Abstract:
OBJECT:A typical finding in supraclavicular exploration of infants with severe obstetric brachial plexus lesions (OBPLs) is a neuroma-in-continuity with the superior trunk and/or a root avulsion at C-5, C-6, or C-7. The operative strategy in these cases is determined by the intraoperative assessment of the severity of the lesion. Intraoperative nerve action potential (NAP) and evoked compound motor action potential (CMAP) recordings have been shown to be helpful diagnostic tools in adults, whereas their value in the intraoperative assessment of infants with OBPLs remains to be determined. METHODS:Intraoperative NAPs and CMAPs were systematically recorded from damaged and normal nerves of the upper brachial plexus in a consecutive series of 95 infants (mean age 175 days) with OBPLs. A total of 599 intraoperative NAP and 836 CMAP recordings were analyzed. The severity of the nerve lesions was graded as normal, axonotmesis, neurotmesis, or root avulsion, based on surgical, clinical, histological, and radiographic criteria. RESULTS:The correlation of NAP and CMAP recordings with the severity of the lesion was assessed. The specificity of an absent NAP or CMAP to predict a severe lesion (neurotmesis or avulsion) was > 0.9. However, the sensitivity of an absent NAP or CMAP for predicting a severe lesion was low (typically < 0.3). The severity of the nerve lesion was related to CMAP and NAP amplitudes. Cutoff points useful for intraoperative decision making could not be found to differentiate between lesion types in individual patients. CONCLUSIONS:Intraoperative NAP and CMAP recordings do not assist in decision making in the surgical treatment of infants with OBPLs. The authors' findings in infants cannot be generalized to adults.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Pondaag W,van der Veken LP,van Someren PJ,van Dijk JG,Malessy MJdoi
10.3171/JNS/2008/109/11/0946subject
Has Abstractpub_date
2008-11-01 00:00:00pages
946-54issue
5eissn
0022-3085issn
1933-0693journal_volume
109pub_type
杂志文章abstract:OBJECT:Peripheral nerve injury in a limb usually causes intrahemispheric functional reorganization of the contralateral motor cortex. Recently, evidence has been emerging for significant interhemispheric cortical plasticity in humans, mostly from studies of direct cortical damage. However, in this study, a long-range i...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.1.JNS09448
更新日期:2010-07-01 00:00:00
abstract::The authors have analyzed retrospectively a series of 288 consecutive patients with severe head injury observed between January, 1977, and May, 1980. Seventy-three patients were excluded as not being compatible with those of the International Data Bank. The remaining 215 patients complied with the definition of coma g...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1982.57.6.0779
更新日期:1982-12-01 00:00:00
abstract:OBJECT:Spontaneous spinal cerebrospinal fluid (CSF) leakage with development of the intracranial hypotension syndrome and acquired Chiari I malformation due to lumbar spinal CSF diversion procedures have both been well described. However, concomitant presentation of both syndromes has rarely been reported. The object o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.88.2.0237
更新日期:1998-02-01 00:00:00
abstract:OBJECT:Noninvasive neuroimaging techniques are increasingly identifying unruptured intracranial arterial dissections (IADs) at examination for headache or ischemic symptoms. Approximately 3% of cases of aneurysmal subarachnoid hemorrhage (SAH) are caused by IADs in Japan, but the natural history of unruptured IADs is n...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.9.JNS10668
更新日期:2011-04-01 00:00:00
abstract::In this study of 110 cranial cavities from adult cadavers, the superior sagittal sinus was found to divide into two channels. In most cases, the division was associated with a dural partition. Essentially, the variations as observed in this study could be grouped into three types: Type 1 includes those specimens in wh...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.1.0090
更新日期:1985-01-01 00:00:00
abstract:OBJECT:A visual field deficit resulting from the management of an arteriovenous malformation (AVM) significantly impacts a patient's quality of life. The present study was designed to investigate the clinical and radiological outcomes of stereotactic radiosurgery (SRS) performed for AVMs involving the postgeniculate vi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.10.JNS1453
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:The optimal margin size in postoperative stereotactic radiosurgery (SRS) for brain metastases is unknown. Herein, the authors investigated the effect of SRS planning target volume (PTV) margin on local recurrence and symptomatic radiation necrosis postoperatively. METHODS:Records of patients who received pos...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.9.JNS171735
更新日期:2018-04-20 00:00:00
abstract::Microvascular end-to-end anastomoses of rat common carotid arteries measuring 0.6 to 0.7 mm in diameter were performed using an argon surgical laser system. Vascular bonding with the argon laser was accomplished in all cases. The anastomosed carotid artery segments were evaluated both angiographically and histological...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.5.0771
更新日期:1985-11-01 00:00:00
abstract::The authors report a case of subarachnoid hemorrhage in an 11-month-old infant with tragic outcome. Radiological investigation showed an anterior communicating aneurysm, and postmortem examination confirmed the aneurysm to be a so-called "berry" aneurysm. There were also typical signs of fibromuscular hyperplasia of t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.5.0756
更新日期:1978-11-01 00:00:00
abstract:OBJECT:Surgeries for CNS tumors are frequently performed by general neurosurgeons and by those who specialize in surgical neurooncology. Subspecialization in neurosurgical practice has become common and may improve patient morbidity and mortality rates. However, the potential benefits for patients of having their surge...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.10.JNS132057
更新日期:2015-02-01 00:00:00
abstract:OBJECT:Onyx, an ethylene-vinyl alcohol copolymer mixed in a dimethyl sulfoxide solvent, is currently one of the most widely used liquid materials for embolization of intracranial arteriovenous malformations (AVMs). The goal of this study was to define the risks and benefits of stereotactic radiosurgery (SRS) for patien...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.12.JNS141437
更新日期:2015-07-01 00:00:00
abstract::Cushing's experience with the surgical treatment of pituitary adenomas and other lesions producing the chiasmal syndrome is reviewed. The conclusion is that his ultimate rejection of the transsphenoidal route was not due to his dissatisfaction with this procedure, but rather came about because of the transfrontal rout...
journal_title:Journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.3171/jns.1981.54.4.0448
更新日期:1981-04-01 00:00:00
abstract::Spinal epidural hematomas (SEHs) are uncommon complications of traumatic injury to the spine. Emergency surgical evacuation is the standard treatment. Although it is recognized in the literature, the possibility of nonsurgical treatment of traumatic SEH is far from being codified. The authors report excellent outcomes...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.1999.91.1.0128
更新日期:1999-07-01 00:00:00
abstract::The lateral extracavitary approach to the spine was used for resection of displaced bpne and disc located anterior to the dura in 62 patients with traumatic lesions of the thoracic and lumbar spine. Fifty-two patients had closed vertebral fractures and 10 had gunshot wounds. The spinal cord was involved in 44 patients...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.45.6.0628
更新日期:1976-12-01 00:00:00
abstract::OBJECTIVE Outpatient craniotomy has many advantages to the psychological and physical well-being of patients, as well as benefits to the health care system. Its efficacy and safety have been well demonstrated, but barriers to its widespread adoption remain. Among the challenges is a perception that its application is ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.11.JNS152151
更新日期:2016-11-01 00:00:00
abstract::Meningiomas have been reported to have associated areas of surrounding low density on computerized tomography (CT). These low-density areas may represent edema, widened subarachnoid spaces, loculated cerebrospinal fluid, demyelination, or adjacent tumor. Two cases are presented in which this adjacent area of low densi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.1.0103
更新日期:1979-01-01 00:00:00
abstract::In this paper, the authors describe the history of neurosurgery at St. Michael's Hospital, University of Toronto. St. Michael's has long been regarded as one of the top teaching and research hospitals in Canada. A detailed literature review of published and unpublished works was performed to formulate a succinct but i...
journal_title:Journal of neurosurgery
pub_type: 历史文章,杂志文章
doi:10.3171/2016.9.JNS161119
更新日期:2017-12-01 00:00:00
abstract::Subependymomas of the fourth ventricle are generally considered incidental postmortem findings, and have received scant attention from neurosurgeons. The authors present a surgical series of 12 cases of this disorder diagnosed over a 13-year period. The clinical and radiological findings were reviewed and correlations...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.4.0508
更新日期:1985-04-01 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::OBJECTIVE Mineralized or desiccated colloid cysts pose some unique challenges to endoscopic removal. The extrusion of the solid matrix into the intraventricular compartment has not been previously reported and, as such, no guidance exists regarding its predilection, prevention, and fate. METHODS Postoperative imaging ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.6.JNS142676
更新日期:2016-09-01 00:00:00
abstract::OBJECT Spontaneous intracranial hypotension is an increasingly recognized cause of headaches. Pituitary enlargement and brain sagging are common findings on MRI in patients with this disorder. The authors therefore investigated pituitary function in patients with spontaneous intracranial hypotension. METHODS Pituitary...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.9.JNS132687
更新日期:2015-05-01 00:00:00
abstract::Activated leukocytes appear to be directly involved in potentiating ischemic central nervous system (CNS) injury. Adhesion of leukocytes to endothelium is essential for their migration and requires the binding of adhesion receptors of the leukocyte (CD 18) to an intercellular adhesion molecule (ICAM) on endothelium. M...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.75.4.0623
更新日期:1991-10-01 00:00:00
abstract:OBJECT:Renal cell carcinoma (RCC) is an aggressive malignancy that frequently metastasizes. When RCC metastasizes to the spine, significant pain and neurological dysfunction often follow. Because systemic therapy and radiotherapy have a limited effect in controlling spinal disease, surgery is frequently required; howev...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2001.94.1.0018
更新日期:2001-01-01 00:00:00
abstract::The authors' initial experience with the endoscopic extradural supraorbital approach to the temporal pole and adjacent area is reported. Fully endoscopic surgery using the extradural space via a supraorbital keyhole was performed for tumors in or around the temporal pole, including temporal pole cavernous angioma, sph...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.3.JNS162228
更新日期:2018-06-01 00:00:00
abstract::Procedures for relief of coronal synostosis and metopic synostosis have resulted in some undesirable sequelae. The authors present combined neurological and plastic surgical modifications to prevent additional synostoses, forehead ridging, and lateral orbital wall step-off. They recommend bifrontal craniotomy with lat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.2.0245
更新日期:1983-08-01 00:00:00
abstract:OBJECT:The activity of gamma-aminobutyric acid (GABA), the principal inhibitory neurotransmitter, is reduced in the hippocampus in patients with complex partial seizures from mesial temporal sclerosis. To provide preliminary safety and distribution data on using convection-enhanced delivery of agents to treat complex p...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.103.6.1035
更新日期:2005-12-01 00:00:00
abstract:OBJECT:A classification is proposed to organize anterior cranial base fractures systematically according to their location and size. The goal of this study was to determine whether these two variables, irrespective of cerebrospinal fluid (CSF) rhinorrhea, are related to the long-term risk of posttraumatic meningitis an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.88.3.0471
更新日期:1998-03-01 00:00:00
abstract::Monitoring of cerebral oxygenation is considered to be of great importance in minimizing secondary hypoxic and ischemic brain damage following severe head injury. Although the threshold for cerebral hypoxia in jugular bulb oximetry (measurement of O2 saturation in the jugular vein (SjvO2)) is generally accepted to be ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.5.0751
更新日期:1996-11-01 00:00:00
abstract:OBJECT:Thymosin β4 (Tβ4) is a regenerative multifunctional peptide. The aim of this study was to test the hypothesis that Tβ4 treatment initiated 6 hours postinjury reduces brain damage and improves functional recovery in rats subjected to traumatic brain injury (TBI). METHODS:Traumatic brain injury was induced by con...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.1.JNS111729
更新日期:2012-05-01 00:00:00
abstract:OBJECT:The majority of sinonasal malignancies present with advanced disease, and cure rates are generally poor. Surgical extirpation remains the mainstay of treatment. In cases of sinonasal malignancy with orbital apex extension, gross-total tumor resection requires orbital exenteration and bony skull base resection ar...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.9.JNS141256
更新日期:2015-07-01 00:00:00