Abstract:
:The authors report the neuroimaging features, treatment planning, and outcome in a case of radiosurgical thalamotomy targeting the centromedian nucleus (CMN) for stroke-induced thalamic pain. A 79-year-old man, with embolic occlusion of the left middle cerebral artery and large hemispheric infarction involving the thalamus, suffered a right hemiplegia and expressive aphasia. One year poststroke, severe right-sided facial, scalp, arm, and trunk pain developed and was exacerbated by any tactile contact. Medical treatment had failed. Medical illness, including mandatory anticoagulation therapy for atrial fibrillation, precluded surgical procedures. Minimally invasive radiosurgery was offered as an alternative. Magnetic resonance imaging and computed tomography were used to localize the left CMN. A single shot of 140 Gy was delivered to the 100% isodose line by using the 4-mm collimator helmet. The patient was evaluated at regular intervals. By 12 weeks posttreatment, he had significant improvements in pain control and his ability to tolerate physical contact during activities of daily living. Magnetic resonance imaging demonstrated baseline encephalomalacia from his prior stroke, and signal changes in the left CMN consistent with gamma irradiation-based thalamotomy. Currently, nearly 7 years after radiosurgery, he continues to enjoy a marked reduction in pain without the need of analgesic medications. Thalamic pain syndrome is generally refractory to conventional treatment. Neurosurgical interventions provide modest benefit and carry associated risks of invasive surgery and anesthesia. The CMN is readily localized with neuroimaging and is an approximate target to reduce the suffering aspect of pain. In this case, radiosurgery was a safe and effective treatment, providing durable symptom control and improved quality of life.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Keep MF,Mastrofrancesco L,Craig AD,Ashby LSdoi
10.3171/sup.2006.105.7.222subject
Has Abstractpub_date
2006-12-01 00:00:00pages
222-8eissn
0022-3085issn
1933-0693journal_volume
105 Supplpub_type
杂志文章,评审abstract::Acute cerebellar hemorrhages, treated medically with subsequent complete recovery, have been designated "benign cerebellar hemorrhages." Ordinarily, acute cerebellar hemorrhage does require early surgical intervention and reported surgical mortality is relatively low (17%) in awake patients with this lesion. Clinical ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.3.0374
更新日期:1979-03-01 00:00:00
abstract::Delayed cerebral vasospasm is an important determinant of the clinical outcome after subarachnoid hemorrhage, but its prevention and treatment has met with limited success. Since cerebral arteries were found to be sensitive to the vasoconstrictor effect of angiotensin II, the possibility of angiotensin's contribution ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.55.6.0884
更新日期:1981-12-01 00:00:00
abstract::A new microclip for use on blood vessels 300 mu to 1 mm in diameter is described. This clip is suitable for either temporary or permanent occlusion and has been used in experimental applications. Potential clinical applications are described. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.5.0822
更新日期:1986-05-01 00:00:00
abstract:OBJECT:Growth factors such as bone morphogenetic protein-2 (BMP-2) have been proven to promote spine fusion and to overcome the disadvantages of an autologous bone graft. The optimum method to deliver such growth factors remains a matter of discussion. The purpose of this study was to determine the safety and efficacy ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.97.1.0040
更新日期:2002-07-01 00:00:00
abstract:OBJECT:The purpose of this study was to evaluate both replication-competent and replication-restricted recombinant vesicular stomatitis virus (VSV) vectors as therapeutic agents for high-grade gliomas by using an organotypic brain tissue slice-glioma coculture system. METHODS:The coculture system involved growing diff...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.100.6.1049
更新日期:2004-06-01 00:00:00
abstract::The authors describe an experimental model that allows dynamic studies of blood flow in the pituitary gland. Twenty-eight male Wistar rats were anesthetized and the pituitary gland was exposed using a parapharyngeal approach. Teflon-coated platinum wire electrodes were placed in the adenohypophysis near the midline an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.1.0116
更新日期:1985-07-01 00:00:00
abstract::The authors report an unusual case of a traumatic aneurysm of the right superior cerebellar artery (SCA). A 22-year-old woman presented with continuous headaches that appeared 15 days after she experienced closed head trauma as a result of a cycling accident. Computerized tomography scanning performed 3 months later s...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1997.87.6.0950
更新日期:1997-12-01 00:00:00
abstract:OBJECT:The prevalence of deformational, or positional, plagiocephaly has increased during the last decade. Treatments vary among centers, ranging from expectant management to orthotic helmet therapy to craniofacial remodeling. This management variability is partially due to a lack of objective methods with which to mea...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2004.100.5.0537
更新日期:2004-05-01 00:00:00
abstract::The aim of this study was to establish a standard method for determining the pressure setting of the Codman Hakim valve (CHV) in patients with hydrocephalus. The authors' investigation was twofold. It focused on: 1) the relationships among CHV setting, intracranial pressure (ICP), intraabdominal pressure (IAP), hydros...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.92.1.0181
更新日期:2000-01-01 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:OBJECT:Temporary arterial occlusion (TAO) during aneurysm surgery carries the risk of ischemic sequelae. Because monitoring of regional cerebral blood flow (rCBF) may limit neurological damage, the authors evaluated a novel thermal diffusion (TD) microprobe for use in the continuous and quantitative assessment of rCBF ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.95.3.0402
更新日期:2001-09-01 00:00:00
abstract::OBJECTIVE Quantitative assessment of tumor microvascularity has the potential to improve prognostication, advance understanding of tumor biology, and help narrow potential molecular therapies. While the role of tumor microvascularity has been widely studied in meningiomas, this study examines both the role of automate...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.10.JNS161825
更新日期:2018-03-01 00:00:00
abstract::Direct spinal cord stimulation and recording was performed in five dogs to identify the dorsal root entry zone (DREZ) and long tracts within the dorsal and dorsolateral spinal cord using electrophysiological mapping techniques. Intrathecal recordings were obtained from sites distal to the site of stimulation. Conducti...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.4.0592
更新日期:1995-04-01 00:00:00
abstract::Results of computerized tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), xenon-133 measurement of cerebral blood flow (CBF), and neuropsychological assessments are described in three head-injured patients. The patients were selected because they presented with intracranial hemorrh...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.5.0760
更新日期:1986-05-01 00:00:00
abstract::OBJECTIVEThe goal of this study was to identify parameters from routine T1- and T2-weighted MR sequences and diffusion tensor imaging (DTI) that best predict the volumetric changes in a meningioma after treatment with Gamma Knife radiosurgery (GKRS).METHODSIn 32 patients with meningioma, routine MRI and DTI data were ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.7.GKS181327
更新日期:2018-12-01 00:00:00
abstract:OBJECT:Knowing the rate of rupture associated with unruptured cerebral aneurysms (UCAs) can help surgeons determine a case management strategy in patients harboring these lesions. According to large-scale cohort studies involving populations in North America and Europe, small unruptured aneurysms carry a very low risk ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.2005.102.4.0601
更新日期:2005-04-01 00:00:00
abstract::The authors report the case of a 6-year-old boy with cerebral sparganosis due to infection with a plerocercoid tapeworm larva of Spirometra mansoni. Magnetic resonance imaging revealed an area of irregular long T2 signal in the right frontal lobe. When compared with images obtained 2 years earlier, the lesion appeared...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2006.105.6.470
更新日期:2006-12-01 00:00:00
abstract:OBJECT:Detachable platinum coils are widely used in the endovascular treatment of intracranial aneurysms. The use of coil placement produces a higher incidence of aneurysm recurrence compared with surgical clipping. To reduce the incidence of recurrence by promoting clot organization, the authors designed a platinum co...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.103.4.0681
更新日期:2005-10-01 00:00:00
abstract::Superior sagittal sinus thrombosis was diagnosed on computerized tomography (CT) scanning and was subsequently confirmed by angiography in two patients. Small ventricles and filling defects occurring within the sinus (the empty triangle sign) appeared to be highly suggestive of superior sagittal sinus thrombosis, and ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.61.6.1129
更新日期:1984-12-01 00:00:00
abstract::Intracranial arteriovenous malformations (AVM's) have been classified as pure pial, pure dural, and mixed pial and dural. Dural AVM's are relatively uncommon, with 377 cases documented up to 1990. These lesions were believed to be situated within the walls of the sinuses, but during the last decade researchers discove...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.4.0620
更新日期:1994-10-01 00:00:00
abstract::OBJECTIVEBlood vessel tortuosity may play an important role in the development of vessel abnormalities such as aneurysms. Currently, however, there are no studies analyzing the impact of brain blood vessel tortuosity on the risk of aneurysm formation. Therefore, the authors performed a computer-aided analysis of middl...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.12.JNS172114
更新日期:2018-05-18 00:00:00
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journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1998.88.6.1111
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:Craniopharyngiomas are rare and benign tumors of the sellar and/or parasellar region. Primary treatment involves resection followed by adjuvant radiotherapy. While the grade of resection was frequently analyzed following surgery, the neurological outcome and especially neuropsychological deficits and quality ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.10.JNS181557
更新日期:2019-04-19 00:00:00
abstract::OBJECTIVE The purpose of this study was to describe in detail the cortical and subcortical anatomy of the central core of the brain, defining its limits, with particular attention to the topography and relationships of the thalamus, basal ganglia, and related white matter pathways and vessels. METHODS The authors stud...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.5.JNS162897
更新日期:2018-09-01 00:00:00
abstract::Ischemic stroke remains a leading cause of morbidity and death for which few therapeutic options are available. The development of neuroprotective agents, a once promising field of investigation, has failed to translate from bench to bedside successfully. This work reviews the ischemic cascade, agents targeting steps ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2012.11.JNS12408
更新日期:2013-05-01 00:00:00
abstract::Fourteen cases of primary intracranial germ-cell tumors are presented. Histologically, there were eight germinomas, three teratomas, and three germ-cell tumors of more than one histological type. Immunohistochemical studies revealed alpha-fetoprotein in yolk-sac tumor components in two cases and beta human choriogonad...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.6.0826
更新日期:1985-06-01 00:00:00
abstract::OBJECTIVEThe purpose of this study was to analyze national trends in adult cranial cases performed by neurological surgery residents as logged into the Accreditation Council for Graduate Medical Education (ACGME) system.METHODSThe ACGME resident case logs were retrospectively reviewed for the years 2009-2017. In these...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.2.JNS172734
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:Convexity meningiomas are commonly managed with resection. Motor outcomes and predictors of new deficits after surgery are poorly studied. The objective of this study was to determine whether postoperative diffusion-weighted imaging (DWI) was associated with neurological deficits after convexity meningioma re...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.8.JNS193537
更新日期:2021-01-29 00:00:00
abstract:OBJECT:Accurate diagnosis of the topographical relationships of craniopharyngiomas (CPs) involving the third ventricle and/or hypothalamus remains a challenging issue that critically influences the prediction of risks associated with their radical surgical removal. This study evaluates the diagnostic accuracy of MRI to...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.1.JNS111722
更新日期:2013-08-01 00:00:00
abstract::Dose responses in vitro of the basilar arteries of the dog, rabbit, and man to human hemoglobin and reported. For each species, the response occurred over a range of 10(-9)M to greater than 10(-5)M hemoglobin. When compared to a maximum serotonin contraction, the relative constriction induced by 10(-5)M hemoglobin was...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.4.0486
更新日期:1980-10-01 00:00:00