Abstract：
OBJECT:Botulinum toxin injections are the best therapeutic option in patients with spasmodic torticollis. Although a small number of patients do not benefit from such therapy, the majority respond well but may develop antibodies to the toxin after repeated applications. In those termed primary nonresponders, no improvement related to botulinum toxin has been shown. In patients in whom no response was shown and those in whom resistance to the therapy developed, selective peripheral denervation is a neurosurgical option. METHODS:Between June 1988 and August 2001, 155 patients underwent selective peripheral denervation. Surgery was performed at a mean of 8.5 years after the onset of symptoms (range 0.5-37 years). The mean age of the patients at the onset of dystonia was 39.7 years (range 17-77 years). For evaluation of results, patients' responses were assessed. Results were obtained in 140 patients in whom the follow-up period ranged from 3 to 124 months (mean 32.8 months): 18 reported complete relief of their symptoms, 50 significant relief, and 34 moderate relief; 19 noted only minor relief and the remaining 19 no improvement. The results differ substantially when compared with those previously demonstrated in patients who received botulinum toxin injections. Although 80% of the secondary nonresponders were satisfied with the result of surgery, only 62% of the primary nonresponders considered the operation helpful. There were no major side effects. The recurrence rate was 11%. CONCLUSIONS:The injection of botulinum toxin should be the first-choice treatment. If surgery is required, selective peripheral denervation provides the best results and has the fewest side effects compared with all surgical options.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Braun V,Richter HPdoi
10.3171/spi.2002.97.2.0207subject
Has Abstractpub_date
2002-09-01 00:00:00pages
207-12issue
2 Suppleissn
0022-3085issn
1933-0693journal_volume
97pub_type
杂志文章abstract：:Intrathecal ossification causing progressive myelopathy or radiculopathy does not occur frequently. The majority of the reported lesions have been in the thoracic spine and seldom in the sacral canal. This report presents the occurrence of disabling low backache and sciatica from intradural periradicular ossification ...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1978.49.1.0132
更新日期：1978-07-01 00:00:00
abstract：:Cerebral blood volume (CBV) was calculated in gerbils from specific-gravity (SG) changes between normal and saline-perfused brains. Furthermore, changes in CBV were investigated during ischemia using carbon-14-labeled dextran (MW 70,000) as an intravascular marker. Both data were used to evaluate the possible error du...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1985.62.5.0704
更新日期：1985-05-01 00:00:00
abstract：OBJECT:Neurocognitive performance is used to assess multiple cognitive domains, including motor coordination, before and after carotid endarterectomy (CEA). Although gross motor strength is impaired with ischemia of large cortical areas or of the internal capsule, the authors hypothesize that patients undergoing CEA de...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/2014.8.JNS1459
更新日期：2015-01-01 00:00:00
abstract：:Magnetic resonance (MR) angiography offers a safe, noninvasive alternative to conventional angiography in patients with suspected carotid stenosis; however, it tends to overestimate the severity of stenosis. Loss of the MR signal with a resulting flow gap is a frequent finding in cases of high-grade stenosis. The auth...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1996.85.3.0384
更新日期：1996-09-01 00:00:00
abstract：:The authors report a case with two mycotic aneurysms in the cavernous portion of the internal carotid artery, presumably secondary to a transient bacteremia from pneumonia. The strikingly rapid development of the aneurysms was demonstrated by angiography. Painful total ophthalmoplegia and extophthalmos were the main c...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1976.44.1.0105
更新日期：1976-01-01 00:00:00
abstract：:The mortality rate, risk of rebleeding, relevant subjective and objective symptoms, and daily functional capacity after a verified subarachnoid hemorrhage (SAH) of unknown etiology were evaluated in 44 patients treated during a 5-year period (1978 to 1983). A vascular basis for the SAH had been excluded by bilateral c...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1984.61.6.1029
更新日期：1984-12-01 00:00:00
abstract：:OBJECTIVE Despite persisting questions regarding its appropriateness, 30-day readmission is an increasingly common quality metric used to influence hospital compensation in the United States. However, there is currently insufficient evidence to identify which patients are at highest risk for readmission after aneurysm...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/2016.5.JNS152644
更新日期：2017-06-01 00:00:00
abstract：:The magnetic resonance longitudinal relaxation time (T1) and transverse relaxation time (T2) of the water proton of the periventricular white and cortical gray matter were measured for 17 control patients and 21 patients with suspected normal-pressure hydrocephalus (NPH). Of the latter group, 14 showed good response t...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1990.73.6.0864
更新日期：1990-12-01 00:00:00
abstract：OBJECT:Although nucleus ventralis intermedius stimulation has been shown to be safe and efficacious in the treatment of essential tremor, there is a subset of patients who eventually lose benefit from their stimulation. Proposed causes for this phenomenon include tolerance, disease progression, and suboptimal location....
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/JNS/2008/109/10/0640
更新日期：2008-10-01 00:00:00
abstract：OBJECT:Appropriate management of hemorrhage after Gamma Knife surgery (GKS) for arteriovenous malformations (AVMs) of the brain is poorly understood, although a certain proportion of patients suffer from hemorrhage. METHODS:Among 500 patients observed for 1 to 183 months (median 70 months) after GKS, 32 patients (6.4%...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/sup.2006.105.7.52
更新日期：2006-12-01 00:00:00
abstract：:A modification of a Cloward lateral cervical retractor with sharp blades is described. The purpose of the adaptation is to help prevent injuries to soft tissues of the neck and to facilitate placement during anterior cervical discectomy and fusion. ...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1984.61.1.0193
更新日期：1984-07-01 00:00:00
abstract：:The pathogenesis of intracranial aneurysms and spontaneous cervical artery dissection is incompletely understood but a primary arteriopathy, possibly similar in both disorders, may be of importance. To investigate the frequency of intracranial aneurysms in patients with spontaneous cervical artery dissection, the angi...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1992.76.1.0062
更新日期：1992-01-01 00:00:00
abstract：:This study provides an objective assessment of the reliability of histological grading of astrocytoma specimens obtained using stereotactic biopsy. Pathological diagnosis of brain tumors provides an index of disease severity and guides clinical practice in their treatment. It also functions as the gold standard in ass...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1996.85.6.1091
更新日期：1996-12-01 00:00:00
abstract：:OBJECTIVE Access to the third ventricle is a veritable challenge to neurosurgeons. In this context, anatomical and morphometric studies are useful for establishing the limitations and advantages of a particular surgical approach. The transchoroidal approach is versatile and provides adequate exposure of the middle and...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/2016.8.JNS16403
更新日期：2017-07-01 00:00:00
abstract：OBJECT:The aim of this study was to clarify the clinical outcome of schwannomatosis, a rare condition characterized by multiple nonvestibular schwannomas in the absence of meningiomas, intraspinal ependymomas, and other clinical signs of neurofibromatosis type 2 (NF2). METHODS:Nine patients with schwannomatosis treate...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1998.89.1.0036
更新日期：1998-07-01 00:00:00
abstract：:Transcranial Doppler ultrasonography was used to monitor 71 patients suffering from intracranial hypertension with subsequent brain death. Among these, 29 patients were also assessed for systemic arterial pressure and epidural intracranial pressure, so that a correlation between cerebral perfusion pressure and the Dop...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：
更新日期：1988-05-01 00:00:00
abstract：:Retrovirus-mediated herpes simplex virus-thymidine kinase (HSV-tk) gene therapy is a promising approach in the treatment of brain tumors. Previous in vitro and in vivo studies have demonstrated a bystander effect in which nonmodified tumor cells in proximity to HSV-tk-modified tumor cells are killed with the modified ...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1995.83.4.0698
更新日期：1995-10-01 00:00:00
abstract：:The mortality rate has recently been reduced to only a small percentage of patients selected for early aneurysm surgery. Despite recovery without neurological deficits, however, a diffuse encephalopathy may remain, with emotional and psychological sequelae that will interfere with rehabilitation and social reintegrati...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1985.62.5.0673
更新日期：1985-05-01 00:00:00
abstract：OBJECT:Intracranial aneurysms of the anterior circulation might become symptomatic by causing visual deficits. The influence of treatment modality on improvement is still unclear. The objective of this study was to analyze the recovery of visual deficits caused by the mass effect of intracranial aneurysms after surgica...
journal_title：Journal of neurosurgery
pub_type： 杂志文章,评审
doi：10.3171/2011.5.JNS101983
更新日期：2011-10-01 00:00:00
abstract：:The results of anterior cervical surgery for treatment of cervical spondylotic myelopathy (CSM) are assessed 1 to 7 years postoperatively in 32 patients. At follow-up review, 50% were improved after surgery and 50% were unimproved or had deteriorated in spite of surgery. The results could not be statistically linked t...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1980.53.1.0012
更新日期：1980-07-01 00:00:00
abstract：:Experiments were carried out to compare the effectiveness of oncotic and osmotic therapy in dogs with experimental cerebral edema caused by a left parietal cold lesion. Animals were divided into five groups and treated for 6 hours with either crystalloid (control group), or mannitol, albumin, furosemide, or albumin/fu...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1984.60.3.0481
更新日期：1984-03-01 00:00:00
abstract：OBJECT:The authors conducted a study to determine the factors associated with right-sided language dominance in patients with cerebrovascular malformations. METHODS:Twenty-two patients with either arteriovenous malformations (AVMs [15 cases]) or cavernous malformations (7 cases) underwent functional MR (fMR) imaging s...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/2010.2.JNS091595
更新日期：2010-10-01 00:00:00
abstract：OBJECT:The authors conducted a study to determine the results of decompressive surgery without fusion in selected patients who presented with radicular compression syndromes caused by degenerative lumbar spondylolisthesis and in whom there was no evidence of hypermobility on flexion-extension radiographs. METHODS:The ...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/spi.2002.97.3.0281
更新日期：2002-10-01 00:00:00
abstract：OBJECT:Mitoxantrone is a drug with potent in vitro activity against malignant brain tumor cell lines; however, its effectiveness as a systemic agent has been hampered by poor central nervous system penetration and dose-limiting myelosuppression. To avoid these problems, we incorporated mitoxantrone into biodegradable p...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.2002.97.5.1173
更新日期：2002-11-01 00:00:00
abstract：:To evaluate the biology of thyrotropin (TSH)-producing pituitary adenomas, the authors reviewed the charts of 19 patients who underwent transsphenoidal surgery within a 15-year period at the University of California, San Francisco (UCSF). Between 1989 and 1991, the period during which immunostaining techniques were us...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1993.79.4.0521
更新日期：1993-10-01 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：:The authors describe a new headframe system, by which a variety of instruments, such as brain retractors, suction tubes, mirrors, forks, armrests, and cotton-sheet trays, can be simultaneously supported. This frame enables neurosurgeons to perform operations with greater ease and fewer problems. ...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1989.71.6.0945
更新日期：1989-12-01 00:00:00
abstract：:Obsessive-compulsive disorder (OCD) is a chronic and debilitating psychiatric condition. Traditionally, anterior capsulotomy (AC) was an established procedure for treatment of patients with refractory OCD. Over recent decades, deep brain stimulation (DBS) has gained popularity. In this paper the authors review the pub...
journal_title：Journal of neurosurgery
pub_type： 杂志文章,评审
doi：10.3171/2014.11.JNS132618
更新日期：2015-05-01 00:00:00
abstract：:The effect of intravenous nimodipine on the incidence of mortality and delayed ischemic neurological deficits of patients after aneurysmal subarachnoid hemorrhage (SAH) and surgery was studied in a prospective double-blind placebo-controlled trial. Upon admission, all of the patients were in Grades I to III according ...
journal_title：Journal of neurosurgery
pub_type： 临床试验,杂志文章
doi：10.3171/jns.1988.69.5.0683
更新日期：1988-11-01 00:00:00
abstract：OBJECT:The purpose of this study was to analyze patient outcomes and to define the role of radiosurgery in patients who have undergone prior microsurgical resection of their vestibular schwannoma. METHODS:The authors evaluated the pre- and postoperative clinical and neuroimaging characteristics of 76 consecutive patie...
journal_title：Journal of neurosurgery
pub_type： 杂志文章
doi：10.3171/jns.1998.89.6.0944
更新日期：1998-12-01 00:00:00
