Abstract:
:Chiari malformation is a developmental disorder that is often associated with other abnormalities of the cerebrospinal axis. Despite widespread recognition of this association, there is relatively little information on the treatment of these coexisting disorders in the setting of cerebellar tonsillar ectopia. In an effort to improve the care provided to pediatric patients with Chiari malformations the authors reviewed their management practices over the last 20 years. Specifically, they recorded presenting symptoms, radiological studies, comorbidities, and management (surgical and nonsurgical) of 112 patients (all < 20 years of age) with Chiari malformation without myelodysplasia. They found an associated syrinx in 29% of patients, basilar invagination in 17%, and scoliosis in 14%. The basal angle varied from 120 to 190 degrees and Boogard's angle varied from 120 to 220 degrees ; both angles were larger than those measured in normal controls. The vertical height of the posterior fossa was shortened and the volume decreased as compared with normal controls. The surgical management of this group of patients included posterior decompressive (44%), combined transoral and posterior decompressive (31%), combined posterior decompressive and posterior fusion (8%), and multiple posterior decompressive procedures in the same patient (5%). The authors conclude that pediatric patients with a Chiari malformation should be specifically examined for evidence of additional craniovertebral malformations so that procedures are directed at correcting both the comorbidities and the herniation of the cerebellar tonsils through the foramen.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Greenlee J,Garell PC,Stence N,Menezes AHdoi
10.3171/foc.1999.6.6.5subject
Has Abstractpub_date
1999-06-15 00:00:00pages
e4issue
6issn
1092-0684pii
060604journal_volume
6pub_type
杂志文章abstract:OBJECT:Whole-brain radiation therapy (WBRT) has been the traditional approach to minimize the risk of intracranial recurrence following resection of brain metastases, despite its potential for late neurotoxicity. In 2007, the authors demonstrated an equivalent local recurrence rate to WBRT by using stereotactic radiosu...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.9.FOCUS09191
更新日期:2009-12-01 00:00:00
abstract::For decades, lumbar disc herniation and lumbar stenosis have been treated surgically via traditional open techniques. With recent emphasis on minimally invasive approaches in spine surgery, a number of new techniques has been introduced that are aimed at treating these 2 common pathological conditions. Currently the m...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC/2008/25/8/E11
更新日期:2008-01-01 00:00:00
abstract:OBJECT:Tumors of the lateral ventricle can be removed via two major approaches: the transcallosal or the transcortical route. The purpose of this study is to discuss the techniques and outcomes in transcortical surgery of tumors located in the lateral ventricle. METHODS:An experience with 29 consecutive lateral ventri...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2001.10.6.3
更新日期:2001-06-15 00:00:00
abstract::This paper describes some of the more common patterns in neurobehavioral deficits and their underlying neuroanatomical basis in myelomeningocele (MMC). Patients with MMC can face a lifetime of specific organ system dysfunction, chief among them spinal cord malformations, orthopedic issues, hydrocephalus, and urologica...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.7.FOCUS19445
更新日期:2019-10-01 00:00:00
abstract::Object In the last decade the indications for the endoscopic endonasal approach have been progressively expanded to include lesions that have not been traditionally considered amenable to resection through the transsphenoidal route. In this study, the authors analyze their experience with hypothalamic gliomas treated ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.7.FOCUS14317
更新日期:2014-01-01 00:00:00
abstract:OBJECT:Resorbable polymer implants have become a compelling option in the treatment of acquired and congenital craniofacial deformities. In particular, the resorbable polylactide and polyglycolide polymers have demonstrated excellent safety profiles in multiple in vitro, animal, and clinical studies and are currently b...
journal_title:Neurosurgical focus
pub_type: 临床试验,杂志文章
doi:10.3171/foc.2004.16.3.13
更新日期:2004-03-15 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:OBJECT:Ossification of the posterior longitudinal ligament (OPLL) is a disorder afflicting as many as 2% of East Asians. However, reports of OPLL in non-Asians have been sporadic in the medical literature. This study describes clinical and radiographic findings with OPLL in non-Asians at a tertiary care center treating...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2010.12.FOCUS10277
更新日期:2011-03-01 00:00:00
abstract::In this video, the authors demonstrate a minimally invasive approach and resection of a paraspinal schwannoma. Using an expandable retractor, the authors were able to identify important adjacent bony landmarks and hence visualize and remove this peripheral nerve sheath tumor. While a tubular retractor is commonly used...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.1.FocusVid.17572
更新日期:2018-01-01 00:00:00
abstract::Ankylosing spondylitis (AS) is a chronic, progressive inflammatory rheumatic disease involving primarily the sacroiliac joints and the axial skeleton. The main clinical features are back pain and progressive stiffness of the spine. Oligoarthritis of the hips and shoulders, enthesopathy, and anterior uveitis are common...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC/2008/24/1/E2
更新日期:2008-01-01 00:00:00
abstract::OBJECTIVE Traumatic brain injury (TBI) in children is a significant public health concern estimated to result in over 500,000 emergency department (ED) visits and more than 60,000 hospitalizations in the United States annually. Sports activities are one important mechanism leading to pediatric TBI. In this study, the ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.1.FOCUS15612
更新日期:2016-04-01 00:00:00
abstract:OBJECT:The middle third of the clivus and the region around the petrous internal carotid artery (ICA) is a difficult area of the skull base in terms of access. This is a deep area rich with critical neurovascular structures, which is often host to typical skull base diseases. Expanded endoscopic endonasal approaches of...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:2005-07-15 00:00:00
abstract::Complex posterior circulation aneurysms are formidable lesions with an abysmal natural history. Their management continues to present a challenge to both endovascular and open microsurgical approaches. Affording an expansive, combined supra- and infratentorial exposure, the petrosal approaches are well suited for thes...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2012.6.FOCUS12131
更新日期:2012-08-01 00:00:00
abstract::Spina bifida is the most common nonchromosomal birth defect, resulting in permanent disability of multiple organ systems, yet compatible with long-term survival. Important advances across various disciplines have now improved survival among the spina bifida population. Although the majority of individuals living with ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.7.FOCUS19441
更新日期:2019-10-01 00:00:00
abstract::The histological appearance of a meningioma is an important predictor of tumor behavior and is frequently a factor in decisions concerning therapy. The relationship between histological features and prognosis is formalized in grading schemes such as those published by the World Health Organization (WHO), most recently...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC-07/10/E3
更新日期:2007-01-01 00:00:00
abstract::Resection of intramedullary spinal cord tumors carries a high risk for surgical damage to the motor pathways. This surgery is therefore optimal for testing the performance of intraoperative motor evoked potential (MEP) monitoring. This report attempts to provide evidence for the accurate representation of patients' pr...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1998.4.5.4
更新日期:1998-05-15 00:00:00
abstract:OBJECT:Mild traumatic brain injury (MTBI), often referred to as concussion when it occurs in sports, produces persistent cognitive problems in at least 15% of patients. Unfortunately, conventional neuropsychological tests usually yield results within normal limits in this population. The main objective of this event-re...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2012.10.FOCUS12253
更新日期:2012-12-01 00:00:00
abstract::Direct cerebral revascularization is an important procedure in the treatment of certain complex aneurysms and skull base tumors when acute sacrifice of the internal carotid artery is required. It likely remains an appropriate treatment in a small subgroup of patients with cerebral ischemia refractory to maximal medica...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:
更新日期:2003-03-15 00:00:00
abstract:OBJECT:The object of this study was to evaluate facial nerve outcomes in the surgical treatment of large vestibular schwannomas (VSs; ≥ 2.5 cm maximal or extrameatal cerebellopontine angle diameter) based on both the operative approach and extent of tumor resection. METHODS:A PubMed search was conducted of English lan...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2012.7.FOCUS12199
更新日期:2012-09-01 00:00:00
abstract::Lumbar discectomy is the most common surgical procedure performed in neurosurgery clinics. Such a large number of procedures underscore not only the prevalence of conditions such as intervertebral disc herniation, but also the strong belief of surgeons that the operation does provide benefits to patients suffering fro...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2001.11.5.9
更新日期:2001-11-15 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::OBJECTIVE The object of this study was to determine the percentage of high-dose (1800-2600 cGy) single-fraction stereotactic radiosurgery (SF-SRS) treatments to the spine that result in peripheral nervous system (PNS) injury. METHODS All patients treated with SF-SRS for primary or metastatic spine tumors between Janua...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.11.FOCUS16348
更新日期:2017-03-01 00:00:00
abstract::Spine surgery is a key target for cost reduction within the United States health care system. One possible strategy involves the transition of inpatient surgeries to the ambulatory setting. Lumbar laminectomy with or without discectomy, lumbar fusion, anterior cervical discectomy and fusion, and cervical disc arthropl...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2018.2.FOCUS17790
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:Frailty has been recognized as a predictor of adverse surgical outcomes across multiple surgical disciplines, but until now the relationship between frailty and intracranial meningioma surgery has not been studied. The goal of the present study was to determine the relationship between increasing frailty (det...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.7.FOCUS20324
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:Advancements in less invasive lateral retropleural/retroperitoneal approaches aim to address the limitation of posterolateral approaches and avoid complications associated with anterior open thoracotomy or thoracoabdominal approaches. METHODS:Consecutive patients treated with a mini-open lateral approach for...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.6.FOCUS20360
更新日期:2020-09-01 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::The ability of diffusion tensor MRI to detect the preferential diffusion of water in cerebral white matter tracts enables neurosurgeons to noninvasively visualize the relationship of lesions to functional neural pathways. Although viewed as a research tool in its infancy, diffusion tractography has evolved into a neur...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2019.11.FOCUS19785
更新日期:2020-02-01 00:00:00
abstract::Several cases of congenital or acquired temporal encephaloceles have been reported in the literature as the causative mechanism of simple and/or complex partial seizures. In this report the authors describe a rare case of spontaneous parietal encephalocele presenting with simple partial seizures and progressively incr...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2005.19.3.11
更新日期:2005-09-15 00:00:00
abstract::The authors describe a new piece of equipment that enables simultaneous monitoring of the endoscopic image and unilateral microscopic image; that is, "picture-in-picture" images for endoscope-assisted microsurgery. The system is simple and purely optical, consisting of light-weight semi-rigid fibers and a special adap...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1999.6.4.13
更新日期:1999-04-15 00:00:00
abstract::Over the last decade, the analysis of genetic defects in primary tumors has been central to the identification of molecular events and biological pathways involved in the pathogenesis of medulloblastoma, the most common malignant brain tumor of childhood. Despite this, understanding of the molecular basis of the major...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2005.19.5.11
更新日期:2005-11-15 00:00:00