Abstract:
OBJECT:Appropriate management of hemorrhage after Gamma Knife surgery (GKS) for arteriovenous malformations (AVMs) of the brain is poorly understood, although a certain proportion of patients suffer from hemorrhage. METHODS:Among 500 patients observed for 1 to 183 months (median 70 months) after GKS, 32 patients (6.4%) suffered a hemorrhage. Hemorrhage developed even after angiographically documented obliteration of the AVM in five (2%) of 250 patients followed for 1 to 133 months (median 75 months) post-GKS. These patients had been treated according to their pathological condition. Treatment of these patients and their outcomes were retrospectively reviewed. As a management strategy in patients with preobliteration hemorrhage, the intracerebral hematoma and the AVM nidus were removed in four patients, and chronic encapsulated hematoma was removed in three. Among 11 patients who were conservatively treated, AVMs were ultimately obliterated in five, including three patients who underwent repeated GKS. Intracerebral hematoma from angiographically documented obliterated AVMs was radically resected in two patients, including one who also underwent aspiration of an accompanying symptomatic cyst. Intraoperative bleeding was easily controlled in these patients. Outcomes after hemorrhage, measured with the modified Rankin Scale, were significantly better in patients with postobliteration hemorrhage than in those with preobliteration hemorrhage (p < 0.05). CONCLUSIONS:Various types of hemorrhagic complications after GKS for AVMs can be properly managed based on an understanding of each pathological condition. Although a small risk of bleeding remains after angiographically demonstrated obliteration, surgery for such AVMs is safe, and the patient outcomes are more favorable. Radical resection to prevent further hemorrhage is recommended for ruptured AVMs after obliteration because such AVMs can cause repeated hemorrhages.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Maruyama K,Shin M,Tago M,Kurita H,Kawahara N,Morita A,Saito Ndoi
10.3171/sup.2006.105.7.52subject
Has Abstractpub_date
2006-12-01 00:00:00pages
52-7eissn
0022-3085issn
1933-0693journal_volume
105 Supplpub_type
杂志文章abstract:OBJECT:Oxidative stress may play a role in spontaneous intracerebral hemorrhage (ICH), but data on oxidative burden in cerebral hemorrhage are limited, and it is not clear whether oxidative markers add predictive power regarding ICH outcome beyond that of traditional factors. The authors therefore examined redox status...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.7.JNS11718
更新日期:2011-12-01 00:00:00
abstract::The case of General Leonard Wood is notable both for its contribution to the field of neurosurgery and its historical significance. As one of Harvey Cushing's first successful brain tumor operations in 1910, Wood's surgery was part of the case series that culminated in Cushing's monograph Meningioma. This case was imp...
journal_title:Journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.3171/2011.7.JNS102067
更新日期:2011-12-01 00:00:00
abstract::Giant-cell tumor rarely affects the sphenoid bone. Ten cases of this tumor seen at the Mayo Clinic are reviewed, bringing the number of cases in the world literature to 31. These tumors, which present in the second and third decades of life and are slightly more frequent in women than in men, may present with various ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.2.0322
更新日期:1983-08-01 00:00:00
abstract:OBJECT:Emergency access to the ventricular system is sometimes necessary for the treatment of raised intracranial pressure with ensuing herniation. One procedure described in the literature is a transorbital approach performed using a spinal needle. Because past publications have been case reports with minimal definiti...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.3.JNS081651
更新日期:2009-12-01 00:00:00
abstract:OBJECT:Hemangioblastomas (HBs) occur sporadically or as a manifestation of von Hippel-Lindau (VHL) disease. In the majority of VHL-related HBs, inactivation of the VHL tumor suppressor gene (TSG), which is located on chromosome 3p25-26, is found. The VHL gene is assumed to be involved also in the development of sporadi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.4.0977
更新日期:2002-10-01 00:00:00
abstract::OBJECTIVEIntrinsic third ventricular craniopharyngiomas (IVCs) have been reported by some authors to "pose the greatest surgical challenge" of all craniopharyngiomas (CPAs). A variety of open microsurgical approaches have historically been used for resection of these tumors. Despite increased utilization of the endosc...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.5.JNS18198
更新日期:2018-11-01 00:00:00
abstract::Review of a series of 460 patients with spontaneous intracranial hemorrhage showed that 241 had demonstrable aneurysms and 38 had multiple aneurysms. The importance of demonstrating the entire circulation following ligation of one aneurysm is emphasized. Treatment of the 38 patients with multiple aneurysms is describe...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1971.35.3.0291
更新日期:1971-09-01 00:00:00
abstract:OBJECT:Approximately 25% of patients exhibit cognitive dysfunction 24 hours after carotid endarterectomy (CEA). One of the purported mechanisms of early cognitive dysfunction (eCD) is hypoperfusion due to inadequate collateral circulation during cross-clamping of the carotid artery. The authors assessed whether poor co...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.5.JNS131736
更新日期:2014-09-01 00:00:00
abstract::OBJECTIVE Direct and indirect bypass surgeries are recognized as the most effective treatments for preventing further stroke in adults with moyamoya disease (MMD). However, the risk factors for postoperative infarction after bypass surgery for MMD are not well established. Therefore, the objective of this study was to...
journal_title:Journal of neurosurgery
pub_type: 评论,杂志文章
doi:10.3171/2016.3.JNS152256
更新日期:2017-05-01 00:00:00
abstract:OBJECT:It has been demonstrated that growth of cerebral meningiomas found in humans is controlled by a variety of factors, including growth factors, aminergic agents, neuropeptides, and steroids. To further our knowledge of this process, the authors investigated the presence and function of the cytokines leukemia inhib...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.88.3.0541
更新日期:1998-03-01 00:00:00
abstract:OBJECT:Most patients with preganglionic lesions after brachial plexus injuries suffer pain that is hard to control through medication or neuromodulation. Lesioning in the dorsal root entry zone (DREZ) is undeniably effective. Fifty-five patients who had undergone the so-called microsurgical DREZotomy (MDT) procedure we...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.2005.102.6.1018
更新日期:2005-06-01 00:00:00
abstract::Forty-seven patients with medulloblastoma were treated postoperatively with procarbazine, followed by craniospinal radiation therapy in combination with hydroxyurea. The radiation dose to the posterior fossa was 55 Gy; the spinal cord received 25 Gy and the whole brain 25 to 35 Gy (mean 33 Gy). Seventeen tumors recurr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.68.3.0383
更新日期:1988-03-01 00:00:00
abstract::OBJECTIVE Patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) (World Federation of Neurosurgical Societies Grade IV or V) are often considered for decompressive craniectomy (DC) as a rescue therapy for refractory intracranial hypertension. The authors performed a systematic review and meta-analysis to a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,meta分析
doi:10.3171/2016.9.JNS161383
更新日期:2017-12-01 00:00:00
abstract::A 24-year-old man presented with a history of recurrent meningitis secondary to cerebrospinal fluid (CSF) rhinorrhea. The patient had bilateral optic disc dysplasia in association with a basal encephalocele, but had no midline facial anomalies. The syndrome is rare, and this is the first report of a patient with this ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.6.0807
更新日期:1981-06-01 00:00:00
abstract::Intracerebral hemorrhage occurred in this 61-year-old woman with preexisting diplopia and proptosis. Results of angiography demonstrated a persistent primitive trigeminal artery (PPTA)-cavernous sinus fistula with cortical venous reflux. Two microcatheters were introduced transarterially through the PPTA into the two ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.101.4.0697
更新日期:2004-10-01 00:00:00
abstract::A simple method is presented for localizing the anatomical site of vertex lesions seen on a computerized tomography (CT) brain scan, using the patient's plain lateral skull film. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.1.0071
更新日期:1978-07-01 00:00:00
abstract:OBJECTIVE:Meningiomas at the falcotentorial junction represent a rare subgroup of complex meningiomas. Debate remains regarding the appropriate treatment strategy for and optimal surgical approach to these tumors, and surgical outcomes have not been well described in the literature. The authors reviewed their single-in...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.4.JNS19208
更新日期:2019-08-02 00:00:00
abstract::Tuberous sclerosis complex is a genetic disorder characterized by the development of hamartomas in multiple organs including the brain, skin, eye, kidney, and heart. Neurological features include seizures and mental retardation. Cortical tubers and subependymal nodules are the characteristic intracranial lesions of tu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2005.102.3.0322
更新日期:2005-04-01 00:00:00
abstract::The authors report on a 17-year-old boy with cervical myelopathy from dilated epidural veins due to cerebrospinal fluid (CSF) overdrainage. The patient had a long-standing subdural-peritoneal shunt and presented with incapacitating spastic tetraparesis. Magnetic resonance imaging revealed significant cervical spinal c...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2007.106.3.227
更新日期:2007-03-01 00:00:00
abstract:OBJECT:Brain metastases from gastrointestinal cancers are rare. However, the incidence is increasing because patients with gastrointestinal carcinoma tend to live longer due to earlier diagnosis and more effective treatment of systemic disease. The purpose of this study was to evaluate the efficacy of Gamma Knife surge...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.9.JNS08281
更新日期:2009-09-01 00:00:00
abstract:OBJECT:Whereas most pituitary adenomas are removable via the transsphenoidal approach, certain cases, such as dumbbell-shaped or suprasellar adenomas and recurrent and/or fibrous tumors, remain difficult to treat. The authors present their experience with the extended endoscopic endonasal approach to the suprasellar ar...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.9.JNS10262
更新日期:2011-02-01 00:00:00
abstract::The second lumbar vertebra was surgically removed from 10 dogs, and the shortened vertebral column was stabilized by internal fixation with two types of plastic plates. Shortening of the spinal column was usually not associated with detectable loss of function or neurological deficit. Histological lesions, however, in...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.42.1.0047
更新日期:1975-01-01 00:00:00
abstract::The authors report a case of craniopharyngioma presenting in the right cerebellopontine angle. The tumor was removed totally. The purpose of this report is to record this very unusual localization of a craniopharyngioma. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.4.0842
更新日期:1984-04-01 00:00:00
abstract:OBJECT:Proper screening, management, and follow-up of Grade 1 and 2 blunt carotid artery injuries (BCIs) remains controversial. These low-grade BCIs were analyzed to define their natural history and establish a rational management plan based on lesion progression and cerebral infarction. METHODS:A retrospective review...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.1.JNS14642
更新日期:2015-05-01 00:00:00
abstract:OBJECT:The authors conducted a study to determine clinical, patient/family satisfaction, and financial outcomes following application of a management scheme that involves evaluation of computerized tomography (CT) scans and emergency department observation, rather than overnight admission, for children who have sustain...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2004.101.2.0038
更新日期:2004-08-01 00:00:00
abstract::The acquired immune deficiency syndrome (AIDS) is a recently described T-cell deficiency predisposing patients to a spectrum of opportunistic infections. Kaposi's sarcoma, and other neoplasms. It appears primarily among homosexual males and intravenous drug abusers, but is now being observed in other groups as well. T...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.6.0994
更新日期:1983-12-01 00:00:00
abstract::The therapeutic application of barbiturate-induced coma was evaluated in a primate model of focal cerebral ischemia. A standardized regimen of pentobarbital was used, and the times of initiation of administration were varied following a 6-hour middle cerebral artery occlusion in baboons. Three groups of five animals w...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1982.56.5.0685
更新日期:1982-05-01 00:00:00
abstract::The authors reviewed 229 consecutive patients treated intramurally by resection of solitary cerebral metastasis. Patients were classified into four groups on the basis of whether a gross total resection or subtotal resection was performed and whether systemic disease was present or absent at the time of craniotomy. Gr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.77.4.0531
更新日期:1992-10-01 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 authors report on the morphological features of a pituitary adenoma that produced growth hormone (GH) and adrenocorticotropic hormone (ACTH). This hormone combination produced by a single adenoma is extremely rare; a review of the available literature showed that only one previous case has been published. The tumo...
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