Abstract:
OBJECT:This investigation was performed to determine the tolerance and toxicities of split-course fractionated gamma knife radiosurgery (FSRS) given in combination with conventional external-beam radiation therapy (CEBRT). METHODS:Eighteen patients with previously unirradiated, gliomas treated between March 1995 and January 2000 form the substrate of this report. These included 11 patients with malignant gliomas, six with low-grade gliomas, and one with a recurrent glioma. They were stratified into three groups according to tumor volume (TV). Fifteen were treated using the initial FSRS dose schedule and form the subject of this report. Group A (four patients), had TV of 5 cm3 or less (7 Gy twice pre- and twice post-CEBRT); Group B (six patients), TV greater than 5 cm3 but less than or equal to 15 cm3 (7 Gy twice pre-CEBRT and once post-CEBRT); and Group C (five patients), TV greater than 15 cm3 but less than or equal to 30 cm3 (7 Gy once pre- and once post-CEBRT). All patients received CEBRT to 59.4 Gy in 1.8-Gy fractions. Dose escalation was planned, provided the level of toxicity was acceptable. All patients were able to complete CEBRT without interruption or experiencing disease progression. Unacceptable toxicity was observed in two Grade 4/Group B patients and two Grade 4/Group C patients. Eight patients required reoperation. In three (38%) there was necrosis without evidence of tumor. Neuroimaging studies were available for evaluation in 14 patients. Two had a partial (> or = 50%) reduction in volume and nine had a minor (> 20%) reduction in size. The median follow-up period was 15 months (range 9-60 months). Six patients remained alive for 3 to 60 months. CONCLUSIONS:The imaging responses and the ability of these patients with intracranial gliomas to complete therapy without interruption or experiencing disease progression is encouraging. Excessive toxicity derived from combined FSRS and CEBRT treatment, as evaluated thus far in this study, was seen in patients with Group B and C lesions at the 7-Gy dose level. Evaluation of this novel treatment strategy with dose modification is ongoing.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Regine WF,Patchell RA,Strottmann JM,Meigooni A,Sanders M,Young Bdoi
10.3171/jns.2000.93.supplementsubject
Has Abstractpub_date
2000-12-01 00:00:00pages
37-41eissn
0022-3085issn
1933-0693journal_volume
93 Suppl 3pub_type
临床试验,杂志文章abstract::Paget disease is an idiopathic metabolic disease of bone that may involve the axial and appendicular skeleton. In up to one third of patients there may be pagetoid involvement of the spine, which can cause back pain and vertebral collapse, with instability or myeloradiculopathy. Although medical therapy is the mainsta...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2003.99.1.0110
更新日期:2003-07-01 00:00:00
abstract::Liposomes have a variety of attributes as a drug delivery system. Targeting of liposomes to specific cells has been investigated by using appropriate cytophilic ligands such as monoclonal antibodies (MAb's). In the present study, liposomes with selective cytotoxicity toward glioma cells were obtained. An MAb which rea...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.71.3.0382
更新日期:1989-09-01 00:00:00
abstract:OBJECT:The application accuracy of the Neuromate neurosurgical robot has been validated in vitro but has not been evaluated in vivo for deep brain stimulation (DBS) electrode implantations. The authors conducted a study to evaluate this application accuracy in routine frame-based DBS procedures, with an independent sys...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.9.JNS14256
更新日期:2015-01-01 00:00:00
abstract::Susceptibility weighted imaging (SWI) is a relatively new imaging technique. Its high sensitivity to hemorrhagic components and ability to depict microvasculature by means of susceptibility effects within the veins allow for the accurate detection, grading, and monitoring of brain tumors. This imaging modality can als...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2015.1.JNS142349
更新日期:2015-12-01 00:00:00
abstract::The use of a pulsed echo Doppler technique during procedures for occlusion of intracranial aneurysms is described. Saccular aneurysms can be located with reference to probe position and depth setting. Tracings of intra-aneurysmal flow are presented, and the characteristic flow pattern is disucssed. Special emphasis ha...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.5.0570
更新日期:1979-05-01 00:00:00
abstract::In this report the authors describe the endovascular treatment of dural arteriovenous fistulas (DAVFs) through transcranial puncture of the feeding arteries. Four patients had DAVFs that were fed by occipital arteries (OAs) that supplied blood to the intracranial meningeal arteries via the transcranial branches and co...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2007.106.5.912
更新日期:2007-05-01 00:00:00
abstract:OBJECT:Chordomas and chondrosarcomas of the skull base are aggressive and locally destructive tumors with a high tendency for local progression despite treatment. The authors evaluated the effect of stereotactic radiosurgery (SRS) on local tumor control and survival. METHODS:Twenty-eight patients with histologically c...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/10/0758
更新日期:2007-10-01 00:00:00
abstract::The purpose of this prospective study was twofold: 1) to determine the sensitivity and specificity of computer-derived density spectral array in detecting analog electroencephalographic (EEG) ischemic pattern changes during carotid artery cross-clamping in patients undergoing carotid endarterectomy; and 2) to assess t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.78.6.0884
更新日期:1993-06-01 00:00:00
abstract::A substantial number of patients with coronal synostosis who undergo frontoorbital advancement still require additional surgical treatment to correct increased intracranial pressure or unsatisfactory craniofacial structure. However, frontoorbital advancement currently requires elevation of the frontal as well as the o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.89.6.1058
更新日期:1998-12-01 00:00:00
abstract::OBJECTIVE Meningioma consistency, firmness or softness as it relates to resectability, affects the difficulty of surgery and, to some degree, the extent of resection. Preoperative knowledge of tumor consistency would affect preoperative planning and instrumentation. Several methods of prediction have been proposed, bu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.1.JNS152329
更新日期:2017-01-01 00:00:00
abstract:OBJECT:In this report the authors explore the use of standardized plugging templates in formulating stereotactic radiosurgery dose plans for the Leksell gamma knife. METHODS:Unplugged gamma knife dose plans previously used in the treatment of patients with trigeminal neuralgia (TN) and vestibular schwannoma (VS) were ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.supplement
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:Gliomas occur in 3-4 individuals per 100,000 individuals and are one of the most common primary brain tumors. Treatment options are limited for gliomas despite the progressive nature of the disease. The authors used the Value Driven Outcomes (VDO) database to identify cost drivers and subgroups that are invol...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.12.JNS183109
更新日期:2019-03-29 00:00:00
abstract:OBJECT:Occipital encephaloceles are relatively frequently encountered. Many investigators have addressed the embryogenesis of these formations, but the dural system has never before been studied. In this retrospective analysis the authors sought to gain a better understanding of the origins of these defects. METHODS:T...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.89.5.0738
更新日期:1998-11-01 00:00:00
abstract:OBJECT:It has been demonstrated that an extensive resection (total or subtotal) may significantly increase the overall survival in patients with WHO Grade II gliomas (low-grade gliomas [LGGs]). Yet, recent data have shown that conventional MR imaging underestimates the spatial extent of LGG, since tumor cells were foun...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.3.JNS101333
更新日期:2011-08-01 00:00:00
abstract:OBJECT:Recurrent laryngeal nerve (RLN) injury occurs after anterior cervical spine procedures. In this study the authors used intraoperative electromyographic (EMG) monitoring of the posterior pharynx as a surrogate for RLN function and monitored endotracheal tube (ET) cuff pressure to determine if there was an associa...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.1999.91.2.0170
更新日期:1999-10-01 00:00:00
abstract::The authors report on the morphological features of a pituitary adenoma that produced growth hormone (GH) and adrenocorticotropic hormone (ACTH). This hormone combination produced by a single adenoma is extremely rare; a review of the available literature showed that only one previous case has been published. The tumo...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1998.88.6.1111
更新日期:1998-06-01 00:00:00
abstract:OBJECT:Spinal cord injury without radiological abnormality (SCIWORA) was defined in the era when magnetic resonance (MR) images were not popularly used as diagnostic tools. Although it is generally accepted that MR imaging can effectively illustrate the level and severity of spinal cord injury in the acute phase of tra...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2005.103.1.0017
更新日期:2005-07-01 00:00:00
abstract::The authors report the first DNA-based diagnosis of Bartonella henselae cultured from a brain lesion in a patient with acquired immune deficiency syndrome. This human immunodeficiency virus-infected patient presented with altered mental status, fever, and diabetes insipidus. Magnetic resonance imaging revealed multifo...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1998.89.4.0640
更新日期:1998-10-01 00:00:00
abstract::Tandem internal carotid artery (ICA) origin occlusion and middle cerebral artery (MCA) thromboembolism is a life-threatening condition with poor neurological outcome. The authors report on a patient presenting with acute ischemic stroke from a tandem ICA and MCA occlusion with penumbra. Emergency MCA mechanical thromb...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.6.JNS162368
更新日期:2018-09-01 00:00:00
abstract::OBJECT Experimental studies have shown numerous neuroprotective properties of alcohol ("ethanol") after TBI, but clinical studies have provided conflicting results. The authors aimed to assess the relationship between positive blood alcohol concentration (BAC) on hospital admission and mortality after moderate to seve...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.3171/2015.4.JNS141746
更新日期:2016-06-01 00:00:00
abstract::The author describes the syndrome of suprascapular nerve entrapment neuropathy that occurs as that nerve passes beneath the transverse scapular ligament, and discusses the anatomy, comparative anatomy, and five case histories. The cardinal findings include pain in the shoulder, weakness, and wasting of spinati muscles...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.43.3.0337
更新日期:1975-09-01 00:00:00
abstract::The present study investigates the hematological reaction to arterial injury during the first 10 minutes after endarterectomy in dogs to determine if heparin reversal during this early period predisposes to thrombus formation. Known platelet physiology would predict that heparinization during this early period would b...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.58.5.0708
更新日期:1983-05-01 00:00:00
abstract:OBJECT:Several methods are used for stereotactically guided implantation of electrodes into the subthalamic nucleus (STN) for continuous high-frequency stimulation in the treatment of Parkinson's disease (PD). The authors present a stereotactic magnetic resonance (MR) method relying on three-dimensional (3D) T1-weighte...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.92.4.0615
更新日期:2000-04-01 00:00:00
abstract::Spinal epidural hematomas (SEHs) are uncommon complications of traumatic injury to the spine. Emergency surgical evacuation is the standard treatment. Although it is recognized in the literature, the possibility of nonsurgical treatment of traumatic SEH is far from being codified. The authors report excellent outcomes...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.1999.91.1.0128
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVE:Some adult patients with moyamoya disease (MMD) undergoing revascularization surgery show an improvement or decline in cognition postoperatively. Revascularization surgery for ischemic MMD augments cerebral blood flow (CBF) and improves cerebral oxygen metabolism. However, cerebral hyperperfusion, which is a ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.7.JNS18149
更新日期:2018-12-14 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:OBJECTIVES:Increasing PaO2 can increase brain tissue PO2 (PbtO2). Nevertheless, the small increase in arterial O2 content induced by hyperoxia does not increase O2 delivery much, especially when cerebral blood flow (CBF) is low, and the effectiveness of hyperoxia as a therapeutic intervention remains controversial. The...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/108/01/0053
更新日期:2008-01-01 00:00:00
abstract::Intravascular papillary endothelial hyperplasia (IPEH), commonly known as Masson's tumor, is a benign lesion that manifests as an excessive proliferation of endothelial cells within a vessel wall. IPEH is extremely rare in the brain, with only 36 intracranial cases previously described in the literature. It is commonl...
journal_title:Journal of neurosurgery
pub_type:
doi:10.3171/2019.8.JNS191767
更新日期:2019-11-01 00:00:00
abstract::A technique employing a Doppler ultrasound flowmeter in determining cerebrospinal fluid shunt patency is described. The technique has proven to be a valuable aid in the elevaluation of the patient in whom shunt function is in question. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.42.6.0728
更新日期:1975-06-01 00:00:00
abstract:OBJECT:Acute subdural hematomas (SDHs) impart serious morbidity and mortality on the elderly population, with only 5% of those older than 65 years of age attaining functional independence. Despite its widespread use, oral antithrombotic therapy (OAT) in the context of acute SDH has not been extensively studied. The aut...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.7.JNS10446
更新日期:2011-01-01 00:00:00