Abstract:
:Advances in medical and surgical treatments in the last few decades have resulted in quantum leaps in the overall survival of patients with malignant disease outside the central nervous system, whereas survival of patients with malignant gliomas (World Health Organization Grades III and IV) has remained essentially unchanged. Resection and external-beam fractionated radiotherapy remain the pillars of therapy for malignant gliomas and have shown significant beneficial effects on outcome in many clinical studies. On the other hand, numerous human trials with adjuvant agents, most of them administered systemically and causing serious complications and side effects, have not succeeded in achieving a noteworthy additional extension of survival duration, or have done so only with a considerable deterioration in the quality of life of the treated patients. The concept of local invasiveness of gliomas is not new, but only in the last one to two decades has significant attention been focused on the cell biology and molecular genetics of gliomas. Improved understanding of the fundamental features of tumor cells has resulted in the introduction and increasing clinical use of local therapies in which practitioners opt for spatially defined delivery methods and tumor-selective agents specifically designed to be used in the environment of a brain invaded by glioma. In this review, the authors summarize the key findings in some of the most important clinical studies of locally administered treatments for malignant glioma. A few such therapies have emerged in the last decade, and have shown considerable antitumor activity and a favorable profile of local and systemic side effects. These include biodegradable polymers for interstitial chemotherapy, targeted toxins administered by convection-enhanced delivery, and intra- and peritumorally injected genetically modified viruses conferring glioma-selective toxicity. In addition, areas of possible improvement of these therapies and essential further developments are outlined.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Rainov NG,Söling A,Heidecke Vsubject
Has Abstractpub_date
2006-04-15 00:00:00pages
E9issue
4issn
1092-0684pii
200409journal_volume
20pub_type
杂志文章,评审abstract::There has been increasing awareness that glioblastoma, which may seem histopathologically similar across many tumors, actually represents a group of molecularly distinct tumors. Emerging evidence suggests that cells even within the same tumor exhibit wide-ranging molecular diversity. Parallel to the discoveries of mol...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2014.9.FOCUS14521
更新日期:2014-12-01 00:00:00
abstract::Since its inception, one of the major issues in transsphenoidal surgery has been the adequate visualization of anatomical structures. As transsphenoidal surgery evolved, technical advancements improved the surgical view of the operative field and the orientation. The operating microscope replaced Cushing's headlight a...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章,评审
doi:10.3171/foc.2005.19.6.4
更新日期:2005-12-15 00:00:00
abstract::Deep brain stimulation (DBS) is the treatment of choice for otherwise healthy patients with advanced Parkinson disease who are suffering from disabling dyskinesias and motor fluctuations related to dopaminergic therapy. As DBS is an elective procedure, it is essential to minimize the risk of morbidity. Further, precis...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2010.4.FOCUS10103
更新日期:2010-08-01 00:00:00
abstract:OBJECT:Currently, reliable low-cost and noninvasive techniques to assess cerebral perfusion in the operating room are not available. The authors report on their first clinical experience with laser speckle contrast analysis (LASCA) as a complementary imaging tool for the noninvasive and dynamic assessment of cerebral b...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.8.FOCUS09148
更新日期:2009-10-01 00:00:00
abstract:OBJECT:In this report the authors review the role of bioinformatics in the design of a research project in which the molecular genetics of malignant glioma were studied. A project to characterize Pokemon expression in malignant glioma was developed, refined, and implemented using bioinformatics methods. METHODS:Using ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2005.19.4.9
更新日期:2005-10-15 00:00:00
abstract::Deep brain stimulation (DBS) has a record of safety and efficacy for an expanding range of indications. Recently,the Food and Drug Administration provided approval through a Humanitarian Device Exemption for DBS of the globus pallidus internus and subthalamic nucleus for the treatment of dystonia. There is increasing ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2004.17.1.1
更新日期:2004-07-15 00:00:00
abstract::In the treatment of acoustic neuroma, operative results have improved greatly during recent years, with high rates of functional cranial nerve preservation. Because of this, it has become more important to consider issues of patient satisfaction and quality of life (QOL) following treatment for these lesions. The auth...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:1998-09-15 00:00:00
abstract::The authors present three cases of iatrogenic paracervical abscesses caused by infiltration therapy of pain medications used in conservative treatment in patients with chronic cervicobrachialgia. All three patients had received this therapy several times before presenting with clinical signs of a local infection. The ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2004.17.6.13
更新日期:2004-12-15 00:00:00
abstract::Brain arteriovenous malformations (BAVMs) are an important cause of intracerebral hemorrhage (ICH) in young adults. Biological predictors of future ICH risk are lacking, and controversy exists over previous studies of natural history risk among predominantly ruptured BAVM cohorts. Recent studies have suggested that th...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2009.2.FOCUS0926
更新日期:2009-05-01 00:00:00
abstract::The prepsoas retroperitoneal approach is a minimally invasive technique used for anterior lumbar interbody fusion. The approach may have a more favorable risk profile than the transpsoas approach, decreasing the risks that come with dissecting through the psoas muscle. However, the oblique angle of the spine in the pr...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.5.FOCUS17168
更新日期:2017-08-01 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::Cerebral venous sinus thrombosis is sometimes fatal. The standard treatment for sinus thrombosis is anticoagulation, but endovascular intervention must be considered when medical treatment fails. Mechanical thrombectomy is usually required when a large clot burden exits. Unfortunately, in sinus thrombosis attributable...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.1.FOCUS16519
更新日期:2017-04-01 00:00:00
abstract:OBJECT:Anterior cervical discectomy (ACD) is an effective and safe treatment for nerve root or spinal cord compression caused by disc herniation or spondylosis. Cervical interbody fusion allows preservation of the physiological lordosis and stability of the cervical spine. Based on data reported in the literature, fusi...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2002.12.1.4
更新日期:2002-01-15 00:00:00
abstract::Epidermoid tumors comprise about 1% of all intracranial tumors. They are congenital lesions that arise from paramedian cisterns within the posterior fossa. These tumors present as heterogeneous hyperintense lesions on FLAIR and homogenous hyperintense lesions on DWI. Surgical resection remains the most accepted form o...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.V1.FOCUS13308
更新日期:2014-01-01 00:00:00
abstract::Tumor-associated epilepsy is an important contributor to morbidity in patients with brain tumors. Proposed pathophysiological mechanisms to explain these effects range from neuronal and glial dysfunction to deranged vascular homeostasis, to ionic and pH changes. Perilesional tissue alterations play a vital role in the...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2009.5.FOCUS09101
更新日期:2009-08-01 00:00:00
abstract::Surgery of the mind has a rather checkered past. Though its history begins with the prehistoric trephination of skulls to allow "evil spirits" to escape, the early- to mid-20th century saw a surge in the popularity of psychosurgery. The 2 prevailing operations were topectomy and leukotomy for the treatment of certain ...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2017.6.FOCUS17259
更新日期:2017-09-01 00:00:00
abstract::Recent technical advances have revolutionized the fields of surgical endoscopy, laparoscopy, thoracoscopy, and microsurgical spinal endoscopy. The authors discuss the rich history and recent evolution of these techniques. Thoracoscopy had been widely used for the treatment of pleural conditions associated with tubercu...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/foc.2000.9.4.10
更新日期:2000-10-15 00:00:00
abstract::OBJECTIVE The authors describe their results using an endoscope as an adjunct to microsurgical resection of inferior vestibular schwannomas (VSs) with extension into the fundus of the internal auditory canal below the transverse crest. METHODS All patients who had undergone middle fossa craniotomy for VSs performed by...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.12.FOCUS17663
更新日期:2018-03-01 00:00:00
abstract::Primary leiomyosarcoma of the central nervous system is rare and has been described both de novo and following temporally remote radiotherapy for a different unrelated malignancy. The authors report the case of a 42-year-old man in whom 60Co radiation treatment had been performed for an unknown primary mass in the bra...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2002.12.6.13
更新日期:2002-06-15 00:00:00
abstract::Aquaporin-4 (AQP4) channels play an important role in brain water homeostasis. Water transport across plasma membranes has a critical role in brain water exchange of the normal and the diseased brain. AQP4 channels are implicated in the pathophysiology of hydrocephalus, a disease of water imbalance that leads to CSF a...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2016.7.FOCUS16191
更新日期:2016-09-01 00:00:00
abstract::Arteriovenous malformation (AVM) presenting with epilepsy significantly impacts patient quality of life, and it should be considered very much a seizure disorder. Although hemorrhage prevention is the primary treatment aim of AVM surgery, seizure control should also be at the forefront of therapeutic management. Sever...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.1.FOCUS19899
更新日期:2020-04-01 00:00:00
abstract:OBJECT:Positional plagiocephaly (PP) has been on the rise in recent years. In this review, the authors' aim was to assess the effectiveness of current recommendations to parents on this exceedingly common problem through a comprehensive literature search. Additionally, the current treatment options and the most recent ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,meta分析,评审
doi:10.3171/2013.8.FOCUS13261
更新日期:2013-10-01 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:OBJECT:The DIAM is a polyester-encased silicone interspinous dynamic stabilization device that can unload the anterior column and reestablish the functional integrity of the posterior column. METHODS:The DIAM was implanted in 104 patients between May 1, 2001 and October 30, 2001. A retrospective evaluation was perform...
journal_title:Neurosurgical focus
pub_type: 杂志文章,多中心研究
doi:10.3171/foc.2007.22.1.6
更新日期:2007-01-15 00:00:00
abstract::Arteriovenous fistulae of the internal maxillary artery are exceedingly rare, with less than 30 cases reported in the literature. Most of these lesions are congenital, iatrogenic, or posttraumatic. The most common presentation of internal maxillary artery fistulae is pulsatile tinnitus and headache. Because these lesi...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.1.FocusVid.18479
更新日期:2019-01-01 00:00:00
abstract::Interventional neuroradiology is a less invasive modality than open neurosurgery for the treatment of a wide range of neurovascular disorders. Refinements in technique and improvements in the design of microcatheters, guide wires, and embolic materials have yielded superior clinical outcomes and provided an impetus to...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2003.15.4.7
更新日期:2003-10-15 00:00:00
abstract::The authors detail the life and career of Dr. J. Lawrence Pool, as well as his significant contributions to the field of cerebrovascular neurosurgery. The discipline of cerebrovascular neurosurgery is a young and dynamic field, which underwent rapid and substantial growth during the middle of the twentieth century. As...
journal_title:Neurosurgical focus
pub_type: 传,历史文章,杂志文章
doi:
更新日期:2006-06-15 00:00:00
abstract::In this article the authors attempt to raise awareness of the pitfalls and controversial issues in nerve tumor surgery. In a case-guided format, examples of ambiguous findings, inappropriate tumor removal, repeated surgery, and nerve repairs are provided. The authors also discuss the need to establish a correct diagno...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2007.22.6.20
更新日期:2007-06-15 00:00:00
abstract::Intravenous and intraarterial recombinant tissue plasminogen activator remains underutilized in the treatment of acute ischemic stroke, largely due to strict adherence to the concept of the therapeutic time window for administration. Recent efforts to expand the number of patients eligible for thrombolysis have been m...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.4.FOCUS10296
更新日期:2011-06-01 00:00:00
abstract:OBJECT:Convection-enhanced delivery (CED) is an increasingly used novel local/regional delivery method targeted directly to tissue. It relies on a continuous pressure gradient for distribution of therapeutic agents into the interstitial space, with administration of the infusate over a few days. Cintredekin besudotox (...
journal_title:Neurosurgical focus
pub_type: 临床试验,杂志文章
doi:
更新日期:2006-04-15 00:00:00