Abstract:
:Intraoperative facial nerve monitoring (IFNM) is a suitable technique for intraoperative facial nerve identification and dissection, especially in large vestibular schwannomas (VS) (acoustic neuroma). To evaluate its feasibility for estimating functional nerve outcome after VS resection 60 patients underwent surgery using IFNM. Out of this group the last 40 patients were included in a prospective study evaluating the prognostic value of various IFNM parameters (proximal and distal absolute EMG amplitude, stimulation threshold, and proximal-to-distal amplitude ratio) for prediction of initial postoperative facial nerve function and recovery of function. Stimulation threshold and absolute EMG amplitude proximally at the brain stem were both predictive for postoperative nerve function. Good initial facial nerve outcome (modified House Brackmann grading, mHB degree I and degree II) was found in 15/16 patients with a proximal EMG amplitude greater than 800 microV and in 19/22 patients with proximal stimulation threshold less than 0.3 mA. Sixteen of 16 patients with proximal stimulation threshold equal to or greater than 0.3 mA had moderate-to-severe facial palsy (mHB degree III or worse). Six of six patients without evokable proximal amplitude initially had insufficient nerve function (mHB degree IV). Intraoperative decrease of the proximal amplitude was associated with an unfavourable outcome, whereas distal amplitudes usually stayed unchanged. Mean distal EMG amplitudes were also found to be decreased with poor nerve function, which may mean that the tumour had already affected the nerve. A proximal amplitude of 300 microV or less and a proximal-to-distal amplitude ratio below 1:3 were found in the absence of functional recovery in 6/8 (75%) and 5/6 (83%) patients with initial mHB degree IV, respectively. Two patients with initial mHB degree IV improved to mHB degree III despite intraoperative evidence of missing functional nerve integrity. Therefore, functional recovery cannot be predicted by IFNM in all cases of anatomical nerve preservation. We conclude that a minimum follow-up period of 1 year may still be advisable even in certain patients without evidence of intraoperative functional nerve integrity.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Sobottka SB,Schackert G,May SA,Wiegleb M,Reiss Gdoi
10.1007/s007010050090subject
Has Abstractpub_date
1998-01-01 00:00:00pages
235-42; discussion 242-3issue
3eissn
0001-6268issn
0942-0940journal_volume
140pub_type
杂志文章abstract:BACKGROUND:We introduce a user-friendly, standardized protocol for tractography of the major language fiber bundles. METHOD:The introduced method uses dMRI images for tractography whereas the ROI definition is based on structural T1 MPRAGE MRI templates, without normalization to MNI space. ROIs for five language-relev...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03899-0
更新日期:2019-06-01 00:00:00
abstract::A case of anterior interosseous nerve palsy is demonstrated due to an anatomical variation not recorded before causing this syndrome. Main median-nerve trunk and anterior interosseous nerve passed differently in relation to the pronator teres muscle. Surgery led to a rapid recovery of nerve function. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01424572
更新日期:1988-01-01 00:00:00
abstract::We present a case of recurrent metastatic brain tumour spread across a cranial fixation device. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1369-9
更新日期:2007-12-01 00:00:00
abstract::Two-hundred seven patients who were operated on consecutively between January 1983 and December 1990 to relieve disabling positional vertigo (DPV) using the microvascular decompression (MVD) procedure were studied. Selection of the patients for MVD operations was based on both case history and the results of otoneurol...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401831
更新日期:1993-01-01 00:00:00
abstract::Myelocystoceles are rare lesions. Rarer still are thoracic myelocystoceles. Two patients with thoracic myelocystoceles are being reported. The first patient presented with swelling in the thoracic region with paraplegia and incontinence. MR with MR myelography revealed the malformation to be a thoracic myelocystocele....
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-006-0734-4
更新日期:2006-07-01 00:00:00
abstract::This case illustrates the correlation between Magnetic Resonance Imaging (MRI) and the pathological findings in a case of cavernous sinus (CS) aspergilloma. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-004-0449-3
更新日期:2005-03-01 00:00:00
abstract::We present a retrospective study of 41 patients treated by simple decompression for ulnar neuropathy. Pre- and postoperatively, patients were evaluated clinically and electrophysiologically. The median follow-up was 2 years (minimum: 0.5 years, maximum: 5.1 years). The leading pre-operative sign was motor loss in the ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01411742
更新日期:1996-01-01 00:00:00
abstract::In 15 patients without acute brain injury the concentrations of Neuron-specific Enolase (NSE), S-100 Protein (S-100), Creatine Kinase (CK), and Creatine Kinase BB isoenzyme (CK-BB) in ventricular cerebrospinal fluid (CSF) were measured immediately after lateral ventricle cannulation for diagnostic or treatment purpose...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400675
更新日期:1991-01-01 00:00:00
abstract::First described on pre-B leukemia cells, the common acute lymphoblastic leukemia antigen (cALLa) is also expressed on glioma cells in vitro. Its identity to neutral endopeptidase (NEP) (E.C.3.24.11) was corroborated by our finding that cALLa positive glioma cells had NEP activity. To study cALLa/NEP distribution on gl...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401105
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:Distal middle cerebral artery (dMCA) aneurysms are very rare with a reported frequency of 2-6%. Typically, patients with ruptured distal MCA aneurysms have poor clinical outcomes because often there is both a subarachnoid haemorrhage (SAH) and an intracerebral haematoma (ICH). The goals of this study were to ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1061-5
更新日期:2007-01-01 00:00:00
abstract::Forty-two patients with 44 cephaloceles treated between 1966 and 1993 are presented. Eighteen lesions were occipital, 2 parietal, 1 at the anterior fontanelle, 11 sincipital, and 12 basal. In recent years computerized tomography (CT) and magnetic resonance imaging (MRI) provided better information on the site and natu...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01417678
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Although 30-50 % of patients with brain tumors experience epileptic seizure as the presenting clinical symptom, and another 10-30 % are at risk for developing epilepsy in the later stages of the disease, the mechanisms of tumor-related epileptogenesis are poorly understood. We used magnetoencephalography (ME...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1781-2
更新日期:2013-08-01 00:00:00
abstract::A computer system, based on IBM PC, was designed for the cerebrospinal compensatory model identification. The intracranial pressure (ICP) signal, registered during the lumbo-lumbar infusion test is analyzed by means of the spectral analysis algorithm in order to measure precisely the pulse wave amplitude. The amplitud...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01669992
更新日期:1990-01-01 00:00:00
abstract::Low-frequency deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) has been reported to improve akinesia and gait difficulties in patients with Parkinson's disease (PD). We report on a patient with PD and L: -dopa refractory gait symptoms who developed detrusor over-activity immediately after right PPN D...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-1155-6
更新日期:2011-12-01 00:00:00
abstract:OBJECT:Although functional mapping facilitates the planning of surgery in and around eloquent areas, the resection of tumors adjacent to language areas remains challenging. In this report, we took notice that the language areas (Broca's and Wernicke's) present at the perisylvian fissure. We posit that if there is non-e...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-006-0857-7
更新日期:2007-02-01 00:00:00
abstract::A new atraumatic method for patency and blood flow control of microvascular anastomoses has been developed. Sounds proximal and distal to a suture line are separately detected by means of two specially modified miniature microphones built together as an auscultation unit and named a diplo-microphone. Transmission of t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02074518
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:Neurogenic pulmonary edema (NPE) is a clinical syndrome characterized by the acute onset of pulmonary edema after a significant central nervous system (CNS) insult. NPE occurs as a result of release of catecholamines into the blood immediately after aneurysm rupture. The aim of this study is to investigate t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3091-6
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:The study was conducted to determine the causative factors in the postoperative recurrence (PR) of chronic subdural haematomas (CSDHs) and to evaluate the efficacy of surgery in adults enrolled in this trial. METHODS:99 patients with 121 CSDHs, who were operated on between January 1999 and December 2001, we...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0616-1
更新日期:2005-12-01 00:00:00
abstract::Twiddler syndrome occurs when a patient intentionally or unintentionally manipulates an implantable generator (usually a pacemaker) and dislodges the pacing leads, causing malfunction of the device. Though the syndrome has been described in patients with pacemakers, to our knowledge only one spontaneous case has been ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0366-6
更新日期:2010-03-01 00:00:00
abstract::In this study, which comprises 144 consecutive head injuries, the initial clinical assessment and the findings of the initial CT scan are related to the outcome. The mortality is related to the patient's level of consciousness and pupillary light reflex on admission. The disability rate (= number of disabled/number of...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405444
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND:An intracranial in situ side to side posterior circulation procedure is performed infrequently. The scope of treatment modalities of vertebral artery-PICA aneurysms and vertebral dissections is limited due to the lack of many representations of this procedure's technical nuances. METHODS:To demonstrate the ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1874-y
更新日期:2013-11-01 00:00:00
abstract::To study the in-vivo effects of direct Low-Energy Laser Irradiation (LELI) on the Peripheral Nervous System, the sciatic nerve in rats was surgically exposed, crushed and then subjected to the direct irradiation of either of two continuous-wave HeNe lasers--0.3 mW or 17 mW. We found that the 0.3 mW laser significantly...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406620
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Anterior cranial fossa dural arterio-venous fistulas (DAVFs) represent 6% of all intracranial DAVFs; characteristically they show an aggressive behaviour with high risk of intracranial haemorrhage. Peculiar anatomical features, such as feeding by the ethmoidal arteries and the pattern of venous drainage (fre...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,多中心研究
doi:10.1007/s00701-017-3107-2
更新日期:2017-05-01 00:00:00
abstract::We report the case of a large osteoblastoma arising in the frontal bone of a 20-year-old female. The lesion was first noted after a fall, and grew steadily in size following further head injury during pregnancy. Initial plain radiography demonstrated an area of radiolucency, with subsequent cross-sectional imaging rev...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-3024-9
更新日期:2017-02-01 00:00:00
abstract::The neural activity pattern of the subthalmic nucleus (STN) was investigated in five patients with Parkinson's disease who were scheduled for electrode implantation for chronic stimulation of the STN. The initial target was placed 8 mm or 10 mm lateral to the midline, 3 mm to 4 mm posterior to the midcommissural point...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050251
更新日期:1998-01-01 00:00:00
abstract:INTRODUCTION:Spontaneous posterior interosseous nerve palsy is a rare condition. Entrapment is mostly at level of the arcade of Frohse, and a few cases of distal entrapment have been described. METHODS:A case of entrapment distal to the arcade of Frohse is described here. Cases of distal entrapment have been reviewed ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-018-3615-8
更新日期:2018-09-01 00:00:00
abstract::Intramedullary clear cell meningioma (CCM), which is more aggressive than other meningioma variants, is extremely rare. To date, only one case of such a spinal tumour has been documented. We report the first case of an intramedullary CCM originating in the thoracic region of the spinal cord. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0695-z
更新日期:2006-04-01 00:00:00
abstract::We present the case of a 51-year-old female who had a four-year history of Parkinson's disease with severe "on-off' and disabling progression of symptoms on chronic levodopa therapy. After obtaining FDA approval, we implanted a Medtronic deep brain stimulation lead stereotactically into the right anterior pallidum con...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02188792
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Trauma to the craniocervical junction (CCJ) encompasses a wide and complex spectrum of injury with an even broader range of clinical presentation, and since trauma to this area borderlines neurosurgical main areas of interest, these relatively rare injuries can be overlooked. In fact, there has been an abund...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010200078
更新日期:2002-06-01 00:00:00
abstract::In our department extensive decompression craniectomies became the treatment of choice for patients with massive cerebral oedema following either trauma or acute cerebral infarction. The remarkable survival rates of this neurosurgical technique created the problem of adequate vault defect reconstruction. To evaluate t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050335
更新日期:1999-01-01 00:00:00