Abstract:
BACKGROUND:Patients with intervertebral disc herniation undergo surgical removal of herniated disc material in cases of persisting symptoms and/or neurologic deficits. While motor deficits often prompt surgery, little is known about the optimal timing of surgery in these cases. The aim of this study was to prospectively evaluate the impact of timing of disc surgery on motor recovery. Does postponing surgical treatment worsen outcome? METHOD:In total, 120 patients with sciatica and/or sensorimotor deficits due to a lumbar disc herniation were surgically treated at the authors' center within a 3-month period. In 60 patients, motor deficits were present at the time of admission. Motor function was assessed using manual muscle testing and subdivided according to the Medical Research Council (MRC) scale. Patient demographics, neurologic deficits, duration of motor deficits, treatment characteristics, and outcome were assessed. At a minimum follow-up of 1 year, functional recovery and complications were collated. Patients were subdivided into groups according to the severity of the paresis (MRC ≤ 3/5 vs. MRC 4/5). Intra-group differences were compared based on the duration of the neurologic deficits. RESULTS:Patients with moderate and severe paresis (MRC ≤ 3/5) benefit from treatment within 72 h as they were shown to have a significantly higher complete recovery rate at 1-year follow-up (75% vs. 0%; p < 0.001). CONCLUSION:Immediate surgery should be offered to patients with moderate and severe motor deficits to increase the likelihood of neurologic recovery. This prospective data may have an impact on emergency triage in these patients.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Kögl N,Brawanski K,Girod PP,Petr O,Thomé Cdoi
10.1007/s00701-020-04614-0subject
Has Abstractpub_date
2021-01-01 00:00:00pages
275-280issue
1eissn
0001-6268issn
0942-0940pii
10.1007/s00701-020-04614-0journal_volume
163pub_type
杂志文章abstract:OBJECT:Although functional mapping facilitates the planning of surgery in and around eloquent areas, the resection of tumors adjacent to language areas remains challenging. In this report, we took notice that the language areas (Broca's and Wernicke's) present at the perisylvian fissure. We posit that if there is non-e...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-006-0857-7
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:Early recognition of emerging delayed neurological deficits (DND) in patients after subarachnoid haemorrhage (SAH) is not always possible by transcranial Doppler sonography. Aim of this study was to investigate a) whether determination of blood flow velocities in deep cerebral basal veins can predict DND in ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010170033
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Surgical treatment of giant clinoidal meningiomas remains a challenging task for neurosurgeons. Here, we present details of the surgical techniques for the dissection of encased perforators. METHODS:The dissection of encased perforators is summarized as follows: (1) split the tumor above the encased arterie...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1750-9
更新日期:2013-08-01 00:00:00
abstract:INTRODUCTION:Pituitary adenomas (PA) are common intracranial tumors. In the context of the aging of the population, the question is whether postsurgical outcomes are comparable to the younger ones. The primary objective of the present study was to review published resection and recurrence rates after transsphenoidal re...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,meta分析
doi:10.1007/s00701-020-04300-1
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Coregistration of any neuroimaging studies into treatment planning for stereotactic radiosurgery became easily applicable using the Leksell Gamma Knife 4C, a new model of gamma knife. The authors investigated the advantage of this image processing. METHOD:Since installation of the Leksell Gamma Knife 4C at ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0279-4
更新日期:2009-05-01 00:00:00
abstract::The facial nerve may be damaged by trauma, surgical manipulation, inflammation or neoplastic disease. Current techniques for repair and regeneration of the damaged nerve produce suboptimal results. This review outlines the current knowledge of experimental facial nerve regeneration in vitro and in vivo to provide an i...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s007010170114
更新日期:2001-01-01 00:00:00
abstract::The management of vestibular schwannomata is controversial. Surveillance remains an acceptable option for elderly patients or those with small lesions. Stereoradiosurgery is also an option, while surgery is often preferred in younger patients with larger lesions. In elderly patients with lesions causing brainstem comp...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0493-0
更新日期:2010-01-01 00:00:00
abstract:PURPOSE:Malignant gliomas are highly infiltrative tumours with a fatal prognosis. F18-fluoroethyl-tyrosine (FET)-positron emission tomography (PET) often reveals a broader extension of these tumours compared with contrast-enhanced magnetic resonance imaging (MRI). Complete resection of the contrast-enhancing lesion is ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0462-7
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Several studies have investigated the relation between intraoperative abnormal muscle response (AMR) findings and postoperative results in patients undergoing microvascular decompression (MVD) for hemifacial spasm (HFS). However, there is some debate over the reliability of AMR as an indicator of postoperati...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0571-x
更新日期:2005-09-01 00:00:00
abstract::On the basis of a series of 75 patients, the practical use of Icp continuous long-term recording in severe head injuries without mass lesions or remaining deeply comatose after surgical procedures is critically analyzed. ICP monitoring alone seems to be not essential for prognosis. Conversely it is of much greater use...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406729
更新日期:1977-01-01 00:00:00
abstract::The system consists of an inverted U-shaped frame with right angled corners, so mounted that it can be adjusted vertically, antero-posteriorly and made to rotate on an axis ("the axis of the frame") formed by its free ends. The frame carries an arc probe carrier whose probe holder slides on an arc which is centered on...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406198
更新日期:1983-01-01 00:00:00
abstract:OBJECTIVE:The purpose of the study was to measure the effects of increased inspired oxygen on patients suffering severe head injury and consequent influences on the correlations between CPP and brain tissue oxygen (PtiO2) and the effects on brain microdialysate glucose and lactate. METHODS:In a prospective, observatio...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-003-0027-0
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Morphological and microstructural changes of the trigeminal nerve due to neurovascular compression (NVC) have been reported in primary trigeminal neuralgia (PTN) patients. This investigation was to examine the relationship between the trigeminal-pontine angle and nerve microstructural changes. METHODS:Twent...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-04099-6
更新日期:2019-12-01 00:00:00
abstract::Renal cell carcinoma has a complex and variable natural history. We report a case underlining this who presented concomitant renal cell carcinoma metastasis with pituitary and adrenocortical adenomas. A 62-year-old woman presented with visual loss. Imaging revealed a large sellar mass with suprasellar extension. Four ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-002-1060-0
更新日期:2003-03-01 00:00:00
abstract::Octreotide is a potent agonist of somatostatin that lowers the serum level of growth hormone (GH), and reduces the size of somatotropinomas. However, the detailed mechanism of shrinkage of this tumour is not known. We, therefore, evaluated 11 patients with somatotropinomas who were treated with octreotide 300 microgra...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01411403
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:This prospective observational study was undertaken to investigate the advantages, the safety, and the drawbacks of reconstructing a cervical corpectomy with a distractible corpectomy cage. According to the author's literature search, this is the second clinical report on a distractible cervical corpectomy c...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-006-0871-9
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Thoracic disc herniation (TDH) is a rare condition with severe neurological sequelae. Surgical management is still a matter of debate and challenging. METHOD:We present a modification of the transdural approach for TDH. The approach has been described in a stepwise fashion, analysing pre-, peri-, and postop...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04387-6
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:The ventro-lateral thalamus is the stereotactic target of choice for severe intention tremor. Nevertheless, the optimal target area has remained controversial, and targeting of the subthalamic area has been suggested to be superior. PATIENTS AND METHODS:Eleven patients with disabling intention tremor of dif...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1230-1
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:The asymmetry of tonsillar ectopia, syringomyelia, and clinical manifestations, and their correlations in adult Chiari I malformation (CIM) are seldom discussed. METHODS:Clinical and imaging data of 104 consecutive adult patients with CIM and syringomyelia were retrospectively reviewed. A method was devised...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2000-5
更新日期:2014-04-01 00:00:00
abstract::In this study, which comprises 144 consecutive head injuries, the initial clinical assessment and the findings of the initial CT scan are related to the outcome. The mortality is related to the patient's level of consciousness and pupillary light reflex on admission. The disability rate (= number of disabled/number of...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405444
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND:Intraoperative fluorescence angiography with indocyanine green (ICG) as a tracer has recently been introduced as a novel technique for neurosurgery. We evaluated the feasibility and efficacy of near-infrared (NIR) indocyanine green (ICG) videoangiography for patients undergoing carotid endarterectomy (CEA). ...
journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章
doi:10.1007/s00701-011-1018-1
更新日期:2011-08-01 00:00:00
abstract::A lateral route between the SCM and the lateral border of the internal jugular vein is defined from an anatomical study for exposure of the VA. It offers the simplest route for controlling any part or the whole length of the VA, including its intracranial portion. Surgical indications are discussed on the basis of our...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406753
更新日期:1980-01-01 00:00:00
abstract::The clinical findings and operation results in two series of patients with medial prolapse of an intervertebral disc with total or partial occlusion of the spinal canal are reported. In one of the series (30 patients) symptoms of cauda equina compression, with bladder and rectal disturbances, were present, and in the ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405333
更新日期:1978-01-01 00:00:00
abstract:BACKGROUND:Fever occurs frequently in acute brain injury patients, and its occurrence is associated with poorer outcomes. Paracetamol, an antipyretic frequently employed in patients with cerebral damage, may cause hypotension. We evaluated the cerebral and hemodynamic effects of intravenous (IV) paracetamol for the con...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2129-2
更新日期:2014-10-01 00:00:00
abstract::After ventricular catheterization magnetic resonance (MR) imaging very often demonstrates a focal area of high signal along the drain track which corresponds to parenchymal oedema. This high signal seemed to be more pronounced when the frontal area was catheterized than when the junctional parieto-temporo-occipital pa...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406499
更新日期:1994-01-01 00:00:00
abstract::Although primary treatment of medulloblastoma is now successful in a high percentage of patients, its secondary manifestations still bear a poor prognosis. Thorough studies of secondary manifestations are therefore pivotal to plan therapeutic approaches for the long-term management of medulloblastoma. Here we describe...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01410612
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:van Gijn and co-workers identified "Perimesencephalic haemorrhage" (PM) as distinct, benign, non-aneurysmal subarachnoid haemorrhage. However, there is only one retrospective series of this entity outside the Netherlands. PURPOSE:to confirm (or not) the benign nature of perimesencephalic subarachnoid haemor...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01404842
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:The management of pineal cysts is still debatable, especially for asymptomatic incidental ones. For symptomatic cysts associated with hydrocephalus, the surgical management is mandatory and may include either classical microsurgical approaches to the pineal region or endoscopic trans-ventricular approaches i...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1849-z
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:The evolution of pituitary surgery has made it a safe and effective form of treatment; however, risks of inadequate tumor resection, cerebrospinal fluid (CSF) leak, pituitary dysfunction, and vascular injury still exist. The use of intraoperative ultrasonography (IOUS) in pituitary surgery has been well desc...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04674-2
更新日期:2021-01-05 00:00:00
abstract::To understand the clinicopathology features of leptomeningeal dissemination of malignant gliomas, a total of 157 consecutive patients treated between 1978 and 1989 were analysed. Twenty-two patients (14%) were judged to have dissemination. In 20 patients, the dissemination was diagnosed antemortem. Eleven patients had...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01476415
更新日期:1994-01-01 00:00:00