Abstract:
OBJECT:Management of disease in patients undergoing neurosurgical treatment for tumors requires balancing the competing risks of hemorrhage and thrombosis. The authors compared the incidence of clinically apparent deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients admitted for treatment of intracranial and spinal tumors at three institutions. At the public hospital (the Royal North Shore Hospital [RNSH]) nonsequential calf compression was used, and at the other two private neurosurgery services sequential calf compression with low-molecular-weight heparin was used in patients undergoing spinal surgery. All patients wore compression stockings and underwent follow-up scanning after surgery. METHODS:The authors identified from their neurosurgery databases 2779 discharges of patients with tumor from the RNSH and private hospitals between January 1, 1995 and December 31, 2003. Patient admissions were relatively well matched for age, sex, duration of stay, and tumor type. For patients who underwent spinal surgery, the incidence of DVT was higher in the RNSH (2.6% of admissions) than in private hospitals, where no case of DVT was seen (p = 0.02). The incidence of PE was higher in admissions patients who had been treated for cranial tumors in the RNSH (2.9%) than in those treated in the private hospitals (1.3%, p = 0.01). Possible reasons for these discrepancies include a higher proportion of ambulatory patients before and after surgery in the group treated at private hospitals. More emergency and semi-emergency surgery was performed in the RNSH than in the private hospitals. Nevertheless, fewer patients discharged from the RNSH had undergone surgery, which is a known risk factor for DVT. CONCLUSIONS:Patients with intracranial tumors had a higher incidence of PE than those with spinal tumors. The incidence of DVT and PE was higher in patients admitted to the public hospital. The incidence of DVT in patients undergoing spinal procedures was lower when low-molecular-weight heparin was used judiciously, but the incidence of PE in patients undergoing cranial procedures was lower with the private hospital protocol, which did not include prophylaxis with anticoagulating agents.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Smith SF,Simpson JM,Sekhon LHdoi
10.3171/foc.2004.17.4.4subject
Has Abstractpub_date
2004-10-15 00:00:00pages
E4issue
4issn
1092-0684pii
170404journal_volume
17pub_type
杂志文章abstract:OBJECT:Coil embolization of aneurysms has been shown to be as safe and effective as surgical clip ligation, but has a higher recurrence rate. Advances in coil technology aim to reduce aneurysm recurrence by coating the devices with biological substances. An example of this is MicroVention's HydroCoil, which is a platin...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2005.18.2.6
更新日期:2005-02-15 00:00:00
abstract::OBJECTIVE The treatment of cervical spinal metastases represents a controversial issue regarding the type, extent, and invasiveness of interventions. In the lumbar and thoracic spine, kypho- and vertebroplasties have been established as minimally invasive procedures for patients with metastases to the vertebral bodies...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.5.FOCUS17175
更新日期:2017-08-01 00:00:00
abstract:OBJECT:Intracranial hypotension (ICH) can present with a wide variety of visual symptoms and findings. Deficits in visual acuity and visual fields as well as ophthalmoplegia due to cranial nerve dysfunction have been frequently described. The aim of this review was to identify the most commonly reported ocular manifest...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC-07/11/E8
更新日期:2007-01-01 00:00:00
abstract::The transthoracic approach to herniated thoracic discs is an important procedure in the management of these uncommonly encountered lesions. Whereas posterior and posterolateral microsurgical approaches and thoracoscopic procedures have been widely advocated in the recent neurosurgical literature, the transthoracic ope...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2000.9.4.8
更新日期:2000-10-15 00:00:00
abstract:OBJECT:Early and aggressive resection of low-grade gliomas (LGGs) leads to increased overall patient survival, decreased malignant progression, and better seizure control. This case series describes the authors' approach to achieving optimal neurological and surgical outcomes in patients referred by outside neurosurgeo...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2012.12.FOCUS12338
更新日期:2013-02-01 00:00:00
abstract::A petroclival meningioma represents a challenging tumor to resect in the cerebellopontine angle and ventral to the brain stem. Multiple cranial nerves and blood vessels may be intimately involved with the tumor. A partial labyrinthectomy presigmoid transpetrosal approach can facilitate resection while preserving heari...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.V1.FOCUS13425
更新日期:2014-01-01 00:00:00
abstract::There is a paucity of surviving texts from ancient and medieval times that can shed light on the early development of spine surgery. Nevertheless, the author reviews many of the available books and fragments and discusses early developments in the field of spine surgery from the point of view of physicians' personalit...
journal_title:Neurosurgical focus
pub_type: 传,历史文章,杂志文章
doi:10.3171/foc.2004.16.1.3
更新日期:2004-01-15 00:00:00
abstract::This video demonstrates a surgical technique of resecting dorsum sellae meningioma using a combined interhemispheric translamina terminalis approach and pterional approach with clinoidectomy. The tumor, 5 cm in maximum diameter, originated from the dorsum sellae, compressed the third ventricle and the midbrain, and di...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.10.FocusVid.17302
更新日期:2017-10-01 00:00:00
abstract::A 29-year-old woman is diagnosed with a large broad-base right ophthalmic artery aneurysm. Despite an intact visual field, she complained of mild right visual blurriness. Between endovascular and surgical treatments, surgery was favored due to her young age. It was decided to perform the surgery with simultaneous endo...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.7.FocusVid.14570
更新日期:2015-07-01 00:00:00
abstract::The authors report the history of the Tabulae Anatomicae of Bartolomeo Eustachio (ca. 1510-1574). In the tables, the anatomical illustrations were drawn inside a numerical frame, with pairs of numbers on the y- and x-axes to identify single anatomical details in the reference table. The measures and the references cou...
journal_title:Neurosurgical focus
pub_type: 传,历史文章,杂志文章
doi:10.3171/2019.6.FOCUS19339
更新日期:2019-09-01 00:00:00
abstract::Spinal laser interstitial thermal therapy has been developed as a minimally invasive modality to treat epidural spinal tumors percutaneously. The safe and effective use of this technology requires meticulous preoperative trajectory planning and an intraoperative workflow incorporating navigation and MR thermography. I...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.4.FocusVid.17732
更新日期:2018-04-01 00:00:00
abstract:OBJECT:Jugular foramen tumors are rare skull base lesions that present diagnostic and complex management problems. The purpose of this study was to evaluate a series of patients with jugular foramen tumors who were surgically treated in the past 16 years, and to analyze the surgical technique, complications, and outcom...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2004.17.2.5
更新日期:2004-08-15 00:00:00
abstract:OBJECT:Previous methods to determine stroke prevalence, such as nationwide surveys, are labor-intensive endeavors. Recent advances in search engine query analytics have led to a new metric for disease surveillance to evaluate symptomatic phenomenon, such as influenza. The authors hypothesized that the use of search eng...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2011.2.FOCUS1124
更新日期:2011-06-01 00:00:00
abstract::While the majority of cerebral revascularization advancements were made in the last century, it is worth noting the humble beginnings of vascular surgery throughout history to appreciate its progression and application to neurovascular pathology in the modern era. Nearly 5000 years of basic human inquiry into the vasc...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2018.11.FOCUS18527
更新日期:2019-02-01 00:00:00
abstract:OBJECT:For patients with glioblastoma multiforme, median survival time is approximately 14 months. Longer progression-free and overall survival times correlate with gross-total resection of tumor. The ability to identify tumor cells intraoperatively could result in an increased percentage of tumor resected and thus inc...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2013.12.FOCUS13488
更新日期:2014-02-01 00:00:00
abstract:OBJECT:Minimally invasive lumbar discectomy is a refinement of the standard open microsurgical discectomy technique. Proponents of the minimally invasive technique suggest that it improves patient outcome, shortens hospital stay, and decreases hospital costs. Despite these claims there is little support in the literatu...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC/2008/25/8/E20
更新日期:2008-01-01 00:00:00
abstract::OBJECTIVE The introduction of ventriculoperitoneal shunts changed the way hydrocephalus was treated. Whereas much is known about the causes of shunt failure in the first few years, there is a paucity of data in the literature regarding the cause of late shunt failures. The authors conducted a study to find out the dif...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.8.FOCUS16277
更新日期:2016-11-01 00:00:00
abstract::Drug addiction represents a significant public health concern that has high rates of relapse despite optimal medical therapy and rehabilitation support. New therapies are needed, and deep brain stimulation (DBS) may be an effective treatment. The past 15 years have seen numerous animal DBS studies for addiction to var...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2018.5.FOCUS18163
更新日期:2018-08-01 00:00:00
abstract::Epidermoid cysts or tumors comprise 1% of intracranial tumors with a predilection for the cerebellopontine angle or parasellar cisterns. These tumors are derived from an ectopic ectodermal implant seeded between fusing ectodermal surfaces. This results in a benign proliferation of stratified squamous epithelium along ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.1.FocusVid.15466
更新日期:2016-01-01 00:00:00
abstract:OBJECT:The goal of this paper is to elucidate the clinical presentation of tethered cord syndrome (TCS) following repair of a myelomeningocele. METHODS:Approximately 10 to 30% of children will develop TCS following repair of a myelomeningocele. Because essentially all children with repaired myelomeningocele will have ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2004.16.2.8
更新日期:2004-02-15 00:00:00
abstract::OBJECTIVE Despite the advances in skull base techniques, large petroclival meningiomas (PCMs) still pose a challenge to neurosurgeons. The authors' objective of this study was to describe a pretemporal trans-Meckel's cave transtentorial approach for large PCMs and to report the surgical outcomes. METHODS From 2014 to ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.1.FOCUS17733
更新日期:2018-04-01 00:00:00
abstract::Cushing's syndrome can present a complex problem of differential diagnosis. Of cases in which hypercortisolemia results from an adrenocorticotropic hormone (ACTH)-dependent process, approximately 80% are due to a pituitary adenoma (Cushing's disease [CD]), 10% are due to adrenal lesions, and the remaining 10% are seco...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2007.23.3.3
更新日期:2007-01-01 00:00:00
abstract::Vein of Galen malformations are rare congenital intracranial vascular malformations. Based on reports in the literature, spontaneous thrombosis or regression of these lesions is rare. Patients have variable outcomes from an asymptomatic course to death. The reasons behind spontaneous thrombosis are not entirely unders...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.8.FOCUS09162
更新日期:2009-11-01 00:00:00
abstract::The widespread use of fusion procedures in the management of spinal disorders has led investigators to explore the use of growth and differentiation factors in such procedures. As an adjuvant to allograft bone or as a replacement for harvested autograft, bone morphogenetic proteins (BMPs) appear to improve fusion rate...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2001.10.4.4
更新日期:2001-04-15 00:00:00
abstract:OBJECTIVE:Acute traumatic subdural hematoma (atSDH) can be a life-threatening neurosurgical emergency that necessitates immediate evacuation. The elderly population can be particularly vulnerable to tearing bridging veins. The aim of this study was to evaluate inpatient morbidity and mortality, as well as predictors of...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.7.FOCUS20439
更新日期:2020-10-01 00:00:00
abstract::OBJECT Cushing's disease (CD) is a potentially lethal neuroendocrinopathy that often requires specialized multidisciplinary treatment to achieve optimized outcomes. The authors analyzed data pertaining to patient, hospital, and admission characteristics as they relate to outcomes following transsphenoidal surgery (TSS...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.11.FOCUS14694
更新日期:2015-02-01 00:00:00
abstract::Since the publication of preliminary results from the International Study of Unruptured Intracranial Aneurysms in 1998 there has been a great deal of debate concerning the natural history of these lesions and their attendant risk of aneurysmal subarachnoid hemorrhage. Therefore, the authors reviewed a selected number ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2004.17.5.3
更新日期:2004-11-15 00:00:00
abstract::Chronic subarachnoid hemorrhage may cause deposition of hemosiderin on the leptomeninges and subpial layers of the neuraxis, leading to superficial siderosis (SS). The symptoms and signs of SS are progressive and fatal. Exploration of potential sites responsible for intrathecal bleeding and subsequent hemosiderin depo...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2004.16.5.11
更新日期:2004-05-15 00:00:00
abstract::OBJECTIVEAdult spinal deformity surgery is an effective way of treating pain and disability, but little research has been done to evaluate the costs associated with changes in health outcome measures. This study determined the change in quality-adjusted life years (QALYs) and the cost per QALY in patients undergoing s...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.9.FOCUS18381
更新日期:2018-12-01 00:00:00
abstract::OBJECTIVEPapers from 2002 to 2017 have highlighted consistent unique socioeconomic challenges and opportunities facing military neurosurgeons. Here, the authors focus on the reserve military neurosurgeon who carries the dual mission of both civilian and military responsibilities.METHODSSurvey solicitation of current a...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.9.FOCUS18378
更新日期:2018-12-01 00:00:00