Abstract:
OBJECT:The head-shaking method combined with cisternal irrigation has been proposed to be effective in preventing cerebral vasospasm after subarachnoid hemorrhage (SAH) by facilitating rapid washout of the clot from the subarachnoid space. This study was conducted to evaluate the effectiveness of this method. METHODS:The inclusion criteria included the following: 1) Fisher Grade 3 SAH on admission computerized tomography (CT) scans; 2) aneurysm secured within 48 hours of SAH onset; and 3) no focal deficit and ability to obey commands within 24 hours postsurgery. Two hundred thirty patients treated between 1994 and 2002 fulfilled the criteria. Because only one machine was available and it required I month of maintenance every other month, 114 patients underwent irrigation combined with the head-shaking method (head-shaking group), whereas the remaining 116 patients received cisternal irrigation alone (control group). There were no significant differences in sex, age, site of aneurysm, or preoperative grade between the two groups. The incidence of symptomatic vasospasm with or without infarction, cerebral infarction on CT scans, and permanent ischemic neurological deficit was 25.7, 17.7, and 8.8%, respectively, in the control group and 15.2, 4.5, and 2.7% in the head-shaking group. The difference was statistically significant for symptomatic vasospasm, cerebral infarction, and permanent ischemic neurological deficit (p < 0.05). In a multivariate backward stepwise logistic regression analysis, absence of head shaking was the only variable that was predictive of permanent ischemic neurological deficit (p = 0.061). The outcomes evaluated using the modified Rankin Scale were better in the head-shaking group (p = 0.051). CONCLUSIONS:The head-shaking method significantly reduced the incidence of symptomatic vasospasm, cerebral infarction, and permanent ischemic neurological deficit and improved the clinical outcomes in patients who underwent cisternal irrigation therapy after aneurysmal SAH.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Kawamoto S,Tsutsumi K,Yoshikawa G,Shinozaki MH,Yako K,Nagata K,Ueki Kdoi
10.3171/jns.2004.100.2.0236subject
Has Abstractpub_date
2004-02-01 00:00:00pages
236-43issue
2eissn
0022-3085issn
1933-0693journal_volume
100pub_type
杂志文章abstract::The ocular complications of intracarotid infusion of drugs for brain-tumor chemotherapy may be eliminated by infusion of the chemotherapeutic agent into the carotid artery above the origin of the ophthalmic artery. The authors have developed a catheter that can negotiate the carotid siphon. This catheter is not balloo...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.58.4.0616
更新日期:1983-04-01 00:00:00
abstract::A consecutive series of 82 acromegalic patients who underwent transsphenoidal surgery during a 5-year period is presented. Preoperative and postoperative values for human growth hormone (HGH) were available in 80 cases. Microadenomas were present in 18 patients with a mean preoperative HGH value of 25.2 ng/ml, diffuse...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.4.0454
更新日期:1979-04-01 00:00:00
abstract:OBJECT:Carotid artery (CA) angioplasty with stent placement has been proposed as an alternative technique for revascularization in cases of CA stenosis. In this report the authors review the results of a multicenter Phase I study in which they evaluated the safety and feasibility of using a new self-expanding nitinol s...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.3171/jns.2002.96.5.0830
更新日期:2002-05-01 00:00:00
abstract:OBJECT:In this study the authors compare the clinical outcomes after particle embolization of hemangioblastomas in the cerebellum and spinal cord. They also review the literature of similar cases. METHODS:Seven patients with hemangioblastomas in the spinal cord (four patients) and cerebellum (three patients) underwent...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2007.106.6.994
更新日期:2007-06-01 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:OBJECT:Despite the controversy over the clinical significance of Gamma Knife surgery (GKS) for refractory mesial temporal lobe epilepsy (MTLE), the modality has attracted attention because it is less invasive than resection. The authors report long-term outcomes for 7 patients, focusing in particular on the long-term c...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.2.JNS111296
更新日期:2012-06-01 00:00:00
abstract::In a series of 32 surgical cases of carotid-ophthalmic artery aneurysm, seven of the lesions were located in the "carotid cave." This special type of aneurysm is usually small and projects medially on the anteroposterior view of the angiogram. At surgery, it is located intradurally at the dural penetration of the inte...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.70.2.0216
更新日期:1989-02-01 00:00:00
abstract::The supplementary motor area (SMA) is a region located within each cerebral hemisphere at the posterior mesial border of the frontal lobe adjacent to the falx. The functional significance of this area has been somewhat unclear, and information regarding its influence on motor output has largely been based on evoked re...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.75.1.0062
更新日期:1991-07-01 00:00:00
abstract::The authors report a case of in-stent restenosis (ISR) of the middle cerebral artery (MCA) following bare-metal stent (BMS) deployment and subsequent treatment using a drug-eluting stent (DES). This 65-year-old woman presented with frequent transient ischemic attacks. Initial studies revealed occlusion of the left int...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.8.JNS081609
更新日期:2010-04-01 00:00:00
abstract::Gas myelography was carried out in 22 patients with acute cervical spinal cord injuries in whom oily contrast media seemed contraindicated. The authors believe this technique makes a valuable contribution to the basic decision regarding the surgical versus medical treatment of a specific patient with a cervical cord i...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.42.3.0330
更新日期:1975-03-01 00:00:00
abstract::Forty-five studies of regional cerebral blood volume (rCBV), regional cerebral blood flow (rCBF), and regional cerebral oxygen utilization (rCMRO2) were performed in 30 patients undergoing diagnostic cerebral angiography for evaluation of a subarachnoid hemorrhage due to a ruptured intracranial aneurysm. Tracer method...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.46.4.0446
更新日期:1977-04-01 00:00:00
abstract:OBJECT:The goal of this study was to find which central nervous system (CNS) pathways are involved in volitional control over reinnervated biceps or pectoral muscles. METHODS:Intercostal nerves (ICNs) were coapted to the musculocutaneous nerve (MCN) or the medial pectoral nerve (MPN) in 23 patients with root avulsions...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.89.4.0568
更新日期:1998-10-01 00:00:00
abstract:OBJECT:Knowing the rate of rupture associated with unruptured cerebral aneurysms (UCAs) can help surgeons determine a case management strategy in patients harboring these lesions. According to large-scale cohort studies involving populations in North America and Europe, small unruptured aneurysms carry a very low risk ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.2005.102.4.0601
更新日期:2005-04-01 00:00:00
abstract:OBJECT:Congenital occipitocervical (OC) instability is uncommon in healthy children but can occur in many children with Down syndrome. A simple morphometric method of evaluating the OC joint in children with OC instability is presented, supported by a qualitative image analysis based on computed tomography (CT). METHO...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2006.105.1.50
更新日期:2006-07-01 00:00:00
abstract::This report describes a large, asymptomatic, subdural skeletal-type condrosarcoma originating from the meninges. Distinction between the mesenchymal and skeletal types of intracranial chondrosarcoma is important since they have different prognoses. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.48.5.0825
更新日期:1978-05-01 00:00:00
abstract:OBJECT:Patients with gliomas frequently have cognitive deficits, and surgery can exacerbate these deficits. Preoperative assessment is therefore crucial in patients undergoing surgery for glioma in eloquent areas, because the proximity of functional areas increases the risk of permanent postoperative cognitive disturba...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.7.JNS12263
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:Corpus callosotomy is a palliative procedure that is effective at reducing seizure burden in patients with medically refractory epilepsy. The procedure is traditionally performed via open craniotomy with interhemispheric microdissection to divide the corpus callosum. Concerns for morbidity associated with cra...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.9.JNS191769
更新日期:2019-12-13 00:00:00
abstract::The clinical and angiographic findings of 55 patients with a spinal dural arteriovenous malformation (AVM) are reviewed, and the results of surgery assessed. The symptoms of dural AVM are usually gradual in onset, and hemorrhage from this type of AVM is less common than in true spinal cord angiomas. Other clinical fea...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.2.0238
更新日期:1984-02-01 00:00:00
abstract::The authors have analyzed retrospectively a series of 288 consecutive patients with severe head injury observed between January, 1977, and May, 1980. Seventy-three patients were excluded as not being compatible with those of the International Data Bank. The remaining 215 patients complied with the definition of coma g...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1982.57.6.0779
更新日期:1982-12-01 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::Paget disease is an idiopathic metabolic disease of bone that may involve the axial and appendicular skeleton. In up to one third of patients there may be pagetoid involvement of the spine, which can cause back pain and vertebral collapse, with instability or myeloradiculopathy. Although medical therapy is the mainsta...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2003.99.1.0110
更新日期:2003-07-01 00:00:00
abstract::A new technique is presented in which expandable compressed Ivalon sponge emboli were used to obliterate an intramedullary arteriovenous malformation of the spinal cord by intraparenchymal embolization. A case is described in which this method was used. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.1.0119
更新日期:1977-07-01 00:00:00
abstract:OBJECT:A wide variation in postoperative drainage volumes is observed during treatment of chronic subdural hematoma (CSDH) with twist-drill or burr-hole craniostomy and closed-system drainage. In this study the authors investigate the causes of the variation, the clinical significance thereof, and its influence on trea...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.93.5.0796
更新日期:2000-11-01 00:00:00
abstract:OBJECT:Although traumatic brain injury (TBI) is the leading cause of death and morbidity in young adults, no effective pharmaceutical treatment is available. By inhibiting glycogen synthase kinase-3 (GSK-3) and histone deacetylases (HDACs), respectively, lithium and valproate (VPA) have beneficial effects in diverse ne...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.6.JNS13135
更新日期:2013-09-01 00:00:00
abstract::In a retrospective analysis, the authors studied the pial and dural blood supplies in 74 intracranial meningiomas and quantified their associated peritumoral brain edema (PTBE). The extent and localization of pial blush in relation to the total tumor volume were determined angiographically. The amount of edema and tum...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.87.3.0368
更新日期:1997-09-01 00:00:00
abstract::The authors present the case of a 20-year-old man who, 3 months after his initial injury, underwent repair of a 1.7-cm defect of the ulnar nerve at the wrist; repair was performed with an acellular nerve allograft. Given the absence of clinical or electrophysiological recovery at 8 months postrepair, the patient under...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.4.JNS121938
更新日期:2013-09-01 00:00:00
abstract::By the time Harvey Cushing entered medical school, nerve reconstruction techniques had been developed, but peripheral nerve surgery was still in its infancy. As an assistant surgical resident influenced by Dr. William Halsted, Cushing wrote a series of reports on the use of cocaine for nerve blocks. Following his resi...
journal_title:Journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.3171/2010.11.JNS10804
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:One of the goals in this study was to set up a semiautomatic method to estimate blood-brain barrier disruption obtained in patients with glioblastoma by using an implantable, unfocused, ultrasound device. Another goal was to correlate the probability of significant ultrasound-induced signal enhancement (SUISE...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.9.JNS182001
更新日期:2019-02-01 00:00:00
abstract::The ability of hemodilution to lower blood viscosity and increase cerebral blood flow has been proven experimentally; however, the optimum hematocrit for maximum oxygen delivery to ischemic brain tissue is not known, and a study was designed to determine this. Fifty dogs were selected for inclusion in the study using ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.80.3.0469
更新日期:1994-03-01 00:00:00
abstract::Rarely are both sides of the hippocampus available for pathological study in a patient with intractable temporal lobe epilepsy (TLE). The authors report a patient with TLE investigated with bilateral depth electrodes who had an episode of postictal psychosis. The patient died 4 weeks after temporal lobectomy of unknow...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.2.0228
更新日期:1995-02-01 00:00:00