Abstract:
:In a series of 75 patients with surgically treated lipomyelomeningoceles, the neurological condition of six patients deteriorated 6 months to 14 years after the operation due to repeat tethering of the spinal cord. The tethering resulted from postoperative dense adhesion between the cord and the overlying dura mater. Two of the six patients underwent conventional repeat untethering procedures, and the remaining four were successfully treated with a new surgical technique developed by the authors to prevent such dural adhesion. For this procedure, after complete untethering of the spinal cord, the lumbosacral cord is retained in the center of the dural sac by fine stay sutures between the pia mater of the conus medullaris and the ventral dura mater. In addition, the dura mater is tacked to the posterior arch which is reconstructed with bone grafts at one or two bifid vertebral levels. During a postoperative follow-up period of 1 to 3 years, no further deterioration has been observed and magnetic resonance studies have demonstrated a space filled with cerebrospinal fluid (CSF) around the lumbosacral cord. The authors conclude that long-term observation, both neurological and radiological, is essential even after successful repair of a lipomyelomeningocele. This new surgical procedure can maintain a CSF bath around the lumbosacral cord, thus preventing dural adhesion. Application of this technique will hopefully be beneficial in lipomyelomeningocele patients with a high risk of cord retethering after initial repair.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Sakamoto H,Hakuba A,Fujitani K,Nishimura Sdoi
10.3171/jns.1991.74.5.0709subject
Has Abstractpub_date
1991-05-01 00:00:00pages
709-14issue
5eissn
0022-3085issn
1933-0693journal_volume
74pub_type
杂志文章abstract::The health care needs of children with hydrocephalus continue beyond childhood and adolescence; however, pediatric hospitals and pediatric neurosurgeons are often unable to provide them care after they become adults. Each year in the US, an estimated 5000-6000 adolescents and young adults (collectively, youth) with hy...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.6.JNS188
更新日期:2018-11-01 00:00:00
abstract::A spinal cord injury was produced in Wistar rats by extradural compression of the cord with a Sugita aneurysm clip for 5 seconds. During a 2-week observation period following the injury, the tissue norepinephrine (NE), dopamine (DA), and serotonin (5-HT) concentrations decreased uniformly at and below the injured site...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.5.0743
更新日期:1985-05-01 00:00:00
abstract::In this study, the authors performed deep brain stimulation (DBS) of the subgenual anterior cingulate cortex (SACC) in a patient with a history of bipolar disorder. After a right thalamic stroke, intractable depression without mood elevation or a mixed state developed in this patient. He underwent bilateral SACC DBS a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.2.JNS081299
更新日期:2009-10-01 00:00:00
abstract::Delayed cerebral vasospasm is an important determinant of the clinical outcome after subarachnoid hemorrhage, but its prevention and treatment has met with limited success. Since cerebral arteries were found to be sensitive to the vasoconstrictor effect of angiotensin II, the possibility of angiotensin's contribution ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.55.6.0884
更新日期:1981-12-01 00:00:00
abstract:OBJECT:Emerging evidence supports the hypothesis that modulation of specific central neuronal systems contributes to the clinical efficacy of deep brain stimulation (DBS) and motor cortex stimulation (MCS). Real-time monitoring of the neurochemical output of targeted regions may therefore advance functional neurosurger...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.3.JNS081348
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:Coverage of the anterior spinal artery (ASA) ostia is a source of considerable consternation regarding flow diversion (FD) in vertebral artery (VA) aneurysms due to cord supply. The authors sought to assess the association between coverage of the ASA, posterior spinal artery (PSA), or lateral spinal artery (L...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.1.JNS193293
更新日期:2020-03-27 00:00:00
abstract:OBJECT:Surgical mortality is a frequent outcome measure in studies of volume-outcome relationships, and the Agency for Healthcare Research and Quality has endorsed surgical mortality after craniotomies as an Inpatient Quality Indicator. Still, the frequency and causes of 30-day mortality after neurosurgical procedures ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.12.JNS11339
更新日期:2012-04-01 00:00:00
abstract::In clinical follow-up studies after radiosurgery, imaging modalities such as computerized tomography (CT) and magnetic resonance (MR) imaging are used. Accurate determination of the residual lesion volume is necessary for realistic assessment of the effects of treatment. Usually, the diameters rather than the volume o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.93.supplement
更新日期:2000-12-01 00:00:00
abstract:OBJECT:In this paper, the authors' goal was to define the long-term outcomes and risks of stereotactic radiosurgery (SRS) for arteriovenous malformations (AVMs) of the medulla, pons, and midbrain. METHODS:Between 1987 and 2006, the authors performed Gamma Knife surgery in 996 patients with brain AVMs; 67 patients had ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.9.JNS11176
更新日期:2012-01-01 00:00:00
abstract:OBJECT:The aim of this study was to assess long-term clinical outcomes in patients who underwent Gamma Knife surgery (GKS) with a low margin dose-14 Gy or less-to treat vestibular schwannoma (VS) unrelated to neurofibromatosis Type II. METHODS:Between December 1994 and December 2001, 200 patients with VSs underwent GK...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.7.GKS12783
更新日期:2012-12-01 00:00:00
abstract::Supracerebellar transtentorial (SCTT) approaches have become a popular option for treatment of a variety of pathologies in the medial and basal temporal and occipital lobes and thalamus. Transtentorial approaches provide numerous advantages over transcortical approaches, including obviating the need to traverse eloque...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.2.JNS192952
更新日期:2020-04-24 00:00:00
abstract::Myelomeningocele presenting as a retromediastinal mass originating from the midline defect through the fused T-4, T-5, and T-6 VBs is described. An 11-year-old boy with a completely normal systemic and neurological examination suffering pulmonary problems such as effort dyspnea and severe kyphosis was evaluated and an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2005.103.1.0079
更新日期:2005-07-01 00:00:00
abstract:OBJECT:The poor prognosis for traumatic acute subdural hematoma (ASDH) might be due to underlying primary brain damage, ischemia, or both. Ischemia in ASDH is likely caused by increased intracranial pressure (ICP) leading to decreased cerebral perfusion pressure (CPP), but the degree to which these phenomena occur is u...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.95.4.0569
更新日期:2001-10-01 00:00:00
abstract::Infestation of the central nervous system with sparganum, the larva of Spirometra mansoni, is rare. Only 27 cases have been reported in the literature; however, the true incidence might be underestimated. Two cases are reported that were definitively diagnosed by stereotactic biopsy techniques. Without a positive hist...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.78.1.0129
更新日期:1993-01-01 00:00:00
abstract::OBJECTIVE Pituitary MR imaging fails to detect over 50% of microadenomas in Cushing's disease and nearly 80% of cases of dural microinvasion. Surface coils can generate exceptionally high-resolution images of the immediately adjacent tissues. To improve imaging of the pituitary gland, a receive-only surface coil that ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.11.JNS151465
更新日期:2016-12-01 00:00:00
abstract::The pathology of hematomyelia was examined in 35 rats following the stereotactic injection of 2 microliters blood into the dorsal columns of the thoracic spinal cord. This experimental model produced a small ball-hemorrhage without associated neurological deficits or significant tissue injury. Histological sections of...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.75.6.0911
更新日期:1991-12-01 00:00:00
abstract::Prolonged coma afterhead trauma is associated with depletion of 3', 5' cyclic adenosine monophosphate (cAMP) in the cerebrospinal fluid (CSF). Because cAMP has previously been implicated in neurorendocrine secretion, this study examines the pituitay-hypothalamic function in 15 adult male patients (to exclude the effec...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.5.0650
更新日期:1978-11-01 00:00:00
abstract::A rare case of migration of a distal catheter from a subdural atrial shunt into the pulmonary arteries is presented. The indication for surgical treatment is briefly discussed. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.52.1.0106
更新日期:1980-01-01 00:00:00
abstract::OBJECTIVE Neurosurgery is among the most competitive residencies, as evidenced by the high number of applicants for relatively few positions. Although it is important to recruit candidates who have the intellectual capacity and drive to succeed, traditional objective selection criteria, such as US Medical Licensing Ex...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.7.JNS15880
更新日期:2016-10-01 00:00:00
abstract:OBJECT:The average 65-year-old patient with moderate dementia can look forward to only 1.4 quality-adjusted life years (QALYs), that is, longevity times quality of life. Some of these patients suffer from normal-pressure hydrocephalus (NPH) and respond dramatically to shunt insertion. Currently, however, NPH cannot be ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2006.105.6.815
更新日期:2006-12-01 00:00:00
abstract:OBJECT:Preoperative anemia may be treated with a blood transfusion. Both are associated with adverse outcomes in various surgical procedures, but this has not been clearly elucidated in surgery for cerebral aneurysms. In this study the authors assessed the association of preoperative anemia and perioperative blood tran...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.3171/2014.10.JNS14551
更新日期:2015-07-01 00:00:00
abstract::OBJECTIVEDecompressive craniectomy is used for uncontrolled intracranial pressure in traumatic brain injury and malignant hemispheric stroke. Subcutaneous preservation of the autologous bone flap in the abdomen is a simple, portable technique but has largely been abandoned due to perceived concerns of resorption. The ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.6.JNS17943
更新日期:2018-12-01 00:00:00
abstract::Four adults with unilateral (three cases) or bilateral (one case) closed schizencephaly, medically intractable epilepsy, and otherwise normal neurological examinations are presented. Three were examined preoperatively with magnetic resonance imaging and one with computerized tomography. Scalp electroencephalographic (...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.80.5.0820
更新日期:1994-05-01 00:00:00
abstract::Klatzo's classification of brain edema into two types, vasogenic and cytotoxic, has been in general use since 1967. The former involves overall brain swelling due to fluid entry from the vasculature because of openings in the blood-brain barrier (BBB), whereas the latter refers to cell swelling without any loss of the...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1995.83.6.1051
更新日期:1995-12-01 00:00:00
abstract::Primary leptomeningeal gliomatosis is rare, and the diffuse form is even rarer with only three cases reported in the literature. A fourth case is described in this report. Computerized tomography (CT) findings showed hydrocephalus with enhancement of the cerebral cisterns, and analysis of cerebrospinal fluid obtained ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.2.0283
更新日期:1985-08-01 00:00:00
abstract::Hemangiopericytoma is a vascular neoplasm consisting of capillaries outlined by an intact basement membrane that separates the endothelial cells of the capillaries from the spindle-shaped tumor cells in the extravascular area. These neoplasms are found in soft tissues but have rarely been shown to involve the spinal c...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.6.0914
更新日期:1978-12-01 00:00:00
abstract:OBJECT:A pullout strength biomechanical study was performed in 20 fresh swine vertebral bodies in which titanium expander (Group 1) and conventional screws (Group 2) were placed. METHODS:The screws were inserted into the anterosuperior portion of the anterior spine, and assessment was performed after application of lo...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.97.3.0346
更新日期:2002-10-01 00:00:00
abstract::One hundred and one fiberoptic pressure transducers (59 subdural and 42 ventricular) were studied in 86 patients (some in whom more than one device had been inserted). Only four complications occurred: two transient cerebrospinal fluid leaks after removal and two clinically insignificant intracerebral hematomas. No in...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.1997.86.6.0927
更新日期:1997-06-01 00:00:00
abstract::In 10 patients with supratentorial ependymomas, the tumors exhibited hyperdensity on computerized tomography (CT) scanning prior to contrast infusion and, with one exception, all tumors were mixed lesions with the low densities suggesting cystic or necrotic portions. Eighty percent of the tumors contained small calcif...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.2.0209
更新日期:1986-02-01 00:00:00
abstract::A patient is reported with a purely pial arteriovenous malformation (AVM) supplied from the posterior parietal artery. The prominent middle meningeal artery contributed to opacification of the angular branches distal to the AVM, but did not contribute to the AVM. After total removal of the AVM, the angular branches be...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.4.0522
更新日期:1979-04-01 00:00:00