Abstract:
OBJECT:The aim of this study was to evaluate the usefulness and limitations of gamma surgery (GS) in the treatment of brain metastases from melanoma. METHODS:Imaging and clinical outcomes in 45 patients treated for 92 brain metastases from melanoma between October 1989 and October 1999 were retrospectively analyzed. Follow-up imaging studies were available in 35 patients with 66 treated lesions. Twenty-four percent of the lesions disappeared, 35% shrank, 23% remained unchanged, and 18% increased in size. No undue radiation-induced changes were observed in the surrounding brain. Clinical data were available in all patients. No deaths or neurological morbidity related to GS was observed. The median survival time, calculated using the Kaplan-Meier method, was 10.4 months from the time of GS. In both univariate and multivariate Cox regression analyses, a single brain lesion and lack of visceral metastases were statistically predictive of a better prognosis. Six of eight patients with solitary metastasis (that is, a single brain metastasis with no primary visceral tumor) were still alive at the close of the study, none of them with disease progression, with a follow-up period ranging between 14 and 82 months. Sixteen patients in this series received adjunctive whole-brain radiation therapy, which had no impact on their survival time or local and distant control of the brain disease. CONCLUSIONS:Gamma surgery is effective in treating melanoma metastases in the brain. It appears that the radiobiology of a single high dose overcomes the radioresistance barrier, yielding better results than fractionated radiation.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Mingione V,Oliveira M,Prasad D,Steiner M,Steiner Ldoi
10.3171/jns.2002.96.3.0544subject
Has Abstractpub_date
2002-03-01 00:00:00pages
544-51issue
3eissn
0022-3085issn
1933-0693journal_volume
96pub_type
杂志文章abstract::The medical records and histological specimens from 26 patients with choroid plexus papillomas operated on at one institution were reviewed retrospectively. Four patients died perioperatively, and 21 of the remaining 22 patients were followed through March, 1986; the patient lost to follow-up review was last seen 14 y...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.69.6.0843
更新日期:1988-12-01 00:00:00
abstract::In a study examining the possible therapeutic effects of recombinant human tumor necrosis factor-alpha (rHuTNF-alpha) on malignant gliomas without expression of tumor necrosis factor (TNF)-receptors, RG-2 glioma cells were tested in vitro as well as in a rat experimental glioma model. A growth inhibition assay reveale...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.75.4.0597
更新日期:1991-10-01 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::Intraventricular rupture of a colloid cyst is a rare phenomenon and has been proposed as a mechanism for sudden death in patients with colloid cysts. Imaging of a colloid cyst during rupture has been described in only one other instance. The authors report a highly unusual case of a 53-year-old man who presented with ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.5.JNS153015
更新日期:2017-06-01 00:00:00
abstract::A sensitive enzyme-linked immunosorbent assay (ELISA) was used in a retrospective study of placental alkaline phosphatase (PLAP) levels in serum, cerebrospinal fluid (CSF), and intratumoral cyst fluid in primary intracranial germinoma. The ELISA showed no cross-reactivity with intestinal alkaline phosphatase except in...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.68.5.0710
更新日期:1988-05-01 00:00:00
abstract::The authors describe a newly recognized complication of lumboperitoneal (LP) shunt placement, namely, intracranial hypotension from leakage of cerebrospinal fluid (CSF) through a defect in the lumbar dura created by the shunt catheter. They report on a 47-year-old obese woman with idiopathic intracranial hypertension ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/07/0173
更新日期:2007-07-01 00:00:00
abstract::Although in several histological studies of arteriovenous malformation (AVM) nidi the presence of compartments has been documented, no clinical study has been published. The present study was conducted to determine the presence of nidus compartments in clinical cases by using a new radiographic method. Two patients wi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.96.4.0770
更新日期:2002-04-01 00:00:00
abstract:OBJECT:The objective of this study was to evaluate endovascular stent therapy for carotid artery dissections (CADs). METHODS:Retrospective review of data at Millard Fillmore Gates Hospital identified 43 patients with 44 CADs (intracranial and/or extracranial) treated with carotid artery (CA) stent placement between Ja...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.1.JNS091806
更新日期:2011-07-01 00:00:00
abstract::The authors report a case of ossification of the ligamentum flavum at T-10 and T-11 associated with compressive myelopathy. Metrizamide myelography with computerized tomography allowed precise preoperative diagnosis and anatomic localization of the lesion. The patient had satisfactory and prompt improvement after surg...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1982.56.3.0448
更新日期:1982-03-01 00:00:00
abstract::Rhombencephalosynapsis (RS) is a relatively rare developmental disorder of the cerebellum in which the cerebellar hemispheres are fused across the midline without being separated by a cleft or the vermis. The condition may be associated with hydrocephalus and other intracranial and extracranial abnormalities. The auth...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.93.2.0323
更新日期:2000-08-01 00:00:00
abstract:OBJECT:Systemic administration of 23.5% hypertonic saline enhances cerebral blood flow (CBF) in patients with poor-grade spontaneous subarachnoid hemorrhage (SAH). Whether the increment of change in CBF correlates with changes in autoregulation of CBF or outcome at discharge remains unknown. METHODS:Thirty-five patien...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/JNS-07/08/0274
更新日期:2007-08-01 00:00:00
abstract:OBJECT:Surgical or endovascular occlusion of the parent artery proximal to an aneurysm has been recommended for treatment of dissecting aneurysms of the intracranial posterior circulation. However, dissecting aneurysms may rupture even after proximal occlusion because distal progression of thrombus is necessary to occl...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.90.5.0853
更新日期:1999-05-01 00:00:00
abstract::To characterize the temporal course of radiosurgical lesions, 19 cats were irradiated in an animal linear accelerator radiosurgical device. The animals were followed clinically and, at 3.5, 6, 12, 18, 23, 29, and 63 weeks, were studied with gadolinium-enhanced magnetic resonance (MR) imaging. They were then sacrificed...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.80.6.1046
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVE:Surgery for low-grade gliomas (LGGs) aims to achieve maximal tumor removal and maintenance of patients' functional integrity. Because extent of resection is one of the factors affecting the natural history of LGGs, surgery could be extended further than total resection toward a supratotal resection, beyond tu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.2.JNS183408
更新日期:2019-05-17 00:00:00
abstract::The case of a 33-year-old woman with bilateral partial agenesis (type D) of the posterior arch of the atlas and recurrent transient quadriparesis due to contusion of the spinal cord after minor cervical trauma is described. At least some patients with type C or D congenital anomalies of the posterior arch of the atlas...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.84.4.0663
更新日期:1996-04-01 00:00:00
abstract:OBJECT:Cellular density is a major factor for change in the apparent diffusion coefficient (ADC). The authors hypothesized that loss of tumor cells after Gamma Knife surgery (GKS) may alter the ADC value and used diffusion weighted MR imaging (DW imaging) to evaluate cellular changes in brain tumors to detect their tre...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:
更新日期:2010-12-01 00:00:00
abstract::This article reviews the English language medical literature published from January, 1960, through June, 1978, on selected morbidity measures and economic costs of injury to the head or spinal cord. Most of the reports discussed here come from outside the United States. Regardless of the source of the report, however,...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:
更新日期:1980-11-01 00:00:00
abstract:OBJECT:Glutamate is important in the pathogenesis of brain damage after cerebral ischemia and traumatic brain injury. Notably, brain extracellular and cerebrospinal fluid as well as blood glutamate concentrations increase after experimental and clinical trauma. While neurons are one potential source of glutamate, plate...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.3.JNS132130
更新日期:2014-12-01 00:00:00
abstract::Vertebral artery dissection may be spontaneous or related to some traumatic event. Diagnosis has usually been made by angiography, an invasive procedure with certain well-known risks. The authors describe the magnetic resonance (MR) appearance (both on conventional spin-echo and on gradient refocused "flow" sequences)...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.72.6.0964
更新日期:1990-06-01 00:00:00
abstract::Endolymphatic sac tumors (ELSTs) are locally invasive neoplasms that arise in the posterior petrous bone and are associated with von Hippel-Lindau (VHL) disease. These tumors cause symptoms even when microscopic in size (below the threshold for detectability on imaging studies) and can lead to symptoms such as hearing...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/08/0421
更新日期:2007-08-01 00:00:00
abstract::The authors present the case of progressive thoracic myelopathy caused by the extensive ossification of the arachnoid membrane and associated intramedullary syrinx. Based on their findings and results of the literature search, they describe a pathological basis for this rare condition, discuss its incidence and sympto...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/spi.1999.91.2.0223
更新日期:1999-10-01 00:00:00
abstract::Patients with hereditary hemorrhagic telangiectasia (HHT) are at risk for the development of cerebral arteriovenous malformations (AVMs). The authors report a case of a spontaneously regressing cerebral AVM in a patient with HHT. The lesion was diagnosed on the basis of findings on screening magnetic resonance imaging...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2006.105.5.428
更新日期:2006-11-01 00:00:00
abstract::An anatomical study of three microsurgical intraorbital routes to the optic nerve and orbital apex, which can be reached through a fronto-orbital craniotomy, was conducted on cadaver specimens. The structures that could be exposed via the medial, central, or lateral approaches directed through the orbital roof were de...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.1.0078
更新日期:1994-07-01 00:00:00
abstract::This is the report of a case of vertebral sarcoidosis causing collapse of cervical vertebrae with resulting tetraplegia. The patient was successfully treated by decompression and subsequent anterior removal of the invaded three vertebral bodies, followed by an autologous bone graft. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.5.0665
更新日期:1979-05-01 00:00:00
abstract::A multi-center double-blind randomized clinical trial was conducted by the National Acute Spinal Cord Injury Study Group to examine the efficacy of high-dose methylprednisolone (1000-mg bolus and 1000 mg daily thereafter for 10 days) compared with that of a standard dose (100-mg bolus and 100 mg daily for 10 days). No...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.3171/jns.1985.63.5.0704
更新日期:1985-11-01 00:00:00
abstract:OBJECT:Onyx, an ethylene-vinyl alcohol copolymer mixed in a dimethyl sulfoxide solvent, is currently one of the most widely used liquid materials for embolization of intracranial arteriovenous malformations (AVMs). The goal of this study was to define the risks and benefits of stereotactic radiosurgery (SRS) for patien...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.12.JNS141437
更新日期:2015-07-01 00:00:00
abstract:OBJECT:Hospital readmission within 30 days of discharge is a major contributor to the high cost of health care in the US and is also a major indicator of patient care quality. The purpose of this study was to investigate the incidence, causes, and predictors of 30-day readmission following craniotomy for malignant supr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.1.JNS131264
更新日期:2014-05-01 00:00:00
abstract::This study examined the effect of hypocapnia (PaCO2 20 mm Hg) on cerebral metabolism and the electroencephalogram (EEG) findings in 12 dogs during nitroglycerin (NTG)-induced hypotension. Previous studies suggest that NTG is a more potent cerebral vasodilator than sodium nitroprusside or trimethaphan. It was speculate...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.6.0924
更新日期:1986-06-01 00:00:00
abstract:OBJECT:There is increasing evidence that simulation provides high-quality, time-effective training in an era of resident duty-hour restrictions. Simulation may also permit trainees to acquire key skills in a safe environment, important in a specialty such as neurosurgery, where technical error can result in devastating...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.3171/2014.5.JNS131766
更新日期:2014-08-01 00:00:00
abstract::A feasibility study reveals that a standard linear accelerator, with only slight modification, can function in a manner similar to Leksell's multiple cobalt radiation device. A high radiation dose can be delivered to a 1-cm or 0.5-cm volume target with insignificant radiation effect on the surrounding tissue. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.4.0814
更新日期:1984-04-01 00:00:00