Abstract:
OBJECTIVE:Gamma knife surgery (GKS) has become established as a minimally invasive treatment modality for patients with vestibular schwannomas. Treatment failure and/or tumor regrowth, however, is occasionally encountered, and microsurgical resection is usually warranted in such cases. The role of repeat GKS in these situations is still unclear. The goal of this study was to investigate whether repeat GKS is an effective treatment for recurrent vestibular schwannomas and to assess the conservation of residual neurological function. METHODS:Between July 1992 and December 2007, 1951 patients harboring a unilateral vestibular schwannoma were treated with GKS. Of these, 48 patients (2.5%) had to undergo a subsequent intervention because of progression or regrowth of the tumor. Repeat GKS was performed in a total of 15 patients, 8 of whom had more than 2 years of follow-up and were eligible to be enrolled in the present study. The median follow-up period after repeat GKS was 64 months, and the median interval between these interventions was 46 months. The median tumor volume was 0.51 and 1.28 mL at the initial and second GKS treatments, respectively. Patients received a median prescription dose of 12.0 Gy at both interventions. RESULTS:We report no cases of failure. Six patients demonstrated a significant reduction in tumor volume. In 1 patient, the final tumor volume was less than the initial volume. The other 2 patients showed stabilization of tumor growth. Useful hearing ability was preserved in only 1 of the 3 patients who had serviceable hearing ability at the time of the second GKS. Neither aggravation of facial nerve dysfunction nor other neurological deficits secondary to GKS were observed. CONCLUSION:This is the first report to address repeat GKS for vestibular schwannomas. After long-term follow-up, repeat GKS with a low marginal dose seems to be a safe and effective treatment in selected patients harboring regrowth of small vestibular schwannomas that have previously been treated with GKS.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Yomo S,Arkha Y,Delsanti C,Roche PH,Thomassin JM,Régis Jdoi
10.1227/01.NEU.0000327692.74477.D5subject
Has Abstractpub_date
2009-01-01 00:00:00pages
48-54; discussion 54-5issue
1eissn
0148-396Xissn
1524-4040journal_volume
64pub_type
杂志文章相关文献
NEUROSURGERY文献大全abstract::Intravenously enhanced computed tomography (CT) was used in patients in whom the differential diagnosis between recurrent herniated disc and postoperative scar was considered. Enhanced CT images demonstrated postoperative herniated discs more accurately than clinical criteria, myelography, or plain or postmetrizamide ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198702000-00018
更新日期:1987-02-01 00:00:00
abstract:OBJECTIVE:Most of the endoscopes used for endonasal transsphenoidal surgery use 4-mm diameter lenses. The applicability of a newly developed neuroendoscope with a lens diameter of only 2 mm was tested in endonasal transsphenoidal pituitary surgery. METHODS:The newly developed rigid-rod neuroendoscope with a 2-mm lens ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000255381.64969.C8
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Surgery for tumors in eloquent brain faces immense challenges when attempting to maximize resection and avoid neurological deficits. OBJECTIVE:In order to give the surgeon real-time atlas-based anatomic information linked to the patient's anatomy, we developed a software-based interface between deformable a...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000199
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:Internal carotid artery (ICA) injury during sellar dural opening is a potentially catastrophic complication of transsphenoidal surgery. We describe two ICA injuries that occurred early in our endonasal transsphenoidal experience. We then describe our subsequent protocol to prevent this complication in which w...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000255408.84269.A8
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Capillary telangiectasias, cavernous malformations, and developmental venous anomalies are all vascular malformations that occur on the capillary-venous side of the cerebral circulation. The associations of capillary telangiectasias with venous malformations, cavernous malformations with venous...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200111000-00044
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVE:To determine the understanding of the conceptual basis and diagnostic tests used for brain death (BD) by neurosurgeons in Canada. METHODS:Between February and June 2006, a previously developed survey was mailed to every neurosurgeon in Canada. RESULTS:Of 223 surveys mailed, 147 (66%) were returned; of these...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000303200.84994.ae
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Xanthogranulomas involving the central or peripheral nervous system are extraordinarily rare. None have been reported in the lower extremity. Here, we report and characterize the first case of xanthogranuloma of the sciatic nerve. CLINICAL PRESENTATION:A 58-year-old woman presented with poorly...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVE:Free-hand insertion of an external ventricular drain (EVD) is a common emergency neurosurgical procedure, mostly performed for critically ill patients. Although EVD complications have been studied thoroughly, the accuracy of EVD positioning has been audited only occasionally. METHODS:Post-EVD insertion compu...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000356973.39913.0B
更新日期:2009-12-01 00:00:00
abstract::Hemorrhagic infarction after vasospasm is a rare condition in patients with aneurysmal subarachnoid hemorrhage (SAH). Induced hypertensive therapy is used for patients with vasospasm, but this treatment has a risk of inducing hemorrhagic infarction. A total of 221 patients whose first computed tomographic (CT) scans w...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198604000-00004
更新日期:1986-04-01 00:00:00
abstract:OBJECTIVE:To analyze the incidence and impact of an intracerebral hematoma (ICH) on treatment and outcome in patients with aneurysmal subarachnoid hemorrhage. METHODS:Data of 585 consecutive patients with subarachnoid hemorrhage from June 1999 to December 2005 were prospectively entered in a database. ICH was diagnose...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000335170.76722.B9
更新日期:2008-12-01 00:00:00
abstract::Stereo depth electroencephalography (EEG) is of proven benefit in lateralizing and localizing seizure origin in select cases of epilepsy. There are potential hazards and technical considerations inherent with depth EEG, however, that have limited the general applicability of this technique. A new depth EEG electrode w...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198305000-00015
更新日期:1983-05-01 00:00:00
abstract:OBJECTIVE:To physiologically repair damaged neural circuitry using neural transplantation, the donor cells must be able to differentiate into the optimal type and number of neurons for the host brain environment. They must also be capable of functional regulation by the host brain. These features are important to optim...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000351281.45986.76
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:The surgical strategies and outcomes for 70 patients operated on for tuberculum sellae meningioma were analyzed retrospectively. The analysis was based on factors that probably determined the difficulties encountered during surgery, assisted in predicting the extent of resectability, and helped in predicting ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:Frequently, the cervicothoracic junction can be reached through a simple anterior approach. In some cases, access to this region requires a much more aggressive surgical intervention, such as manubriotomy or sternotomy. Information regarding the need for such interventions is particularly useful to have preop...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000347472.07670.EB
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Several studies have demonstrated that omitting the routine use of adjuvant whole-brain radiation therapy for patients with newly diagnosed brain metastases may be a reasonable first-line strategy. Retrospective evidence suggests that fractionated stereotactic radiotherapy (fSRT) may have a lower level of to...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000325
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:We present three cases of endolymphatic sac tumors and review the previously published cases. Despite frequent extension to the cerebellopontine angle, these rare tumors have only recently been recognized by neurosurgeons. CLINICAL PRESENTATION:A 26-year-old man developed a progressive hearing...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1097/00006123-199804000-00139
更新日期:1998-04-01 00:00:00
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
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND AND IMPORTANCE:Flow diversion with the pipeline embolization device (PED) is an emerging endovascular technology allowing curative embolization of very large and giant intracranial aneurysms. Many patients with these complex aneurysms are older. The presence of a tortuous type III aortic arch reduces the cha...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e31827e0d67
更新日期:2013-09-01 00:00:00
abstract::Even though neurosurgeons exercise these enormous and versatile skills, the COVID-19 pandemic has shaken the fabrics of the global neurosurgical family, jeopardizing human lives, and forcing the entire world to be locked down. We stand on the shoulders of the giants and will not forget their examples and their teachin...
journal_title:Neurosurgery
pub_type: 历史文章,杂志文章
doi:10.1093/neuros/nyaa314
更新日期:2020-09-15 00:00:00
abstract::In the May 2009 issue of The Lancet Neurology, the 5-year follow-up results of the International Subarachnoid Aneurysm Trial (ISAT) were published. The authors concluded that, although the significant difference between coiling and neurosurgical clipping of ruptured intracranial aneurysms in terms of death and severe ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000368152.67151.73
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:To study the biomechanical behavior of lumbar interbody instrumentation techniques using titanium cages as either transforaminal lumbar interbody fusion (TLIF) or anterior lumbar interbody fusion (ALIF), with and without posterior pedicle fixation. METHODS:Six fresh-frozen lumbar spines (L1-L5) were loaded w...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000245609.01732.E4
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Preoperative diffusion tensor imaging (DTI) is used to demonstrate corticospinal tract (CST) position. Intraoperative brain shifts may limit preoperative DTI value, and studies characterizing such shifts are lacking. OBJECTIVE:To examine tumor characteristics that could predict intraoperative shift in tumor...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000338
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:Neurophysiological intraoperative monitoring of the glossopharyngeal nerve has been performed only with needle electrodes inserted into the pharyngeal muscles or soft palate. We describe a noninvasive method of monitoring this cranial nerve. METHODS:A 30-year-old man who presented with headache, as well as s...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000316425.21752.E2
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Desmoplastic infantile gangliogliomas (DIGs) are extremely rare tumors that respond well to treatment. However, their biological behavior remains to be clarified. We describe two patients whose DIGs spontaneously regressed after surgery, without adjuvant therapy. CLINICAL PRESENTATION:A 9-mont...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/01.neu.0000084165.60662.6d
更新日期:2003-10-01 00:00:00
abstract:Background:Blister aneurysms of the supraclinoid internal carotid artery (ICA) are challenging lesions with high intraoperative rupture rates and significant morbidity. An optimal treatment strategy for these aneurysms has not been established. Objective:To analyze treatment strategy, operative techniques, and outcome...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000001259
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Neurofibromas are benign neural sheath tumors arising from intraneural supporting cells. Such tumors are characteristic of neurofibromatosis Type I (von Recklinghausen disease) but also occur sporadically. Vascular involvement by neurofibromata is rare, but has been described in the past in the...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000210293.67328.A7
更新日期:2006-05-01 00:00:00
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
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:Fourth ventricular neurocysticercosis (FVNCC) usually presents with obstructive hydrocephalus. Available treatment options are medical, external cerebrospinal fluid diversion, microsurgical, or endoscopic removal alone or in combination. We present our experience of transaqueductal removal of FVNCC by angiogr...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000255382.72593.81
更新日期:2007-04-01 00:00:00
abstract::This study retrospectively and prospectively analyzes uncomplicated, noninfected, primary ventriculoperitoneal shunting procedures and ventriculoperitoneal shunt revisions in children done at the University of Wisconsin Hospital from July 1973 to December 1979. We compared the infection rates between patients whose pr...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198107000-00002
更新日期:1981-07-01 00:00:00
abstract::Intervertebral disc space infection can be a serious and disabling complication of any procedure that affords entry for bacteria into the susceptible disc space. Most disc space infections occur after cervical or lumbar laminectomies. Discitis has been reported after myelography, lumbar puncture, paravertebral injecti...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198605000-00017
更新日期:1986-05-01 00:00:00