The surgical management of symptomatic peripheral nerve sheath tumors.

Abstract:

OBJECTIVE:To determine the clinical presentation and morbidity of the surgical management of peripheral nerve sheath tumors (PNSTs). METHODS:We performed a retrospective chart review of surgically treated PNSTs at the University of Miami between 1991 and 2008. RESULTS:There were a total of 140 cases, including 87 schwannomas, 34 neurofibromas, and 19 malignant peripheral nerve sheath tumors (MPNSTs). The average age of the total study group was 49.0 years; it was significantly lower for patients with neurofibroma. There was a high correlation between neurofibroma tumors and neurofibromatosis-1. Most patients with benign tumors presented with a painful mass, paresthesias, or numbness without significant weakness. Patients who had previously undergone attempted resections and preoperative biopsy had a significantly increased risk (41%) for developing postoperative neurologic deficits when compared with patients who presented with de novo tumors (15%). Intraoperative monitoring appeared to reduce the risk of postoperative motor deficit, particularly in neurofibromas. Most MPNSTs (>80%) were diagnosed at stage IIB or higher and had a combined mortality rate of 31.6% at 78 months. Tumor size was the best predictor of adverse outcome, as all MPNST mortalities occurred in patients with a tumor size of more than 7 cm. CONCLUSION:PNSTs are a heterogeneous group of lesions. Benign tumors respond well to marginal excision, whereas MPNSTs are aggressive sarcomas that require multimodal management. There was a significantly increased risk of postoperative neurologic deficits in patients who had undergone a previous biopsy, and thus tertiary referral without biopsy is recommended when a PNST is suspected.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Levi AD,Ross AL,Cuartas E,Qadir R,Temple HT

doi

10.1227/01.NEU.0000367636.91555.70

subject

Has Abstract

pub_date

2010-04-01 00:00:00

pages

833-40

issue

4

eissn

0148-396X

issn

1524-4040

journal_volume

66

pub_type

杂志文章
  • Quantitative assessment of surgical decompression of the cervical spine with cine phase contrast magnetic resonance imaging.

    abstract:OBJECTIVE:We measured cerebrospinal fluid flow velocity by use of cine phase contrast magnetic resonance imaging to quantitate the effectiveness of surgical decompression in patients with cervical myelopathy. METHODS:Forty-seven patients with cervical myelopathy attributable to either spondylosis or ossification of th...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200204000-00020

    authors: Tominaga T,Watabe N,Takahashi T,Shimizu H,Yoshimoto T

    更新日期:2002-04-01 00:00:00

  • A large aneurysm of the persistent primitive hypoglossal artery.

    abstract::An aneurysm of a persistent primitive hypoglossal artery (PHA) particularly at its junction with the basilar artery, often poses therapeutic problems. This is attributable not only to the size and location of the aneurysm but also to the fact that the persistent PHA is functionally the single artery providing blood in...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:

    authors: Kanai H,Nagai H,Wakabayashi S,Hashimoto N

    更新日期:1992-05-01 00:00:00

  • Is aspect ratio a reliable predictor of intracranial aneurysm rupture?

    abstract:OBJECTIVE:This study was undertaken to assess the reliability of the aspect ratio (AR) (i.e., aneurysm depth to aneurysm neck) in predicting aneurysm rupture. It has been shown that the AR is a key factor in predicting intraaneurysmal blood flow and aneurysm rupture. METHODS:Seventy-five patients with subarachnoid hem...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000124482.03676.8b

    authors: Nader-Sepahi A,Casimiro M,Sen J,Kitchen ND

    更新日期:2004-06-01 00:00:00

  • Percutaneous radiofrequency upper thoracic sympathectomy.

    abstract::Between June 1979 and May 1994, I performed 148 unilateral or bilateral sympathectomies on 247 limbs in 110 patients using a percutaneous radiofrequency technique, usually on an outpatient surgery basis. Patient ages ranged from 10 to 81 years, with 45 male and 65 female patients. Four patients had unsuccessfully unde...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Wilkinson HA

    更新日期:1996-04-01 00:00:00

  • Determination of the minimum improvement in pain, disability, and health state associated with cost-effectiveness: introduction of the concept of minimum cost-effective difference.

    abstract:BACKGROUND:Minimum clinical important difference (MCID) has been adopted as the smallest improvement in patient-reported outcome needed to achieve a level of improvement thought to be meaningful to patients. OBJECTIVE:To use a common MCID calculation method with a cost-utility threshold anchor to introduce the concept...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000462079.96571.dc

    authors: Parker SL,McGirt MJ

    更新日期:2015-03-01 00:00:00

  • Intraventricular hematoma secondary to a ventriculoperitoneal shunt.

    abstract::A rare and serious complication of ventriculoperitoneal shunt is reported. A huge intraventricular hematoma was confirmed by computed tomography scanning and autopsy. This is the first report of such a complication in a newborn with hydrocephalus. ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198203000-00016

    authors: Kuwamura K,Kokunai T

    更新日期:1982-03-01 00:00:00

  • Epilepsy surgery of the cingulate gyrus and the frontomesial cortex.

    abstract:BACKGROUND:Epilepsy surgery involving the cingulate gyrus has been mostly presented as case reports, and larger series with long-term follow-up are not published yet. OBJECTIVE:To report our experience with focal epilepsy arising from the cingulate gyrus and surrounding structures and its surgical treatment. METHODS:...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0b013e318237aaa3

    authors: von Lehe M,Wagner J,Wellmer J,Clusmann H,Kral T

    更新日期:2012-04-01 00:00:00

  • Neurosurgical Practice in Transition: A Review.

    abstract::Neurosurgery is experiencing a period of acute change driven by 2 forces: (1) the perception that the healthcare system in the United States is wasteful and that patients are receiving low "value" care, (2) the belief that quality and long-term outcomes can be measured accurately. We believe 3 important shifts will em...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1093/neuros/nyx008

    authors: Kim DH,Dagi TF,Bean JR

    更新日期:2017-04-01 00:00:00

  • Meningioma with intracerebral hematoma.

    abstract::A case of spontaneous intracranial hemorrhage associated with a meningioma is presented. Intracranial hemorrhage has been reported to be associated with meningioma in 45 cases. A comprehensive review of the subject is presented. The importance of the diagnosis of associated hemorrhage and subsequent surgical intervent...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198408000-00014

    authors: Kohli CM,Crouch RL

    更新日期:1984-08-01 00:00:00

  • Promises and Perils of Artificial Intelligence in Neurosurgery.

    abstract::Artificial intelligence (AI)-facilitated clinical automation is expected to become increasingly prevalent in the near future. AI techniques may permit rapid and detailed analysis of the large quantities of clinical data generated in modern healthcare settings, at a level that is otherwise impossible by humans. Subsequ...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1093/neuros/nyz471

    authors: Panesar SS,Kliot M,Parrish R,Fernandez-Miranda J,Cagle Y,Britz GW

    更新日期:2020-07-01 00:00:00

  • Staged removal of acoustic tumors: techniques and lessons learned from a series of 83 patients.

    abstract::The removal of large acoustic tumors is associated with increased mortality and cranial nerve injury. One method for treating these difficult lesions is staged resection. Between 1972 and 1992, more than 600 acoustic tumors were resected at our institution. Of these, 83 were removed in stages. This represents the larg...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1227/00006123-199511000-00010

    authors: Comey CH,Jannetta PJ,Sheptak PE,Joh HD,Burkhart LE

    更新日期:1995-11-01 00:00:00

  • Recanalization of a symptomatic extracranial internal carotid artery near occlusion with proximal and distal protection: technical case report.

    abstract:OBJECTIVE:To describe a novel approach to recanalizing symptomatic extracranial internal carotid artery near occlusion using proximal and distal emboli protection devices. METHODS:Patients presenting with symptomatic extracranial internal carotid artery near occlusion who underwent endovascular recanalization between ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000279742.38178.f6

    authors: Edgell RC,Yavagal DR,Agner C,Adamo M,Boulos AS

    更新日期:2007-07-01 00:00:00

  • Is aqueductal stroke volume, measured with cine phase-contrast magnetic resonance imaging scans useful in predicting outcome of shunt surgery in suspected normal pressure hydrocephalus?

    abstract:OBJECTIVE:To evaluate clinical usefulness of cerebrospinal fluid stroke volume (SV) assessed in the cerebral aqueduct, via cine phase-contrast magnetic resonance imaging, for predicting outcome after shunt surgery in suspected normal pressure hydrocephalus. METHODS:Thirty-eight patients with suspected normal pressure ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000249208.04344.A3

    authors: Kahlon B,Annertz M,Ståhlberg F,Rehncrona S

    更新日期:2007-01-01 00:00:00

  • Radiographic and anatomic basis of endoscopic anterior craniocervical decompression: a comparison of endonasal, transoral, and transcervical approaches.

    abstract:OBJECTIVE:To evaluate surgical access to the craniocervical junction using 3 endoscopic approaches: endonasal, transoral, and transcervical. METHODS:Nine cadaveric specimens were used. Image guidance was used in 1 specimen for each approach; fluoroscopy was used in every case. The Vitrea imaging station (Vital Images ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000345641.97181.ED

    authors: Baird CJ,Conway JE,Sciubba DM,Prevedello DM,Quiñones-Hinojosa A,Kassam AB

    更新日期:2009-12-01 00:00:00

  • Photocoagulation of cerebral arteriovenous malformations and arterial aneurysms with the neodymium: yttrium-aluminum-garnet or argon laser: preliminary results in twelve patients.

    abstract::Six arteriovenous malformations (AVMs) and five arterial aneurysms (AAs) were treated with either argon or neodymium:yttrium-aluminum-garnet laser irradiation; one AVM was treated with both. All AVMs were occluded completely, leaving adjacent tissue untouched and preserving the regional vascularization. Photocoagulati...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198212000-00003

    authors: Fasano VA,Urciuoli R,Ponzio RM

    更新日期:1982-12-01 00:00:00

  • Craniotomy and clipping of intracranial aneurysm in a stereoscopic virtual reality environment.

    abstract:OBJECTIVE:The release of results of International Subarachnoid Aneurysm Trial in 2003 caused a shift in the paradigm of management of ruptured intracranial aneurysms. The cases selected for microsurgical clipping nowadays are usually those patients with aneurysms that are not suitable for embolization, and are often co...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000290904.46061.0D

    authors: Wong GK,Zhu CX,Ahuja AT,Poon WS

    更新日期:2007-09-01 00:00:00

  • Iliac screw fixation using computer-assisted computer tomographic image guidance: technical note.

    abstract:BACKGROUND:Iliac screw fixation is a powerful tool used by spine surgeons to achieve fusion across the lumbosacral junction for a number of indications, including deformity, tumor, and pseudarthrosis. Complications associated with screw placement are related to blind trajectory selection and excessive soft tissue disse...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0b013e318230517a

    authors: Shin JH,Hoh DJ,Kalfas IH

    更新日期:2012-03-01 00:00:00

  • Experimental subarachnoid hemorrhage: cerebral blood flow and brain metabolism during the acute phase in three different models in the rat.

    abstract:OBJECTIVE:To study the cerebral metabolism and its relationship to cerebral blood flow (CBF) acutely after subarachnoid hemorrhage (SAH). METHODS:SAH was induced in rats by endovascular perforation of the internal carotid artery, blood injection into the prechiasmatic cistern or the cisterna magna. CBF (measured by la...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000103670.09687.7a

    authors: Prunell GF,Mathiesen T,Svendgaard NA

    更新日期:2004-02-01 00:00:00

  • Intraoperative Near-Infrared Optical Imaging Can Localize Gadolinium-Enhancing Gliomas During Surgery.

    abstract:BACKGROUND:Although real-time localization of gliomas has improved with intraoperative image guidance systems, these tools are limited by brain shift, surgical cavity deformation, and expense. OBJECTIVE:To propose a novel method to perform near-infrared (NIR) imaging during glioma resections based on preclinical and c...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0000000000001450

    authors: Lee JY,Thawani JP,Pierce J,Zeh R,Martinez-Lage M,Chanin M,Venegas O,Nims S,Learned K,Keating J,Singhal S

    更新日期:2016-12-01 00:00:00

  • Introduction of the human Horsley-Clarke stereotactic frame.

    abstract::It is well known that the Horsley-Clarke frame was developed and first used by Robert Henry Clarke and the pioneer neurosurgeon Victor Horsley in 1906 for making lesions in the central nervous system of animals. The Horsley-Clarke frame was extensively used throughout the next 4 decades for excitation and lesion produ...

    journal_title:Neurosurgery

    pub_type: 历史文章,杂志文章

    doi:10.1097/00006123-199603000-00029

    authors: Jensen RL,Stone JL,Hayne RA

    更新日期:1996-03-01 00:00:00

  • Percutaneous minidose metrizamide endomyelographic computed tomography in syringomyelia.

    abstract::Two patients presented with syringomyelia, each unusual. After neuroradiographic diagnosis with delayed metrizamide computed tomography (CT) or magnetic resonance imaging (MRI), an interesting diagnostic question arose. A percutaneous minidose metrizamide endomyelographic CT (PMDMECT) study clarified each situation an...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198703000-00013

    authors: Blumenkopf B

    更新日期:1987-03-01 00:00:00

  • Distribution of angiographic vasospasm after subarachnoid hemorrhage: implications for diagnosis by transcranial Doppler ultrasonography.

    abstract::A study was undertaken to determine how frequently angiographic vasospasm occurs outside the normal access range of transcranial Doppler ultrasound in patients who have suffered a subarachnoid hemorrhage. Vasospasm located in the basal vessels is readily identifiable using transcranial Doppler ultrasound whereas spasm...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Newell DW,Grady MS,Eskridge JM,Winn HR

    更新日期:1990-10-01 00:00:00

  • Alexia without agraphia in a musician after transcallosal removal of a left intraventricular meningioma.

    abstract::After a meningioma situated in the trigone of the left lateral ventricle was excised by the transcallosal approach of Kempe and Blaylock, a right-handed musician with a right hemianopsia developed alexia without agraphia. In contrast to previously reported cases of this syndrome arising from other etiologies, he was u...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-197902000-00011

    authors: Levin HS,Rose JE

    更新日期:1979-02-01 00:00:00

  • Paraplegia after tethered cord surgery: an uncommon combined anomaly of spinal arteriovenous fistula and sacral lipoma--case report.

    abstract:OBJECTIVE AND IMPORTANCE:The coexistence of spinal arteriovenous malformation (AVM) with congenital abnormalities is relatively common. However, the association of a spinal AVM and lipoma is rare. We present an adult patient with this combined anomaly and discuss the clinical relevance of this case. CLINICAL PRESENTAT...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000171028.96829.69

    authors: Cheung AC,Kalkanis SN,Ogilvy CS

    更新日期:2005-09-01 00:00:00

  • Neuropathy caused by spontaneous intraneural hemorrhage: case report.

    abstract::A case of ulnar neuropathy at the elbow produced by spontaneous intraneural hemorrhage in a patient with acquired immunodeficiency syndrome and thrombocytopenia is reported. Intraneural hemorrhage in patients with bleeding disorders occurs infrequently. It consists of acute intrafascicular bleeding, presumably produci...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199102000-00019

    authors: Poppi M,Staffa G,Martinelli P,Fabrizi AP,Giuliani G

    更新日期:1991-02-01 00:00:00

  • Robot-assisted stereotactic laser ablation in medically intractable epilepsy: operative technique.

    abstract:BACKGROUND:Stereotactic laser ablation offers an advantage over open surgical procedures for treatment of epileptic foci, tumors, and other brain pathology. Robot-assisted stereotactic laser ablation could offer an accurate, efficient, minimally invasive, and safe method for placement of an ablation catheter into the t...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0000000000000286

    authors: Gonzalez-Martinez J,Vadera S,Mullin J,Enatsu R,Alexopoulos AV,Patwardhan R,Bingaman W,Najm I

    更新日期:2014-06-01 00:00:00

  • Surgery of intrinsic cerebral tumors.

    abstract::Tumors and other structural lesions located with and adjacent to the cerebral cortex present certain challenges in terms of the overall management and design of surgical strategies. This comprehensive analysis attempts to define the current understanding of cerebral localization and function and includes the latest ad...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1227/01.NEU.0000255489.88321.18

    authors: Berger MS,Hadjipanayis CG

    更新日期:2007-07-01 00:00:00

  • Stereotactic Radiosurgery for Arteriovenous Malformations: The Effect of Treatment Period on Patient Outcomes.

    abstract:BACKGROUND:Stereotactic radiosurgery (SRS) has been performed on patients with cerebral arteriovenous malformations (AVMs) for over 40 years. OBJECTIVE:To evaluate the impact of treatment period on obliteration, intracranial hemorrhage (ICH), and radiation-induced complications (RICs). METHODS:Retrospective compariso...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0000000000001085

    authors: Pollock BE,Link MJ,Stafford SL,Garces YI,Foote RL

    更新日期:2016-04-01 00:00:00

  • Novel, compact, intraoperative magnetic resonance imaging-guided system for conventional neurosurgical operating rooms.

    abstract:OBJECTIVE:Preliminary clinical experience with a novel, compact, intraoperative magnetic resonance imaging (MRI)-guided system that can be used in an ordinary operating room is presented. DESCRIPTION OF INSTRUMENTATION:The system features an MRI scanner integrated with an optical and MRI tracking system. Scanning and ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200104000-00021

    authors: Hadani M,Spiegelman R,Feldman Z,Berkenstadt H,Ram Z

    更新日期:2001-04-01 00:00:00

  • Temporal lobe arteriovenous malformations: surgical outcomes with a focus on visual field defects and epilepsy.

    abstract:BACKGROUND:Temporal lobe arteriovenous malformations (AVMs) represent a subgroup of intracranial AVMs with particular characteristics and management issues. OBJECTIVE:To characterize the surgical outcomes of temporal lobe AVMs with emphasis on visual field deficits (VFDs) and seizures. METHODS:Between 1992 and 2008, ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0000000000000122

    authors: Lopez-Ojeda P,Labib M,Burneo J,Lownie SP

    更新日期:2013-11-01 00:00:00