Abstract:
OBJECT:Medically refractory dystonia has recently been treated using deep brain stimulation (DBS) targeting the globus pallidus internus (GPI). Outcomes have varied depending on the features of the dystonia. There has been limited literature regarding outcomes for refractory dystonia following DBS of the subthalamic nucleus (STN). METHODS:Four patients with medically refractory, predominantly cervical dystonia underwent STN DBS. Intraoperative assessments with the patients in a state of general anesthesia were performed to determine the extent of fixed deformities that might predict outcome. Patients were rated using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) preoperatively and 3 and 12 months following surgery by a rater blinded to the study. Mean changes and standard errors of the mean in scores were calculated for each subscore of the two scales. Scores were also analyzed using analysis of variance and probability values were generated. Neuropsychological assessments and quality of life ratings using the 36-Item Short Form Health Survey (SF-36) were evaluated longitudinally. RESULTS:Significant improvements were seen in motor (p = 0.04), disability (p = 0.02), and total TWSTRS scores (p = 0.03). Better outcomes were seen in those patients who did not have fixed deformities. There was marked improvement in the mental component score of the SF-36. Neuropsychological function was not definitively impacted as a result of the surgery. CONCLUSIONS:Deep brain stimulation of the STN is a novel target for dystonia and may be an alternative to GPI DBS. Further studies need to be performed to confirm these conclusions and to determine optimal candidates and stimulation parameters.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Kleiner-Fisman G,Liang GS,Moberg PJ,Ruocco AC,Hurtig HI,Baltuch GH,Jaggi JL,Stern MBdoi
10.3171/JNS-07/07/0029subject
Has Abstractpub_date
2007-07-01 00:00:00pages
29-36issue
1eissn
0022-3085issn
1933-0693journal_volume
107pub_type
杂志文章abstract::OBJECTIVE Glioblastoma (GBM) is a highly aggressive malignancy that requires a multidisciplinary therapeutic approach of surgery, chemotherapy, and radiation therapy, but therapy is frequently limited by side effects. The most common adverse effect of chemotherapy with temozolomide (TMZ) is myelosuppression. It remain...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.7.JNS16609
更新日期:2017-07-01 00:00:00
abstract::Clinical results of an extra-intracranial arterial bypass (EIAB) procedure for cerebral ischemia are assessed in 65 patients. The 5-year-study suggests that the EIAB procedure has a protective effect against further clinically significant cerebrovascular accidents in properly selected patients. Correlation with angiog...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.44.3.0313
更新日期:1976-03-01 00:00:00
abstract::Damage to the olfactory nerve during frontotemporal approach to the basal cisternal region has not previously been investigated in a quantified manner. In this retrospective study of 25 patients operated on for ruptured intracranial aneurysms via the frontotemporal route, 22 patients suffered postoperatively from anos...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.72.6.0864
更新日期:1990-06-01 00:00:00
abstract::OBJECTIVE A subset of patients with Chiari I malformation demonstrate patent subarachnoid spaces around the cerebellum, indicating that reduced posterior fossa volume alone does not account for tonsillar descent. The authors distinguish two subsets of Chiari I malformation patients based on the degree of "posterior fo...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.6.JNS152998
更新日期:2017-06-01 00:00:00
abstract::Considerable difference of opinion has arisen as to whether intravenously administered steroids affect cerebrospinal fluid (CSF) production in the acute laboratory animal undergoing ventriculocisternal perfusion. Our experiments with ventriculocisternal perfusion in dogs indicate that, when given intravenously, neithe...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.4.0477
更新日期:1979-04-01 00:00:00
abstract::An audible, noisy cerebrospinal fluid flow is an uncommon sequela of ventriculoperitoneal shunting. Two cases presenting this phenomenon are described. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.67.3.0460
更新日期:1987-09-01 00:00:00
abstract:OBJECT:Chiari malformation Type I (CM-I) is characterized by hindbrain deformity. We investigated the effects of craniocervical decompression surgery on the anatomical features of hindbrain deformity with a prospective MRI study of patients with CM-I. METHODS:A prospective longitudinal study was conducted in 48 patien...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.8.JNS111476
更新日期:2012-11-01 00:00:00
abstract:OBJECT:Resection of brain tumors has been shown to increase patient survival. The extent of the possible resection, however, depends on whether the tumor has invaded brain regions important for motor, sensory, or cognitive processes and whether the brain tissue surrounding the tumor maintains its functional role. The g...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/108/2/0258
更新日期:2008-02-01 00:00:00
abstract:OBJECT:Chronic sinusitis can be a debilitating disease with significant impact on quality of life. Frontal sinusitis has a relatively low prevalence, but complications can be severe due to its anatomical location. After failure of conservative measures, typically endoscopic procedures are performed to improve the drain...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2011.11.JNS101849
更新日期:2012-03-01 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::OBJECT This study explored whether there were differences between the autoimmune disease prevalence rates in unilateral and bilateral moyamoya disease (MMD). METHODS The authors performed a retrospective review of data obtained from the medical records of their hospital, analyzing and comparing the clinical characteri...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.4.JNS142936
更新日期:2016-05-01 00:00:00
abstract::One hundred and eighty-one patients with single aneurysms involving the anterior circulation were treated either by wrapping (60 cases) or clipping (121 cases), and 96.1% of them were followed for 10 years. The rate of early rebleeding (less than 6 months) from wrapped aneurysms was 8.6% (confidence interval 1.4% to 1...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.70.6.0841
更新日期:1989-06-01 00:00:00
abstract::A previous undescribed cause of ventriculoperitoneal shunt malfunction is presented. Limitation of abdominal excursion by a spica cast used to correct congenital hip dislocation reduced cerebrospinal fluid flow through a shunt. This easily correctable cause of "shunt failure" nearly resulted in replacement of a workin...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.46.6.0830
更新日期:1977-06-01 00:00:00
abstract::Two patients with large vascular carotid body tumors underwent preoperative intravascular embolization of the major arterial feeders. The tumor vascularity was reduced markedly, and complete surgical extirpation was accomplished without difficulty. The literature on carotid body tumors is briefly reviewed. The role of...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.5.0867
更新日期:1983-11-01 00:00:00
abstract:OBJECT:The aim of this study was to determine the clinicopathological features of patients with intracranial bleeding from unsuspected meningioma and to relate these data to surgery-related outcome. METHODS:The authors report on two cases in which hemorrhage of an unsuspected meningioma occurred in the tentorial ridge...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.2005.103.3.0473
更新日期:2005-09-01 00:00:00
abstract::The authors report a rare case of spontaneous left vertebrovertebral fistula associated with neurofibromatosis Type 1 in a young woman. The patient had undergone previous failed surgical attempts to close the fistula and presented to the authors with recurrence of the fistula and neurological deterioration. Successful...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.12.JNS081209
更新日期:2009-07-01 00:00:00
abstract::Hematoporphyrin derivative (HPD) is a photosensitizing agent that has been used to locate and kill tumors. The distribution of tritiated (3H)-HPD was studied in a transplantable canine glioma model following intraperitoneal or direct intraneoplastic injection. Compared to intraperitoneal administration of 3H-HPD, dire...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.65.3.0364
更新日期:1986-09-01 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:OBJECTIVE:Safety-net hospitals deliver care to a substantial share of vulnerable patient populations and are disproportionately impacted by hospital payment reform policies. Complex elective procedures performed at safety-net facilities are associated with worse outcomes and higher costs. The effects of hospital safety...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.10.JNS18103
更新日期:2019-02-22 00:00:00
abstract::The authors report a case of traumatic femoral nerve palsy caused by a pseudoaneurysm of the iliolumbar artery and a iliacus muscle hematoma. This case report details not only the classic history and physical findings seen in patients such as this one, but also illustrates an unusual source of the hematoma and a discu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.102.2.0382
更新日期:2005-02-01 00:00:00
abstract::The authors have developed a method to induce chronic cerebral vasospasm after subarachnoid hemorrhage (SAH) in monkeys. With microsurgical techniques, 33 monkeys had a frontotemporal craniectomy and unilateral opening of the subarachnoid cisterns. Cerebrospinal fluid was drained and a fresh hematoma, obtained from an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.6.1167
更新日期:1984-06-01 00:00:00
abstract::Twenty-two patients with closed myelomeningoceles, shunted hydrocephalus, and symptomatic Arnold-Chiari malformations were studied retrospectively. Seventeen of the 22 patients were aged 6 months or younger; five patients were aged 3 to 23 years. Patients in the younger group presented with stridor, apnea, and/or feed...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.66.6.0812
更新日期:1987-06-01 00:00:00
abstract::The authors reviewed the clinical findings, radiological evaluation, and operative therapy of 39 patients with syringomyelia. Syringoperitoneal (SP) shunting was used in 15 patients and other procedures were used in 24 patients. Follow-up periods ranged from 1 1/2 to 12 years. During the period of this study, metrizam...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.61.3.0531
更新日期:1984-09-01 00:00:00
abstract:OBJECTIVE:Although ventricular shunting is an effective therapy for idiopathic normal pressure hydrocephalus (iNPH), the effect of shunt valve type on the incidence of revision surgery is not well defined. To address this issue, shunt revision rates between patients with iNPH receiving a fixed-setting valve (FSV) versu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.3.JNS183077
更新日期:2019-06-07 00:00:00
abstract:OBJECT:The authors' objective was 2-fold: 1) to compare outcomes of microsurgical resection for vestibular schwannoma (VS) between patients aged 70 years or older and patients younger than 70 years and 2) to test the hypothesis that symptomatic tumors in elderly patients represent a more aggressive variant of VS than t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.6.JNS122433
更新日期:2014-01-01 00:00:00
abstract:OBJECT:Endothelial tight junction (TJ) expression is mostly absent in cerebral cavernous malformations (CMs), which causes increased perilesional erythrocyte and fluid oozing. However, in a subset of CM lesions, foci of preserved TJ staining are observed along endothelial cell contacts. The clinical relevance of this f...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.6.JNS132775
更新日期:2014-09-01 00:00:00
abstract::An abscess was removed from the left occipital region in a 73-year-old woman with no previous history of tuberculosis. The patient later died from aspiration bronchopneumonia. Autopsy revealed a basilar tuberculous meningitis and miliary tuberculosis in the peritracheal lymphatic glands, the liver, the spleen, and in ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.52.3.0419
更新日期:1980-03-01 00:00:00
abstract::In this paper the authors trace the history of early craniometry, referring to the technique of obtaining cranial measurements for the accurate correlation of external skull landmarks to specific brain regions. Largely drawing on methods from the newly emerging fields of physical anthropology and phrenology in the lat...
journal_title:Journal of neurosurgery
pub_type: 历史文章,杂志文章
doi:10.3171/2015.6.JNS15424
更新日期:2016-06-01 00:00:00
abstract::Tandem internal carotid artery (ICA) origin occlusion and middle cerebral artery (MCA) thromboembolism is a life-threatening condition with poor neurological outcome. The authors report on a patient presenting with acute ischemic stroke from a tandem ICA and MCA occlusion with penumbra. Emergency MCA mechanical thromb...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.6.JNS162368
更新日期:2018-09-01 00:00:00
abstract::The cerebrospinal fluid (CSF) flow rates in 12 patients with symptoms suggestive of CSF shunt obstruction were measured with magnetic resonance (MR) phase imaging. The shunts were imaged over the skull, just distal to any reservoir, using a curved surface coil. Images perpendicular to the direction of flow were made o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.75.4.0535
更新日期:1991-10-01 00:00:00