Abstract:
OBJECT:Thromboembolic phenomena (TEPs) continue to be a significant source of morbidity and mortality in patients undergoing neurosurgery. Although the efficacy of low-dose heparin in preventing TEPs in neurosurgical patients is well established, neurosurgeons are reluctant to use it perioperatively because of concern for increased bleeding complications. To clarify this issue, the authors used a prospective, randomized, double-blind design to evaluate the safety of minidose heparin treatment in patients undergoing surgery for supratentorial brain tumors. METHODS:One hundred three patients, all 40 years of age or older, were treated with either 5000 U of heparin (55 patients) or placebo (48 patients) starting 2 hours before surgery and continuing until full mobilization or for 7 days. Both groups were well matched for sex, weight, duration of surgery, and tumor diagnosis. Subjective and objective parameters were used to estimate and calculate the perioperative bleeding tendency in all patients. Red blood cell mass loss was calculated by assessing the preoperative and postoperative hematocrit and the patient's weight. Intraoperative blood loss was determined by measuring the quantity of blood in the suction containers and subtracting the amount of irrigation fluids. Postoperative bleeding was measured by determining the amount of fluid in the subgaleal drain, and blood cell replacement was monitored during and after the procedure. Intracranial bleeding was graded according to findings on the postoperative computerized tomography scan obtained 48 to 72 hours after surgery. In addition, the senior surgeon in each case was asked to assess each patient's bleeding tendency during the operation. The results showed that perioperative administration of heparin did not significantly alter bleeding tendency by any measured parameter. The surgeon was blinded to which group individual patients had been allocated. CONCLUSIONS:Perioperative minidose heparin is safe for use in patients undergoing craniotomy for supratentorial tumors. This relatively simple and inexpensive measure is recommended as a routine regimen for the prevention of TEPs in patients undergoing neurosurgery.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Constantini S,Kanner A,Friedman A,Shoshan Y,Israel Z,Ashkenazi E,Gertel M,Even A,Shevach Y,Shalit M,Umansky F,Rappaport ZHdoi
10.3171/jns.2001.94.6.0918subject
Has Abstractpub_date
2001-06-01 00:00:00pages
918-21issue
6eissn
0022-3085issn
1933-0693journal_volume
94pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECT:The purpose of this study was to evaluate the involvement of platelet-activating factor (PAF) in the formation of edema surrounding meningiomas. METHODS:Volumes of tumor and peritumoral edema were calculated based on three-dimensional reconstructed magnetic resonance images in 31 patients with intracranial meni...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.88.2.0304
更新日期:1998-02-01 00:00:00
abstract:OBJECT:It remains unclear whether selective amygdalohippocampectomy, an operative technique developed for use in epilepsy surgery to spare unaffected brain tissue and thus minimize the cognitive consequences of temporal lobe surgery, actually leads to a better memory outcome. The present study was performed to determin...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.9.JNS08247
更新日期:2009-06-01 00:00:00
abstract::A case is reported of eosinophilic granuloma at the cervicothoracic junction presenting with profound quadriparesis preoperatively. The patient underwent excision via an anterior approach, with splitting of the sternum to gain access to the T-1 vertebra. Postoperatively, he has had an excellent return of function. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1989.71.6.0942
更新日期:1989-12-01 00:00:00
abstract::Cerebral protection from an ischemic/hypoxic insult implies that tissue injury can be controlled or even prevented by certain therapeutic maneuvers. For example, physiological thresholds may be altered so that tissue vulnerability to the insult is reduced, or the intensity of an insult may be blunted by enhancing brai...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1986.65.5.0579
更新日期:1986-11-01 00:00:00
abstract::An audible, noisy cerebrospinal fluid flow is an uncommon sequela of ventriculoperitoneal shunting. Two cases presenting this phenomenon are described. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.67.3.0460
更新日期:1987-09-01 00:00:00
abstract:OBJECT:Aneurysmal subarachnoid hemorrhage rarely occurs in young adults. The aim of this work was to clarify the clinical characteristics of ruptured aneurysms in young adults in the third and fourth decades of life and to compare these two age groups. METHODS:The authors retrospectively investigated 2493 patients who...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.99.2.0276
更新日期:2003-08-01 00:00:00
abstract:OBJECT:The goal in this study was to compare flat-panel detector (FD) CT with multislice (MS) CT in the visualization of intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), intraventricular hemorrhage, and external ventricular drains (EVDs) to evaluate the diagnostic quality and limitations of the new FD CT ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.2.JNS091054
更新日期:2010-10-01 00:00:00
abstract::Space-occupying lesions of the basal ganglia are a rare cause of extrapyramidal dysfunction in children. Metastatic pineal germinoma in both basal ganglia produced dystonia in a 12-year-old boy. The literature is reviewed. Extrapyramidal manifestations in the child are compared with previously reported cases of basal ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.48.1.0108
更新日期:1978-01-01 00:00:00
abstract::Myelomeningoceles are routinely diagnosed prenatally by using ultrasonography. Because the level of the neural defect has been shown to correlate with functional and cognitive outcome in infants with myelomeningocele, it is of prognostic importance to identify the level prenatally. The authors report on a case in whic...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.2005.102.2.0248
更新日期:2005-03-01 00:00:00
abstract::A case of hemangioblastoma of the spinal cord is described in which the tumor presented in an intradural extramedullary location. The patient did not have von Hippel-Lindau's disease or metastatic seeding. It is assumed that the tumor arose in the pia, and its direction of growth was purely extramedullary. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.48.3.0461
更新日期:1978-03-01 00:00:00
abstract::Meningiomas have been reported to have associated areas of surrounding low density on computerized tomography (CT). These low-density areas may represent edema, widened subarachnoid spaces, loculated cerebrospinal fluid, demyelination, or adjacent tumor. Two cases are presented in which this adjacent area of low densi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.1.0103
更新日期:1979-01-01 00:00:00
abstract::Levels of protein kinase C (PKC) isoforms in eight human glioblastoma cell lines and two normal human glial cell cultures were determined. Earlier studies identified PKC-alpha and PKC-gamma in these cell lines but PKC-beta was not present. In this study, PKC-epsilon and PKC-zeta are demonstrated immunologically in the...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.5.0734
更新日期:1994-11-01 00:00:00
abstract:OBJECT:Cushing's disease is a challenging neuroendocrine disorder. Although resection remains the primary treatment option for most patients, the disease persists if there is residual or recurrent tumor. Stereotactic radiosurgery has been used to treat patients with persistent Cushing's disease after a prior resection....
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.7.JNS13217
更新日期:2013-12-01 00:00:00
abstract:OBJECT:The authors sought to establish whether the volume of the posterior fossa in children suffering from Chiari malformation Type I (CM-I) is smaller than normal, as has been suggested previously. They also investigated the role of syringomyelia in posterior fossa development. METHODS:Both posterior fossa volume (P...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2006.105.2.101
更新日期:2006-08-01 00:00:00
abstract::OBJECTIVE Neurosurgery is among the most competitive residencies, as evidenced by the high number of applicants for relatively few positions. Although it is important to recruit candidates who have the intellectual capacity and drive to succeed, traditional objective selection criteria, such as US Medical Licensing Ex...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.7.JNS15880
更新日期:2016-10-01 00:00:00
abstract::The authors present a case of spontaneous regression of a herniated cervical nucleus pulposus in a patient with myelopathy. This 37-year-old woman developed sudden quadriparesis; she had reported no history of trauma. Magnetic resonance (MR) imaging revealed a large disc herniation and increased signal intensity of th...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.1999.90.1.0138
更新日期:1999-01-01 00:00:00
abstract::Sir Victor Horsley was a pioneering British neurosurgeon known for his numerous neurosurgical, scientific, and sociopolitical contributions. Although word of these surgical and scientific achievements quickly spread throughout Europe and North America in the late 19th century, much of modern neurosurgery's view of Hor...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.8.JNS171438
更新日期:2018-03-01 00:00:00
abstract:OBJECT:Arterial embolization reduces blood loss in patients undergoing surgery for hypervascular spinal tumors. The objectives of this study were twofold: 1) to evaluate the role of magnetic resonance (MR) imaging in predicting tumor vascularity and 2) to assess the effectiveness of preoperative embolization in devascu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2003.98.2.0156
更新日期:2003-03-01 00:00:00
abstract::Excision of human cerebral arteriovenous malformations (AVMs) can be complicated by postoperative edema and hemorrhage in adjacent brain tissue, despite the complete excision of the malformation. Various theories have purported to explain the hemodynamic basis for this predisposition, including disordered autoregulati...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.86.3.0519
更新日期:1997-03-01 00:00:00
abstract::The authors describe a new technique for treating unclippable aneurysms. The method involves a modification of the traditional wrapping technique, including a clip-reinforced cotton sling. The results of this method in four patients are presented. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.77.3.0478
更新日期:1992-09-01 00:00:00
abstract::Although severe hypovolemia can lead to hypotension and neurological decline, many patients with neurosurgical disorders experience a significant hypovolemia while autonomic compensatory mechanisms maintain a normal blood pressure. To assess the effects of normotensive hypovolemia upon cerebral hemodynamics, transcran...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.76.6.0961
更新日期:1992-06-01 00:00:00
abstract:OBJECT:Despite the controversy over the clinical significance of Gamma Knife surgery (GKS) for refractory mesial temporal lobe epilepsy (MTLE), the modality has attracted attention because it is less invasive than resection. The authors report long-term outcomes for 7 patients, focusing in particular on the long-term c...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.2.JNS111296
更新日期:2012-06-01 00:00:00
abstract::Iniencephaly is a rare congenital anomaly characterized by spina bifida of the cervical vertebrae, fixed retroflexion of the head on the cervical spine, and occipital bone defect. There are only five reports of surviving patients with iniencephaly. The authors report the case of a newborn who presented with iniencepha...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1998.89.2.0317
更新日期:1998-08-01 00:00:00
abstract::Analysis of the authors' experience over the last 10 years has indicated that excellent pain control has rarely been obtained by thalamic relay nucleus stimulation in patients with thalamic pain. In the present study, 11 patients with thalamic pain were treated by chronic stimulation of the precentral gyrus. In eight ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.78.3.0393
更新日期:1993-03-01 00:00:00
abstract::Two patients with fusiform aneurysms and at least one previous subarachnoid hemorrhage were treated by excision of the aneurysms and reconstruction of the arteries. The first case presented with two fusiform aneurysms, the larger of which involved the angular and the smaller one the temporal branch of the left middle ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.2.0272
更新日期:1978-08-01 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::The purpose of this study is to report a surgical technique of nerve transfer to restore radial nerve function after a complete palsy due to a proximal injury to the radial nerve. The authors report the case of a patient who underwent direct nerve transfer of redundant or expendable motor branches of the median nerve ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/09/0666
更新日期:2007-09-01 00:00:00
abstract::Two groups of rats with induced arterial hypertension were studied. One group underwent section of the left common carotid artery with an end-to-side anastomosis of the proximal segment to the right common carotid artery. The second group was subjected to ligation of the left common carotid artery. The number of aneur...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.65.3.0398
更新日期:1986-09-01 00:00:00
abstract::The authors report four cases of primary intracranial choriocarcinoma, all in young males. There tumors occurred in the pineal region and one in the lateral ventricle. Besides the signs of increased intracranial pressure and ophthalmological disorders, skin pigmentation or eruption was observed in three cases and prec...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.3.0369
更新日期:1980-09-01 00:00:00
abstract:OBJECT:The effectiveness and safety of radiosurgery for small- to medium-sized cerebral arteriovenous malformations (AVMs) have been well established. However, the management for large cerebral AVMs remains a great challenge to neurosurgeons. In the past 5 years the authors performed preplanned staged radiosurgery to t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/109/12/S11
更新日期:2008-12-01 00:00:00