Continuous monitoring of regional cerebral blood flow during temporary arterial occlusion in aneurysm surgery.

Abstract:

OBJECT:Temporary arterial occlusion (TAO) during aneurysm surgery carries the risk of ischemic sequelae. Because monitoring of regional cerebral blood flow (rCBF) may limit neurological damage, the authors evaluated a novel thermal diffusion (TD) microprobe for use in the continuous and quantitative assessment of rCBF during TAO. METHODS:Following subcortical implantation of the device at a depth of 20 mm in the middle cerebral artery or anterior cerebral artery territory, rCBF was continuously monitored by TD microprobe (TD-rCBF) throughout surgery in 20 patients harboring anterior circulation aneurysms; 46 occlusive episodes were recorded. Postoperative radiographic evidence of new infarction was used as the threshold for failure of occlusion tolerance. The mean subcortical TD-rCBF decreased from 27.8+/-8.4 ml/100 g/min at baseline to 13.7+/-11.1 ml/100 g/min (p < 0.0001) during TAO. The TD microprobe showed an immediate exponential decline of TD-rCBF on clip placement. On average, 50% of the total decrease was reached after 12 seconds, thus rapidly indicating the severity of hypoperfusion. Following clip removal, TD-rCBF returned to baseline levels after an average interval of 32 seconds, and subsequently demonstrated a transient hyperperfusion to 41.4+/-18.3 ml/l 00 g/min (p < 0.001). The occurrence of postoperative infarction (15%) and the extent of postischemic hyperperfusion correlated with the depth of occlusion-induced ischemia. CONCLUSIONS:The new TD microprobe provides a sensitive, continuous, and real-time assessment of intraoperative rCBF during TAO. Occlusion-induced ischemia is reliably detected within the 1st minute after clip application. In the future, this may enable the surgeon to alter the surgical strategy early after TAO to prevent ischemic brain injury.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Thomé C,Vajkoczy P,Horn P,Bauhuf C,Hübner U,Schmiedek P

doi

10.3171/jns.2001.95.3.0402

subject

Has Abstract

pub_date

2001-09-01 00:00:00

pages

402-11

issue

3

eissn

0022-3085

issn

1933-0693

journal_volume

95

pub_type

杂志文章
  • Microvascularization of Grade I meningiomas: effect on tumor volume, blood loss, and patient outcome.

    abstract::OBJECTIVE Quantitative assessment of tumor microvascularity has the potential to improve prognostication, advance understanding of tumor biology, and help narrow potential molecular therapies. While the role of tumor microvascularity has been widely studied in meningiomas, this study examines both the role of automate...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2016.10.JNS161825

    authors: Karsy M,Burnett B,Di Ieva A,Cusimano MD,Jensen RL

    更新日期:2018-03-01 00:00:00

  • Nondural-based lumbar clear cell meningioma. Case report.

    abstract::This 32-year-old man had noticed right leg pain for 4 years and developed classic right sciatica after heavy lifting, followed by episodes of buckling of both legs 1 month prior to admission. His medical history included congenital left abducens palsy. Examination revealed a right Lasègue's sign and Fajersztajn's sign...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1996.84.2.0264

    authors: Holtzman RN,Jormark SC

    更新日期:1996-02-01 00:00:00

  • Desmopressin administration and rebleeding in subarachnoid hemorrhage: analysis of an observational prospective database.

    abstract::OBJECTIVERebleeding remains a frequent and catastrophic event leading to poor outcome after subarachnoid hemorrhage (SAH). Reduced platelet function after the initial bleed is associated with higher risk of early rebleeding. Desmopressin (DDAVP) is a well-known hemostatic agent, and recent guidelines already suggest i...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2017.7.JNS17990

    authors: Francoeur CL,Roh D,Schmidt JM,Mayer SA,Falo MC,Agarwal S,Connolly ES,Claassen J,Elkind MSV,Park S

    更新日期:2018-01-01 00:00:00

  • Value of gas myelography in early management of acute cervical spinal cord injuries.

    abstract::Gas myelography was carried out in 22 patients with acute cervical spinal cord injuries in whom oily contrast media seemed contraindicated. The authors believe this technique makes a valuable contribution to the basic decision regarding the surgical versus medical treatment of a specific patient with a cervical cord i...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1975.42.3.0330

    authors: Rossier AB,Berney J,Rosenbaum AE,Hachen J

    更新日期:1975-03-01 00:00:00

  • Large extra-abdominal cyst as a postpartum complication of peritoneal shunt. Case report.

    abstract::An extra-abdominal cyst filled with cerebrospinal fluid was found postpartum in a patient with a ventriculoperitoneal (VP) shunt. No similar complication of VP shunting has been reported before. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1986.64.1.0151

    authors: Nugent P,Hoshek S

    更新日期:1986-01-01 00:00:00

  • Brain injury from a spent bullet descending vertically. Report of five cases.

    abstract::This is a report of five cases in which a bullet penetrated the vertex of the skull and brain, apparently during its vertical descent after having been fired into the air. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1971.34.2part1.0222

    authors: Hanieh A

    更新日期:1971-02-01 00:00:00

  • Spontaneous intracerebral hematoma in carotid-cavernous fistula. Report of three cases.

    abstract::Spontaneous intracerebral hematoma associated with carotid-cavernous fistula is rare. Three new cases are presented. In each, the hemorrhage originated in the vicinity of localized intracranial venous engorgement, as demonstrated by cerebral angiography. Rupture of one or several of the distended venous channels from ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1983.59.4.0680

    authors: Turner DM,Vangilder JC,Mojtahedi S,Pierson EW

    更新日期:1983-10-01 00:00:00

  • Disc herniation at T1-2. Report of four cases and literature review.

    abstract::In preparing this paper, the authors reviewed their experiences with four cases of T1-2 disc herniation as well as the medical literature on the subject. Intervertebral thoracic disc herniations are uncommon and high thoracic disc herniations are rare. In the upper third of the thoracic spine, T1-2 is the most common ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.3171/jns.1998.88.1.0148

    authors: Morgan H,Abood C

    更新日期:1998-01-01 00:00:00

  • Novalis Shaped Beam Radiosurgery of arteriovenous malformations.

    abstract:OBJECT:The authors studied outcomes and complications in patients who harbored arteriovenous malformations (AVMs) and underwent stereotactic radiosurgery involving the Novalis shaped beam unit. METHODS:Between January 1998 and January 2002, 83 patients were treated with radiosurgery at University of California, Los An...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2004.101.supplement 3.0425

    authors: Pedroso AG,De Salles AA,Tajik K,Golish R,Smith Z,Frighetto L,Solberg T,Cabatan-Awang C,Selch MT

    更新日期:2004-11-01 00:00:00

  • Spinal deformities following selective dorsal rhizotomy.

    abstract:OBJECT:Selective dorsal rhizotomy (SDR) has been shown to provide considerable benefit to children with spastic cerebral palsy (CP). The authors sought to evaluate the risks of postoperative spinal deformities in patients following SDR. METHODS:All patients who underwent SDR at McGill University between 1991 and 2001 ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/ped.2007.106.6.441

    authors: Golan JD,Hall JA,O'Gorman G,Poulin C,Benaroch TE,Cantin MA,Farmer JP

    更新日期:2007-06-01 00:00:00

  • Diagnostic value of preoperative inflammatory markers in patients with glioma: a multicenter cohort study.

    abstract::OBJECTIVE Glioma is the most common form of brain tumor and has high lethality. The authors of this study aimed to elucidate the efficiency of preoperative inflammatory markers, including neutrophil/lymphocyte ratio (NLR), derived NLR (dNLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), and progno...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,多中心研究

    doi:10.3171/2017.3.JNS161648

    authors: Zheng SH,Huang JL,Chen M,Wang BL,Ou QS,Huang SY

    更新日期:2018-09-01 00:00:00

  • Acute occlusion of the posterior spinal vein. Experimental study in monkeys.

    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

    authors: Doppman JL,Girton M,Popovsky MA

    更新日期:1979-08-01 00:00:00

  • High-dose BCNU with autologous bone marrow rescue for recurrent glioblastoma multiforme.

    abstract::Eleven patients with recurrent malignant glioma were treated with single high doses of BCNU ranging from 600 to 1400 mg/sq m. To prevent the characteristic late myelosuppression observed after conventional doses of BCNU, autologous bone marrow harvested just before drug treatment was infused 24 to 36 hours after thera...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1981.54.4.0455

    authors: Hochberg FH,Parker LM,Takvorian T,Canellos GP,Zervas NT

    更新日期:1981-04-01 00:00:00

  • Observer variability in assessing the clinical features of subarachnoid hemorrhage.

    abstract::Clinical assessment of patients with subarachnoid hemorrhage (SAH) is important both in determining management and in predicting outcome. A previous report showed considerable observer inconsistency when patients were graded with either the Hunt and Hess or the Nishioka system. This study evaluates observer variabilit...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1983.58.1.0057

    authors: Lindsay KW,Teasdale GM,Knill-Jones RP

    更新日期:1983-01-01 00:00:00

  • The effect of thymidine kinase transduction and ganciclovir therapy on tumor vasculature and growth of 9L gliomas in rats.

    abstract::Eradication of malignant brain tumors by in situ intratumoral, retrovirally mediated transfer of the herpes simplex virus thymidine kinase (HSVtk) gene, which sensitizes the tumor cells to ganciclovir, has recently been demonstrated in animal models. The observation that tumors studied in vitro and in animals can be c...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1994.81.2.0256

    authors: Ram Z,Walbridge S,Shawker T,Culver KW,Blaese RM,Oldfield EH

    更新日期:1994-08-01 00:00:00

  • Preliminary evaluation of a novel intraparenchymal capacitive intracranial pressure monitor.

    abstract:OBJECT:Intracranial pressure (ICP) monitors are currently based on fluid-filled, strain gauge, or fiberoptic technology. Capacitive sensors have minimal zero drift and energy requirements, allowing long-term implantation and telemetric interrogation; their application to neurosurgery has only occasionally been reported...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2011.4.JNS101920

    authors: Aquilina K,Thoresen M,Chakkarapani E,Pople IK,Coakham HB,Edwards RJ

    更新日期:2011-09-01 00:00:00

  • Mycotic aneurysms of the internal carotid artery. Case report.

    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

    authors: Shibuya S,Igarashi S,Amo T,Sato H,Fukumitsu T

    更新日期:1976-01-01 00:00:00

  • The transfacet pedicle-sparing approach for thoracic disc removal: cadaveric morphometric analysis and preliminary clinical experience.

    abstract::A number of operative techniques have been described for the treatment of herniated thoracic discs. The transfacet pedicle-sparing approach allows for complete disc removal with limited spinal column disruption and soft-tissue dissection. Fifteen cadaveric spinal columns were used for evaluation of exposure, developme...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1995.83.6.0971

    authors: Stillerman CB,Chen TC,Day JD,Couldwell WT,Weiss MH

    更新日期:1995-12-01 00:00:00

  • Gamma knife treatment of subfoveal, classic neovascularization in age-related macular degeneration: a pilot study.

    abstract:OBJECT:Age-related macular degeneration (AMD) is the leading cause of severe vision loss in people older than age 65 years in the western world. The visual acuity loss usually results from the ingrowth of new vessels from the choroid capillaries, so called choroidal neovascularization (CNV). The aim of this pilot study...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2000.93.supplement

    authors: Haas A,Papaefthymiou G,Langmann G,Schröttner O,Feigl B,Leber KA,Hanselmayer R,Pendl G

    更新日期:2000-12-01 00:00:00

  • Modified stereotactic insertion of the Ommaya reservoir. Technical note.

    abstract::Ommaya reservoirs are used primarily for the repeated injection of intrathecal chemotherapy for leptomeningeal metastasis from hematopoietic and solid malignancies. Insertion of this device in a relatively large nondisplaced ventricle is not a difficult task, but challenges arise when the ventricle is small and/or dis...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2000.92.6.1050

    authors: Al-Anazi A,Bernstein M

    更新日期:2000-06-01 00:00:00

  • Imaging studies of cerebral hyperperfusion after carotid endarterectomy. Case report.

    abstract::A case is reported of severe unilateral hemispheric edema and localized hemorrhage associated with seizures following endarterectomy of an ipsilateral high-grade carotid stenosis. Imaging studies including angiography, computerized tomography (CT), magnetic resonance imaging/angiography, and xenon-CT, suggested postop...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1995.83.1.0133

    authors: Penn AA,Schomer DF,Steinberg GK

    更新日期:1995-07-01 00:00:00

  • The second-generation eCLIPs Endovascular Clip System: initial experience.

    abstract::OBJECTIVE Treatment of wide-necked intracranial aneurysms is associated with higher recanalization and complication rates; however, the most commonly used methods are not specifically designed to work in bifurcation lesions. To address these issues, the authors describe the evolution in the design and use of the eCLIP...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,多中心研究

    doi:10.3171/2016.10.JNS161731

    authors: Chiu AH,De Vries J,O'Kelly CJ,Riina H,McDougall I,Tippett J,Wan M,de Oliveira Manoel AL,Marotta TR

    更新日期:2018-02-01 00:00:00

  • Pretreatment texture analysis of routine MR images and shape analysis of the diffusion tensor for prediction of volumetric response after radiosurgery for meningioma.

    abstract::OBJECTIVEThe goal of this study was to identify parameters from routine T1- and T2-weighted MR sequences and diffusion tensor imaging (DTI) that best predict the volumetric changes in a meningioma after treatment with Gamma Knife radiosurgery (GKRS).METHODSIn 32 patients with meningioma, routine MRI and DTI data were ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2018.7.GKS181327

    authors: Speckter H,Bido J,Hernandez G,Rivera D,Suazo L,Valenzuela S,Miches I,Oviedo J,Gonzalez C,Stoeter P

    更新日期:2018-12-01 00:00:00

  • Cortical calculation localization using electrostimulation.

    abstract:OBJECT:A naming task has been used to spare cortical areas involved in language. In the present study, a calculation task was combined with electrostimulation mapping (awake surgery) to spare cortical areas involved in calculation in patients undergoing surgery for brain lesions. The organization of language and calcul...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2008.8.JNS17649

    authors: Roux FE,Boukhatem L,Draper L,Sacko O,Démonet JF

    更新日期:2009-06-01 00:00:00

  • Experience with a shunt system using the third ventricle. Technical note.

    abstract::The authors present a technique involving placement of a catheter in the third ventricle in shunt systems for hydrocephalus, in order to avoid obstruction of the proximal catheter by particles of chorioid plexus. They emphasize the simplicity of the technique, lack of morbidity, and the good results they have obtained...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1975.42.1.0104

    authors: Gutierrez-Lara F,Hakim S

    更新日期:1975-01-01 00:00:00

  • Distribution of cerebellar tonsil position: implications for understanding Chiari malformation.

    abstract:OBJECT:Prior attempts to define normal cerebellar tonsil position have been limited by small numbers of patients precluding analysis of normal distribution by age group. The authors' objective in the present study was to analyze cerebellar tonsil location in every age range. METHODS:Two thousand four hundred patients ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2013.5.JNS121825

    authors: Smith BW,Strahle J,Bapuraj JR,Muraszko KM,Garton HJ,Maher CO

    更新日期:2013-09-01 00:00:00

  • Venous outflow restriction as a predictor of cavernous sinus dural arteriovenous fistula obliteration after Gamma Knife surgery.

    abstract:OBJECTIVE:Gamma Knife surgery (GKS) obliterates 65%-87% of cavernous sinus dural arteriovenous fistulas (CSDAVFs). However, the hemodynamic effect on GKS outcomes is relatively unknown. The authors thus used the classification scheme developed by Suh et al. to explore this effect. METHODS:The authors retrospectively (...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2018.9.JNS182040

    authors: Wu CA,Yang HC,Hu YS,Wu HM,Lin CJ,Luo CB,Guo WY,Lee CC,Liu KD,Chung WY

    更新日期:2019-01-25 00:00:00

  • Scar formation in the carotid sheath identified during carotid endarterectomy in patients with previous cardiac surgery: significance of history of intraoperative Swan-Ganz catheter insertion. Clinical article.

    abstract:OBJECT:Scar formation in the carotid sheath is often identified during carotid endarterectomy (CEA) in patients with previous cardiac surgery, and dissection of the carotid sheath and exposure of the carotid arteries in such patients are difficult. The purpose of the present study was to investigate factors related to ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2010.4.JNS091819

    authors: Yoshida K,Ogasawara K,Kobayashi M,Tsuboi J,Okabayashi H,Ogawa A

    更新日期:2010-10-01 00:00:00

  • Intracranial vessels lack vasa vasorum.

    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

    authors: Clower BR,Sullivan DM,Smith RR

    更新日期:1984-07-01 00:00:00

  • The role of surgery for high-grade intracranial dural arteriovenous fistulas: importance of obliteration of venous outflow.

    abstract:OBJECT:Surgical intervention may be required if endovascular embolization is insufficient to completely obliterate intracranial dural arteriovenous fistulas (DAVFs). The authors report their 14-year experience with 23 patients harboring diverse intracranial DAVFs that required surgical intervention. METHODS:Between 19...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2008.9.JNS08733

    authors: Liu JK,Dogan A,Ellegala DB,Carlson J,Nesbit GM,Barnwell SL,Delashaw JB

    更新日期:2009-05-01 00:00:00