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 metastasis, followed by systemic chemotherapy with or without radiotherapy. In 43 patients with tumors located in noneloquent areas, the authors performed microscopic total resections (MTRs) that included tumor cells infiltrating adjacent brain parenchyma, and they pathologically confirmed during surgery that the resection margins were free of tumor cells (MTR group). In 51 patients with lesions in eloquent locations, gross-total resections (GTRs) were performed without the removal of neighboring brain parenchyma (GTR group). The 2 groups were then compared for local recurrence and survival. RESULTS:The MTR group had better local control of the tumor than did the GTR group; 10 (23.3%) of 43 patients in the MTR group and 22 (43.1%) of 51 patients in the GTR group had a local recurrence (p = 0.04). The median time to tumor progression in the MTR group could not be calculated using the Kaplan-Meier method, whereas it was 11.4 months in the GTR group. The 1- and 2-year respective local recurrence rates were 29.1 and 29.1% in the MTR group and 58.6 and 63.2% in the GTR group (p = 0.01). Multivariate analysis showed that the MTR procedure was associated with a decreased risk of local recurrence (p = 0.003). A Cox regression analysis revealed that the hazard ratio for a local recurrence in the MTR group versus the GTR group was 3.14 (95% CI 1.47-6.72, p = 0.003). There was no significant difference in the local recurrence rate between the MTR group without radiotherapy (10 [30.3%] of 33) and the GTR group with postoperative radiotherapy (5 [26.3%] of 19). CONCLUSIONS:The results in this study suggest that MTRs including tumor cells infiltrating adjacent brain parenchyma for a single brain metastasis provide better local tumor control.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Yoo H,Kim YZ,Nam BH,Shin SH,Yang HS,Lee JS,Zo JI,Lee SHdoi
10.3171/2008.8.JNS08448subject
Has Abstractpub_date
2009-04-01 00:00:00pages
730-6issue
4eissn
0022-3085issn
1933-0693journal_volume
110pub_type
杂志文章abstract::The pathophysiology of extracranial traumatic aneurysm formation has not been fully elucidated. Intraarterial optical coherence tomography (OCT), an imaging modality capable of micrometer cross-sectional resolution, was used to evaluate patients presenting with saccular traumatic aneurysms of the internal carotid arte...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.1.JNS142840
更新日期:2016-02-01 00:00:00
abstract::A 6-year-old girl with a history of a nondisplaced skull fracture diagnosed with computerized tomography (CT) scanning 3 years previously presented with a 6-week history of headaches and decreased use of her right side. On admission CT scans, a large cystic mass was identified in the left frontal lobe region of the br...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.2001.95.6.1040
更新日期:2001-12-01 00:00:00
abstract::Between 1975 and 1989, 25 children treated with myelomeningocele closure and shunting for hydrocephalus at the Children's Hospital of Pittsburgh developed progressive lower brain-stem dysfunction from their Chiari malformation. Retrospective univariate and multivariate analyses of these cases were undertaken to assess...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.77.6.0881
更新日期:1992-12-01 00:00:00
abstract::Traumatic acute subdural hematoma remains one of the most lethal of all head injuries. Since 1981, it has been strongly held that the critical factor in overall outcome from acute subdural hematoma is timing of operative intervention for clot removal; those operated on within 4 hours of injury may have mortality rates...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.74.2.0212
更新日期:1991-02-01 00:00:00
abstract::Saccular intracranial aneurysms are a common and often fatal lesion. Whereas surgical treatment of these aneurysms continues to be the gold standard of care, certain situations arise for which surgery may not be the best option. In some of these cases, electrolytically detachable coils have been proven to provide outc...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.86.4.0724
更新日期:1997-04-01 00:00:00
abstract:OBJECT:The severity of neurological impairment following traumatic brain injury (TBI) is exacerbated by several endogenous processes, including hyperglycemia, hypotension, and the generation of glutamate. However, in addition to controlling hyperglycemia, insulin has pleiotropic effects on tissue metabolism, which incl...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.4.JNS10263
更新日期:2011-01-01 00:00:00
abstract::Two patients with fusiform aneurysms and at least one previous subarachnoid hemorrhage were treated by excision of the aneurysms and reconstruction of the arteries. The first case presented with two fusiform aneurysms, the larger of which involved the angular and the smaller one the temporal branch of the left middle ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.2.0272
更新日期:1978-08-01 00:00:00
abstract::Leiomyosarcomas (LMSs) of the central nervous system are extremely rare; however, they are becoming more prevalent in immunocompromised patients. The authors present the cases of two patients with acquired immunodeficiency syndrome: one with LMS of the thoracic vertebral body and the other with LMS originating from th...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.92.4.0688
更新日期:2000-04-01 00:00:00
abstract:OBJECT:The goal of this study was to elucidate the genotype-phenotype relationship in syndromic craniosynostoses by analyzing the mutations of the fibroblast growth factor receptor (FGFR) gene and its clinical manifestations in patients, particularly those in atypical cases. METHODS:Twenty patients with craniosynostos...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2005.102.1.0023
更新日期:2005-01-01 00:00:00
abstract::We are reporting a retrospective study of 62 patients whose head injury was sufficiently severe to cause a high probability of posttraumatic epilepsy. Of 50 patients treated with phenytoin, 10% developed epilepsy of late onset. Twelve patients not treated with phenytoin but who had head injuries of equal magnitude had...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.51.4.0507
更新日期:1979-10-01 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:OBJECT:Aneurysms located on the distal portion of the posterior inferior cerebellar artery (PICA) are uncommon, and their underlying pathology, natural history, and clinical management are poorly understood. To clarify these lesions more fully, the authors undertook a retrospective analysis of the clinical features and...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.4.0756
更新日期:2002-10-01 00:00:00
abstract::The authors report a case of craniopharyngioma in a newborn infant. Marked hydrocephalus of the fetal head was recognized in the pelvimetric roentgenograms of the mother and massive suprasellar calcification was seen in the plain skull films. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.42.1.0091
更新日期:1975-01-01 00:00:00
abstract::The translabyrinthine route or an extension of it was used to remove 150 acoustic nerve tumors. The mortality was 2% and the morbidity low. Preservation of the facial nerve was achieved in 100% of the small and 80% of the medium-sized tumors, but in only 20% of the large growths. The complications encountered are disc...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.52.2.0210
更新日期:1980-02-01 00:00:00
abstract:OBJECT:The authors undertook this study to identify predictors of persistent postoperative seizures in their group of 28 Dutch pediatric and adolescent patients with medically intractable epilepsy who underwent functional hemispherectomy. METHODS:The records of 28 pediatric and adolescent patients who underwent a func...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/PED-07/10/275
更新日期:2007-10-01 00:00:00
abstract::Orbital pseudotumors are inflammatory lesions of the orbit of unknown etiology, which initially mimic an orbital neoplasm. Involvement of the other orbit is uncommon, and extension into the paranasal sinus rare. Intracranial extension of pseudotumor of the orbit is previously unreported. This is a case report of a pat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.3.0625
更新日期:1984-03-01 00:00:00
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 ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.3171/2010.11.JNS10967
更新日期:2011-05-01 00:00:00
abstract::The clinical features, perioperative course, and postoperative outcomes of 144 patients who underwent microsurgical resection of craniopharyngioma were reviewed. Overall, 90% of the tumors were completely resected and 7% recurred. Evaluation of those patients who underwent primary resection revealed much better result...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.73.1.0003
更新日期:1990-07-01 00:00:00
abstract::Intracranial aneurysms in infants are rare, but are associated with a high risk of rupture and subarachnoid hemorrhage. The authors report a case of an incidentally diagnosed, probably congenital, asymptomatic giant aneurysm of the posterior communicating artery in a 9-month-old girl, which completely thrombosed follo...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.1.0184
更新日期:2002-07-01 00:00:00
abstract::OBJECTIVE Meningioma consistency, firmness or softness as it relates to resectability, affects the difficulty of surgery and, to some degree, the extent of resection. Preoperative knowledge of tumor consistency would affect preoperative planning and instrumentation. Several methods of prediction have been proposed, bu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.1.JNS152329
更新日期:2017-01-01 00:00:00
abstract:OBJECT:The effectiveness and safety of radiosurgery for small- to medium-sized cerebral arteriovenous malformations (AVMs) have been well established. However, the management for large cerebral AVMs remains a great challenge to neurosurgeons. In the past 5 years the authors performed preplanned staged radiosurgery to t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/109/12/S11
更新日期:2008-12-01 00:00:00
abstract::The accuracy of high-resolution ultrasound scans in detecting foreign bodies and hemorrhage within the brain was evaluated by comparison with computerized tomography (CT) scans and gross pathology. The test lesions were blood and foreign bodies consisting of bone, wood, and metal placed in the brain of an experimental...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.3.0304
更新日期:1981-03-01 00:00:00
abstract::In contemporary American culture, the term "brain surgeon" conjures up the image of an intensely single-minded professional, who deals with terribly complex matters of life and death. These descriptors find their personification in Harvey Cushing, because they are derived directly from him. This hypothesis was tested ...
journal_title:Journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.3171/jns.1991.75.5.0808
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVE:Two-session Gamma Knife surgery (GKS) has recently been demonstrated to be an effective and less-invasive alternative for large brain metastases not treatable by microsurgical resection. This raises the clinical question of whether the 2-session GKS strategy further improves treatment outcomes for patients wi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.7.JNS191193
更新日期:2019-10-18 00:00:00
abstract::We have operated on 12 of 14 cases of arteriovenous malformation (AVM) in the posterior fossa since 1968, with one death. The lesions were in the cerebellum in 10 cases (three anteromedial, one central, three lateral, and three posteromedial), and in the cerebellopontine angle in two; in two cases the lesions were dir...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.1.0050
更新日期:1977-07-01 00:00:00
abstract::The authors present a case of acoustic neuroma associated with spontaneous hemorrhage. The sudden onset of new symptoms was noted and appears to be common to all such cases. The computerized tomography appearance of the mass underwent changes consistent with the clinical, surgical, and pathological findings. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1982.56.3.0417
更新日期:1982-03-01 00:00:00
abstract::The radiographic features and long-term clinical outcome in three patients who presented at birth with a cystic suboccipital mass in direct communication with the fourth ventricle are reviewed. The pathological findings in a fourth infant who died are also discussed. All surviving infants were treated with cyst excisi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.61.2.0348
更新日期:1984-08-01 00:00:00
abstract::Liposomes have a variety of attributes as a drug delivery system. Targeting of liposomes to specific cells has been investigated by using appropriate cytophilic ligands such as monoclonal antibodies (MAb's). In the present study, liposomes with selective cytotoxicity toward glioma cells were obtained. An MAb which rea...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.71.3.0382
更新日期:1989-09-01 00:00:00
abstract::The anterior condylar confluence (ACC) is located on the external orifice of the canal of the hypoglossal nerve and provides multiple connections with the dural venous sinuses of the posterior fossa, internal jugular vein, and the vertebral venous plexus. Dural arteriovenous fistulas (DAVFs) of the ACC and hypoglossal...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/109/8/0335
更新日期:2008-08-01 00:00:00
abstract::Metrizamide computerized tomographic cisternography (MCTC) has proved 100% successful in documenting the precise anatomic location of the dural osseous defect in three patients with sphenoethmoidal rhinorrhea. In each patient, direct surgical approach to the site indicated by MCTC terminated the leakage in a single pr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.2.0222
更新日期:1980-08-01 00:00:00