Abstract:
OBJECT:Intracerebral hemorrhage (ICH) is an uncommon complication of carotid endarterectomy (CEA), and carries a high rate of mortality and morbidity. Traditionally, attention has been focused on the cerebral hyperperfusion syndrome (HPS) as the leading cause of ICH after CEA. Other mechanisms, such as a perioperative cerebral ischemic event, cerebral infarction, and use of postoperative anticoagulation therapy, may also be important. METHODS:The authors performed a retrospective case control study to identify factors leading to ICH after CEA. Records of CEAs performed over the past 10 years at the Mayo Clinic were searched for occurrences of ICH within 30 days of the procedure. The relationship of ICH to known cerebrovascular risk factors, perioperative electroencephalographic studies, and 133Xe cerebral blood flow (CBF) studies was compared with that in a control group. Hyperperfusion was defined as hypertension with symptoms of either severe headache, seizures, or confusion, or a doubling of intraoperative CBF values. The clinical history and imaging of ischemic events and the ICH were carefully reviewed to determine the possible underlying mechanism(s). Twelve (0.4%) of 2747 patients who underwent CEAs suffered a postoperative ICH. A doubling of CBF values was found in five of eight cases in which CBF studies were performed, and occurred more commonly in the patients with ICH than in controls. Clinical symptoms of the HPS were less common (three cases). A perioperative cerebral ischemic event (four cases) and anticoagulation therapy (six cases) were other contributors to a subsequent ICH. Seven of the 12 patients with ICHs died and five achieved a moderate outcome. CONCLUSIONS:An ICH following CEA is an unusual complication that occurs in the setting of hyperperfusion, perioperative cerebral ischemia, anticoagulation therapy, or multiple mechanisms. Identification of CBF doubling at surgery may assist in identifying patients at risk for ICH following CEA.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Henderson RD,Phan TG,Piepgras DG,Wijdicks EFdoi
10.3171/jns.2001.95.6.0964subject
Has Abstractpub_date
2001-12-01 00:00:00pages
964-9issue
6eissn
0022-3085issn
1933-0693journal_volume
95pub_type
杂志文章abstract::Monitoring of cerebral oxygenation is considered to be of great importance in minimizing secondary hypoxic and ischemic brain damage following severe head injury. Although the threshold for cerebral hypoxia in jugular bulb oximetry (measurement of O2 saturation in the jugular vein (SjvO2)) is generally accepted to be ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.5.0751
更新日期:1996-11-01 00:00:00
abstract:OBJECT:The aim of this study was to assess the diagnostic yield of imaging tests performed in patients in whom the cause of subarachnoid hemorrhage (SAH) had not been demonstrated on initial angiography. METHODS:By reviewing medical records of 806 patients with SAH who had been admitted during a 6.5-year period, the a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.98.6.1235
更新日期:2003-06-01 00:00:00
abstract:OBJECT:Patients with subarachnoid hemorrhage (SAH) and their close friends and family may be excessively fearful that the patient will have a recurrence, and such fears could play a critical role in the poor recovery shown by many patients The authors examined whether these fears could account for significant variance ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.5.JNS121688
更新日期:2013-10-01 00:00:00
abstract::Thirty-eight patients underwent transsphenoidal microsurgical treatment of non-neoplastic intrasellar cysts: 36 had cyst drainage and biopsy of the cyst wall, and in two the cyst was totally removed. Surgical morbidity was 8%. The mean follow-up time was 46.3 months; 100% patient follow-up evaluation was achieved. Six...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.1.0008
更新日期:1984-01-01 00:00:00
abstract::Spontaneous intracranial hypotension due to a cerebrospinal fluid (CSF) leak in the spine is an important cause of new, daily persistent headaches. Most patients respond well to conservative treatments including epidural blood patching. Limited options for effective treatment are available for patients in whom these t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.100.6.1098
更新日期:2004-06-01 00:00:00
abstract::Arteriovenous malformations (AVM's) of lateral and sigmoid sinuses are acquired lesions evolving from a previously thrombosed dural sinus. Their natural history is usually that of gradual progression and hence surgery is frequently necessary. The preferred surgical treatment is complete excision coupled with packing o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.1.0032
更新日期:1983-07-01 00:00:00
abstract::The commonest initial computerized tomography (CT) finding in head-injured children is bilateral diffuse cerebral swelling. Cerebral blood flow and CT density studies suggest that this swelling is due to cerebral hyperemia and increased blood volume, not to edema. The clinical history, course, and outcome of 63 childr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.2.0170
更新日期:1981-02-01 00:00:00
abstract::The cases of 127 consecutive patients with subarachnoid hemorrhage (SAH), in whom cerebral panangiography revealed no cause for the bleeding nor any sign of an intraparenchymatous hemorrhage, were reviewed in a study of the long-term prognosis and the possible prognostic factors in this condition. Data for all 127 pat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.3.0349
更新日期:1985-09-01 00:00:00
abstract::OBJECT Approximately 250 million surgical procedures are performed annually worldwide, and data suggest that major complications occur in 3%-17% of them. Many of these complications can be classified as avoidable, and previous studies have demonstrated that preoperative checklists improve operating room teamwork and d...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.4.JNS142184
更新日期:2016-06-01 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::Experience indicates that stand-alone cages may lack the necessary stability to secure highly unstable motion segments at the lumbosacral junction. The authors have designed a special carbon fiber composite interbody cage that allows additional screw placement in anterior lumbar interbody fusion procedures performed a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2003.98.2.0222
更新日期:2003-03-01 00:00:00
abstract:OBJECT:Until now there has been no reliable stimulation protocol for inducing transient language disruptions while mapping Broca's area. Despite the promising data of only a few studies in which speech arrest and language disturbances have been induced, certain concerns have been raised. The purpose of this study was t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.11.JNS13952
更新日期:2014-05-01 00:00:00
abstract::The purpose of this report was to review the results of stereotactic radiosurgery in the management of patients with residual neurocytomas after initial resection or biopsy procedures. Four patients underwent stereotactic radiosurgery for histologically proven neurocytoma. Clinical and imaging studies were performed t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.95.5.0879
更新日期:2001-11-01 00:00:00
abstract:OBJECT:Selective posterior rhizotomy is a well-established treatment for spasticity associated with cerebral palsy. At most medical centers, responses of dorsal rootlets to electrical stimulation are used to determine ablation sites; however, there has been some controversy regarding the reliability of intraoperative s...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.95.1.0067
更新日期:2001-07-01 00:00:00
abstract:OBJECT:Convection-enhanced delivery (CED) can be used safely to perfuse regions of the central nervous system (CNS) with therapeutic agents in a manner that bypasses the blood-brain barrier (BBB). These features make CED a potentially ideal method for the distribution of potent chemotherapeutic agents with certain phar...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.99.5.0893
更新日期:2003-11-01 00:00:00
abstract::Bacteriological studies were performed on 45 craniocerebral missile wounds incurred in Vietnam within 2 to 4 hours of occurrence. All missiles had penetrated into the brain. Aerobic and anaerobic cultures were taken of the skin wound, brain, and indriven bone fragments. Forty-four of the skin wounds were contaminated,...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1971.34.2part1.0145
更新日期:1971-02-01 00:00:00
abstract:OBJECT:Recently, concern has been raised that hyperventilation following severe traumatic brain injury (TBI) could lead to cerebral ischemia. In acute ischemic stroke, in which the baseline metabolic rate is normal, reduction in cerebral blood flow (CBF) below a threshold of 18 to 20 ml/100 g/min is associated with ene...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.96.1.0103
更新日期:2002-01-01 00:00:00
abstract::Experience over a 2-year period with the use of porcine dermis as a dural substitute is reported. In this series, porcine dermis was used for dural repair in a total of 72 patients. In a further 28 patients, one of the authors (A.E.B.) used porcine dermis to wrap lumbar nerve roots at the time of surgery for either pr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.61.2.0351
更新日期:1984-08-01 00:00:00
abstract::A micro-corrosion technique was used to demonstrate an extensive vasa vasorum network in extracranial vessels but did not reveal this system in intracranial vessels of comparable size in three species of animals. The absence of a vasa vasorum network in cerebral vessels may result in a higher level of susceptibility t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.61.1.0044
更新日期:1984-07-01 00:00:00
abstract::Gadolinium-diethylenetriaminepenta-acetic acid (Gd-DTPA) is a chelated paramagnetic contrast agent under clinical trial for use in magnetic resonance (MR) imaging. The increased signal intensity following the intravenous infusion of contrast medium may improve the ability of MR imaging to delineate tumors. The use of ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.71.1.0049
更新日期:1989-07-01 00:00:00
abstract::The authors report a case in which sellar and suprasellar osteogenic sarcoma developed 10 years after radiation therapy for pituitary adenoma. The literature is reviewed and the rarity of this condition discussed. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.44.1.0088
更新日期:1976-01-01 00:00:00
abstract::The treatment of patients with low-grade gliomas remains a subject of controversy, especially with respect to new treatment modalities such as interstitial radiosurgery (brachytherapy), radiosurgery, and stereotactic radiotherapy. In a retrospective analysis conducted between 1979 and 1991, the authors studied the res...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.3.0418
更新日期:1995-03-01 00:00:00
abstract:OBJECT:Chronic sinusitis can be a debilitating disease with significant impact on quality of life. Frontal sinusitis has a relatively low prevalence, but complications can be severe due to its anatomical location. After failure of conservative measures, typically endoscopic procedures are performed to improve the drain...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2011.11.JNS101849
更新日期:2012-03-01 00:00:00
abstract::OBJECTIVE Anterior capsulotomy (AC) is sometimes used as a last resort for treatment-refractory obsessive-compulsive disorder (OCD). Previous studies assessing neuropsychological outcomes in patients with OCD have identified several forms of cognitive dysfunction that are associated with the disease, but few have focu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.9.JNS152494
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:Iatrogenic nerve injuries are devastating to both the patient and the surgeon. This study focuses on the anatomical relationship of the palmar recurrent branch with the parent median nerve in an attempt to identify higher risk types. METHODS:The palmar recurrent branch was dissected in 75 embalmed cadavers. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.4.JNS19516
更新日期:2019-07-05 00:00:00
abstract::A melanin-producing, encapsulated, histologically benign-appearing tumor of the trigeminal nerve was surgically removed from a 9-year-old boy. It recurred 6 months later and was then subtotally resected and treated with radiation therapy. The clinical and pathological features of this and 10 similar cases reported in ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.66.1.0050
更新日期:1987-01-01 00:00:00
abstract::The authors present the case of a 78-year-old woman who developed right lower-extremity paralysis after a focal seizure. Neuroradiological studies revealed a small parasagittal meningioma, which at the time of resection was found to contain a bacterial intratumoral abscess secondary to Proteus mirabilis. This is only ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.88.5.0895
更新日期:1998-05-01 00:00:00
abstract::Two patients with chronic spinal subdural hematomas are described. Both had a fluctuating clinical course, not previously documented in the literature. Surgical evacuation resulted in almost complete recovery. The pathogenesis of spinal subdural hematoma is discussed and the pertinent literature is reviewed. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.4.0636
更新日期:1985-10-01 00:00:00
abstract::A patient with a posttraumatic leptomeningeal cyst is described. The cyst simulated an occipital encephalocele and communicated with an epidural cerebrospinal fluid collection in the posterior fossa. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.65.5.0704
更新日期:1986-11-01 00:00:00
abstract::To evaluate the reported benefit of ipsilateral single-application ophthalmic anesthetic eyedrops in patients with typical trigeminal neuralgia, a randomized double-blind placebo-controlled trial was performed. Forty-seven patients were randomly assigned to receive two drops of either proparacaine (25 cases) or saline...
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.1994.80.6.0993
更新日期:1994-06-01 00:00:00