Abstract:
OBJECT:The poor prognosis for traumatic acute subdural hematoma (ASDH) might be due to underlying primary brain damage, ischemia, or both. Ischemia in ASDH is likely caused by increased intracranial pressure (ICP) leading to decreased cerebral perfusion pressure (CPP), but the degree to which these phenomena occur is unknown. The authors report data obtained before and during removal of ASDH in five cases. METHODS:Five patients who underwent emergency evacuation of ASDH were monitored. In all patients, without delaying treatment, a separate surgical team (including the senior author) placed an ICP monitor and a jugular bulb catheter, and in two patients a laser Doppler probe was placed. The ICP prior to removing the bone flap in the five patients was 85, 85, 50, 59, and greater than 40 mm Hg, resulting in CPPs of 25, 3, 25, 56, and less than 50 mm Hg, respectively. Removing the bone flap as well as opening the dura and removing the blood clot produced a significant decrease in ICP and an increase in CPP. Jugular venous oxygen saturation (SjvO2) increased in four patients and decreased in the other during removal of the hematoma. Laser Doppler flow also increased, to 217% and 211% compared with preevacuation flow. CONCLUSIONS:Intracranial pressure is higher than previously suspected and CPP is very low in patients with ASDH. Removal of the bone flap yielded a significant reduction in ICP, which was further decreased by opening the dura and evacuating the hematoma. The SjvO2 as well as laser Doppler flow increased in all patients but one immediately after removal of the hematoma.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Verweij BH,Muizelaar JP,Vinas FCdoi
10.3171/jns.2001.95.4.0569subject
Has Abstractpub_date
2001-10-01 00:00:00pages
569-72issue
4eissn
0022-3085issn
1933-0693journal_volume
95pub_type
杂志文章abstract:OBJECT:The authors report on the surgical anatomy of the juxta-dural ring area of the internal carotid artery to add to the information available about this important structure. METHODS:Twenty sides of cadaver specimens were used in this study. The plane of the dural ring was found to incline in the posteromedial dire...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.89.2.0250
更新日期:1998-08-01 00:00:00
abstract::To investigate overcrowding in the posterior cranial fossa as the pathogenesis of adult-type Chiari malformation, the authors studied the morphology of the brainstem and cerebellum within the posterior cranial fossa (neural structures consisting of the midbrain, pons, cerebellum, and medulla oblongata) as well as the ...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.1997.86.1.0040
更新日期:1997-01-01 00:00:00
abstract::The treatment of craniospinal war wounds proved to be a significant driving force in the early growth of neurosurgery as a specialty. This publication explores the historical relationship between the evolution of combat methodology from antiquity through modern conflicts as it dovetails with and drives corresponding a...
journal_title:Journal of neurosurgery
pub_type: 历史文章,杂志文章
doi:10.3171/2013.8.JNS122369
更新日期:2014-01-01 00:00:00
abstract::The authors report a series of 34 meningiomas of the sphenoid ridge. Eight tumors were totally removed uneventfully: two from the middle sphenoid ridge and six from the pterion or Sylvian point. Five tumors were not operated on because of their extensions or the patient's age. Twenty-one tumors raised serious surgical...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.5.0587
更新日期:1980-11-01 00:00:00
abstract::The posterior spinal vein was occluded with silicone in seven rhesus monkeys, and locally resected in one. There were no neurological findings associated with acute venous obstruction of the cord. Follow-up arteriography revealed diversion of venous outflow into the anterior spinal venous system. Histology revealed gl...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.51.2.0201
更新日期:1979-08-01 00:00:00
abstract:OBJECT:The angles of arterial bifurcations are governed by principles of work minimization (optimality principle). This determines the relationship between the angle of a bifurcation and the radii of the vessels. Nevertheless, the model is predicated on an absence of significant communication between these branches. Th...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.101.1.0108
更新日期:2004-07-01 00:00:00
abstract::The surgical treatment of cerebrovascular malformations intrigued early neurosurgeons. Cushing defined vascular malformations as tumors arising from cerebral blood vessels. He successfully resected the first arteriovenous malformation 3 years after it had been irradiated. In the absence of angiography, the pathoanatom...
journal_title:Journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.3171/jns.2004.101.3.0553
更新日期:2004-09-01 00:00:00
abstract::The authors report an unusual case of a widely metastatic glioblastoma. DNA copy number microarray profile of the resected specimen revealed complex rearrangements found throughout chromosome 6, a phenomenon known as chromothripsis. Such chromothripsis pattern was not observed in 50 nonmetastatic glioblastoma specimen...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.4.JNS153052
更新日期:2017-05-01 00:00:00
abstract::A patient is reported whose hydrocephalus was controlled by diverting the ventricular cerebrospinal fluid directly into the urinary bladder. This drainage route may have a useful place in the management of the adult pressure-sensitive patient whose more conventional shunt requires frequent revision for repeated obstru...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.6.0858
更新日期:1980-12-01 00:00:00
abstract::The authors have created an experimental model of regional cerebral ischemia in gerbils that is reproducible and has a low mortality rate. In gerbils, either the posterior communicating artery (PCoA) or the middle cerebral artery (MCA) was occluded, and the distribution of cerebral ischemia from each surgical procedur...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.58.3.0362
更新日期:1983-03-01 00:00:00
abstract::The authors report an unusual case of a dural arteriovenous fistula (DAVF) in the cervical spine after a C1-2 fracture. The patient presented with a delayed epidural hematoma and quadriparesis. The DAVF was successfully treated by coil embolization and the patient made a full recovery. The possibility of a DAVF as a l...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2004.100.4.0382
更新日期:2004-04-01 00:00:00
abstract::Cerebrospinal fluid (CSF) was collected preoperatively (by lumbar puncture) or perioperatively (by lumbar or ventricular drain) from 32 patients with subarachnoid hemorrhage (SAH) from ruptured intracranial aneurysms. Samples were also obtained from six control patients without evidence of subarachnoid blood. Smooth-m...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.5.0927
更新日期:1984-05-01 00:00:00
abstract::Tissue acidosis is believed to be a key element in ischemic injury of neural tissue. The goal of this study was to determine whether persisting postischemic acidosis or the extent of acidosis would affect metabolic recovery following an ischemic event. Intracellular pH (pHi), adenosine triphosphate, phosphocreatine, a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.4.0567
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVE:Magnetic resonance imaging-guided focused ultrasound (MRgFUS) is a novel and useful treatment for essential tremor (ET); however, the factors impacting treatment outcome are unknown. The authors conducted this study to determine the factors affecting the outcome of MRgFUS. METHODS:From May 2016 through Augus...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.2.JNS192814
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:To investigate the risk of bleeding from unruptured cerebral aneurysms (UCAs), previous studies have used Kaplan-Meier analyses without treating the definitive treatment as a competing risk event, which may underestimate the rupture rate. The authors analyzed the survival of patients with UCAs alongside the o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.11.JNS181781
更新日期:2019-03-08 00:00:00
abstract::The sequential changes in microvascular architecture following local cold injury in rat brains were studied post mortem by scanning electron microscopy and the vascular casting method. The findings were compared with the results of immunohistochemical studies of injured endothelial cells using the bromodeoxyuridine (B...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.68.4.0608
更新日期:1988-04-01 00:00:00
abstract:OBJECT:The purpose of this study was to evaluate both replication-competent and replication-restricted recombinant vesicular stomatitis virus (VSV) vectors as therapeutic agents for high-grade gliomas by using an organotypic brain tissue slice-glioma coculture system. METHODS:The coculture system involved growing diff...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.100.6.1049
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVE:The endovascular treatment of complex bifurcation aneurysms possessing a neck that incorporates multiple side branches remains a surgical challenge. Double-stent-assisted coiling techniques, such as those with stents in an X and Y configuration, enable the endovascular treatment of wide-necked complex intracr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.9.JNS191733
更新日期:2019-12-06 00:00:00
abstract::OBJECTIVEParaclinoid aneurysms represent approximately 5% of intracranial aneurysms (Drake et al. [1968]). Visual impairment, which occurs in 16%-40% of patients, is among the most common presentations of these aneurysms (Day [1990], Lai and Morgan [2013], Sahlein et al. [2015], and Silva et al. [2017]). Flow-divertin...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.1.JNS171774
更新日期:2018-06-01 00:00:00
abstract::The hydrogen clearance method was used to measure total and focal cerebral blood flow (CBF) in the monkey before and for 5 hours after a simulated subarachnoid hemorrhage (SAH). Some monkeys also received 0.2 to 1.0 mg/kg phentolamine intracisternally 3 hours after SAH. Results show that SAH did not change cerebrovasc...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.44.3.0353
更新日期:1976-03-01 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 clinical and pathological data of 66 patients with orbital cavernous hemangioma are presented. This tumor occurs in females more frequently than in males, and has its peak incidence in early middle age. Visual disability results from a high degree of relative hyperopia or from optic-nerve compression. Postural or ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.51.2.0219
更新日期:1979-08-01 00:00:00
abstract:OBJECT:Historically, destructive procedures for cancer pain were the main line of treatment therapy. However, the use of high-dose opioids has essentially replaced such procedures. Recognition of the limits of medical therapy to treat cancer pain effectively is growing, while conversely, in regions with limited access ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2010.6.JNS10119
更新日期:2011-01-01 00:00:00
abstract:OBJECT:The aim of this study was to assess long-term clinical outcomes in patients who underwent Gamma Knife surgery (GKS) with a low margin dose-14 Gy or less-to treat vestibular schwannoma (VS) unrelated to neurofibromatosis Type II. METHODS:Between December 1994 and December 2001, 200 patients with VSs underwent GK...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.7.GKS12783
更新日期:2012-12-01 00:00:00
abstract::Glioma patients receiving corticosteroids (16 mg/day betamethasone) were examined for evidence of immune cell dysfunction by using quantitative estimates of adenosine diphosphate (ADP)-ribosylation in peripheral mononuclear leukocytes as the physiological indicator. The duration of daily treatment with corticosteroids...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.77.4.0601
更新日期:1992-10-01 00:00:00
abstract::Giant paraclinoidal carotid artery aneurysms frequently require temporary interruption of local circulation to facilitate safe occlusion. Due to brisk retrograde flow through the ophthalmic artery and cavernous branches, simple trapping of the aneurysm by cervical internal carotid artery clamping and intracranial dist...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.73.2.0305
更新日期:1990-08-01 00:00:00
abstract:OBJECT:The aim of this study was to investigate the effect of patient-related factors, extent of surgery, and adjuvant therapy on survival in children presenting with intracranial ependymoma. METHODS:Between 1980 and 1999, 83 children (mean age 36 months) underwent surgery for intracranial ependymomas. Complete resect...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.4.0827
更新日期:2002-10-01 00:00:00
abstract:OBJECT:The purpose of this study was to identify the causes of failed temporal lobe resection in patients with mesial temporal sclerosis (MTS) and the role of repeat surgery for seizure control. METHODS:This is a retrospective study of 105 patients who underwent temporal lobe resection for MTS with unilateral electroe...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.1.JNS08638
更新日期:2009-06-01 00:00:00
abstract:OBJECT:Neuronal injury remains a leading cause of morbidity in both neonates and adults with injuries induced by intracranial hemorrhage, ischemia-reperfusion, and excitotoxicity. To date, a number of neuroprotective strategies have been evaluated, but they have shown little benefit. Poloxamer 188 (P-188), a membrane-a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2007.106.1.36
更新日期:2007-01-01 00:00:00
abstract::Maffucci syndrome is a rare disease characterized by multiple enchondromas and soft-tissue hemangiomas. Additionally, neuroendocrine tumors including pituitary adenomas have been described in these patients. The underlying genetic etiology lies in somatic mosaicism of mutations in isocitrate dehydrogenase 1 (IDH1) or ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.4.JNS15191
更新日期:2016-06-01 00:00:00