Abstract:
:The authors reviewed 229 consecutive patients treated intramurally by resection of solitary cerebral metastasis. Patients were classified into four groups on the basis of whether a gross total resection or subtotal resection was performed and whether systemic disease was present or absent at the time of craniotomy. Group 1 had gross total resection and no systemic disease; Group 2 had subtotal resection and no systemic disease; Group 3 had subtotal resection and systemic disease; and Group 4 had gross total resection and systemic disease. All four groups were further subdivided into Subgroup A (adjuvant whole-brain radiation therapy) or Subgroup B (no adjuvant radiation). Data were collected regarding multiple patient and tumor variables for multivariate analysis. Survival data for the 46 patients in Group 1A (median 1.3 years, 2-year survival rate 41%, 5-year survival rate 21%) were markedly better than those for the 75 in Group 1B (median 0.7 year, 2-year survival rate 19%, 5-year survival rate 4%). The 20 patients in Group 2A also had superior survival data (median 1.1 years, 2-year survival rate 30%, 3-year survival rate 30%) when compared with the eight patients in Group 2B (median 3 months, 1-year survival rate 0%). However, the 16 and 22 patients in Groups 3A and 4A, respectively, had no discernible differences compared to the seven and 35 patients in their Group 3B and 4B counterparts. Multivariate analyses were performed to assess the association of survival with multiple patient, disease, and treatment variables. Poor neurological status and systemic disease were significantly associated with inferior survival, while longer (greater than 36 months) intervals between primary diagnosis and craniotomy were significantly associated with improved survival. After adjusting for the effects of other patient, disease, and treatment characteristics, adjuvant whole-brain radiotherapy was significantly associated with improved survival times. These data support the continued use of craniotomy followed by adjuvant whole-brain radiation therapy for treatment of solitary brain metastasis. However, this aggressive therapy appears relatively contraindicated in the face of either systemic disease or substantial neurological deficit.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Smalley SR,Laws ER Jr,O'Fallon JR,Shaw EG,Schray MFdoi
10.3171/jns.1992.77.4.0531subject
Has Abstractpub_date
1992-10-01 00:00:00pages
531-40issue
4eissn
0022-3085issn
1933-0693journal_volume
77pub_type
杂志文章abstract::A patient is reported with a purely pial arteriovenous malformation (AVM) supplied from the posterior parietal artery. The prominent middle meningeal artery contributed to opacification of the angular branches distal to the AVM, but did not contribute to the AVM. After total removal of the AVM, the angular branches be...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.4.0522
更新日期:1979-04-01 00:00:00
abstract::A case of chronic diploic hematoma of the parietal bone is reported. This lesion is considered to have developed over several years following minor head trauma. Clinical, radiological, and pathological findings of this rare lesion are described. To the authors' knowledge, this is the first reported case of such an unc...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.80.6.1112
更新日期:1994-06-01 00:00:00
abstract:OBJECT:A brief period of hypothermia has recently been shown to induce delayed tolerance to ischemic brain injury. This form of tolerance is initiated several hours after hypothermic preconditioning (HPC) and persists for a few days. Hypothermia-induced tolerance could provide a means for limiting cellular injury durin...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.3.0650
更新日期:2002-09-01 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:OBJECT:The authors conducted a study to determine age-related changes in expression of transforming growth factor (TGF)-beta1, -beta2, -beta3, and Type I and Type II receptors in various cells in the nucleus pulposus and anulus fibrosus. Immunolocalization of TGFbetas and Type I and II receptors was examined during the...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2003.98.1.0063
更新日期:2003-01-01 00:00:00
abstract:OBJECT:Brainstem cavernous malformations (CMs) are challenging due to a higher symptomatic hemorrhage rate and potential morbidity associated with their resection. The authors aimed to preoperatively define the relationship of CMs to the perilesional corticospinal tracts (CSTs) by obtaining qualitative and quantitative...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.12.JNS142169
更新日期:2015-11-01 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::The feasibility of high-frequency transcranial electrical stimulation (TES) through screw electrodes placed in the skull was investigated for use in intraoperative monitoring of the motor pathways in patients who are in a state of general anesthesia during cerebral and spinal operations. Motor evoked potentials (MEPs)...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.2004.100.1.0155
更新日期:2004-01-01 00:00:00
abstract:OBJECT:This study was conducted to evaluate the value of postoperative CT scans in determining the probability of return to the operating room (OR) and the optimal time to obtain such scans to determine the effects of surgery. METHODS:Between January and December 2006 (12 months), all postoperative head CT scans obtai...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.11.JNS081048
更新日期:2010-11-01 00:00:00
abstract::To evaluate microcirculatory disturbance and cerebral edema associated with subarachnoid hemorrhage (SAH), both stereological morphometry on the intraparenchymal capillary network and microgravimetry were performed on a rabbit SAH model. Autologous arterial blood (5 ml) was injected into the cisterna magna, and the an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.73.3.0410
更新日期:1990-09-01 00:00:00
abstract::An extraosseous extradural tumor of the lumbar region with the histological appearance of chordoma produced symptoms in a 58-year-old woman. The tumor occupied the epidural space and produced scalloping of the adjacent vertebral body and pedicle without associated bone destruction. The location of the tumor within Bat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.75.6.0980
更新日期:1991-12-01 00:00:00
abstract::Several types of adjustable clamp have been widely utilized to gradually occlude the carotid artery for the treatment of various intracranial vascular lesions. A fairly large number of patients, many of whom have not been adequately followed, have these clamps still in place. The authors report two patients, initially...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.79.5.0779
更新日期:1993-11-01 00:00:00
abstract::Gadolinium-diethylenetriaminepenta-acetic acid (Gd-DTPA) is a chelated paramagnetic contrast agent under clinical trial for use in magnetic resonance (MR) imaging. The increased signal intensity following the intravenous infusion of contrast medium may improve the ability of MR imaging to delineate tumors. The use of ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.71.1.0049
更新日期:1989-07-01 00:00:00
abstract::OBJECTIVE The authors undertook this study to validate the feasibility and safety of stereotactic radiofrequency thermocoagulation (SRT) for the surgical treatment of giant hypothalamic hamartoma (HH). METHODS Of the 109 patients who underwent SRT for hypothalamic hamartoma (HH) at the authors' institution between 199...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.6.JNS15200
更新日期:2016-10-01 00:00:00
abstract::Lower-extremity pain and paresthesia have multiple origins. Early recognition of the symptoms of peripheral nerve entrapment leads to timely treatment and avoids the cost of unnecessary studies. The authors report on a case of superficial peroneal nerve syndrome resulting from nerve herniation through a fascial defect...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2006.104.5.820
更新日期:2006-05-01 00:00:00
abstract::A study was designed to investigate hyperperfusion syndrome after the restoration of normal cerebral blood flow in a chronically cerebral ischemic state resulting from high-flow arteriovenous malformations or severe carotid stenosis. A fistula between the left distal common carotid artery and the jugular vein was crea...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.76.3.0478
更新日期:1992-03-01 00:00:00
abstract::The authors report and discuss four rare cases of primary, giant cell tumor of the cranial vault, a usually benign tumor that develops in young patients and has an extremely low rate of latent malignancy. The authors believe the preferred treatment to be total surgical removal of the tumor; only in rare cases of malig...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.42.5.0535
更新日期:1975-05-01 00:00:00
abstract::OBJECTIVECerebrovascular bypass surgery is a challenging yet important neurosurgical procedure that is performed to restore circulation in the treatment of carotid occlusive diseases, giant/complex aneurysms, and skull base tumors. It requires advanced microsurgical skills and dedicated training in microsurgical techn...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.11.JNS17318
更新日期:2018-05-11 00:00:00
abstract:OBJECT:Cavernomas in the occipital lobe are relatively rare. Because of the proximity to the visual cortex and incoming subcortical tracts, microsurgical removal of occipital cavernomas may be associated with a risk of visual field defects. The goal of the study was to analyze long-term outcome after operative treatmen...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.5.JNS112102
更新日期:2012-08-01 00:00:00
abstract::Blood flow for the whole spinal cord (SCBF), central cord (largely gray matter), and peripheral cord (largely white matter) has been measured at all segmental levels using radioactive microspheres in conscious sheep. Whole SCBF was greatest in the lower cervical and lumbar enlargements and least in the upper cervical ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.5.0620
更新日期:1981-05-01 00:00:00
abstract:OBJECT:The goal of this paper was to investigate a possible relationship between the consumption of low-dose aspirin (LDA) and traumatic intracranial hemorrhage in an attempt to determine whether older patients receiving prophylactic LDA require special treatment following an incidence of mild-to-moderate head trauma. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.99.4.0661
更新日期:2003-10-01 00:00:00
abstract::The authors evaluated the effects of exogenous basic fibroblast growth factor (bFGF) in combination with intravenous methylprednisolone on neurological function and cord angiogenesis in a model of spinal cord injury. Cord injury was produced by extradural clip compression through a T-1 laminectomy. Rats were randomize...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.83.1.0105
更新日期:1995-07-01 00:00:00
abstract::A 55-year-old man, who had previously had a left atrial myxoma excised, developed recurrent hematomas of the left occipital lobe. Microscopic examination revealed the presence of metastatic myxoma. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1990.72.2.0295
更新日期:1990-02-01 00:00:00
abstract::Seven patients with spasticity of spinal cord origin have been maintained for up to 2 years with continuous spinal intrathecal infusion of baclofen. Prior to treatment, all of the patients had severe rigidity in their lower limbs and most had frequent and extensive spontaneous spasms, all of which greatly interfered w...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.66.2.0181
更新日期:1987-02-01 00:00:00
abstract::The benefits of radiosurgery for cavernous malformations are difficult to assess because of the unclear natural history of this vascular lesion, the inability to image malformation vessels, and the lack of an imaging technique that defines "cure." The authors selected for radiosurgery 47 patients who harbored a hemorr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.83.5.0825
更新日期:1995-11-01 00:00:00
abstract::Granular-cell tumors are exceedingly rare neoplasms in the central nervous system. Their histogenesis has been a subject of longstanding controversy but substantial findings support the current theory of a Schwann cell origin. Other recent histopathological studies point to an astrocytic origin in those tumors which a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1994.81.5.0795
更新日期:1994-11-01 00:00:00
abstract::OBJECT Current recommendations stress the need for cognitive parameters to be integrated in the evaluation of outcomes for intracranial meningioma surgery. The aim of this prospective study was to examine neurocognitive function in meningioma patients pre- and postoperatively. METHODS Patients with skull base (anterio...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.6.JNS1549
更新日期:2016-06-01 00:00:00
abstract::Ten cases of meningioma of the pineal region were histologically verified at a single institution during an 8-year period. These represented 0.3% of 3061 intracranial meningiomas, as well as 6.2% of 164 pineal tumors. Patients were predominantly women. Symptoms and signs of increased intracranial pressure were most co...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.4.0586
更新日期:1996-10-01 00:00:00
abstract::This 61-year-old man with a right-sided tentorial dural arteriovenous fistula (DAVF) was initially treated with staged stereotactic radiosurgery and transarterial embolization. Results of follow-up cerebral angiography performed 4 years later demonstrated complete obliteration of the dAVF and development of a previous...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.93.6.1058
更新日期:2000-12-01 00:00:00
abstract:OBJECT:The aim of this paper was to validate the diffusion tensor imaging (DTI) model for delineation of the corticospinal tract using cortical and subcortical white matter electrical stimulation for the location of functional motor pathways. METHODS:The authors compare probabilistic versus deterministic DTI fiber tra...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.4.JNS131160
更新日期:2014-08-01 00:00:00