Journal of neurosurgery
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Journal of neurosurgery · Apr 2005
Case ReportsTransorbital penetrating brainstem injury in a child: case report.
The authors present the unusual case of a 9-year-old girl who sustained injury to her brainstem as a result of the orbital penetration of a metal projectile (nail) into the juxtamedullary region. This case and others reported in the literature associate this type of injury with relatively minor complications. Thorough imaging of the intracranial contents and surgical removal of the projectile is recommended.
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Journal of neurosurgery · Apr 2005
Clinical TrialCombined use of tractography-integrated functional neuronavigation and direct fiber stimulation.
The aim of this study was better preoperative planning and direct application to intraoperative procedures through accurate coregistration of diffusion-tensor (DT) imaging-based tractography results and anatomical three-dimensional magnetic resonance images and subsequent importation of the combined images to a neuronavigation system (functional neuronavigation). ⋯ Integration of the DT imaging-based tractography information into a traditional neuronavigation system demonstrated spatial relationships between lesions and the CST, allowing for the avoidance of tract injury during lesion resection. Direct fiber stimulation was used for real-time reliable white matter mapping, which served to adjust for any discrepancy between the neuronavigation system data and potentially shifted positions of the brain structures. The combination of these techniques enabled the authors to identify accurate positions of the CST during surgery and to accomplish optimal tumor resections.
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Journal of neurosurgery · Apr 2005
Clinical TrialIntraoperative control of extracranial-intracranial bypass patency by near-infrared indocyanine green videoangiography.
Recently, intraoperative fluorescence angiography in which indocyanine green (ICG) is used as a tracer has been introduced as a novel technique to confirm successful aneurysm clipping. The aim of the present study was to assess whether ICG videoangiography is also suitable for intraoperative confirmation of extracranial-intracranial bypass patency. ⋯ Indocyanine green videoangiography provides a reliable and rapid intraoperative assessment of bypass patency. Thus, ICG videoangiography may help reduce the incidence of early bypass graft failure.
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Journal of neurosurgery · Apr 2005
Comparative StudyFunctional and phenotypic differences between glioblastoma multiforme-derived and normal human brain endothelial cells.
Glioblastomas multiforme (GBMs) are hypervascular tumors characterized by endothelial cell (EC) proliferation. There is increasing evidence that ECs that infiltrate systemic tumors are different from normal blood vessel cells; whether this difference is seen in the central nervous system between GBM and normal brain tissue is not known. The goal of this investigation was to characterize and compare the functional and phenotypic properties of GBM-associated ECs and normal brain ECs. ⋯ The data demonstrated that ECs derived from normal brain and from GBMs have significant phenotypic and functional distinctions. Further characterization of brain tumor ECs is essential for efficient antiangiogenic treatment of gliomas.
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Journal of neurosurgery · Apr 2005
Is gross-total resection sufficient treatment for posterior fossa ependymomas?
The goals of this study were to analyze outcomes in patients with posterior fossa ependymomas, determine whether gross-total resection (GTR) alone is appropriate treatment, and evaluate the role of radiation therapy. ⋯ Gross-total resection should be the intent of surgery when it can be accomplished with an acceptable degree of morbidity. Even after GTR has been confirmed with postoperative imaging, however, adjuvant radiotherapy significantly improves local control. The authors currently recommend the use of postoperative radiotherapy, regardless of whether the resection is gross total or subtotal.