Abstract：
OBJECT:Although nucleus ventralis intermedius stimulation has been shown to be safe and efficacious in the treatment of essential tremor, there is a subset of patients who eventually lose benefit from their stimulation. Proposed causes for this phenomenon include tolerance, disease progression, and suboptimal location. The goal of this study was to assess the factors that may lead to both stimulation failure, defined as loss of meaningful tremor relief, and less satisfactory outcomes, defined as leads requiring voltages>3.6 V for effective tremor control. METHODS:The authors present their clinical outcomes from 31 leads in 27 patients who had effective tremor control for >1 year following nucleus ventralis intermedius stimulation. All patients postoperatively had a mean decrease in both the writing and drawing subscales of the Fahn-Tolosa-Marin Tremor Rating Scale (p<0.001). RESULTS:After a mean follow-up of 40 months, 22 patients continued to have tremor control with stimulation. Four patients eventually lost efficacy of their stimulation at a mean of 39 months. There was no difference in age, duration of disease, or disease severity between the groups. Examination of perioperative factors revealed that suboptimal anteroposterior positioning as evidenced on intraoperative fluoroscopy occurred significantly more frequently in patients with stimulation failure (p=0.018). In patients with less satisfactory outcomes, no difference was seen between group demographics. Fluoroscopy again revealed suboptimal positioning more frequently in these patients (p=0.005). CONCLUSIONS:This study provides further evidence that suboptimal lead position in combination with disease progression or tolerance may result in less satisfactory long-term outcomes.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Pilitsis JG,Metman LV,Toleikis JR,Hughes LE,Sani SB,Bakay RAdoi
10.3171/JNS/2008/109/10/0640subject
Has Abstractpub_date
2008-10-01 00:00:00pages
640-6issue
4eissn
0022-3085issn
1933-0693journal_volume
109pub_type
杂志文章abstract：:The potential role of iron in cerebral vasospasm was examined in the rat femoral artery model by the perivascular application of deferoxamine, a ferric ion chelator and antioxidant. In 25 rats, platelet-rich plasma or fresh autologous whole blood containing deferoxamine at concentrations of 1, 5, 10, or 15 mg/ml was a...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1992.77.5.0763
更新日期：1992-11-01 00:00:00
abstract：OBJECT:In this study the authors investigated the relationship between variations in the circle of Willis observed on magnetic resonance (MR) angiograms and locations of cerebral aneurysms, and evaluated the risk of aneurysm formation. METHODS:One hundred thirty-one patients with cerebral aneurysms were retrospectivel...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.2002.96.4.0697
更新日期：2002-04-01 00:00:00
abstract：:The potential efficacy of early repeat transsphenoidal surgery for persistent Cushing's disease has not previously been examined. On 222 patients with no prior pituitary treatment and a preoperative diagnosis of Cushing's disease, 29 (13%) remained hypercortisolemic after an initial transsphenoidal pituitary explorati...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1994.80.1.0037
更新日期：1994-01-01 00:00:00
abstract：:Calcified cervical intervertebral discs in children are manifestations of an uncommon, distinct disease of unknown cause. Acute symptoms are usually followed by a benign course of spontaneous recovery, frequently culminating in resorption of the calcium. Rarely herniation of the disc may cause neurological complicatio...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1977.46.2.0233
更新日期：1977-02-01 00:00:00
abstract：:The application of several recent advances in cell biology, brain implantation, and cell-mediated tumor immunotherapy requires successful and reproducible placement of viable cell suspensions into brain. Stereotaxic implantation is being used to inject cytotoxic lymphocytes into gliomas and to replace dopaminergic cel...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1988.69.2.0228
更新日期：1988-08-01 00:00:00
abstract：OBJECT:Despite the increasing use of immunotherapy in the treatment of metastatic melanoma, the effects of this therapy on the management of patients with associated brain metastases are not completely defined. The authors undertook this study to determine the effectiveness of resection and the effects of immunotherapy...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/2011.3.JNS091107
更新日期：2011-07-01 00:00:00
abstract：:OBJECTIVE Different surgical routes have been used over the years to achieve adequate decompression of the optic nerve in its canal including, more recently, endoscopic approaches performed either through the endonasal corridor or the transorbital one. The present study aimed to detail and quantify the amount of bone ...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/2016.8.JNS16566
更新日期：2017-07-01 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：OBJECT:Frameless stereotactic biopsy has been shown in multiple studies to be a safe and effective tool for the diagnosis of brain lesions. However, no study has directly evaluated its safety in lesions located in eloquent regions in comparison with noneloquent locations. In this study, the authors determine whether an...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/2009.3.JNS081695
更新日期：2009-10-01 00:00:00
abstract：:A variety of agents have been used to coat aneurysms as an alternative to clipping. These agents were employed more frequently prior to the routine use of the operating microscope and the presently available variety of aneurysm clips. One such coating agent is methyl methacrylate. This report describes a patient with ...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1991.75.2.0305
更新日期：1991-08-01 00:00:00
abstract：:The authors describe the clinical behavior of eight patients with cerebral astrocytomas, in whom computerized tomography (CT) or magnetic resonance (MR) imaging of the brain was characterized by diffuse bilateral cerebral hemisphere tissue density abnormalities and minimal focal mass effect. Five patients were newly d...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1994.81.6.0817
更新日期：1994-12-01 00:00:00
abstract：OBJECT:Chordomas have a high propensity for local recurrence and progression, as well as for systemic and cerebrospinal fluid metastasis. The authors identified and analyzed a series of patients with chordomas, focusing on an underrecognized pathological entity-surgical seeding of tumor cells. METHODS:In a retrospecti...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.2001.95.5.0798
更新日期：2001-11-01 00:00:00
abstract：:One hundred and one fiberoptic pressure transducers (59 subdural and 42 ventricular) were studied in 86 patients (some in whom more than one device had been inserted). Only four complications occurred: two transient cerebrospinal fluid leaks after removal and two clinically insignificant intracerebral hematomas. No in...
journal_title：Journal of neurosurgery
pub_type： 临床试验,杂志文章
doi：10.3171/jns.1997.86.6.0927
更新日期：1997-06-01 00:00:00
abstract：OBJECT:It is known that the spinal cord can sustain traumatic injury without associated injury of the spinal column in some conditions, such as a flexible spinal column or preexisting narrowed spinal canal. The purpose of this study was to characterize the clinical features and to understand the mechanisms in cases of ...
journal_title：Journal of neurosurgery
pub_type： 评论,信件
doi：
更新日期：2001-04-01 00:00:00
abstract：:In clinical follow-up studies after radiosurgery, imaging modalities such as computerized tomography (CT) and magnetic resonance (MR) imaging are used. Accurate determination of the residual lesion volume is necessary for realistic assessment of the effects of treatment. Usually, the diameters rather than the volume o...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.2000.93.supplement
更新日期：2000-12-01 00:00:00
abstract：:In this report, the authors describe three patients with malignant gliomas who experienced paroxysmal neurological symptoms triggered by standing. The symptoms were attributed to acute elevations of intracranial pressure, an uncommon phenomenon called "plateau waves." In each instance, the attacks occurred despite the...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.2002.97.1.0224
更新日期：2002-07-01 00:00:00
abstract：:Overexpression of vascular endothelial growth factor (VEGF) is associated with several central nervous system (CNS) diseases and abnormalities, and is often postulated as a causative factor and promising therapeutic target in these settings. The authors' goal was to reassess the contribution of VEGF to the biology and...
journal_title：Journal of neurosurgery
pub_type： 杂志文章,评审
doi：10.3171/jns.2005.103.5.0853
更新日期：2005-11-01 00:00:00
abstract：:Leukotrienes derive from arachidonic acid metabolism via the lipoxygenase pathway and modulate several cellular events. In the central nervous system, leukotrienes are mainly synthesized in the gray matter and in vascular tissues. Their production is enhanced in ischemic conditions and in experimental subarachnoid hem...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1988.69.4.0488
更新日期：1988-10-01 00:00:00
abstract：:Seven patients with spasticity of spinal cord origin have been maintained for up to 2 years with continuous spinal intrathecal infusion of baclofen. Prior to treatment, all of the patients had severe rigidity in their lower limbs and most had frequent and extensive spontaneous spasms, all of which greatly interfered w...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1987.66.2.0181
更新日期：1987-02-01 00:00:00
abstract：OBJECT:The Wilms tumor 1 (WT1) protein-a developmentally regulated transcription factor-is aberrantly expressed in gliomas and promotes their malignant phenotype. However, little is known about the molecular allies that help it mediate its oncogenic functions in glioma cells. METHODS:The authors used short interfering...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/2011.11.JNS111455
更新日期：2012-04-01 00:00:00
abstract：:In most cases of deep venous sinus thrombosis, systemic anticoagulation represents the initial treatment of choice for preventing propagation of a clot in the dural sinuses. In patients with deep or extensive venous sinus thrombosis, a combination of treatment modalities may be required including systemic anticoagulat...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.2005.103.2.0368
更新日期：2005-08-01 00:00:00
abstract：OBJECT:Acute subdural hematomas (SDHs) impart serious morbidity and mortality on the elderly population, with only 5% of those older than 65 years of age attaining functional independence. Despite its widespread use, oral antithrombotic therapy (OAT) in the context of acute SDH has not been extensively studied. The aut...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/2010.7.JNS10446
更新日期：2011-01-01 00:00:00
abstract：OBJECT:The authors characterized the clinical course of tectal plate lesions in a group of pediatric patients to identify the prognostic factors at presentation that predict progression, in an attempt to differentiate tectal hamartomas from tumors. METHODS:A retrospective review was conducted of the management of tect...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/ped.2006.104.6.369
更新日期：2006-06-01 00:00:00
abstract：OBJECT:Cellular density is a major factor for change in the apparent diffusion coefficient (ADC). The authors hypothesized that loss of tumor cells after Gamma Knife surgery (GKS) may alter the ADC value and used diffusion weighted MR imaging (DW imaging) to evaluate cellular changes in brain tumors to detect their tre...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：
更新日期：2010-12-01 00:00:00
abstract：:The authors present the case of an intraneural ganglion cyst of the peroneal nerve. The cyst was diagnosed by means of ultrasound, which also gave an exact definition of its size and location, confirmed at operation. Some controversial aspects of these lesions are discussed. ...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1992.76.3.0538
更新日期：1992-03-01 00:00:00
abstract：:A modification of the transseptal, transsphenoidal appraoch to the sella turcica is described; it consists of a unilateral separation of the nasal mucosa from the nasal septum. Experience with the technique in 215 cases has indicated that it is a useful, practical appraoch. The advantages are that the septum is spared...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1978.49.1.0138
更新日期：1978-07-01 00:00:00
abstract：:The magnetic resonance longitudinal relaxation time (T1) and transverse relaxation time (T2) of the water proton of the periventricular white and cortical gray matter were measured for 17 control patients and 21 patients with suspected normal-pressure hydrocephalus (NPH). Of the latter group, 14 showed good response t...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1990.73.6.0864
更新日期：1990-12-01 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：:A method of lateral orbital rim advancement is described for periorbital deformities associated with coronal and metopic synostosis in infants. The technique offers the advantages of a smooth lateral rim contour and improvement in accompanying malar recession. In 13 patients with follow-up periods of up to 2 years fol...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1990.72.1.0022
更新日期：1990-01-01 00:00:00
abstract：OBJECTIVE:Herein, the authors report their experience with intraoperative stimulation mapping to locate the descending subcortical motor pathways in patients undergoing surgery for hemispheric gliomas within or adjacent to the rolandic cortex, with particular description of the morbidity and functional outcomes associa...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/2018.3.JNS172494
更新日期：2018-08-17 00:00:00
