Abstract:
OBJECTIVE:Arteriovenous malformations (AVMs) involving the cerebellum and brainstem are relatively rare lesions that most often present clinically as a result of a hemorrhagic episode. Although these AVMs were once thought to have a more aggressive clinical course in comparison with supratentorial AVMs, recent autopsy data suggests that there may be little difference in hemorrhage rates between the two locations. Although current management of these lesions often involves preoperative embolization and stereotactic radiosurgery, surgical resection remains the treatment of choice, conferring immediate protection to the patient from the risk of future hemorrhage. METHODS:Most symptomatic AVMs that involve the cerebellum and the pial or ependymal surfaces of the brainstem are candidates for surgical resection. Preoperative angiography and magnetic resonance imaging studies are critical to determine suitability for resection and choice of operative exposure. In addition to considering the location of the nidus, arterial supply, and predominant venous drainage, the surgical approach must also be selected with consideration of the small confines of the posterior fossa and eloquence of the brainstem, cranial nerves, and deep cerebellar nuclei. RESULTS:Since the 1980s, progressive advances in preoperative embolization, frameless stereotaxy, and intraoperative electrophysiologic monitoring have significantly improved the number of posterior fossa AVMs amenable to microsurgical resection with minimal morbidity and mortality. CONCLUSION:Future improvements in endovascular technology and stereotactic radiosurgery will likely continue to increase the number of posterior fossa AVMs that can safely be removed and further improve the clinical outcomes associated with microsurgical resection.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Sinclair J,Kelly ME,Steinberg GKdoi
10.1227/01.NEU.0000204641.38419.2Dsubject
Has Abstractpub_date
2006-04-01 00:00:00pages
ONS-189-201; discussion ONS-201issue
4 Suppl 2eissn
0148-396Xissn
1524-4040pii
00006123-200604002-00001journal_volume
58pub_type
杂志文章相关文献
NEUROSURGERY文献大全abstract:BACKGROUND:Robot-assisted stereoelectroencephalography (SEEG) may represent a simplified, precise, and safe alternative to the more traditional SEEG techniques. OBJECTIVE:To report our clinical experience with robotic SEEG implantation and to define its utility in the management of patients with medically refractory e...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000001034
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:To determine the understanding of the conceptual basis and diagnostic tests used for brain death (BD) by neurosurgeons in Canada. METHODS:Between February and June 2006, a previously developed survey was mailed to every neurosurgeon in Canada. RESULTS:Of 223 surveys mailed, 147 (66%) were returned; of these...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000303200.84994.ae
更新日期:2007-11-01 00:00:00
abstract::Intracranial epidermoid and dermoid tumors are unusual benign lesions that are potentially curable. Subtotal removal carries a high incidence of recurrence, plus the rare possibility of carcinomatous degeneration of the remnants. Aseptic meningitis from spillage of cyst contents into the subarachnoid space is frequent...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/00006123-198904000-00014
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND:The cervical total disc replacement (cTDR) was developed to treat cervical degenerative disc disease while preserving motion. OBJECTIVE:Cost-effectiveness of this intervention was established by looking at 2-year follow-up, and this update reevaluates our analysis over 5 years. METHODS:Data were derived fr...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000001208
更新日期:2016-07-01 00:00:00
abstract::The neurosurgical role in rehabilitation rehabilitation was studied. Over a 5-year period, 850 individuals were referred to a rehabilitation center after initial acute care. Surgery was indicated for 66 patients. There were 28 quadriplegic or paraplegic individuals with intractable spasticity. Percutaneous radiofreque...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198603000-00009
更新日期:1986-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the benefits of intraoperative autotransfusion of autologous blood on the conservation of allogenic blood, including cost-effectiveness and the consequences for hemoglobin level and coagulation tests. METHODS:The Hoemonetics Cell Saver 4 autotransfusion system (Hoemo...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199704000-00021
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:Although in the developed world the intracranial pressure (ICP) monitor is considered the standard of care for patients with severe traumatic brain injury (TBI), its usefulness to direct treatment decisions has never been tested rigorously. OBJECTIVE:The primary focus was to conduct a high-quality, randomiz...
journal_title:Neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.1227/NEU.0b013e31827276b7
更新日期:2012-12-01 00:00:00
abstract::While the efficacy of Intravenous tissue plasminogen activator (tPA) is well established, its impact on large vessel occlusion (LVO) is controversial. Whether IV tPA should be bypassed in favor of endovascular thrombectomy (MT) will be addressed. Compelling evidence exists to suggest tPA administration might be bypass...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyz083
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Over the last several decades, significant advances have occurred in the assessment and management of spinal deformity. OBJECTIVE:The primary focus of this narrative review is on recent advances in adult thoracic, thoracolumbar, and lumbar deformities, with additional discussions of advances in cervical def...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1093/neuros/nyw048
更新日期:2017-03-01 00:00:00
abstract::A rare and serious complication of ventriculoperitoneal shunt is reported. A huge intraventricular hematoma was confirmed by computed tomography scanning and autopsy. This is the first report of such a complication in a newborn with hydrocephalus. ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198203000-00016
更新日期:1982-03-01 00:00:00
abstract:OBJECTIVE:After the resection of cranial base tumors, there may not be enough free dural margin left for reconstruction after involved bone and dura have been removed. In such a situation, dural reconstruction becomes a problem. We propose a new technique of dural closure in such cases. METHODS:A fascial graft is prep...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200109000-00043
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVE:Oculomotor nerve palsy greatly impairs the patient's daily life. After oculomotor nerve injury, when the central nerve stump is not available, neurotization of the distal nerve stump with a donor nerve may be performed. Here, we present an experimental anatomic study in rats related to the motor nuclear organ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000073988.28813.77
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Epidemiological studies have indicated that postmenopausal women have a higher incidence of intracranial aneurysms than men in the same age group. OBJECTIVE:To investigate whether estrogen or estrogen receptors (ERs) mediate protective effects against the formation of intracranial aneurysms. METHODS:Intrac...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000528
更新日期:2014-12-01 00:00:00
abstract::Intracisternal thrombolysis with recombinant tissue plasminogen activator (rtPA) was performed in 20 patients with aneurysmal subarachnoid hemorrhage. All patients had blood accumulations in the basal cisterns according to Fisher's Grade III, thus being at a high risk for the development of posthemorrhagic delayed isc...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199206000-00010
更新日期:1992-06-01 00:00:00
abstract::We have used three-dimensional reconstruction magnetic resonance imaging techniques to understand the anatomic complexity of operative brain lesions and to improve preoperative surgical planning. We report our experience with 14 cases, including intra- and extra-axial tumors and a vascular malformation. In each case, ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract::We have reviewed our experience with gangliogliomas treated in the post-computed tomography (CT) era at the Children's Hospital of Philadelphia. Of 234 newly histologically verified neoplasms seen at our institution since 1975, 10 (4.3%) were gangliogliomas of the cerebral hemispheres. The presenting complaint was sei...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198308000-00003
更新日期:1983-08-01 00:00:00
abstract:BACKGROUND:Giant fusiform and dolichoectatic aneurysms of the basilar trunk and vertebrobasilar junction (BTVBJ-GFDA) are extremely difficult to treat. OBJECTIVE:To evaluate factors influencing survival and outcome of BTVBJ-GFDA by performing a retrospective multicenter cohort study. METHODS:A total of 32 patients wi...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyaa317
更新日期:2020-12-15 00:00:00
abstract::Eleven cases of cerebral cavernous angiomas (cavernomas) were observed within a period of 3 years. Two patients presented with cerebral hemorrhage, five with epilepsy, three each with a progressive focal neurological deficit, and one with papilledema. The unruptured lesions had a heterogeneous density on computed tomo...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/00006123-198712000-00016
更新日期:1987-12-01 00:00:00
abstract::The use OF chemotherapy to treat patients with brain metastases has been viewed historically with skepticism. To date, a survival benefit has not been demonstrated with the use of systemic chemotherapy in patients with brain metastases. However, the introduction of novel agents and delivery techniques warrants a reexa...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/01.neu.0000182740.39014.9a
更新日期:2005-11-01 00:00:00
abstract::Since 1978, the authors have treated 11 patients with lesions of the ventral thoracic spine via a transpleural anterolateral approach. Each of the patients presented with pain and paraparesis, 8 had sensory dysfunction, and 6 had demonstrated sphincteric disturbances. All 11 had radiographic confirmation of anterior c...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198401000-00007
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:The benefits of intravenous thrombolysis for acute ischemic stroke are still limited. OBJECTIVE:To evaluate the safety and efficacy of double-lumen balloon catheter-based reperfusion therapy with or without intra-arterial thrombolysis for acute occlusion of intracranial arteries. METHODS:Fifty-nine patient...
journal_title:Neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1227/01.NEU.0000380954.29925.CE
更新日期:2010-09-01 00:00:00
abstract::Safety and efficacy of the thrombolytic agent urokinase (URO) in the elimination of subarachnoid clot and prevention of chronic vasospasm was compared with tissue-type plasminogen activator (rt-PA) in a blind, randomized placebo-controlled trial. Twenty monkeys were randomly assigned to one of five groups of four. Eac...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199310000-00020
更新日期:1993-10-01 00:00:00
abstract::A case of primary osteogenic sarcoma of the skull with metastases to the lungs, left diaphragm, 2nd lumbar and 1st sacral vertebral bodies, and both femoral heads was presented. A young man with a lump over his right parieto-occipital region since the age of 14 had noticed rapid growth of the mass after having experie...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1981-09-01 00:00:00
abstract::Today, physicians in general and neurosurgeons in particular practice in an era of fundamental change in Medicine from a profession to an industry. This change has produced erosion in the very personal physician-patient relationship. "The Morning Visit" is a poem written by Oliver Wendell Holmes, Sr., M.D., a 19th cen...
journal_title:Neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.1227/01.NEU.0000351280.04013.65
更新日期:2009-10-01 00:00:00
abstract::Esophageal perforation during surgery for cervical disc herniation is a rare complication. Differences in the time of diagnosis of this complication in three patients--no delay and delays of 6 hours and 4 days, respectively--resulted in different symptoms and outcomes. Early detection of the perforation allows prompt ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199111000-00021
更新日期:1991-11-01 00:00:00
abstract::The recently described multiple tumor suppressor 1/cyclin-dependent kinase inhibitor 2 (MTS1/CDKN2) gene, encoding the cyclin-dependent kinase 4 inhibitor p16, is mutated in a wide variety of tumor cell lines, including gliomas. To investigate the possible role of this gene in the genesis of the central nervous system...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199505000-00013
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:Treatment of giant cerebral arteriovenous malformations (AVMs) remains a challenge. OBJECTIVE:To propose hypofractionated stereotactic radiotherapy (HSRT) as a part of staged treatment, and evaluate its effect by analyzing AVM volume changes. METHODS:From 2001 to 2007, 20 AVMs larger than 5 cm were treated...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e3181efbaef
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:Hyperbaric oxygenation is a rarely used method of treatment for steroid-refractory radiation-induced edema after stereotactic radiosurgery. We present its successful implementation for a radiosurgical complication after the treatment of a deep, large arteriovenous malformation. We also review the literature o...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000255343.41206.6F
更新日期:2007-03-01 00:00:00
abstract::This study investigated the natural course of functional recovery of the vascular endothelium and smooth muscle after clipping injury of the rat carotid artery. Vascular injury was induced by clipping the right carotid arteries of Wistar rats. The contractile response to KCl, serotonin (5-hydroxytryptamine), and norep...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::Intimal proliferation is thought to be initiated by the migration and proliferation of smooth muscle cells after endothelial damage. These changes may be induced, in part, by mitogenic growth factors such as insulin-like growth factor-1 (IGF-1). This study was designed to investigate the role of locally synthesized IG...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199407000-00015
更新日期:1994-07-01 00:00:00