Journal of neurosurgery
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Journal of neurosurgery · Dec 2011
Nationwide investigation of the current status of therapeutic neuroendoscopy for ventricular and paraventricular tumors in Japan.
The authors report their investigation on the current status of neuroendoscopic biopsy for ventricular and paraventricular tumors as well as treatment for associated hydrocephalus in Japan. ⋯ The authors concluded that neuroendoscopic diagnosis using biopsy for ventricular and paraventricular tumors is adequately accurate and safe. It was demonstrated that endoscopic procedures play important roles not only in the treatment of hydrocephalus associated with intra- and paraventricular tumors but also in significantly improving ADL. Furthermore, the long-term outcome of endoscopic third ventriculostomy was clearly favorable.
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Journal of neurosurgery · Dec 2011
Reversal of cerebral vasospasm via intravenous sodium nitrite after subarachnoid hemorrhage in primates.
Subarachnoid hemorrhage (SAH)-induced vasospasm is a significant underlying cause of aneurysm rupture-related morbidity and death. While long-term intravenous infusion of sodium nitrite (NaNO(2)) can prevent cerebral vasospasm after SAH, it is not known if the intravenous administration of this compound can reverse established SAH-induced vasospasm. To determine if the intravenous infusion of NaNO(2) can reverse established vasospasm, the authors infused primates with the compound after SAH-induced vasospasm was established. ⋯ These findings indicate that the intravenous infusion of NaNO(2) can reverse SAH-induced vasospasm in primates. Further, these findings indicate that a similar treatment paradigm could be useful in reversing cerebral vasospasm after aneurysmal SAH.
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Journal of neurosurgery · Dec 2011
Meta AnalysisCurrent comprehensive management of cranial base chordomas: 10-year meta-analysis of observational studies.
The role of surgery and adjuvant radiation therapy for cranial base chordomas is not well established. This meta-analysis measures the relationship of complete resection and type of adjuvant radiation therapy to 5-year progression-free survival (PFS) and overall survival (OS) of cranial base chordomas. ⋯ Patients with complete resection of cranial base chordomas have a prolonged 5-year PFS and OS. Adjuvant proton-beam, carbon ion, and modern fractionated photon radiation therapy techniques offered a similar rate of PFS and OS at 5 years.
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Journal of neurosurgery · Dec 2011
Randomized Controlled TrialInterobserver variability in the interpretation of computed tomography following aneurysmal subarachnoid hemorrhage.
Numerous abnormal findings may be evident on CT scans after aneurysmal subarachnoid hemorrhage (SAH). Here, the authors assess the interobserver variability in the radiological interpretation of the initial CT scan following SAH. ⋯ The authors' findings suggest that there is considerable interobserver variability in the interpretation of CT scans after SAH. Quantitative measures may reduce interobserver variability in comparison with qualitative or categorical scales. Variability in interpretation of CT scans has implications for patient care and conduct of clinical trials. It may be beneficial to develop standardized assessments to ensure consistent evaluation of measured variables.
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Journal of neurosurgery · Dec 2011
Factors associated with hearing preservation after Gamma Knife surgery for vestibular schwannomas in patients who retain serviceable hearing.
Gamma Knife surgery (GKS) has been a safe and effective treatment for small- to medium-sized vestibular schwannomas (VSs) over relatively long-term outcomes. However, even with recent radiosurgical techniques, hearing results following GKS remain unsatisfactory. The purpose of this study was to evaluate the hearing preservation rate as well as factors related to hearing preservation in patients with VSs and serviceable hearing who were treated with GKS. ⋯ For the majority of patients with small- to medium-sized VSs, GKS was an effective and reasonable alternative to resection with satisfactory long-term tumor control. Factors related to hearing preservation included a GR Class I hearing pre-GKS and a lower mean cochlear radiation dose. To retain serviceable hearing, it is important to apply GKS treatment while patients retain GR Class I hearing.