal resection of sellar lesions causing visual impairment were included in this study. Tumor volume ranged from 0.9 cm(3) to 55.7 cm(3) (mean 9.8 ± 11.7 cm(3)). Preoperative assessment showed visual field damage in 31 patients (97%) and loss of visual acuity in 28 patients (88%). The latency period between the appearance of symptoms and transsphenoidal decompression was 14.9 ± 19.5 weeks. RESULTS:Intraoperative MR imaging was performed after the resection was believed to be complete, or if further tumor removal was not safely possible due to changed conditions in the surgical field. Complete resection was detected on these initial scans in 17 patients (53%). Partial resection was achieved in 9 patients (28%) and tumor debulking in 6 (19%). Additional resection was possible in 8 (53%) of these 15 patients. Four (50%) of these 8 cases had suprasellar remnants and the optic chiasm was subsequently decompressed. In 5 cases optimal decompression of the optic chiasm was not possible. On early follow-up within 1 month after surgery, overall improvement of visual field damage was observed in 27 patients (87%). In 23 patients (74%), the Goldmann perimetry demonstrated complete recovery. Improvement of visual acuity was noted in 24 patients (86%). Eighteen patients (64%) regained full visual acuity. Identification of a decompressed optic chiasm on iMR imaging was significantly correlated with visual field improvement (p = 0.0007; positive predictive value 0.96, 95% CI 0.81-0.99) and relief of visual acuity deficits (p = 0.0002; positive predictive value 0.96, 95% CI 0.79-0.99). Two patients needed transcranial procedures for symptomatic tumor remnants detected on iMR imaging. CONCLUSIONS:Intraoperative MR imaging findings correlate with prognosis of visual deficits after transsphenoidal decompression of the anterior optic pathways. The use of iMR imaging may prevent revision surgery for unexpected symptomatic remnants.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Berkmann S,Fandino J,Zosso S,Killer HE,Remonda L,Landolt Hdoi
10.3171/2011.4.JNS101568subject
Has Abstractpub_date
2011-09-01 00:00:00pages
518-27issue
3eissn
0022-3085issn
1933-0693journal_volume
115pub_type
杂志文章abstract::The authors report an unusual case of a traumatic aneurysm of the right superior cerebellar artery (SCA). A 22-year-old woman presented with continuous headaches that appeared 15 days after she experienced closed head trauma as a result of a cycling accident. Computerized tomography scanning performed 3 months later s...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1997.87.6.0950
更新日期:1997-12-01 00:00:00
abstract::The mechanisms that give rise to ischemic brain damage have not been definitively determined, but considerable evidence exists that three major factors are involved: increases in the intercellular cytosolic calcium concentration (Ca++i), acidosis, and production of free radicals. A nonphysiological rise in Ca++i due t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1992.77.3.0337
更新日期:1992-09-01 00:00:00
abstract:OBJECTIVE:Removal of jugular foramen (JF) tumors usually requires extensive skull base approaches and is frequently associated with postoperative morbidities such as lower cranial nerve injury. The endoscope-assisted retrosigmoid infralabyrinthine approach is a relatively new approach to tumors extending into the bony ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.3.JNS142904
更新日期:2016-04-01 00:00:00
abstract::Although severe hypovolemia can lead to hypotension and neurological decline, many patients with neurosurgical disorders experience a significant hypovolemia while autonomic compensatory mechanisms maintain a normal blood pressure. To assess the effects of normotensive hypovolemia upon cerebral hemodynamics, transcran...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.76.6.0961
更新日期:1992-06-01 00:00:00
abstract:OBJECTIVE:Decision-making for intracranial tumor surgery requires balancing the oncological benefit against the risk for resection-related impairment. Risk estimates are commonly based on subjective experience and generalized numbers from the literature, but even experienced surgeons overestimate functional outcome aft...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.4.JNS20643
更新日期:2020-06-12 00:00:00
abstract::High-resolution proton magnetic resonance (MR) spectroscopy was performed on perchlorate extracts of tumors (24 cases) or peritumoral vermis (five cases) obtained at surgery. Fifteen tumors were typical cerebellar astrocytomas and nine were posterior fossa primitive neuroectodermal tumors/medulloblastomas. Spectra obt...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.3.0443
更新日期:1994-09-01 00:00:00
abstract::Calcified cervical intervertebral discs in children are manifestations of an uncommon, distinct disease of unknown cause. Acute symptoms are usually followed by a benign course of spontaneous recovery, frequently culminating in resorption of the calcium. Rarely herniation of the disc may cause neurological complicatio...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.46.2.0233
更新日期:1977-02-01 00:00:00
abstract::Between 1975 and 1989, 25 children treated with myelomeningocele closure and shunting for hydrocephalus at the Children's Hospital of Pittsburgh developed progressive lower brain-stem dysfunction from their Chiari malformation. Retrospective univariate and multivariate analyses of these cases were undertaken to assess...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.77.6.0881
更新日期:1992-12-01 00:00:00
abstract::Nine patients with malignant glioma were treated with the lymphokine interleukin-2 (IL-2) or with lymphokine-activated killer (LAK) cells, and one patient received combination therapy with both LAK cells and IL-2. The LAK cells were generated by culturing recombinant IL-2 with peripheral blood lymphocytes obtained fro...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.1986.64.5.0743
更新日期:1986-05-01 00:00:00
abstract::The Pott puffy tumor is a subperiosteal abscess associated with underlying osteomyelitis, most often of the frontal bone in conjunction with frontal sinusitis. Intracranial sequelae can include epidural abscess, subdural empyema, intraparenchymal abscess, meningitis, and dural venous thrombophlebitis, all with resulta...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2006.105.3.235
更新日期:2006-09-01 00:00:00
abstract:OBJECT:The authors reviewed their experience with endoscopic approaches to determine their safety and efficacy in the treatment of pediatric patients who harbor skull base lesions. Although they were interested in ascertaining outcomes after surgery as well as validating and defining indications and limitations of thes...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2007.106.2.75
更新日期:2007-02-01 00:00:00
abstract:OBJECT:The prognostic significance of tumor grade and resection and the efficacy of prophylactic radiation remain controversial in the management of intracranial ependymoma. The outcomes in patients with intracranial ependymoma treated at the Kyoto University Hospital were reviewed retrospectively, and prognostic signi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.103.1.0031
更新日期:2005-07-01 00:00:00
abstract:OBJECT:Recurrence of seizures immediately following epilepsy surgery can be emotionally devastating, and raises concerns about the chances of successfully attaining long-term seizure control. The goals of this study were to investigate the frequency of acute postoperative seizures (APOS) occurring in the 1st postoperat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.89.2.0177
更新日期:1998-08-01 00:00:00
abstract::This review was undertaken to determine the efficacy of using dorsal root entry zone (DREZ) lesions to treat intractable pain caused by trauma to the conus medullaris and cauda equina. Traumatic lesions of this area are unique in that both the spinal cord and the peripheral nerve roots are injured. Although DREZ lesio...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.1.0028
更新日期:1995-01-01 00:00:00
abstract::Myositis ossificans (MO) is a disorder characterized by the intramuscular proliferation of fibroblasts and osteoblasts, with subsequent deposition of bone and cartilage. A typical clinical presentation involves traumatic injury to a young adult, usually localized to the thigh, buttock, or upper arm, with resultant MO ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.95.3.0525
更新日期:2001-09-01 00:00:00
abstract::Previously presented data showed that Vicryl mesh was a potentially effective dural grafting material. It is easily handled, relatively inexpensive, absorbed over time, and elicits a minimal inflammatory response. The present experimental project was conducted to investigate the effectiveness of a tightly woven versio...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.71.1.0124
更新日期:1989-07-01 00:00:00
abstract::Stereotactic radiosurgery emerged as a neurosurgical discipline in order to utilize energy for the manipulation of brain or nerve tissue, with the goal of minimal access and safe and effective care of a spectrum of neurosurgical disorders. Perhaps no other branch of neurosurgery has been so disruptive across the entir...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2019.2.JNS181712
更新日期:2019-06-01 00:00:00
abstract::The absence of spontaneous respirations at a PaCO2 of 60 mm Hg or above has traditionally been accepted as the respiratory criteria for the determination of brain death. The testing of patients for the presence or absence of apnea has been complicated because the rate of PaCO2 elevation may vary substantially from pat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.76.6.1029
更新日期:1992-06-01 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:OBJECTIVE:This study aimed to assess longitudinal changes in the collateral channels originating from the lenticulostriate artery (LSA), posterior communicating artery (PCoA), and anterior and posterior choroidal arteries (AChA and PChA, respectively) during disease progression and/or aging. The impact of collateral ch...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.9.JNS172231
更新日期:2018-03-23 00:00:00
abstract::The authors present the case of a 64-year-old woman who experienced a left hemiparesis. An initial diagnosis of subdural hematoma was made based on results of computerized tomography scanning. Subsequent magnetic resonance imaging indicated an extraaxial meningioma. Histological findings confirmed an extranodal margin...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.2002.96.3.0611
更新日期:2002-03-01 00:00:00
abstract::The accuracy of high-resolution ultrasound scans in detecting foreign bodies and hemorrhage within the brain was evaluated by comparison with computerized tomography (CT) scans and gross pathology. The test lesions were blood and foreign bodies consisting of bone, wood, and metal placed in the brain of an experimental...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.3.0304
更新日期:1981-03-01 00:00:00
abstract::The authors present a technique involving placement of a catheter in the third ventricle in shunt systems for hydrocephalus, in order to avoid obstruction of the proximal catheter by particles of chorioid plexus. They emphasize the simplicity of the technique, lack of morbidity, and the good results they have obtained...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.42.1.0104
更新日期:1975-01-01 00:00:00
abstract:OBJECT:Meningoencephaloceles are congenital malformations that have a high incidence in the population of Southeast Asia. Frontoethmoidal meningoencephaloceles, the most common variety, require surgical treatment. The authors combined neurosurgical and craniofacial approaches for the development of a simple technique t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2006.104.5.326
更新日期:2006-05-01 00:00:00
abstract::A new microclip for use on blood vessels 300 mu to 1 mm in diameter is described. This clip is suitable for either temporary or permanent occlusion and has been used in experimental applications. Potential clinical applications are described. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.5.0822
更新日期:1986-05-01 00:00:00
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
doi:10.3171/2018.6.JNS18854
更新日期:2018-12-21 00:00:00
abstract::Saccular intracranial aneurysms are a common and often fatal lesion. Whereas surgical treatment of these aneurysms continues to be the gold standard of care, certain situations arise for which surgery may not be the best option. In some of these cases, electrolytically detachable coils have been proven to provide outc...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.86.4.0724
更新日期:1997-04-01 00:00:00
abstract::Susceptibility weighted imaging (SWI) is a relatively new imaging technique. Its high sensitivity to hemorrhagic components and ability to depict microvasculature by means of susceptibility effects within the veins allow for the accurate detection, grading, and monitoring of brain tumors. This imaging modality can als...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2015.1.JNS142349
更新日期:2015-12-01 00:00:00
abstract:OBJECT:Recurrent laryngeal nerve (RLN) injury occurs after anterior cervical spine procedures. In this study the authors used intraoperative electromyographic (EMG) monitoring of the posterior pharynx as a surrogate for RLN function and monitored endotracheal tube (ET) cuff pressure to determine if there was an associa...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.1999.91.2.0170
更新日期:1999-10-01 00:00:00
abstract::Tail-like caudal appendages may be associated with spinal dysraphism, particularly with spinal lipomas or lipomyelomeningoceles. An unusual case is presented of a patient with a myelomeningocele and a thick filum terminale with tethered spinal cord, which presented with the external appearance of a human tail. A revie...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.78.6.0966
更新日期:1993-06-01 00:00:00