Abstract:
OBJECT:Patients with idiopathic normal pressure hydrocephalus (iNPH) often present with impaired gait and cognition together with ventricular enlargement and normal intracranial pressure. Many have vascular risk factors as well as periventricular and deep white matter changes on MR imaging. Abnormal CSF dynamics, that is, high resistance to outflow or improvement after CSF drainage, indicate good effects of shunt surgery. The authors examined whether the worst-case iNPH patients with extensive vascular white matter disease and normal CSF dynamics would benefit from shunt surgery. These patients also fulfilled the criteria for Binswanger disease. Therefore, a randomized controlled double-blind study was performed. METHODS:Fourteen consecutive patients fulfilling the above criteria were randomized to receive either open or closed shunts. At 3 months after surgery, the patients with initially ligated shunts had their shunts opened. Clinical evaluation consisting of 7 quantitative psychometric and 6 continuous gait tests was performed preoperatively and 3 and 6 months after surgery. RESULTS:Patients randomized to receive open shunts had improved motor (30% increase) and psychometric (23% increase) scores 3 months after shunt placement. There were no significant changes between the 3- and 6-month follow-up in these same patients. Conversely, those with initially ligated shunts were unchanged during the first 3-month period, although they improved in both motor (28%) and cognitive (18%) functions following removal of the ligature. CONCLUSIONS:Patients with enlarged ventricles, hydrocephalic symptoms, and extensive vascular white matter changes benefit from shunt surgery.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Tisell M,Tullberg M,Hellström P,Edsbagge M,Högfeldt M,Wikkelsö Cdoi
10.3171/2010.11.JNS10967subject
Has Abstractpub_date
2011-05-01 00:00:00pages
1432-8issue
5eissn
0022-3085issn
1933-0693journal_volume
114pub_type
杂志文章,随机对照试验abstract::A series of 87 patients with severe brain injury were studied. Intracranial pressure (ICP) monitoring and external ventricular drainage were used to control ICP at high and low levels. Clearance of ytterbium-169-labeled diethylenetriaminepentaacetic acid (169Yb-DTPA), Evans blue dye, and ventricular cerebrospinal flui...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.61.4.0707
更新日期:1984-10-01 00:00:00
abstract::Thirty-seven patients harboring recurrent malignant primary or metastatic brain tumors were treated by 40 implantations of high-activity iodine-125 (125I) sources. All patients had been treated with irradiation and most had been treated with chemotherapeutic agents, primarily nitrosoureas. Implantations were performed...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.1.0061
更新日期:1984-01-01 00:00:00
abstract:OBJECT:Rathke cleft cysts (RCCs) are benign lesions that can be diagnosed as an incidental finding associated with headaches, pituitary dysfunction, or vision deterioration. Typically, they occur in a sellar or suprasellar location. The aim of this study was to review the clinical presentation and outcomes associated w...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.10.JNS09348
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is known to reduce motor symptoms of Parkinson's disease (PD). The effects of DBS on various nonmotor symptoms often differ from patient to patient. The factors that determine whether or not a patient will respond to treatment have not been elucida...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.6.JNS201126
更新日期:2020-10-09 00:00:00
abstract::OBJECTIVE Mineralized or desiccated colloid cysts pose some unique challenges to endoscopic removal. The extrusion of the solid matrix into the intraventricular compartment has not been previously reported and, as such, no guidance exists regarding its predilection, prevention, and fate. METHODS Postoperative imaging ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.6.JNS142676
更新日期:2016-09-01 00:00:00
abstract::Hypophosphatemia with osteomalacia may be due to a neoplasm that produces fibroblast growth factor 23 (FGF-23), which inhibits phosphate reabsorption in the kidneys. Most of these tumors occur in bone or soft tissue and occasionally in the head, although intracranial occurrence is very rare. This report describes a tu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2012.12.JNS12598
更新日期:2013-04-01 00:00:00
abstract:OBJECT:The calcium antagonist nimodipine has been shown to reduce the incidence of ischemic complications following aneurysmal subarachnoid hemorrhage (SAH). Although most randomized studies have been focused on the effect of the peroral administration of nimodipine, intravenous infusion is an alternative and the prefe...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.3171/2008.7.JNS08178
更新日期:2009-01-01 00:00:00
abstract::Photodynamic therapy is a promising treatment for human brain tumors because of the selective retention of certain compounds by tumor cells. Certain lipophilic cationic compounds, such as tetraphenylphosphonium (TPP), are selectively taken up by a variety of carcinomas. Although preferential retention of TPP has been ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.74.1.0116
更新日期:1991-01-01 00:00:00
abstract::A technique is described for removing previously placed aneurysm clips and applying new aneurysm clips for the treatment of regrown or reruptured cerebral aneurysms in patients more than 10 years after the original clipping of the aneurysm neck. The adherent tissue covering previously placed clips is cut just on and a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/10/0881
更新日期:2007-10-01 00:00:00
abstract:OBJECT:The authors studied the effect of Gamma Knife irradiation on angiogenesis induced by cerebral arteriovenous malformation (AVM) tissues implanted in the corneas of rats. METHODS:Ten AVM specimens obtained from tissue resections performed at Marmara University between 1998 and 2004 were used. A uniform amount of ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2007.106.3.463
更新日期:2007-03-01 00:00:00
abstract:OBJECT:Systemic administration of 23.5% hypertonic saline enhances cerebral blood flow (CBF) in patients with poor-grade spontaneous subarachnoid hemorrhage (SAH). Whether the increment of change in CBF correlates with changes in autoregulation of CBF or outcome at discharge remains unknown. METHODS:Thirty-five patien...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/JNS-07/08/0274
更新日期:2007-08-01 00:00:00
abstract:OBJECT:This study offers clinical support for the concept that neurosurgical interruption of a midline posterior column pathway by performing a punctate midline myelotomy (PMM) provides significant pain relief without causing adverse neurological sequelae in cancer patients with visceral pain refractory to other therap...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2000.92.2.0125
更新日期:2000-04-01 00:00:00
abstract::A patient with congenital hydrocephalus and poor vision since early childhood, but with normal motor and intellectual development, suffered progressive mental deterioration during the last decade of life. At necropsy he was found to have severe hydrocephalus secondary to a lipoma of the midbrain tectum obstructing the...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.3.0453
更新日期:1978-09-01 00:00:00
abstract::The fibrinolytic activity in cerebrospinal fluid has been monitored by determination of levels of fibrin split products (FSP) in 23 patients with ruptured intracranial aneurysms. In 20 of these 23, FSP was found in the cerebrospinal fluid (CSF), with levels ranging from 10 to 80 micrograms/ml. Eleven of the 23 patient...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.52.4.0453
更新日期:1980-04-01 00:00:00
abstract::OBJECTIVE Many colloid cyst patients present with obstructive hydrocephalus that resolves after resection of the cyst. However, a proportion of patients with these cysts will require cerebrospinal fluid shunting after tumor resection, despite resolution of the obstruction at the foramina of Monro. The goal of this stu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.9.JNS151183
更新日期:2016-09-01 00:00:00
abstract::A study was designed to investigate hyperperfusion syndrome after the restoration of normal cerebral blood flow in a chronically cerebral ischemic state resulting from high-flow arteriovenous malformations or severe carotid stenosis. A fistula between the left distal common carotid artery and the jugular vein was crea...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.76.3.0478
更新日期:1992-03-01 00:00:00
abstract::OBJECTIVE WHO Grade III gliomas are relatively rare and treated with multiple modalities such as surgery, chemotherapy, and radiotherapy. The impact of the extent of resection (EOR) on improving survival in patients with this tumor type is unclear. Moreover, because of the heterogeneous radiological appearance of Grad...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.3.JNS162383
更新日期:2018-07-01 00:00:00
abstract::The surgical resection of neoplasms involving the petrous bone and surrounding areas in 20 patients is reported. Technical advances described include the total resection of several tumors previously considered inoperable due to involvement of dura and brain, petrous internal carotid artery (ICA), the vein of Labbé, an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.76.4.0578
更新日期:1992-04-01 00:00:00
abstract::Forty-one consecutive patients with supratentorial primary brain tumors (38 Grade III and IV astrocytomas, one giant-cell astrocytoma, and two cases with insufficient tissue for diagnosis) were randomly allocated within 2 weeks of surgery to one of three therapeutic groups. Group 1 (15 patients) received radiation the...
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.1976.45.2.0129
更新日期:1976-08-01 00:00:00
abstract::The second lumbar vertebra was surgically removed from 10 dogs, and the shortened vertebral column was stabilized by internal fixation with two types of plastic plates. Shortening of the spinal column was usually not associated with detectable loss of function or neurological deficit. Histological lesions, however, in...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.42.1.0047
更新日期:1975-01-01 00:00:00
abstract::The use of drains in the treatment of syringomyelia has a simple and immediate appeal and has been practiced widely since the report of Abbe and Coley over 100 years ago. Good short-term results have been claimed in the past, but long-term outcome is largely unknown. An experience in Birmingham, England is reviewed in...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.1.0001
更新日期:1995-01-01 00:00:00
abstract::The authors report a case of traumatic femoral nerve palsy caused by a pseudoaneurysm of the iliolumbar artery and a iliacus muscle hematoma. This case report details not only the classic history and physical findings seen in patients such as this one, but also illustrates an unusual source of the hematoma and a discu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.102.2.0382
更新日期:2005-02-01 00:00:00
abstract::The authors of this prospective, single-case study evaluated the potential for functional recovery from chronic spinal cord injury (SCI). The patient was motor complete with minimal and transient sensory perception in the left hemibody. His condition was classified as C-2 American Spinal Injury Association (ASIA) Grad...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.97.2.0252
更新日期:2002-09-01 00:00:00
abstract::Excision of human cerebral arteriovenous malformations (AVMs) can be complicated by postoperative edema and hemorrhage in adjacent brain tissue, despite the complete excision of the malformation. Various theories have purported to explain the hemodynamic basis for this predisposition, including disordered autoregulati...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.86.3.0519
更新日期:1997-03-01 00:00:00
abstract::The authors present the oldest historical case of a so-called beaten-copper cranium. The typical pattern was identified on a skull from a child, probably a boy, who died at approximately 6 years of age and was buried in a provisional cemetery used during the siege of Hanau, Germany, in 1635 and 1636. Morphological and...
journal_title:Journal of neurosurgery
pub_type: 历史文章,杂志文章
doi:10.3171/ped.2007.106.1.71
更新日期:2007-01-01 00:00:00
abstract:OBJECT:The majority of sinonasal malignancies present with advanced disease, and cure rates are generally poor. Surgical extirpation remains the mainstay of treatment. In cases of sinonasal malignancy with orbital apex extension, gross-total tumor resection requires orbital exenteration and bony skull base resection ar...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.9.JNS141256
更新日期:2015-07-01 00:00:00
abstract::Cushing's experience with the surgical treatment of pituitary adenomas and other lesions producing the chiasmal syndrome is reviewed. The conclusion is that his ultimate rejection of the transsphenoidal route was not due to his dissatisfaction with this procedure, but rather came about because of the transfrontal rout...
journal_title:Journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.3171/jns.1981.54.4.0448
更新日期:1981-04-01 00:00:00
abstract:OBJECT:Retrochiasmatic craniopharyngiomas are surgically challenging tumors. Retrochiasmatic craniopharyngiomas with complicated conditions such as large diameter, major calcification, or significant extension to the third ventricle or posterior fossa present surgical challenges; moreover, recurrent retrochiasmatic cra...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.10.JNS13673
更新日期:2014-01-01 00:00:00
abstract::OBJECTIVEIntrinsic third ventricular craniopharyngiomas (IVCs) have been reported by some authors to "pose the greatest surgical challenge" of all craniopharyngiomas (CPAs). A variety of open microsurgical approaches have historically been used for resection of these tumors. Despite increased utilization of the endosc...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.5.JNS18198
更新日期:2018-11-01 00:00:00
abstract::The fourth Editor of the Journal of Neurosurgery offers short vignettes on the Editors who preceded and succeeded him. He recounts some of the challenges that were faced and changes that were made during his time as Editor. One of the major changes was production of the Journal via computer. ...
journal_title:Journal of neurosurgery
pub_type: 历史文章,杂志文章
doi:10.3171/jns.1994.81.1.0147
更新日期:1994-07-01 00:00:00