Abstract:
OBJECT:The objective of this study was to evaluate endovascular stent therapy for carotid artery dissections (CADs). METHODS:Retrospective review of data at Millard Fillmore Gates Hospital identified 43 patients with 44 CADs (intracranial and/or extracranial) treated with carotid artery (CA) stent placement between January 2000 and June 2009. RESULTS:Thirty-two CADs were spontaneous and 12 were traumatic; 35 were symptomatic. Lesion locations included the extracranial internal CA (ICA; 24 cases), extracranial ICA with common CA involvement (4 cases), and extracranial ICA-intracranial ICA (16 cases). Carotid artery occlusion was 100% in 15 cases (34.1%), 99% in 6 cases (13.6%), 70%-98% in 13 cases (29.5%), and < 70% in 10 cases (22.7%). Five patients suffered pseudoaneurysms. Stent deployment was successful in 43 (97.7%) of 44 cases. The mean pretreatment score on the National Institutes of Health Stroke Scale was 6.2 ± 6.2. Recanalization (Thrombolysis in Myocardial Infarction Grade 2 or 3) was accomplished for 42 lesions (95.5%). Four patients demonstrated residual parent vessel stenosis (10%-50% in severity). Procedure-related complications occurred in 7 patients and included middle cerebral artery embolism (1 patient), intracranial hemorrhage (2 patients), worsening of dissection (1 patient), stent malpositioning (1 patient), embolic protection filter overload (1 patient), and filter retrieval device fracture (1 patient). Only 2 of these complications caused permanent deficits: the embolism caused a minor but permanent neurological deficit, and 1 intracranial hemorrhage was fatal. At discharge, 36 patients (83.7%) had modified Rankin Scale scores of 0-2 (favorable outcome). During the follow-up interval (mean 19.2 months, range 4-92 months), no patient suffered a new stroke and 1 patient died secondary to preexisting chronic renal failure. In 20 patients with angiographic follow-up, permanent resolution of the dissection was noted in 90.5%; 2 lesions (9.5%) required retreatment. CONCLUSIONS:Endovascular stent-assisted repair of extra- and intracranial CAD was safe and effective in this experience and can be recommended for selected patients. In particular, patients with symptomatic CADs that are not responsive to medical therapy should be considered for interventional treatment.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Ohta H,Natarajan SK,Hauck EF,Khalessi AA,Siddiqui AH,Hopkins LN,Levy EIdoi
10.3171/2011.1.JNS091806subject
Has Abstractpub_date
2011-07-01 00:00:00pages
91-100issue
1eissn
0022-3085issn
1933-0693journal_volume
115pub_type
杂志文章abstract::OBJECTIVE The pathophysiological mechanisms responsible for the formation of intracranial aneurysms (IAs) remain only partially elucidated. However, current evidence suggests a genetic component. The purpose of this study was to investigate the specific anatomical variations in the arterial complex that are associated...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.3171/2016.4.JNS153032
更新日期:2017-05-01 00:00:00
abstract::OBJECTIVEThe goal of this article is to review the history of surgery for low- and high-grade gliomas located within the insula with particular focus on microsurgical technique, anatomical considerations, survival, and postoperative morbidity.METHODSThe authors reviewed the literature for published reports focused on ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2018.10.JNS181519
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:Magnetic resonance imaging-guided focused ultrasound (MRgFUS) is a novel and useful treatment for essential tremor (ET); however, the factors impacting treatment outcome are unknown. The authors conducted this study to determine the factors affecting the outcome of MRgFUS. METHODS:From May 2016 through Augus...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.2.JNS192814
更新日期:2020-05-01 00:00:00
abstract::Two cases of catecholamine-secreting paragangliomas of the base of the skull are described. The patients presented with uncontrollable hypertension and, after investigation, tumors were discovered in the regions of the glomus jugulare and pterygopalatine ganglion, respectively. After cardiovascular stabilization and t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.66.4.0604
更新日期:1987-04-01 00:00:00
abstract::An unusual case of cerebral actinomycosis of the Gasserian ganglion is reported. The location and the pathological diagnosis of granuloma are both extremely rare. The literature is briefly reviewed with special reference to similar reports. The manner of spread and the course of the disease are described. The present ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.4.0553
更新日期:1981-04-01 00:00:00
abstract::A 2- to 15-year follow-up study is presented of a series of 35 consecutive patients treated for ruptured aneurysms of the middle cerebral artery by reinforcement with gauze wrapping. Only one patient suffered early recurrent hemorrhage in the postoperative period, and none had a late hemorrhage. The procedure carried ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.6.0828
更新日期:1977-12-01 00:00:00
abstract:OBJECT:There is little evidence addressing whether procedures requiring adjunctive devices lead to an increased frequency of thromboembolic complications. The authors report their experience with 155 aneurysms treated with and without adjunctive devices. METHODS:The authors retrospectively reviewed their last 155 aneu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/108/6/1095
更新日期:2008-06-01 00:00:00
abstract::The authors studied the effect of high cervical cord section on the phenomenon of autoregulation in the rhesus monkey with the hydrogen clearance method to measure focal spinal cord blood flow (SCBF). Laminectomies were performed at T7-11 and C1-2. The spinal cord was completely severed at C1-2. Under normocapnic cond...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.44.4.0425
更新日期:1976-04-01 00:00:00
abstract::Magnetic resonance (MR) angiography offers a safe, noninvasive alternative to conventional angiography in patients with suspected carotid stenosis; however, it tends to overestimate the severity of stenosis. Loss of the MR signal with a resulting flow gap is a frequent finding in cases of high-grade stenosis. The auth...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.3.0384
更新日期:1996-09-01 00:00:00
abstract::In this experiment, the effects of ischemia on neural conduction in the monkey spinal cord were studied. In six monkeys generalized ischemia of the spinal cord was created by bleeding the animals to a hypotensive level below the lower limits of autoregulation in the spinal cord. The progressive development of spinal c...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.5.0639
更新日期:1979-05-01 00:00:00
abstract:OBJECT:Dissections were performed in 100 fresh cadaver palms to determine the frequency with which superficial palmar communication between the median and ulnar nerves occurs and to what extent it might incur iatrogenic injury during endoscopic carpal tunnel release. METHODS:Superficial palmar communication between th...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.91.6.1027
更新日期:1999-12-01 00:00:00
abstract::The authors have previously advocated a supraorbital approach to tumors of the orbit. In this paper, they describe a technique in which they take advantage of a large frontal sinus as a means of entering the orbit without the necessity of intracranial exposure, as required by the more conventional supraorbital approac...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.5.0811
更新日期:1985-11-01 00:00:00
abstract::A patient with acute subdural hematoma was successfully treated with hemicraniectomy. He developed contralateral weakness 4 months after surgery which was reversed by cranioplasty. The presumptive mechanism is a gradient between atmospheric and intracranial pressure. Early cranioplasty is suggested to prevent this phe...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.44.4.0506
更新日期:1976-04-01 00:00:00
abstract::The translabyrinthine route or an extension of it was used to remove 150 acoustic nerve tumors. The mortality was 2% and the morbidity low. Preservation of the facial nerve was achieved in 100% of the small and 80% of the medium-sized tumors, but in only 20% of the large growths. The complications encountered are disc...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.52.2.0210
更新日期:1980-02-01 00:00:00
abstract::OBJECTIVE Epilepsy surgery is an effective means of treating focal epilepsy associated with long-term epilepsy-associated tumors. This study evaluated a large population of surgically treated patients with childhood onset of epilepsy and a histologically confirmed diagnosis of long-term epilepsy-associated tumors. The...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.9.JNS161176
更新日期:2017-11-01 00:00:00
abstract::In patients with hemifacial spasm, it has been said that the spasm is due to cross compression of the facial nerve by a blood vessel and that microvascular decompression (MVD) of the facial nerve is an effective treatment. The F waves, which result from backfiring of antidromically activated motor neurons of the facia...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.86.4.0654
更新日期:1997-04-01 00:00:00
abstract:OBJECT:The purpose of this study was to identify the causes of failed temporal lobe resection in patients with mesial temporal sclerosis (MTS) and the role of repeat surgery for seizure control. METHODS:This is a retrospective study of 105 patients who underwent temporal lobe resection for MTS with unilateral electroe...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.1.JNS08638
更新日期:2009-06-01 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::Morning glory syndrome is a congenital anomaly of the optic disc in which the disc is enlarged and excavated, with white glial tissue in the center. A case is presented of morning glory syndrome associated with sphenoid encephalocele, median cleft lip, and agenesis of the corpus callosum. A 22-day-old boy was referred...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1992.77.6.0949
更新日期:1992-12-01 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::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::OBJECTIVE Dysfunction of distributed neural networks underlies many brain disorders. The development of neuromodulation therapies depends on a better understanding of these networks. Invasive human brain recordings have a favorable temporal and spatial resolution for the analysis of network phenomena but have generall...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.11.JNS161162
更新日期:2018-02-01 00:00:00
abstract::A patient with hydrocephalus due to aqueductal stenosis suffered facial pain which was relieved after the insertion of a ventriculoperitoneal shunt. The trigeminal somatosensory evoked response (TSER) of the affected side showed lower amplitudes and longer latencies as compared to the unaffected side. Following surger...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1982.57.2.0267
更新日期:1982-08-01 00:00:00
abstract::Two unusual cases of neurocutaneous melanosis are presented. Both patients had congenital giant hairy nevi and both developed hydrocephalus, seizures, and myelopathy. The first patient displayed multicentric cerebral and spinal cord melanosis, as opposed to the more commonly described basilar leptomeningeal involvemen...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.61.4.0782
更新日期:1984-10-01 00:00:00
abstract:OBJECT:Spontaneous spinal cerebrospinal fluid (CSF) leakage with development of the intracranial hypotension syndrome and acquired Chiari I malformation due to lumbar spinal CSF diversion procedures have both been well described. However, concomitant presentation of both syndromes has rarely been reported. The object o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.88.2.0237
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVE:Intraventricular hemorrhage (IVH) is found in approximately 40% of intracerebral hemorrhages and is associated with increased mortality and poor functional outcome. Cognitive impairment is one of the complications and occurs due to various pathological changes. Amyloid beta (Aβ) accumulation and neuroinflamma...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.1.JNS172938
更新日期:2018-07-20 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:The benefits of measuring cerebral oxygenation in patients with brain injury are well accepted; however, jugular bulb oximetry, which is currently the most popular monitoring technique used has several shortcomings. The goal of this study was to validate the use of a new multiparameter sensor that measures brain...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.96.2.0263
更新日期:2002-02-01 00:00:00
abstract::The author, while a research illustrator at the Smithsonian Institution National Museum of Natural History, studied two ancient skulls from the Incan period in Peru, both with trephination. Her conclusions and illustrations of the skulls are included in this paper. ...
journal_title:Journal of neurosurgery
pub_type: 历史文章,杂志文章
doi:10.3171/jns.1992.76.3.0550
更新日期:1992-03-01 00:00:00
abstract::The lateral extracavitary approach to the spine was used for resection of displaced bpne and disc located anterior to the dura in 62 patients with traumatic lesions of the thoracic and lumbar spine. Fifty-two patients had closed vertebral fractures and 10 had gunshot wounds. The spinal cord was involved in 44 patients...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.45.6.0628
更新日期:1976-12-01 00:00:00