Abstract:
OBJECT:The authors analyzed the role of endoscopic third ventriculostomy (ETV) as a primary treatment for hydrocephalus and also as an alternative to shunt revision for malfunctioning and infected ventriculoperitoneal (VP) shunts. METHODS:A retrospective analysis of clinical notes, operation records, and magnetic resonance imaging procedures before and after ventriculostomy was performed to determine the success or failure of ETVs in 170 patients who underwent a primary ETV and in 63 patients who underwent an ETV for shunt malfunction (secondary ETV). The patients' data were derived from an endoscopy database inaugurated in 1998. Of the 63 patients with shunt malfunctions, 49 patients (78%) had mechanical malfunction only and 14 patients (22%) had both infection and malfunction. Seventy-four percent (126 of 170) of patients in the primary ETV group and 70% (44 of 63) of patients in the secondary ETV had a successful outcome at the time of analysis. The success rate for ETVs in cases involving a mechanical shunt malfunction alone was 67% (33 of 49) compared with 79% (11 of 14) in those cases involving an infected shunt. The origin of the hydrocephalus in the primary and shunt malfunction groups was evaluated as a factor contributing to the success of the ETV. In the primary group, patients with a history of intraventricular hemorrhage (IVH) and meningitis as a cause for hydrocephalus had a poor rate of success after the ETV--27% (four of 15) and 0% (none of two), respectively. This pattern was not seen in the series involving shunt malfunction after the ETV, with 71% (five of seven) and 75% (three of four) of cases having a hydrocephalus origin of IVH and meningitis, respectively, in which a successful outcome was attained. A two-way mixed-model analysis of variance yielded a significant effect for origin (p = 0.011), a significant interaction between group and origin (p = 0.028), and a marginally nonsignificant effect of group (p = 0.0686). More than 95% of failures were evident within 1 month of the ETV in both groups. Complications were minimal in both groups, and there were no procedure-related deaths. CONCLUSIONS:An ETV is a safe procedure with few complications and a high success rate in both primary and secondary groups. An ETV to address shunt malfunction, unlike a primary ETV, is not particularly origin specific. A bonus is its success in dealing with infected shunts. Most failures will be evident early, but long-term follow up is vital.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
O'Brien DF,Javadpour M,Collins DR,Spennato P,Mallucci CLdoi
10.3171/ped.2005.103.5.0393subject
Has Abstractpub_date
2005-11-01 00:00:00pages
393-400issue
5 Suppleissn
0022-3085issn
1933-0693journal_volume
103pub_type
杂志文章abstract::The authors have developed a stereotactic device for use in rabbits that uses the plane at the base of the mandible combined with cranial sutures as an anatomical reference. The device was developed for a study designed to evaluate catheters for infection prophylaxis, and this required the implantation of silicone cat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/108/3/0601
更新日期:2008-03-01 00:00:00
abstract:OBJECT:The objective of the present study was to perform a prospective evaluation of the potential efficacy and safety of intraoperative photodynamic therapy (PDT) using talaporfin sodium and irradiation using a 664-nm semiconductor laser in patients with primary malignant parenchymal brain tumors. METHODS:In 27 patie...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.3171/2013.7.JNS13415
更新日期:2013-10-01 00:00:00
abstract::A patient with an enhancing, completely intracanalicular mass on magnetic resonance imaging was operated on for a presumed acoustic neurilemoma, but was found at surgery to have an intracanalicular vascular malformation. This rare lesion should be distinguished from angiomatous change within an acoustic neurilemoma an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.74.3.0516
更新日期:1991-03-01 00:00:00
abstract::A cohort of 514 hospitalized head-injury survivors was identified based on their injury and 448 (87%) of them were followed for 1 year. Comprehensive neurobehavioral testing was performed 1 month and 1 year after injury. The authors developed predictions of six neuropsychological and two psychosocial outcomes 1 year a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.5.0764
更新日期:1995-05-01 00:00:00
abstract::A multi-center double-blind randomized clinical trial was conducted by the National Acute Spinal Cord Injury Study Group to examine the efficacy of high-dose methylprednisolone (1000-mg bolus and 1000 mg daily thereafter for 10 days) compared with that of a standard dose (100-mg bolus and 100 mg daily for 10 days). No...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.3171/jns.1985.63.5.0704
更新日期:1985-11-01 00:00:00
abstract::Increasing evidence suggests that disturbances in the modulatory influence of the vasoactive peptide, calcitonin gene-related peptide (CGRP), contribute to the pathogenesis of cerebral vasospasm after subarachnoid hemorrhage (SAH). However, only limited success has been achieved in trials attempting to ameliorate vaso...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.1.0091
更新日期:1995-01-01 00:00:00
abstract::The surgical treatment of cerebrovascular malformations intrigued early neurosurgeons. Cushing defined vascular malformations as tumors arising from cerebral blood vessels. He successfully resected the first arteriovenous malformation 3 years after it had been irradiated. In the absence of angiography, the pathoanatom...
journal_title:Journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.3171/jns.2004.101.3.0553
更新日期:2004-09-01 00:00:00
abstract::Cerebral protection from an ischemic/hypoxic insult implies that tissue injury can be controlled or even prevented by certain therapeutic maneuvers. For example, physiological thresholds may be altered so that tissue vulnerability to the insult is reduced, or the intensity of an insult may be blunted by enhancing brai...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1986.65.5.0579
更新日期:1986-11-01 00:00:00
abstract:OBJECT:Neurogenesis continues throughout the life of mammals in the subventricular zone (SVZ) of the lateral ventricles and the dentate gyrus (DG) of the hippocampus. The authors tested the potential of the neuropeptide substance P (SP) acting via the neurokinin-1 receptor (NK1R) in promoting the proliferation of adult...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/09/0593
更新日期:2007-09-01 00:00:00
abstract::The surgical resection of neoplasms involving the petrous bone and surrounding areas in 20 patients is reported. Technical advances described include the total resection of several tumors previously considered inoperable due to involvement of dura and brain, petrous internal carotid artery (ICA), the vein of Labbé, an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.76.4.0578
更新日期:1992-04-01 00:00:00
abstract:OBJECT:Endoscopic third ventriculostomy (ETV) is the treatment of choice for hydrocephalus, but the outcome is dependent on the cause of this disorder, and the procedure remains principally the preserve of pediatric neurosurgeons. The role of ETV in adult patients with hydrocephalus was therefore investigated. METHODS...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.10.JNS17667
更新日期:2009-05-01 00:00:00
abstract::The current management of malignant gliomas is unsatisfactory compared to that of other solid tumors; the expected median survival period is less than 1 year with the patient undergoing conventional surgery, radiotherapy, and chemotherapy treatment. Immunological reagents could be a useful adjunct. Human monoclonal an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.76.4.0660
更新日期:1992-04-01 00:00:00
abstract:OBJECT:High-frequency stimulation (HFS) delivered through implanted electrodes in the subthalamic nucleus (STN) has become an established treatment for Parkinson disease (PD). The precise mechanism of action of deep brain stimulation (DBS) in the STN is unknown, however. In the present study, the authors tested the hyp...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.101.3.0511
更新日期:2004-09-01 00:00:00
abstract:OBJECT:Insular gliomas can be resected with acceptable rates of neurological morbidity, but little is known with regard to impairment of higher-order neurocognitive functions. The frequency and functional impact of neurocognitive deficits in patients with gliomas has until recently been underappreciated. The authors th...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.8.JNS11488
更新日期:2011-12-01 00:00:00
abstract::Coccidioidomycosis is an infection originating in the San Joaquim Valley of southern California, but now seen with increasing frequency throughout southern California and the southwestern United States. Central nervous system involvement is usually manifested as meningitis. The authors present the case of a young man ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.80.1.0140
更新日期:1994-01-01 00:00:00
abstract::Local cortical cooling for termination of epileptic discharges (EDs) has recently become a focus of research. The authors report on a newly devised cooling system that uses a thermoelectric (Peltier) chip and examine the system's performance in experimental neocortical seizures. Experiments were performed in adult mal...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2006.104.1.150
更新日期:2006-01-01 00:00:00
abstract::The metabolic rate was determined in the rat brain during the immediate concussive response to standardized impact accelerations of 7 and 9 m/sec velocity. In one series, the metabolic state was determined in freeze-clamped cortical and brain-stem tissue 20 seconds after the impact. The metabolic rate was calculated f...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.2.0274
更新日期:1977-08-01 00:00:00
abstract::The neurosurgical management of intrinsic brain tumors and brain metastases mandates maximum resection with preservation of functional cortex. There have been previous reports on the use of cortical somatosensory evoked potentials (SSEPs) for localization of functional cortex prior to resection. The identification of ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.2002.97.3.0709
更新日期:2002-09-01 00:00:00
abstract::Transarterial embolization of direct carotid-cavernous fistulas (CCFs) using detachable balloons is the best initial option for occlusion of the fistula and preservation of the internal carotid artery. However, the long-term safety and efficacy of this treatment is unknown. The authors reviewed the long-term outcome o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.84.3.0400
更新日期:1996-03-01 00:00:00
abstract:OBJECT:Deep brain stimulation (DBS) of the ventral [anterior internal] capsule/ventral striatum (VC/VS) is under investigation as an alternative to anterior capsulotomy for severe obsessive-compulsive disorder (OCD). In neuroimaging studies of patients with OCD, dysfunction in the orbitofrontal and anterior cingulate c...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.3171/jns.2006.104.4.558
更新日期:2006-04-01 00:00:00
abstract:OBJECT:CD133(+) cells have the potential to enhance histological and functional recovery from peripheral nerve injury. However, the number of CD133(+) cells safely obtained from human peripheral blood is extremely limited. To address this issue, the authors expanded CD133(+) cells derived from human peripheral blood us...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.7.JNS111503
更新日期:2012-10-01 00:00:00
abstract:OBJECT:Rathke cleft cysts (RCCs) are benign lesions that can be diagnosed as an incidental finding associated with headaches, pituitary dysfunction, or vision deterioration. Typically, they occur in a sellar or suprasellar location. The aim of this study was to review the clinical presentation and outcomes associated w...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.10.JNS09348
更新日期:2010-06-01 00:00:00
abstract::A small group of spinal arteriovenous malformations (AVM's) most commonly present in children or young adults, are characterized by a large size, high flow, the presence of multiple feeders, and frequent extension to paraspinous structures. Cardiac output requirements may be significantly increased by these so-called ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.70.4.0628
更新日期:1989-04-01 00:00:00
abstract::Previously presented data showed that Vicryl mesh was a potentially effective dural grafting material. It is easily handled, relatively inexpensive, absorbed over time, and elicits a minimal inflammatory response. The present experimental project was conducted to investigate the effectiveness of a tightly woven versio...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.71.1.0124
更新日期:1989-07-01 00:00:00
abstract::Acute subdural hematoma (SDH) complicates 20% of severe human head injuries and causes death or severe disability in 60% of these cases, due to brain swelling and high intracranial pressure. Although the mechanisms for these phenomena are unknown, previous studies have implicated excitatory amino acid-mediated mechani...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.4.0655
更新日期:1996-10-01 00:00:00
abstract::Three cases of shunt nephritis in which serial complement levels were obtained during the course of treatment are presented to illustrate the value of monitoring complement levels in the management of this condition. In shunt nephritis, circulating immune complexes are formed which contain antigen from bacteria of low...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.55.1.0099
更新日期:1981-07-01 00:00:00
abstract::OBJECTIVE Different surgical routes have been used over the years to achieve adequate decompression of the optic nerve in its canal including, more recently, endoscopic approaches performed either through the endonasal corridor or the transorbital one. The present study aimed to detail and quantify the amount of bone ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.8.JNS16566
更新日期:2017-07-01 00:00:00
abstract:OBJECT:The nitric oxide system has been linked to the pathogenesis of aneurysmal subarachnoid hemorrhage (SAH). The authors performed a case-control study to investigate the association between SAH and common genetic variants within the endothelial nitric oxide synthase gene (NOS3). METHODS:Three hundred thirty-three ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.5.JNS131572
更新日期:2014-09-01 00:00:00
abstract:OBJECT:The aim of the study was to assess retrospectively the clinical efficacy and possible adverse effects of electrical spinal cord stimulation (SCS) for the treatment of patients with reflex sympathetic dystrophy (RSD). METHODS:Twenty-three patients who suffered severe pain due to RSD were included in the study. T...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.1999.90.1.0079
更新日期:1999-01-01 00:00:00
abstract:OBJECT:The expression of estrogen receptor-related antigen (ER-D5) has been demonstrated in many tumors, including those of the brain, but the actual role of ER-D5 in cell growth is unknown. The authors evaluated the role of ER-D5 in the growth of gliomas in vitro. METHODS:Human glioblastoma multiforme (GBM) cell line...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.100.5.0923
更新日期:2004-05-01 00:00:00