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 electroencephalographic findings. The mean follow-up duration was 36 months (range 24-84 months). Surgeries were all performed by the senior author (F.L.V.). RESULTS:Following initial surgical intervention, 97 patients (92%) improved to Engel Class I or II (Group A), and 8 (8%) did not have significant improvement (Engel Class III or IV; Group B). These 8 patients were restudied using video-electroencephalography (EEG) and MR imaging. All major surgical failures occurred within 1 year after initial intervention. Reevaluation demonstrated 3 patients (37.5%) with contralateral temporal EEG findings. Five patients (62.5%) had evidence of ipsilateral recurrent discharges. Four patients underwent extended neocortical resection along the previous resection cavity. Their outcomes ranged from Engel Class I to Class III. Only 1 patient (12.5%) who failed to improve after initial surgery was found to have incomplete resection of mesial structures. This last patient underwent reoperation to complete the resection and improved to Engel Class I. CONCLUSIONS:Failure of temporal lobe resection for MTS is multifactorial. The cause of failure lies in the pathological substrate of the epileptogenic area. Complete seizure control cannot be predicted solely by conventional preoperative workup. Initial surgical failures from temporal lobe resection often benefit from reevaluation, because reoperation may be beneficial in selected patients. Based on this work, the authors have proposed a management and treatment algorithm for these patients.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Ramos E,Benbadis S,Vale FLdoi
10.3171/2009.1.JNS08638subject
Has Abstractpub_date
2009-06-01 00:00:00pages
1127-34issue
6eissn
0022-3085issn
1933-0693journal_volume
110pub_type
杂志文章abstract:OBJECT:Intracranial germinomas commonly occur in the pineal region, the floor of the third ventricle (hypothalamus), or both, and they are often associated with diabetes insipidus (DI). The authors conducted a study to correlate preoperative DI with the endoscopic and magnetic resonance (MR) imaging evidence of tumor o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2004.100.5.0430
更新日期:2004-05-01 00:00:00
abstract:OBJECT:Chiari Type I malformation (CMI) is a congenital disorder recognized by caudal displacement of the cerebellar tonsils through the foramen magnum and into the cervical canal. Frequently, associated findings include abnormalities of nearby bony and neural elements as well as syringomyelia. Cerebellar tonsillar ect...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.92.6.0920
更新日期:2000-06-01 00:00:00
abstract:OBJECT:The aim of this study was to assess the incidence and outcome of procedure-related rupture of intracranial aneurysms in patients treated with Guglielmi detachable coils (GDCs) and to identify risk factors for this complication. METHODS:Procedure-related rupture occurred in seven of 264 treated aneurysms in 239 ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.94.2.0238
更新日期:2001-02-01 00:00:00
abstract::The authors present the case history of a patient in whom the peritoneal catheter of a ventriculoperitoneal shunt system caused ureter obstruction. This is a rare complication of such a shunt procedure, and the patient's symptoms were relieved by shortening the peritoneal catheter. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.3.0542
更新日期:1983-09-01 00:00:00
abstract::Levels of protein kinase C (PKC) isoforms in eight human glioblastoma cell lines and two normal human glial cell cultures were determined. Earlier studies identified PKC-alpha and PKC-gamma in these cell lines but PKC-beta was not present. In this study, PKC-epsilon and PKC-zeta are demonstrated immunologically in the...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.5.0734
更新日期:1994-11-01 00:00:00
abstract:OBJECT:The aim of this study was to evaluate the usefulness and limitations of gamma surgery (GS) in the treatment of brain metastases from melanoma. METHODS:Imaging and clinical outcomes in 45 patients treated for 92 brain metastases from melanoma between October 1989 and October 1999 were retrospectively analyzed. F...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.96.3.0544
更新日期:2002-03-01 00:00:00
abstract::OBJECTIVEDelay in diagnosis and subsequent treatment of nonconvulsive seizures can lead to worsened outcomes. The gold standard in detecting nonconvulsive seizures is continuous video-electroencephalography (cEEG). Compared to routine, 30-minute EEG, the use of cEEG increases the likelihood of capturing intermittent n...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.1.JNS171466
更新日期:2018-05-01 00:00:00
abstract::In the central nervous system, recurrence of intracranial Masson's vegetant intravascular hemangioendothelioma (MVIH) is rare. To the authors' knowledge, only three recurrent intracranial cases have been reported. The authors report the case of a 75-year-old woman with a recurrent left-sided cerebellopontine angle and...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1999.91.2.0308
更新日期:1999-08-01 00:00:00
abstract::Retrospective analysis of 13 patients who had bifrontal decompressive craniectomy for the management of posttraumatic cerebral edema shows a significant decrease in expected mortality, but severe morbidity in the survivors. Only one patient returned to the pretrauma level of neurological function. No correlation could...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.42.4.0429
更新日期:1975-04-01 00:00:00
abstract::Intrathecal ossification causing progressive myelopathy or radiculopathy does not occur frequently. The majority of the reported lesions have been in the thoracic spine and seldom in the sacral canal. This report presents the occurrence of disabling low backache and sciatica from intradural periradicular ossification ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.1.0132
更新日期:1978-07-01 00:00:00
abstract:OBJECT:The authors assessed the efficacy and complications from gamma knife radiosurgery (GKS) for multiple sclerosis (MS)-associated trigeminal neuralgia (TN). METHODS:There were 15 patients with MS-associated TN (MS-TN). Treatment involved three sequential protocols, 70 to 90-Gy maximum dose, using a single 4-mm iso...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.2002.97.supplement
更新日期:2002-12-01 00:00:00
abstract:OBJECT:The goal of this study was to evaluate the therapeutic impact of the resection of metastatic brain tumor cells infiltrating adjacent brain parenchyma. METHODS:Between July 2001 and February 2007, 94 patients (67 males and 27 females, with a mean age of 55.0 +/-12.0 years) underwent resection of a single brain m...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.8.JNS08448
更新日期:2009-04-01 00:00:00
abstract:OBJECT:The authors have treated intractable pain, particularly cancer pain related to bone metastasis, with various protocols. Cancer pain has been treated by gamma knife radiosurgery (GKS), targeted to the pituitary gland-stalk, as an alternative new pain control method. The purpose of this study was to investigate a ...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.3171/jns.2002.97.supplement
更新日期:2002-12-01 00:00:00
abstract:OBJECT:In this paper the authors aimed to provide information related to major and minor surgical and neurological complications encountered following stereoelectroencephalography and epilepsy surgery.Methods The authors performed a retrospective review of 491 and 1905 patients who underwent intracranial electrode impl...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.8.JNS08338
更新日期:2009-06-01 00:00:00
abstract::OBJECT The present study was conducted to investigate whether microbleeds or microinfarcts are associated with apolipoprotein E (APOE) gene polymorphisms in patients with moyamoya disease (MMD), and if so, whetherAPOE gene polymorphisms are also associated with stroke type in patients with MMD. METHODS This cross-sect...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.3171/2015.5.JNS142973
更新日期:2016-06-01 00:00:00
abstract:OBJECT:The aim of this anatomical study was to define more fully the three-dimensional (3D) relationships between the optic radiations and the temporal horn and superficial anatomy of the temporal lobe by using the Klingler white matter fiber dissection technique. These findings were correlated with established surgica...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.101.5.0739
更新日期:2004-11-01 00:00:00
abstract:OBJECT:Surgical or endovascular occlusion of the parent artery proximal to an aneurysm has been recommended for treatment of dissecting aneurysms of the intracranial posterior circulation. However, dissecting aneurysms may rupture even after proximal occlusion because distal progression of thrombus is necessary to occl...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.90.5.0853
更新日期:1999-05-01 00:00:00
abstract::Eleven patients with recurrent malignant glioma were treated with single high doses of BCNU ranging from 600 to 1400 mg/sq m. To prevent the characteristic late myelosuppression observed after conventional doses of BCNU, autologous bone marrow harvested just before drug treatment was infused 24 to 36 hours after thera...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.4.0455
更新日期:1981-04-01 00:00:00
abstract:OBJECTIVE:Surgery for low-grade gliomas (LGGs) aims to achieve maximal tumor removal and maintenance of patients' functional integrity. Because extent of resection is one of the factors affecting the natural history of LGGs, surgery could be extended further than total resection toward a supratotal resection, beyond tu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.2.JNS183408
更新日期:2019-05-17 00:00:00
abstract::Although posterior plates are increasingly used to manage cervical spinal instability, long-term follow-up evaluation of patients with a critical analysis of efficacy and complications has not been reported. The authors have retrospectively analyzed the outcome in 44 consecutive patients (37 males and seven females, a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.3.0341
更新日期:1994-09-01 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: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::A micro-corrosion technique was used to demonstrate an extensive vasa vasorum network in extracranial vessels but did not reveal this system in intracranial vessels of comparable size in three species of animals. The absence of a vasa vasorum network in cerebral vessels may result in a higher level of susceptibility t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.61.1.0044
更新日期:1984-07-01 00:00:00
abstract:OBJECT:The cause and indication for enlargement of chronic subdural hematomas (CSDHs) have remained unresolved. The authors observed a black band on the inner membrane of a CSDH on T2*-weighted magnetic resonance (MR) images obtained in patients with symptoms. After surgical treatment, the band disappeared. The T2*-wei...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.99.5.0824
更新日期:2003-11-01 00:00:00
abstract::A combined radiological and surgical technique that permits identification of appropriate recipient vessels and accurate placement of the atrial catheter in ventriculoatrial shunts is described. The procedure uses readily available radiological skills and reduces operation time and morbidity related to malpositioning ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.1.0140
更新日期:1995-01-01 00:00:00
abstract::The commonest initial computerized tomography (CT) finding in head-injured children is bilateral diffuse cerebral swelling. Cerebral blood flow and CT density studies suggest that this swelling is due to cerebral hyperemia and increased blood volume, not to edema. The clinical history, course, and outcome of 63 childr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.2.0170
更新日期:1981-02-01 00:00:00
abstract::The authors describe a novel approach to the management of high-output heart failure secondary to an intracranial high-flow dural arteriovenous fistula (DAVF) by using extracorporeal membrane oxygenation (ECMO). To the best of the authors' knowledge, this represents the first report of an embolization performed in con...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2004.100.2.0197
更新日期:2004-02-01 00:00:00
abstract::An anatomical study of three microsurgical intraorbital routes to the optic nerve and orbital apex, which can be reached through a fronto-orbital craniotomy, was conducted on cadaver specimens. The structures that could be exposed via the medial, central, or lateral approaches directed through the orbital roof were de...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.1.0078
更新日期:1994-07-01 00:00:00
abstract:Objective:The authors previously described a graded approach to skull base repair following endonasal microscopic or endoscope-assisted tumor surgery. In this paper they review their experience with skull base reconstruction in the endoscopic era. Methods:A retrospective review of a single-institution endonasal endosc...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.11.JNS172141
更新日期:2018-05-11 00:00:00
abstract:OBJECT:The authors report a simple method for bilateral open-door cervical expansive laminoplasty in which hydroxyapatite (HA) spacers are secured by titanium screws. A biomechanical study was also conducted to confirm the strength of the screw fixation. METHODS:A unilateral posterior approach was used to allow preser...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.96.1.0022
更新日期:2002-01-01 00:00:00