Abstract:
:The absence of spontaneous respirations at a PaCO2 of 60 mm Hg or above has traditionally been accepted as the respiratory criteria for the determination of brain death. The testing of patients for the presence or absence of apnea has been complicated because the rate of PaCO2 elevation may vary substantially from patient to patient, and a nonlinear relationship exists between the rate of PaCO2 increase and the duration of apnea. In an attempt to refine the apnea test and to further elucidate the physiology of hypercapnia in humans, 11 patients who met all but the respiratory criteria for brain death were evaluated using a modification of a previously utilized apnea testing protocol. All patients were brought to a PaCO2 of 40 mm Hg or above prior to the apnea test. Baseline PaCO2 ranged from 40 to 45 mm Hg in six patients (Group I) and from 46 to 51 mm Hg in five patients (Group II). The mean rate of PaCO2 increase was 5.1 +/- 1.4 mm Hg/min in Group I and 6.7 +/- 3.1 mm Hg/min in Group II. No problems with cardiovascular instability or hypoxia were encountered during testing in this series. This refinement of the apnea test allows for a streamlined and safe approach to brain death detection.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Benzel EC,Mashburn JP,Conrad S,Modling Ddoi
10.3171/jns.1992.76.6.1029subject
Has Abstractpub_date
1992-06-01 00:00:00pages
1029-31issue
6eissn
0022-3085issn
1933-0693journal_volume
76pub_type
杂志文章abstract::Pilomyxoid astrocytomas have been identified as a more aggressive variant of pilocytic astrocytomas that occur in infants and in young children. These tumors are characterized by a perivascular arrangement of pilocytic cells that has a monomorphous architecture with uniform, elongated bipolar cells loosely ranged with...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.2003.99.2.0416
更新日期:2003-08-01 00:00:00
abstract::This is a prospective randomized study of the efficacy of steroid therapy in patients with severe head injury. One hundred patients were randomized into two equal groups: the steroid group received 5 mg/kg/day of methylprednisolone, and the nonsteroid group received no drug. The groups were similar in their clinical f...
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.1981.54.5.0596
更新日期:1981-05-01 00:00:00
abstract:OBJECT:Recurrent malignant gliomas have inherent resistance to traditional chemotherapy. Novel therapies target specific molecular mechanisms involved in abnormal signaling and resistance to apoptosis. The proteasome is a key regulator of multiple cellular functions, and its inhibition in malignant astrocytic lines cau...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.7.JNS1323
更新日期:2013-12-01 00:00:00
abstract:OBJECT:In this retrospective study conducted at Atkinson Morley's Hospital and Middlesbrough General Hospital, the authors analyzed 100 matched patients who had suffered subarachnoid hemorrhage (SAH) to determine whether the technical procedure by which aneurysms are treated affects the development of chronic hydroceph...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.92.6.0991
更新日期:2000-06-01 00:00:00
abstract:OBJECT:Onyx, an ethylene-vinyl alcohol copolymer mixed in a dimethyl sulfoxide solvent, is currently one of the most widely used liquid materials for embolization of intracranial arteriovenous malformations (AVMs). The goal of this study was to define the risks and benefits of stereotactic radiosurgery (SRS) for patien...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.12.JNS141437
更新日期:2015-07-01 00:00:00
abstract:OBJECT:Opercular glioma inferolateral to the hand/digit sensorimotor area can be resected safely using a neuronavigation system and functional brain mapping techniques. However, the surgery can still sometimes cause postoperative ischemic complications, the character of which remains unclear. The authors of this study ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2007.106.2.263
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:The objective of this open-label, nonrandomized trial was to evaluate the efficacy and safety of bilateral caudate nucleus deep brain stimulation (DBS) for treatment-resistant tinnitus. METHODS:Six participants underwent DBS electrode implantation. One participant was removed from the study for suicidality u...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.4.JNS19347
更新日期:2019-09-24 00:00:00
abstract::OBJECTIVE The presence, extent, and distribution of intraventricular hemorrhage (IVH) have been associated with negative outcomes in aneurysmal subarachnoid hemorrhage (SAH). Several qualitative scores (Fisher grade, LeRoux score, and Graeb score) have been established for evaluating SAH and IVH. However, no study has...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.11.JNS152839
更新日期:2018-04-01 00:00:00
abstract::Subependymomas of the fourth ventricle are generally considered incidental postmortem findings, and have received scant attention from neurosurgeons. The authors present a surgical series of 12 cases of this disorder diagnosed over a 13-year period. The clinical and radiological findings were reviewed and correlations...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.4.0508
更新日期:1985-04-01 00:00:00
abstract::This study examined the effect of hypocapnia (PaCO2 20 mm Hg) on cerebral metabolism and the electroencephalogram (EEG) findings in 12 dogs during nitroglycerin (NTG)-induced hypotension. Previous studies suggest that NTG is a more potent cerebral vasodilator than sodium nitroprusside or trimethaphan. It was speculate...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.6.0924
更新日期:1986-06-01 00:00:00
abstract:OBJECT:The aim of this prospective study was to evaluate the phagocytic, humoral, and cellular arms of the immune system in comatose patients shortly after severe brain injury and to compare the findings with those reported earlier in patients in a persistent vegetative state. The study was conducted in intensive care ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.94.5.0706
更新日期:2001-05-01 00:00:00
abstract::Heterotopic new bone formation, associated with head injuries, usually affects the shoulder, elbow, and hip joints. The authors present a case with an unusual involvement of the cervical spine, confirmed by bone scanning and computerized tomography. Although the etiology of heterotopic new bone formation is not well u...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.3.0513
更新日期:1986-03-01 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::Intracranial hypertension following traumatic brain injury is associated with considerable morbidity and mortality. Hemorrhagic hypovolemia commonly coexists with head injury in this population of patients. Therapy directed at correcting hypovolemic shock includes vigorous volume expansion with crystalloid solutions. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.79.3.0421
更新日期:1993-09-01 00:00:00
abstract::The authors present the case of an intraneural ganglion cyst of the peroneal nerve. The cyst was diagnosed by means of ultrasound, which also gave an exact definition of its size and location, confirmed at operation. Some controversial aspects of these lesions are discussed. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.76.3.0538
更新日期:1992-03-01 00:00:00
abstract::Cranial and spinal trauma resulted in disseminated intravascular coagulation (DIC) in a 78-year-old man, causing widespread bleeding and incoagulable blood. Traumatized brain tissue was found in the lumina of dural venous sinuses. The mechanisms of DIC are reviewed. It is suggested that intravascular release of potent...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.52.2.0266
更新日期:1980-02-01 00:00:00
abstract::Cushing's experience with the surgical treatment of pituitary adenomas and other lesions producing the chiasmal syndrome is reviewed. The conclusion is that his ultimate rejection of the transsphenoidal route was not due to his dissatisfaction with this procedure, but rather came about because of the transfrontal rout...
journal_title:Journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.3171/jns.1981.54.4.0448
更新日期:1981-04-01 00:00:00
abstract::Iniencephaly is a rare congenital anomaly characterized by spina bifida of the cervical vertebrae, fixed retroflexion of the head on the cervical spine, and occipital bone defect. There are only five reports of surviving patients with iniencephaly. The authors report the case of a newborn who presented with iniencepha...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1998.89.2.0317
更新日期:1998-08-01 00:00:00
abstract::OBJECTIVESince the first clinical application of the incisionless magnetic resonance-guided focused ultrasound (MRgFUS) technology only small series of patients have been reported, and thus only extrapolations of the procedure-related risks could be offered. In this study, the authors analyze side-effects and targetin...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.12.JNS172054
更新日期:2018-05-01 00:00:00
abstract:OBJECT:Subarachnoid hemorrhage (SAH) from ruptured posterior inferior cerebellar artery (PICA) aneurysms is uncommon, and long-term outcome data for patients who have suffered such hemorrhages is lacking. This study investigated in-hospital and long-term clinical data from a prospective cohort of patients with SAH from...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.10.JNS141079
更新日期:2015-08-01 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 authors report four cases of primary intracranial choriocarcinoma, all in young males. There tumors occurred in the pineal region and one in the lateral ventricle. Besides the signs of increased intracranial pressure and ophthalmological disorders, skin pigmentation or eruption was observed in three cases and prec...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.3.0369
更新日期:1980-09-01 00:00:00
abstract:OBJECT:Despite the increasing use of immunotherapy in the treatment of metastatic melanoma, the effects of this therapy on the management of patients with associated brain metastases are not completely defined. The authors undertook this study to determine the effectiveness of resection and the effects of immunotherapy...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.3.JNS091107
更新日期:2011-07-01 00:00:00
abstract:OBJECT:The authors retrospectively reviewed 121 patients with traumatic cervical spine injuries to determine the risk of neurological deterioration following early closed reduction. METHODS:After excluding minor fractures and injuries without subluxation, the medical records and imaging studies (computerized tomograph...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.1999.90.1.0013
更新日期:1999-01-01 00:00:00
abstract::Thirty-one monkeys were randomly divided into three groups to undergo baseline cerebral angiography followed by induction of subarachnoid hemorrhage by placement of autologous blood clot along the right-sided arteries of the anterior circle of Willis (Day 0). The monkeys were then given drug vehicle or one of two endo...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.83.3.0503
更新日期:1995-09-01 00:00:00
abstract::The authors describe two patients in whom tumor swelling and brain swelling (and possible tumor swelling), respectively, developed after undergoing gamma knife surgery. One had a skull defect with a palpable parasagittal tumor. One had neurofibromatosis Type 2 with multiple tumors, one of which was parasagittal. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.102.s_supplement.0001
更新日期:2005-01-01 00:00:00
abstract:OBJECT:There is no description of the change in the posterior cerebral artery (PCA) in the diagnostic criteria of moyamoya disease (MMD). However, PCAs are often involved in the clinical setting, and an understanding of the significance of PCA lesions is therefore of great importance when evaluating the disease progres...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.6.JNS122099
更新日期:2013-10-01 00:00:00
abstract::Lysosomal proteases, although tightly regulated under physiological conditions, are known to contribute to cell injury after various forms of tissue ischemia have occurred. Because cathepsin B is a prominent lysosomal protease found in brain parenchyma, the authors hypothesized that it may contribute to neuronal cell ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.87.5.0716
更新日期:1997-11-01 00:00:00
abstract::The authors report eight cases of trigeminal neurinoma managed over the past 13 years with radical resection at a single-stage operation. Three patients were male and five were female, ranging in age from 25 to 56 years (mean 41.5 years). One had von Recklinghausen's disease. The tumors were located mainly within the ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.71.4.0506
更新日期:1989-10-01 00:00:00
abstract:OBJECT:Pituitary tumors are abnormal growths that develop in the pituitary gland. The Central Brain Tumor Registry of the United States (CBTRUS) contains the largest aggregation of population-based data on the incidence of primary CNS tumors in the US. These data were used to determine the incidence of tumors of the pi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.5.JNS131819
更新日期:2014-09-01 00:00:00