Journal of neurosurgery
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Journal of neurosurgery · Dec 2002
Genetic differences between neurocytoma and dysembryoplastic neuroepithelial tumor and oligodendroglial tumors.
Because of their histological similarities, it is occasionally difficult to differentiate neurocytoma and dysembryoplastic neuroepithelial tumor (DNT) from oligodendroglial tumors. This study was conducted to investigate genetic differences among these tumor types in terms of loss of heterozygosity on chromosomes 1p and 19q, and p53 gene mutation. ⋯ Despite histological similarities, central neurocytomas and DNTs are genetically distinct from oligodendroglial tumors. Examination for allelic loss on 1p and 19q and for p53 mutation can be useful for making this distinction.
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Journal of neurosurgery · Dec 2002
Radiosurgery for non-small cell lung carcinoma metastatic to the brain: long-term outcomes and prognostic factors influencing patient survival time and local tumor control.
Lung carcinoma is the leading cause of death from cancer. More than 25% of those patients with lung cancer develop a brain metastasis at some time during the course of their disease. Corticosteroid therapy, radiotherapy, and resection have been the mainstays of treatment. Nonetheless, the median survival for patients with lung carcinoma metastasis is approximately 3 to 6 months. The authors examine the efficacy of gamma knife radiosurgery (GKS) for treating non-small cell lung carcinoma (NSCLC) metastases to the brain and evaluate factors affecting long-term patient survival. ⋯ Gamma knife surgery for NSCLC metastases affords effective local tumor control in approximately 84% of patients. Early detection of brain metastases, aggressive treatment of systemic disease, and a therapeutic strategy including GKS can afford patients an extended survival time.
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Journal of neurosurgery · Dec 2002
Increased levels of lipid peroxides as predictive of symptomatic vasospasm and poor outcome after aneurysmal subarachnoid hemorrhage.
Cerebral vasospasm remains a devastating medical complication of aneurysmal subarachnoid hemorrhage (SAH). Reactive oxygen species and subsequent lipid peroxidation are reported to participate in the causes of cerebral vasospasm. This clinical study was performed to investigate the relationships between levels of lipid peroxides in cerebrospinal fluid (CSF) and both delayed cerebral vasospasm and clinical outcome after SAH. ⋯ Increased levels of lipid peroxides measured in the CSF during the acute stage of SAH were predictive of both symptomatic vasospasm and poor outcome. Measurements of lipid peroxides in the CSF may be useful prognostically for patient outcomes as well as for predicting symptomatic vasospasm.
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Journal of neurosurgery · Dec 2002
Vision of the future: initial experience with intraoperative real-time high-resolution dynamic infrared imaging. Technical note.
High-resolution dynamic infrared (DIR) imaging provides intraoperative real-time physiological, anatomical, and pathological information; however, DIR imaging has rarely been used in neurosurgical patients. The authors report on their initial experience with intraoperative DIR imaging in 30 such patients. A novel, long-wave (8-10 microm), narrow-band, focal-plane-array infrared photodetector was incorporated into a camera system with a temperature resolution of 0.006 degrees C, providing 65,000 pixels/frame at a data acquisition rate of 200 frames/second. ⋯ Dynamic infrared imaging may prove to be a powerful adjunctive intraoperative diagnostic tool in the neurosurgical imaging armamentarium. Real-time assessment of cerebral vessel patency and cerebral perfusion are the most direct applications of this technology. Uses of this imaging modality in the localization of epileptic foci, identification of functional cortex during awake craniotomy, and determination of tumor border and intraoperative brain shift are avenues of inquiry that require further investigation.
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Journal of neurosurgery · Dec 2002
Clinical TrialEndovascular reconstruction of intracranial arteries by stent placement and combined techniques.
The authors investigated the feasibility, safety, and short-term outcome of stent treatment for intracranial aneurysms, stenoses, and dissections. ⋯ These findings indicate that stent treatment is feasible and seems to be an effective modality for arterial reconstruction. This versatile tool allows the treatment of a wide variety of challenging intracranial lesions.