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' pre- and postoperative motor status by combined epidural and muscle MEP monitoring during intramedullary surgery. The authors used transcranial electrical motor cortex stimulation to elicit MEPs, which were recorded from the spinal cord (with an epidural electrode) and from limb target muscles (thenar, anterior tibial) with needle electrodes. The amplitude of the epidural MEPs and the presence or absence of muscle MEPs were the parameters for MEP interpretation. A retrospective analysis was performed on data from the resection of 100 consecutive intramedullary tumors and MEP data were compared with the pre- and postoperative motor status. Intraoperative monitoring was feasible in all patients without severe preoperative motor deficits. Preoperatively paraplegic patients had no recordable MEPs. The sensitivity of muscle MEPs to detect postoperative motor deficits was 100% and its specificity was 91%. There was no instance in which a patient with stable MEPs developed a motor deficit postoperatively. Intraoperative MEPs adequately represented the motor status of patients undergoing surgery for intramedullary tumors. Because deterioration of the motor status was transient in all cases, it can be considered that impairment of the functional integrity of the motor pathways was detected before permanent deficits occurred.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Kothbauer KF,Deletis V,Epstein FJdoi
10.3171/foc.1998.4.5.4subject
Has Abstractpub_date
1998-05-15 00:00:00pages
e1issue
5issn
1092-0684pii
040501journal_volume
4pub_type
杂志文章abstract:OBJECT:Hypothalamic hamartomas (HHs) are devastating lesions causing refractory epilepsy, rage attacks, social ineptitude, and precocious puberty. Microsurgical and/or endoscopic resection offers an excellent risk/benefit profile for cure or improvement of epilepsy. METHODS:The authors reviewed a prospective database ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2010.11.FOCUS10250
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:Tractography is a useful technique that is standardly applied to visualize subcortical pathways. However, brain shift hampers tractography use during the course of surgery. While intraoperative MRI (ioMRI) has been shown to be beneficial for use in oncology, intraoperative tractography can rarely be performed...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.10.FOCUS20774
更新日期:2021-01-01 00:00:00
abstract::Laser interstitial thermal therapy (LITT) is a minimally invasive procedure used to treat a variety of intracranial lesions. Utilization of robotic assistance with stereotactic procedures has gained attention due to potential for advantages over conventional techniques. The authors report the first case in which robot...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.4.FOCUS1622
更新日期:2016-10-01 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:Multiple brain metastases are a common health problem, frequently found in patients with cancer. The prognosis, even after treatment with whole-brain radiation therapy (WBRT), is poor, with an average expected survival time of less than 6 months. Investigators at numerous centers have evaluated the role of stere...
journal_title:Neurosurgical focus
pub_type: 杂志文章,随机对照试验
doi:10.3171/foc.2000.9.2.5
更新日期:2000-08-15 00:00:00
abstract:OBJECT:Fifteen hundred patients have received deep brain stimulation (DBS) to treat neuropathic pain refractory to pharmacotherapy over the last half-century, but few during the last decade. Deep brain stimulation for neuropathic pain has shown variable outcomes and gained consensus approval in Europe but not the US. T...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2013.7.FOCUS1346
更新日期:2013-09-01 00:00:00
abstract::Shunt systems with differential pressure valves are prone to the complications of overdrainage. A programmable valve permits adjustment of the opening pressure of the valve. In this paper the authors report the incidence of subdural fluid collections in a randomized trial of programmable compared with conventional val...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1999.7.4.2
更新日期:1999-10-15 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::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: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::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::Endoscopic surgery represents a new and very useful modality of treatment for intracranial cysts. The authors review the cases of 19 patients with intracranial malformative CSF cysts (seven intraventricular, six paraventricular, and six arachnoid) who underwent endoscopic fenestration by using a burr-hole approach. Th...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:1999-04-15 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:Vertebroplasty and kyphoplasty are minimally invasive procedures used to treat persistently symptomatic vertebral compression fractures (VCFs). Both interventions usually involve injection of polymethyl methacrylate (PMMA). The purpose of this technical note was to review the theory and surgical technique for a ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2005.18.3.11
更新日期:2005-03-15 00:00:00
abstract::Surgical removal remains one of the key treatment modalities for vestibular schwannomas. A team approach between a neurotologist and a neurosurgeon offers the patient the expertise of both specialties and maximizes the chances for an optimal outcome. Vestibular schwannomas can typically be resected through 1 of 3 main...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2012.6.FOCUS12190
更新日期:2012-09-01 00:00:00
abstract::Cellular therapy has been evaluated in small animals, subhuman primates, and now humans for the potential repair of brain injury due to stroke. Experimental striate stroke models have proven useful for the purpose of evaluating different treatment paradigms. Early clinical trials involving neuronal transplantation in ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2002.13.5.2
更新日期:2002-11-15 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::Traumatic intracranial aneurysms are rare, occurring in fewer than 1% of patients with cerebral aneurysms. They can occur following blunt or penetrating head trauma and are more common in the pediatric population. Traumatic aneurysms can be categorized histologically as true, false, or mixed, with false aneurysms bein...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2000.8.1.1829
更新日期:2000-01-15 00:00:00
abstract::The retrosigmoid approach is a work-horse approach to the cerebellopontine angle (CPA), providing access from the foremen magnum to the tentorium. Indications for this approach are variable such as resection of meningiomas, acoustic neuromas and epidermoid tumors, treatment of vascular lesions of vertebrobasilar syste...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.V1.FOCUS13445
更新日期:2014-01-01 00:00:00
abstract::Deep brain stimulation (DBS) has been used to treat various neurological and psychiatric disorders. Over the years, the most suitable surgical candidates and targets for some of these conditions have been characterized and the benefits of DBS well demonstrated in double-blinded randomized trials. This review will disc...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2009.4.FOCUS0982
更新日期:2009-07-01 00:00:00
abstract:OBJECT:In this study the authors address the efficacy and safety of frameless stereotaxy in transsphenoidal surgery. METHODS:One thousand transsphenoidal operations were performed at the authors' institution between June 2000 and July 2005. This series consists of a retrospective review of 176 patients entered in a pr...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2006.20.2.10
更新日期:2006-02-15 00:00:00
abstract:OBJECT:Clinoidal meningiomas remain a major neurosurgical challenge. Surgery-related outcome has been less than desirable in the past, and little attention has been directed toward improving visual deficits. The authors advocate a skull base technique for the removal of these difficult tumors and describe its advantage...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2003.14.6.5
更新日期:2003-06-15 00:00:00
abstract:OBJECT:The authors describe their experience with a technique for robotic implantation of depth electrodes in patients concurrently undergoing craniotomy and placement of subdural monitoring electrodes for the evaluation of intractable epilepsy. METHODS:Patients included in this study underwent evaluation in the Dartm...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC/2008/25/9/E19
更新日期:2008-09-01 00:00:00
abstract:OBJECT:The safety and effectiveness of osteogenic protein (OP)-1 putty (recombinant human bone morphogenetic protein-7) in promoting fusion in complex spinal cases was studied in nine cases. METHODS:The authors prospectively evaluated nine patients requiring spinal fusion in whom there were medical risk factors that w...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2002.13.6.5
更新日期:2002-12-15 00:00:00
abstract:OBJECTIVE:Treatment failure and inevitable tumor recurrence are the main reasons for the poor prognosis of glioblastoma (GB). Gross-total resection at repeat craniotomy for GB recurrence improves patient overall survival but requires early and reliable detection. It is known, however, that even advanced MRI approaches ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.9.FOCUS19613
更新日期:2019-12-01 00:00:00
abstract::There are many options for the surgical treatment of lumbar spondylolisthesis, including anterior and posterior techniques. Among the most versatile is a 360 degrees fusion. In consideration of the added risk of morbidity of two procedures, circumferential fusion leads to the highest fusion rates. This is particularly...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:
更新日期:2002-07-15 00:00:00
abstract::Patients taking antithrombotic agents are very common in neurosurgical practice. The perioperative management of these patients can be extremely challenging especially as newer agents, with poorly defined laboratory monitoring and reversal strategies, become more prevalent. This is especially true with emergent cases ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2017.8.FOCUS17447
更新日期:2017-11-01 00:00:00
abstract::Optical imaging of intrinsic signals (OIS) is a well-established neuroimaging modality by which functional cortical activity is mapped by detecting activity-related changes in cortical light reflectance. Light reflectance changes are detected by a charged-coupled device camera that captures images of the exposed corte...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2002.13.4.2
更新日期:2002-10-15 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
abstract::The authors report the case of a 30-year-old woman who was a long-term intranasal cocaine abuser and who presented with transient ischemic attacks and multiple cerebral infarctions that were associated with moyamoya syndrome. The authors suggest that, because of its sympathomimetic effects, chronic cocaine use may pro...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:1998-11-15 00:00:00