Abstract:
OBJECTIVE:The purpose of this study is to investigate the anatomic relationship between neurovascular structures and the transverse carpal ligament (TCL) so as to avoid complications during an endoscopic carpal tunnel release procedure. METHODS:Fresh cadaver hands from seven men and 12 women (age range, 48-74 yr) were used. The neurovascular structures just over and under the TCL were meticulously dissected under loupe magnification. Several anatomic landmarks were calculated (average length of the TCL; average distance between the TCL distal margin and the neurovascular structures; and average lengths of the superficial palmar arch, ramus communicantes, recurrent motor branch, and palmar cutaneous branch of the median nerve). The ulnar neurovascular structure was studied with the wrist positioned in neutral, ulnar flexion, and radial flexion. RESULTS:The anatomic relationships between the TCL and vascular and neural structures were measured. The ulnar neurovascular structures usually passed just over ulnar to the superior portion of the hook of the hamate. However, in 11 hands, a looped ulnar artery coursed 1 to 4 mm radial to the hook of the hamate and continued to the superficial palmar arch. The looped ulnar artery migrates on the ulnar side of Guyon's canal (-2-2 mm radial to the hook of the hamate) with the wrist in radial flexion (of the wrist). During ulnar flexion of the wrist, the ulnar artery shifts more radially beyond the hook of the hamate (2-7 mm). CONCLUSION:It is appropriate to transect the ligament over 4 mm apart from the lateral margin of the hook of the hamate without placing the edge of the scalpel toward the ulnar side. We would also recommend not transecting the TCL in the ulnar flexed wrist position to protect the ulnar neurovascular structure. The proximal portal could be made just ulnar to the palmaris longus tendon to spare the neurovascular structures in the proximal portion of the TCL.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Hong JT,Lee SW,Han SH,Son BC,Sung JH,Park CK,Park CK,Kang JK,Kim MCdoi
10.1227/01.NEU.0000193883.02372.3Esubject
Has Abstractpub_date
2006-02-01 00:00:00pages
ONS127-33; discussion ONS127-33issue
1 Suppleissn
0148-396Xissn
1524-4040pii
00006123-200602001-00017journal_volume
58pub_type
杂志文章相关文献
NEUROSURGERY文献大全abstract::The sitting prone position is compared with the standard laminectomy prone position and the sitting up position for posterior fossa surgery. We measured central venous pressure and airway pressure with the patient in different positions to determine the comparative efficacy of the sitting prone position. On a linear a...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1982-02-01 00:00:00
abstract:OBJECTIVE:Cadaveric fibula with locking plate internal fixation has been reported to be associated with fewer complications and better long-term results, compared with autologous iliac crest. With the knowledge that cortically dense allografts collapse less with time, new machined femoral ring allografts were developed...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Artificial neural networks (ANNs) excel at analyzing challenging data sets and can be exceptional tools for decision support in clinical environments. The present study pilots the use of ANNs for determining prognosis in neuro-oncology patients. OBJECTIVE:To determine whether ANNs perform better at predicti...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e31828ea04b
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Instrumentation of the spine depends on choosing the correct insertion angles to implant screws. Although modern image guidance facilitates precise instrumentation of the spine, the equipment is costly and availability is limited. Although most surgeons use lateral fluoroscopy to guide instrumentation in the...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000023
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Endoscopic third ventriculostomy (ETV) has been used predominantly in the pediatric population in the past. Application in the adult population has been less extensive, even in large neurosurgical centers. To our knowledge, this report is one of the largest adult ETV series reported and has the consistency o...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000994
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:We evaluated and analyzed the effect of superficial temporal artery to middle cerebral artery bypass for internal carotid artery occlusion on pure motor function using motor activation single photon emission computed tomography. METHODS:Motor activation single photon emission computed tomographic (SPECT) ima...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199711000-00009
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:In spinal cord stimulation for low-back pain, the use of electrode arrays with both low-power requirements and selective activation of target dorsal column (DC) fibers is desired. The aligned transverse tripolar lead configuration offers the best DC selectivity. Electrode alignment of the same configuration ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e31827d0e12
更新日期:2013-03-01 00:00:00
abstract::Serious central nervous system injuries after lightning strikes are fortunately rare. Optimal neurological and neurosurgical management has not been firmly established. We describe the successful neurological resuscitation and critical care management using intracranial pressure monitoring of an adult who sustained a ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199106000-00024
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND:Dramatic growth of meningiomas is occasionally encountered during pregnancy. While cell proliferation is often assumed, hemodynamic changes have also been touted as a cause. OBJECTIVE:We identified 17 meningiomas resected during pregnancy or within 3 weeks post-partum and characterized them to determine the...
journal_title:Neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1227/NEU.0b013e31826adf65
更新日期:2012-11-01 00:00:00
abstract::A case of hemangioma calcificans in the 4th ventricle is reported. Skull x-ray films demonstrated a dense calcification in the posterior fossa. Computed tomography disclosed a hyperdense mass in the 4th ventricle. The clinical picture was of increased intracranial pressure due to obstructive hydrocephalus. An hemangio...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198406000-00016
更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:Assessment of basilar artery blood flow is of interest in many neurosurgical situations. With use of ultrasonography, the standard posterior approach is difficult in neurointensive care. OBJECTIVE:To evaluate the accuracy of an alternative submandibular approach for the assessment of blood flow in the basil...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e3182124835
更新日期:2011-06-01 00:00:00
abstract::T-lymphocyte subpopulations (Tg or "suppressor cells" and Tm or "helper cells") in the peripheral blood of 16 patients with malignant intracranial gliomas were analyzed. The number of Tm-lymphocytes was very close to normal in both pre- and postoperative samples, whereas Tg-lymphocytes were significantly increased pre...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198205000-00004
更新日期:1982-05-01 00:00:00
abstract:OBJECTIVE:Our previous studies demonstrated that simvastatin promotes neurological functional recovery after traumatic brain injury (TBI) in rat; however, the underlying mechanisms remain poorly understood. The purpose of this study was to investigate the anti-inflammatory effect of simvastatin by measuring the level o...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000346272.76537.DC
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Vestibular schwannomas with meningioma islets have been rarely reported in the literature; they have been observed only among patients with neurofibromatosis Type II. We present a case of a sporadic mixed tumor in a patient without neurofibromatosis Type II that was not suspected before surgery...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200008000-00037
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of depressed and anxious mood states in patients with cervical spondylotic myelopathy (CSM), a degenerative spine condition with symptoms of neck pain, numb clumsy hands, gait difficulties, sphincter dysfunction, and impotence. To examine the relation between mood and functional de...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000166664.19662.43
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:Fifty percent of implanted cerebrospinal fluid (CSF) shunts fail within 2 years, primarily because of obstruction of the proximal catheter. Percutaneous techniques to reduce the morbidity of shunt revision are being developed. The authors describe the development of a device that uses ultrasonic cavitation to...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000233968.80352.25
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:Patients undergoing surgery for degenerative cervical spine disease may require future surgery for disease progression. We investigated factors related to the rate of additional cervical spine surgery, the associated length of stay, and hospital charges. METHODS:The was a longitudinal retrospective cohort st...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000360347.10596.BD
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:The role of women in Western society has changed dramatically in the past several decades. Despite this, many gender disparities still exist for professionals in the health care sector. In neurosurgery, a disproportionately small percentage of the workforce in the United States and Canada is female. These fig...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/01.NEU.0000232671.44297.DF
更新日期:2006-10-01 00:00:00
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:OBJECTIVES:To determine if a window of time could be defined during which angioplasty would be most effective in reversing neurological decline and ultimately improving outcome. METHODS:Of a group of 466 patients, 93 underwent endovascular management of clinical vasospasm that was medically refractory. Eighty-four of ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199905000-00022
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND AND IMPORTANCE:Because of their rarity, the pathogenesis and clinical features of isolated spinal artery aneurysms are still unclear, and their diagnoses and treatments are challenging. We report a case of an isolated posterior spinal artery aneurysm and review previous reports thoroughly to identify the gen...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/NEU.0b013e31825ea539
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:The posterior orbit contains a number of important and vulnerable structures, including the optic nerve, the ophthalmic artery and vein, and the ocular muscles and their motor nerves, which makes surgical access to the lesion in this region quite difficult. Transfrontal, transfrontal-ethmoidal, and transmaxil...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000220027.49155.80
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:With the decrease in the number of cerebral aneurysms treated surgically and the increase of complexity of those treated surgically, there is a need for simulation-based tools to teach future neurosurgeons the operative techniques of aneurysm clipping. OBJECTIVE:To develop and evaluate the usefulness of a n...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000583
更新日期:2015-03-01 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::Transcranial stab wounds are uncommon. Three such cases are presented. The severity of the wounds may vary from innocuous to devastating. Skull films are useful in delineating the depth of penetration. The presence of the knife blade in situ may make the computed tomographic scan impossible to perform or difficult to ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198811000-00022
更新日期:1988-11-01 00:00:00
abstract::A series of 74 cephaloceles (17 cranial meningoceles and 57 meningoencephaloceles) is reported. Infants born with large meningoencephaloceles containing recognizable cerebral tissue usually did badly despite endeavors to conserve brain function by expanding the cranial capacity (5 cases) or decompressing hydrocephalic...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198407000-00005
更新日期:1984-07-01 00:00:00
abstract::We present two cases of false aneurysm after carotid endarterectomy with primary arteriotomy closure. In both cases, infection appeared to be the precipitating cause. Both lesions were repaired with a saphenous vein patch graft, but infection in one patient persisted, and recurrence of a false aneurysm required ligati...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198609000-00014
更新日期:1986-09-01 00:00:00
abstract:BACKGROUND:Skull base osteosarcomas are aggressive neoplasms characterized by bony invasion and extracompartmental/extra-osseous soft tissue extension that pose obstacles to achieving complete resection. Management is further complicated by the paucity of data regarding the efficacy of surgery within the treatment para...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyz360
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:The increasing number of neurosurgical procedures for elderly patients and the development of skull base neurosurgery have increased interest in cerebral venous injury that might occur in a neurosurgical setting. Brain-derived neurotrophic factor (BDNF) may have neuroprotective effects against cerebral venou...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e31820c048e
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:We report the first example of an anaplastic meningioma arising from an intracranial arachnoid cyst and discuss the diagnostic challenges of this case, including the useful role of genetic markers. CLINICAL PRESENTATION:A 72-year-old man presented with transient episodes of expressive dysphasi...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000370013.55369.92
更新日期:2010-07-01 00:00:00