Gamma knife surgery for cancer pain-pituitary gland-stalk ablation: a multicenter prospective protocol since 2002.

Abstract:

OBJECT:The authors have treated intractable pain, particularly cancer pain related to bone metastasis, with various protocols. Cancer pain has been treated by gamma knife radiosurgery (GKS), targeted to the pituitary gland-stalk, as an alternative new pain control method. The purpose of this study was to investigate a prospective multicenter protocol to prove the efficacy and the safety of this treatment. METHODS:Indications for patient inclusion in this treatment protocol were: 1) pain related to bone metastasis; 2) no other effective pain treatment options; 3) general condition rated as greater than 40 on the Kamofsky Performance Scale; 4) morphine effective for pain control; and 5) no previous treatment with radiation (GKS or conventional radiotherapy) for brain metastasis. The authors at one institution have treated two patients, who suffered from severe cancer pain related to bone metastasis, by using GKS. The target was the pituitary gland. The maximum dose was 160 Gy with one isocenter of an 8-mm collimator, keeping the radiation dose to the optic nerve less than 8 Gy. At another institution two patients were treated in the same way; an additional five patients were treated similarly with targeting of the pituitary gland with two isocenters of 4-mm collimator. In all nine cases, pain resolved without significant complication. Pain relief was observed within several days, and this effect was prolonged until the day that they died. At a follow up of 1 to 24 months, no recurrences and no hormonal dysfunction were observed. CONCLUSIONS:Despite insufficient experience, the efficacy and the safety of GKS for intractable pain were demonstrated in nine patients. This treatment has the potential to ameliorate cancer-related pain, and GKS will play a more important role in the treatment of intractable pain. More experience and additional refined study protocols are needed to evaluate which parameters are important, to determine what treatment strategy is the best, and to clarify the safest option for patients with intractable cancer pain.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Hayashi M,Taira T,Chernov M,Fukuoka S,Liscak R,Yu CP,Ho RT,Regis J,Katayama Y,Kawakami Y,Hori T

doi

10.3171/jns.2002.97.supplement

subject

Has Abstract

pub_date

2002-12-01 00:00:00

pages

433-7

issue

5 Suppl

eissn

0022-3085

issn

1933-0693

journal_volume

97

pub_type

临床试验,杂志文章,多中心研究
  • Depressed skull fracture overlying the superior sagittal sinus as a cause of benign intracranial hypertension. Case report.

    abstract::The use of surgical treatment for depressed skull fractures that are located over major venous sinuses is a matter of controversy. However, if clinical and radiological findings of sinus obliteration and related intracranial hypertension are present, surgical decompression is indicated. The authors present the case of...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1998.88.3.0598

    authors: Uzan M,Ciplak N,Dashti SG,Bozkus H,Erdinçler P,Akman C

    更新日期:1998-03-01 00:00:00

  • American views of Sir Victor Horsley in the era of Cushing.

    abstract::Sir Victor Horsley was a pioneering British neurosurgeon known for his numerous neurosurgical, scientific, and sociopolitical contributions. Although word of these surgical and scientific achievements quickly spread throughout Europe and North America in the late 19th century, much of modern neurosurgery's view of Hor...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2017.8.JNS171438

    authors: Lehner KR,Schulder M

    更新日期:2018-03-01 00:00:00

  • Presence of immunosuppressive factors in brain-tumor cyst fluid.

    abstract::The present investigation was conducted to examine the effects upon normal lymphocyte activation of the addition of brain-tumor cyst fluid or cerebrospinal fluid (CSF) to an in vitro culture system. It was believed that factors present in these fluids may play a role in local and systemic immunosuppression in brain-tu...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1983.59.5.0790

    authors: Kikuchi K,Neuwelt EA

    更新日期:1983-11-01 00:00:00

  • Microsurgical anatomy of the central core of the brain.

    abstract::OBJECTIVE The purpose of this study was to describe in detail the cortical and subcortical anatomy of the central core of the brain, defining its limits, with particular attention to the topography and relationships of the thalamus, basal ganglia, and related white matter pathways and vessels. METHODS The authors stud...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2017.5.JNS162897

    authors: Ribas EC,Yağmurlu K,de Oliveira E,Ribas GC,Rhoton A

    更新日期:2018-09-01 00:00:00

  • CSF dynamics and pressure-volume relationships in communicating hydrocephalus.

    abstract::Twenty-nine patients consecutively admitted with a diagnosis of communicating hydrocephalus underwent continuous intracranial pressure (ICP) monitoring; pressure-volume studies; and measurement of resistance to outflow of cerebrospinal fluid (Rout). The two latter calculations were made by the bolus injection and pres...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1986.64.1.0045

    authors: Kosteljanetz M

    更新日期:1986-01-01 00:00:00

  • A prospective, randomized clinical trial to compare the effect of hyperbaric to normobaric hyperoxia on cerebral metabolism, intracranial pressure, and oxygen toxicity in severe traumatic brain injury.

    abstract:OBJECT:Oxygen delivered in supraphysiological amounts is currently under investigation as a therapy for severe traumatic brain injury (TBI). Hyperoxia can be delivered to the brain under normobaric as well as hyperbaric conditions. In this study the authors directly compare hyperbaric oxygen (HBO2) and normobaric hyper...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,随机对照试验

    doi:10.3171/2009.7.JNS09363

    authors: Rockswold SB,Rockswold GL,Zaun DA,Zhang X,Cerra CE,Bergman TA,Liu J

    更新日期:2010-05-01 00:00:00

  • Endoscopic transorbital surgery for Meckel's cave and middle cranial fossa tumors: surgical technique and early results.

    abstract::OBJECTIVETumors involving Meckel's cave remain extremely challenging because of the surrounding complex neurovascular structures and deep-seated location. The authors investigated a new minimal-access technique using the endoscopic transorbital approach (eTOA) through the superior eyelid crease to Meckel's cave and mi...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2018.6.JNS181099

    authors: Jeon C,Hong CK,Woo KI,Hong SD,Nam DH,Lee JI,Choi JW,Seol HJ,Kong DS

    更新日期:2018-11-01 00:00:00

  • Pediatric spinal injury: review of 174 hospital admissions.

    abstract::Injury to the spinal column and spinal cord occurs relatively infrequently in the pediatric population. A review of 174 pediatric patients is presented, representing 5.4% of all patients admitted with spinal injury. Spinal cord injury was present in 45% of patients. A distinct injury profile, explained by anatomical a...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1992.77.5.0700

    authors: Hamilton MG,Myles ST

    更新日期:1992-11-01 00:00:00

  • Experimental model for induction of cerebral aneurysms in rats.

    abstract::Two groups of rats with induced arterial hypertension were studied. One group underwent section of the left common carotid artery with an end-to-side anastomosis of the proximal segment to the right common carotid artery. The second group was subjected to ligation of the left common carotid artery. The number of aneur...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1986.65.3.0398

    authors: Alvarez F,Roda JM

    更新日期:1986-09-01 00:00:00

  • Intracranial cavernous angioma: presentation and management.

    abstract::Thirteen cases of cerebral cavernous angiomas are reported, and their radiological and pathological features are reviewed. The clinical presentation was variable: 53.8% of patients had seizures, 30.8% intracerebral hemorrhage, and 15.4% focal neurological signs, including one unusual case that presented as a cerebello...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1986.64.5.0720

    authors: Tagle P,Huete I,Méndez J,del Villar S

    更新日期:1986-05-01 00:00:00

  • Assessment of the difference in posterior circulation involvement between pediatric and adult patients with moyamoya disease.

    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

    authors: Hishikawa T,Tokunaga K,Sugiu K,Date I

    更新日期:2013-10-01 00:00:00

  • High-resolution in vivo imaging of peripheral nerves using optical coherence tomography: a feasibility study.

    abstract:OBJECTIVE:Because of their complex topography, long courses, and small diameters, peripheral nerves are challenging structures for radiological diagnostics. However, imaging techniques in the area of peripheral nerve diseases have undergone unexpected development in recent decades. They include MRI and high-resolution ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2019.2.JNS183542

    authors: Carolus AE,Lenz M,Hofmann M,Welp H,Schmieder K,Brenke C

    更新日期:2019-04-26 00:00:00

  • Detailed anatomy of the motor and sensory roots of the trigeminal nerve and their neurovascular relationships: a magnetic resonance imaging study.

    abstract:OBJECT:The trigeminal nerve conducts both sensory and motor impulses. Separate superior and inferior motor roots typically emerge from the pons just anterosuperomedial to the entry point of the sensory root, but to date these two motor roots have not been adequately displayed on magnetic resonance (MR) images. The spec...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2004.101.3.0427

    authors: Yousry I,Moriggl B,Holtmannspoetter M,Schmid UD,Naidich TP,Yousry TA

    更新日期:2004-09-01 00:00:00

  • Bilateral open-door cervical expansive laminoplasty with hydroxyapatite spacers and titanium screws.

    abstract:OBJECT:The authors report a simple method for bilateral open-door cervical expansive laminoplasty in which hydroxyapatite (HA) spacers are secured by titanium screws. A biomechanical study was also conducted to confirm the strength of the screw fixation. METHODS:A unilateral posterior approach was used to allow preser...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/spi.2002.96.1.0022

    authors: Takayasu M,Takagi T,Nishizawa T,Osuka K,Nakajima T,Yoshida J

    更新日期:2002-01-01 00:00:00

  • Founder of modern hydrocephalus diagnosis and therapy: Walter Dandy at the Johns Hopkins Hospital.

    abstract::Because of his exceptional and pioneering contributions to the understanding and treatment of neurosurgical conditions, Walter Dandy is considered to be one of the founders of both neurosurgery and neuroradiology. In the field of hydrocephalus, Dandy developed revolutionary research models, imaging modalities, and ope...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2018.4.JNS172316

    authors: Blitz AM,Ahmed AK,Rigamonti D

    更新日期:2018-10-01 00:00:00

  • Window anatomy for neurosurgical approaches. Laboratory investigation.

    abstract:OBJECT:Knowledge of the cranium projections of the gyral structures is essential to reduce the surgical complications and to perform minimally invasive interventions in daily neurosurgical practice. Thus, in this study the authors aimed to provide detailed information on cranial projections of the eloquent cortical are...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2008.10.JNS08159

    authors: Kendir S,Acar HI,Comert A,Ozdemir M,Kahilogullari G,Elhan A,Ugur HC

    更新日期:2009-08-01 00:00:00

  • Big data, machine learning, and artificial intelligence: a field guide for neurosurgeons.

    abstract::Big data has transformed into a trend phrase in healthcare and neurosurgery, becoming a pervasive and inescapable phrase in everyday life. The upsurge in big data applications is a direct consequence of the drastic boom in information technology as well as the growing number of internet-connected devices called the In...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2020.5.JNS201288

    authors: Raju B,Jumah F,Ashraf O,Narayan V,Gupta G,Sun H,Hilden P,Nanda A

    更新日期:2020-10-02 00:00:00

  • Nonhyperemic blood flow restoration and brain edema in experimental focal cerebral ischemia.

    abstract::The effect of suppression of postischemic reactive hyperemia on the blood-brain barrier (BBB) and ischemic brain edema after temporary focal cerebral ischemia was studied in cats under ketamine and alpha-chloralose anesthesia. Regional cerebral blood flow (rCBF) was measured by a thermal diffusion method and a hydroge...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1989.70.1.0073

    authors: Kuroiwa T,Shibutani M,Okeda R

    更新日期:1989-01-01 00:00:00

  • Quantitative analysis of the surgical exposure and surgical freedom between transcranial and transorbital endoscopic anterior petrosectomies to the posterior fossa.

    abstract:OBJECT:This study proposes a variation of the transorbital endoscopic approach (TOEA) that uses the lateral orbit as the primary surgical corridor, in a minimally invasive fashion, for the posterior fossa (PF) access. The versatility of this technique was quantitatively analyzed in comparison with the anterior transpet...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2018.2.JNS172334

    authors: Noiphithak R,Yanez-Siller JC,Revuelta Barbero JM,Otto BA,Carrau RL,Prevedello DM

    更新日期:2018-08-03 00:00:00

  • Cerebral revascularization and carotid artery resection at the skull base for treatment of advanced head and neck malignancies.

    abstract:OBJECT:Resection of cancer and the involved artery in the neck has been applied with some success, but the indications for such an aggressive approach at the skull base are less well defined. The authors therefore evaluated the outcomes of advanced skull base malignancies in patients who were treated with bypass and re...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2012.9.JNS12332

    authors: Kalani MY,Kalb S,Martirosyan NL,Lettieri SC,Spetzler RF,Porter RW,Feiz-Erfan I

    更新日期:2013-03-01 00:00:00

  • Toxoplasmosis of the conus medullaris in a patient with hemophilia A-associated AIDS. Case report.

    abstract::Toxoplasma gondii has been reported to be the most common cause of focal brain lesions in patients with acquired immunodeficiency syndrome (AIDS). A case of intramedullary toxoplasmosis of the conus medullaris is reported in a patient with hemophilia A-associated AIDS. The diagnosis is discussed, with particular empha...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1990.73.6.0951

    authors: Kayser C,Campbell R,Sartorious C,Bartlett M

    更新日期:1990-12-01 00:00:00

  • Computed tomography angiography, perfusion computed tomography, and a drug-eluting stent for the treatment of in-stent restenosis of the middle cerebral artery.

    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

    authors: Kim SR,You SH,Yoon WK,Kim YW,Kim SD,Park IS,Baik MW

    更新日期:2010-04-01 00:00:00

  • Intentional body clipping of wide-necked basilar artery bifurcation aneurysms.

    abstract:OBJECT:Neck clipping or coil embolization cannot always achieve complete neck obstruction in wide-necked basilar artery (BA) bifurcation aneurysms. Clipping of the aneurysm body, leaving a small aneurysm rest, is one clipping method used for this kind of aneurysm to maintain the patency of the posterior cerebral arteri...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2000.93.2.0169

    authors: Tanaka Y,Kobayashi S,Hongo K,Tada T,Nagashima H,Kakizawa Y

    更新日期:2000-08-01 00:00:00

  • Reduction of cellular energy requirements. Screening for agents that may protect against CNS ischemia.

    abstract::Protection of the brain and spinal cord against ischemia is a goal of vast clinical importance. One approach to this objective is to reduce the tissue's functional activity in order to preserve energy for the metabolic processes that are essential to viability. Experiments to explore ways of reducing function-related ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1988.69.4.0568

    authors: Zager EL,Ames A 3rd

    更新日期:1988-10-01 00:00:00

  • Reduced expression of the transporter associated with antigen processing 1 molecule in malignant glioma cells, and its restoration by interferon-gamma and -beta.

    abstract:OBJECT:It remains unclear whether malignant glioma cells can deliver tumor antigens efficiently to major histocompatibility complex (MHC) Class I molecules. To elucidate the mechanism of antigen presentation in malignant gliomas, the authors examined the expression of the transporter associated with antigen processing ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2006.104.2.264

    authors: Satoh E,Mabuchi T,Satoh H,Asahara T,Nukui H,Naganuma H

    更新日期:2006-02-01 00:00:00

  • Brain metastasis from cutaneous squamous cell carcinoma of the dorsum. Case report.

    abstract::The majority of cutaneous squamous cell carcinoma (SCC) are diagnosed early and cured using local treatment, although a minority of cases metastasize to regional structures. In this report the authors describe an unknown feature of skin SCC, namely, distant brain metastasis. This 54-year-old man, who had undergone sur...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2005.102.6.1155

    authors: Salvati M,Caroli E,Paone C,Frati A,Ferrante L,Giangaspero F,Delfini R

    更新日期:2005-06-01 00:00:00

  • Prophylactic phenytoin in severe head injuries.

    abstract::We are reporting a retrospective study of 62 patients whose head injury was sufficiently severe to cause a high probability of posttraumatic epilepsy. Of 50 patients treated with phenytoin, 10% developed epilepsy of late onset. Twelve patients not treated with phenytoin but who had head injuries of equal magnitude had...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1979.51.4.0507

    authors: Wohns RN,Wyler AR

    更新日期:1979-10-01 00:00:00

  • Intraventricular infusion of nerve growth factor as the cause of sympathetic fiber sprouting in sensory ganglia.

    abstract:OBJECT:The results of previous clinical trials have indicated that intraventricular infusion of nerve growth factor (NGF) in patients with Alzheimer's disease is frustrated by the appearance of weight loss and diffuse back pain. The present study tested whether NGF induces sympathetic sprouting in sensory ganglia. Such...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1999.91.3.0447

    authors: Nauta HJ,Wehman JC,Koliatsos VE,Terrell MA,Chung K

    更新日期:1999-09-01 00:00:00

  • Ossification of the pterygoalar and pterygospinous ligaments: a computed tomography analysis of infratemporal fossa anatomical variants relevant to percutaneous trigeminal rhizotomy.

    abstract:OBJECTIVE:Ossification of pterygoalar and pterygospinous ligaments traversing the superior aspect of the infratemporal fossa results in formation of osseous bars that can obstruct percutaneous needle access to the trigeminal ganglion through the foramen ovale (FO), interfere with lateral mandibular nerve block, and imp...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2019.2.JNS182709

    authors: Matys T,Ali T,Zaccagna F,Barone DG,Kirollos RW,Massoud TF

    更新日期:2019-05-10 00:00:00

  • Intraoperative localization using an armless, frameless stereotactic wand. Technical note.

    abstract::A technique of "frameless" stereotaxy that allows real-time intraoperative neurosurgical localization is described. The system is composed of four components: a hand-held probe containing two ultrasonic emitters, a microphone array that is rigidly affixed to the operating table in proximity to the surgical field, hard...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1993.78.3.0510

    authors: Barnett GH,Kormos DW,Steiner CP,Weisenberger J

    更新日期:1993-03-01 00:00:00