Abstract:
OBJECT:Little has been written about the appropriate diagnosis, investigation, and management of subarachnoid-pleural fistula (SPF). The authors report a series of patients with SPF that developed after resection of spinal tumor and discuss the diagnosis and treatment of this entity. METHODS:Between 1993 and 2002, nine patients with SPF observed after spinal surgery at the M. D. Anderson Cancer Center were prospectively followed. In all patients the tumors were located in the thoracic region, and the most common entity was vertebral body metastasis (six cases), with renal cell carcinoma being the most common form of the disease (three cases). All but one patient underwent surgery via a transthoracic approach; in only one patient an intradural approach was performed. The most common presentation was overt cerebrospinal fluid (CSF) leakage, manifesting as chest tube drainage (four cases) or as leakage through the wound (one case). A definitive diagnosis of SPF was established in four patients, with evidence of extraspinal leakage on an 111In-radionuclide CSF study. Although all patients initially underwent a trial of lumbar CSF drainage, all but one required open repair, including creation of intercostal muscle (three cases) and omental (one case) flaps. CONCLUSIONS:After spinal surgery in which the thorax is entered, a diagnosis of SPF should be considered in any patient with abnormal chest tube output, persistent pleural effusion, or clinical evidence of intracranial hypotension. The diagnosis should be confirmed by performing a radionuclide-labeled CSF study. Definitive open repair is required in most cases and preferentially consists of a vascularized tissue graft, which is most easily obtained from an intercostal muscle flap.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Hentschel SJ,Rhines LD,Wong FC,Gokaslan ZL,McCutcheon IEdoi
10.3171/spi.2004.100.4.0332subject
Has Abstractpub_date
2004-04-01 00:00:00pages
332-6issue
4 Suppl Spineeissn
0022-3085issn
1933-0693journal_volume
100pub_type
杂志文章abstract::A Remington humane stunner was used to deliver a blow to the left side of the surgically-exposed skull in ketamine-anesthetized cats. At 15 minutes after the trauma, brain tissue was frozen in situ. In animals without visible tissue hemorrhage (Grade 0) and in those with unilateral cerebral contusions involving the ce...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.1.0088
更新日期:1985-07-01 00:00:00
abstract::The authors studied the effect of high cervical cord section on the phenomenon of autoregulation in the rhesus monkey with the hydrogen clearance method to measure focal spinal cord blood flow (SCBF). Laminectomies were performed at T7-11 and C1-2. The spinal cord was completely severed at C1-2. Under normocapnic cond...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.44.4.0425
更新日期:1976-04-01 00:00:00
abstract::Delayed intracranial hematomas are an important treatable cause of secondary brain injury in patients with head trauma. Early identification and treatment of these lesions, which appear or enlarge after the initial computerized tomography (CT) scan, may improve neurological outcome. Serial examinations using near-infr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.83.3.0438
更新日期:1995-09-01 00:00:00
abstract::The authors present a modified surgical procedure for extracranial vertebral artery reconstruction. The use of the proposed technique results in access to the V3 segment of the vertebral artery between the C-1 and C-2 vertebrae through the retrojugular space without requiring bone rongeuring. A saphenous vein bypass g...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.77.5.0812
更新日期:1992-11-01 00:00:00
abstract::OBJECT This study explored whether there were differences between the autoimmune disease prevalence rates in unilateral and bilateral moyamoya disease (MMD). METHODS The authors performed a retrospective review of data obtained from the medical records of their hospital, analyzing and comparing the clinical characteri...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.4.JNS142936
更新日期:2016-05-01 00:00:00
abstract::A reversible and presumably neurogenic form of myocardial dysfunction may occur following subarachnoid hemorrhage (SAH), but the relationship of this finding to electrocardiographic abnormalities remains unclear. To clarify this issue, serial electrocardiograms (ECGs, mean 6.2 per patient) and echocardiograms (mean 3....
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.1995.83.5.0889
更新日期:1995-11-01 00:00:00
abstract::A study of computerized tomography (CT) scans was performed in a consecutive series of 100 patients with ruptured saccular cerebral aneurysms who were admitted, diagnosed, and operated on within 72 hours after subarachnoid hemorrhage (SAH) and treated with calcium antagonists. The aneurysms were in the anterior portio...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.65.2.0217
更新日期:1986-08-01 00:00:00
abstract::OBJECTIVE Mutations in the isocitrate dehydrogenase (IDH) genes are of proven diagnostic and prognostic significance for cerebral gliomas. The objective of this study was to evaluate the clinical feasibility of using a recently described method for determining IDH mutation status by using magnetic resonance spectrosco...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.10.JNS161793
更新日期:2018-02-01 00:00:00
abstract:OBJECT:In this paper the authors introduce a novel use of magnetoencephalography (MEG) for noninvasive mapping of language-specific cortex in individual patients and in healthy volunteers. METHODS:The authors describe a series of six experiments in which normative MEG data were collected and the reliability, validity,...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.90.1.0085
更新日期:1999-01-01 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 of this retrospective review and analysis of the literature cover an institutional series of neurenteric cysts of the central nervous system in children treated in the magnetic resonance imaging era during a 14-year period. METHODS:Sixteen patients 20 days to 14 years of age are described. The most ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/ped.2005.103.6.0512
更新日期:2005-12-01 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::The authors report a patient with unilateral anophthalmos who had a large suprasellar aneurysm associated with aplasia of an optic nerve and the chiasmal commissure. The anatomical findings at craniotomy are described. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.43.4.0495
更新日期:1975-10-01 00:00:00
abstract::Teratomas are neoplasms composed of tissues from all three germ layers with varying degrees of differentiation. They are most commonly found in the sacrococcygeal and gonadal regions and rarely occur in the head and neck region. A teratoma is termed "epignathus" when it arises from the skull base or hard palate and is...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/PED-07/09/266
更新日期:2007-09-01 00:00:00
abstract:OBJECT:In many new clinical trials of patients with malignant gliomas surgical intervention is incorporated as an integral part of tumor-directed interstitial therapies such as gene therapy, biodegradable wafer placement, and immunotherapy. Assessment of toxicity is a major component of evaluating these novel therapeut...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.98.6.1175
更新日期:2003-06-01 00:00:00
abstract::The authors studied 31 comatose head-injured patients to assess the clinical usefulness of laser Doppler flowmetry (LDF) in continuous autoregulation monitoring. The LDF probes were placed on the surface of the cerebral cortex. Data on LDF, intracranial pressure (ICP), and arterial blood pressure (ABP) were recorded a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.86.3.0438
更新日期:1997-03-01 00:00:00
abstract::Thirty-five Sprague-Dawley rats with saphenous neuromas underwent acute microfilament recording in the proximal nerve. The effect of the potassium channel-blocking agents, tetraethylammonium bromide (TEA) and 4-aminopyridine, on spontaneous activity in A fibers terminating in the neuroma was observed. The effects of g...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.2.0246
更新日期:1985-08-01 00:00:00
abstract::In an observational study in head-injured patients, cerebrovascular pressure transmission was investigated using a systems analysis approach whereby the blood pressure (BP) waveform was used as a measure of an input stimulus to the cerebrovascular bed (CVB) and the intracranial pressure (ICP) waveform as the response ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1990.73.6.0871
更新日期:1990-12-01 00:00:00
abstract::The clinical course of 12 patients who underwent terminal ventriculostomy for syringomyelia is presented. Opening the central canal at the tip of the conus medullaris is a relatively benign procedure that improves the symptoms of syringomyelia and syringobulbia. This canal normally terminates at the tip of the conus, ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.46.5.0609
更新日期:1977-05-01 00:00:00
abstract::Arachnoid cysts are commonly thought to arise from either congenital defects or trauma. In this article the authors report the spontaneous development of a suprasellar third ventricular arachnoid cyst whose origin was not clearly congenital or traumatic. At the age of 4 months, the patient presented with hypertonia, a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2006.104.6.426
更新日期:2006-06-01 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:OBJECT:Glioma resection under conscious ("awake") sedation (CS) is used for eloquent areas of the brain to minimize postoperative neurological deficits. The objective of this study was to compare the duration of hospital stay, overall hospital cost, perioperative morbidity, and postoperative patient functional status i...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.5.JNS1041
更新日期:2011-03-01 00:00:00
abstract:OBJECT:This study was performed to provide quantitative data on the number of surviving facial motor neurons that extend regenerated nerve fibers through the nerve-injured site and to reveal the relationship between facial function and the number of those motor neurons in which the facial nerve has been transected or r...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2005.102.4.0390
更新日期:2005-05-01 00:00:00
abstract:OBJECT:The authors sought to confirm that the combined supra/infratentorial-transsinus approach offers a safer means of resecting large pineal region tumors than other approaches currently being used. The aforementioned method provides a wider exposure of the pineal region with less brain retraction than the infratento...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.88.6.1050
更新日期:1998-06-01 00:00:00
abstract:OBJECT:Surgical mortality is a frequent outcome measure in studies of volume-outcome relationships, and the Agency for Healthcare Research and Quality has endorsed surgical mortality after craniotomies as an Inpatient Quality Indicator. Still, the frequency and causes of 30-day mortality after neurosurgical procedures ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.12.JNS11339
更新日期:2012-04-01 00:00:00
abstract::A spinal cord injury was produced in Wistar rats by extradural compression of the cord with a Sugita aneurysm clip for 5 seconds. During a 2-week observation period following the injury, the tissue norepinephrine (NE), dopamine (DA), and serotonin (5-HT) concentrations decreased uniformly at and below the injured site...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.5.0743
更新日期:1985-05-01 00:00:00
abstract::A case is reported of a 63-year-old woman with thalamic syndrome as the presenting feature of an unruptured cerebral aneurysm. Unruptured aneurysm is a rare cause of thalamic syndrome; the possible mechanisms of production of the sensory disturbance are discussed. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.2.0291
更新日期:1995-02-01 00:00:00
abstract:OBJECT:Outcome following brain tumor operations is often assessed by health professionals using various gross function scales. However, surprisingly little is known about how modern glioma surgery affects quality of life (QOL) as reported by the patients themselves. In the present study the authors aimed to assess chan...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.1.JNS101657
更新日期:2011-06-01 00:00:00
abstract:OBJECT:Neurointensivists are specialists trained to manage all aspects of the intensive care unit (ICU) stay of neurologically ill patients. No study to date has examined the role of neurointensivists specifically in subarachnoid hemorrhage (SAH) management. This study examined the use of a team-based neurointensivist ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.8.JNS09441
更新日期:2010-03-01 00:00:00
abstract:OBJECT:Grade 3 and 4 blunt vertebral artery (VA) injuries may carry a different natural course from that of lower-grade blunt VA injuries. Proper screening, management, and follow-up of these injuries remain controversial. Grade 3 and 4 blunt VA injuries were analyzed to define their natural history and establish a rat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.9.JNS1461
更新日期:2015-05-01 00:00:00