Journal of neurosurgery
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Journal of neurosurgery · Jun 2013
Case Reports Multicenter StudySpontaneous and therapeutic prognostic factors in adult hemispheric World Health Organization Grade II gliomas: a series of 1097 cases: clinical article.
The spontaneous prognostic factors and optimal therapeutic strategy for WHO Grade II gliomas (GIIGs) have yet to be unanimously defined. Specifically, the role of resection is still debated, most notably because the actual amount of resection has seldom been assessed. ⋯ This large series with its volumetric assessment refines the prognostic value of previously stressed clinical and radiological parameters and highlights the importance of tumor size and location. The results support additional arguments in favor of the predominant role of resection, in accordance with recently reported experiences.
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Journal of neurosurgery · Jan 2013
Randomized Controlled Trial Multicenter StudyEffects of cilostazol on cerebral vasospasm after aneurysmal subarachnoid hemorrhage: a multicenter prospective, randomized, open-label blinded end point trial.
Cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is a major cause of subsequent morbidity and mortality. Cilostazol, a selective inhibitor of phosphodiesterase 3, may attenuate cerebral vasospasm because of its antiplatelet and vasodilatory effects. A multicenter prospective randomized trial was conducted to investigate the effect of cilostazol on cerebral vasospasm. ⋯ Oral administration of cilostazol is effective in preventing cerebral vasospasm with a low risk of severe adverse events. Clinical trial registration no. UMIN000004347, University Hospital Medical Information Network Clinical Trials Registry.
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Journal of neurosurgery · Dec 2012
Multicenter StudySurgery for convexity meningioma: Simpson Grade I resection as the goal: clinical article.
Recently the relevance of Simpson resection grade as a prognostic factor for recurrence of WHO Grade I meningiomas was challenged, contradicting many previous scientific reports and traditional neurosurgical teaching. The objective of this study was to determine whether the predictive value of Simpson resection grade is outdated or remains valid with respect to meningioma recurrence and overall survival. ⋯ Simpson Grade I resection should continue to be the goal for convexity meningiomas.
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Journal of neurosurgery · Sep 2012
Multicenter Study Comparative StudyParadoxical trends in the management of vestibular schwannoma in the United States.
Recent natural history studies of vestibular schwannomas (VSs) suggest that most of these tumors do not grow. The impact of these new data on management trends in the US is currently unknown. The aim in the present study was to evaluate current trends in the treatment of VS in the US by analyzing a national cancer database. ⋯ Study data demonstrated a shift in the management of small VSs in the US between 2004 and 2007, with microsurgical removal giving way to radiation treatment and the overall rate for observation remaining low and stable. With recent literature suggesting that the majority of small tumors do not grow, the authors assert that VSs are being overtreated in the US.
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Journal of neurosurgery · Aug 2012
Multicenter StudyGamma Knife surgery for the management of glomus tumors: a multicenter study.
Glomus tumors are rare skull base neoplasms that frequently involve critical cerebrovascular structures and lower cranial nerves. Complete resection is often difficult and may increase cranial nerve deficits. Stereotactic radiosurgery has gained an increasing role in the management of glomus tumors. The authors of this study examine the outcomes after radiosurgery in a large, multicenter patient population. ⋯ Gamma Knife surgery was a well-tolerated management strategy that provided a high rate of long-term glomus tumor control. Symptomatic tinnitus improved in almost one-half of the patients. Overall neurological status and cranial nerve function were preserved or improved in the vast majority of patients after radiosurgery.