Metastatic choriocarcinoma with neoplastic aneurysms cured by aneurysm resection and chemotherapy

1992 ◽  
Vol 76 (1) ◽  
pp. 148-151 ◽  
Author(s):  
Takashi Fujiwara ◽  
Shogo Mino ◽  
Seigo Nagao ◽  
Takashi Ohmoto
Keyword(s):  
Surgical Treatment ◽  
Lung Metastasis ◽  
Cerebral Hemorrhage ◽  
Intensive Chemotherapy ◽  
Content Type ◽  
Metastatic Lesions ◽  
Aneurysm Resection ◽  
Fine Print

✓ A case of choriocarcinoma with brain and lung metastasis is reported. The patient was admitted for treatment of a cerebral hemorrhage from neoplastic aneurysms and, following removal of the hematoma and resection of the aneurysms, her carcinoma was successfully managed with chemotherapy. She has survived for 6 years after onset without neuroimaging evidence of recurrence. Surgical treatment of metastatic lesions followed by prolonged intensive chemotherapy are indicated for the improved prognosis of choriocarcinoma.

Surgical treatment of spontaneous intracerebral hemorrhage

1973 ◽  
Vol 39 (2) ◽  
pp. 145-151 ◽  
Author(s):  
Jean E. Paillas ◽  
Bernard Alliez
Keyword(s):  
Surgical Treatment ◽  
Intracerebral Hemorrhage ◽  
Cerebral Hemorrhage ◽  
Preoperative Diagnosis ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Content Type ◽  
Selection Of Patients ◽  
Selection Of ◽  
Fine Print

✓ The results of the surgical treatment of cerebral hemorrhage in 250 cases are reported. Preoperative diagnosis, the selection of patients, and the favorable moment to operate are discussed.

Surgical management of metastatic disease of the lumbar spine: experience with 139 patients

2005 ◽  
Vol 2 (5) ◽  
pp. 550-563 ◽  
Author(s):  
Paul J. Holman ◽  
Dima Suki ◽  
Ian McCutcheon ◽  
Jean-Paul Wolinsky ◽  
Laurence D. Rhines ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Metastatic Disease ◽  
Large Series ◽  
Operative Approach ◽  
Survival Duration ◽  
Anatomical Distribution ◽  
Content Type ◽  
Metastatic Lesions ◽  
Fine Print

Object. The surgical treatment of metastatic spinal tumors is an essential component of the comprehensive care of cancer patients. In most large series investigators have focused on the treatment of thoracic lesions because 70% of cases involve this region. The lumbar spine is less frequently involved (20% cases), and it is unclear whether its unique anatomical and biomechanical features affect surgery-related outcomes. The authors present a retrospective study of a large series of patients with lumbar metastatic lesions, assessing neurological and pain outcomes, complications, and survival. Methods. The authors retrospectively reviewed data obtained in 139 patients who underwent 166 surgical procedures for lumbar metastatic disease between August 1994 and April 2001. The impact of operative approach on outcomes was also analyzed. Among the wide variety of metastatic lesions, pain was the most common presenting symptom (96%), including local pain, radicular pain, and axial pain due to instability. Patients underwent anterior, posterior, and combined approaches depending on the anatomical distribution of disease. One month after surgery, complete or partial improvement in pain was demonstrated in 94% of the cases. The median survival duration for the entire population was 14.8 months. Conclusions. The surgical treatment of metastatic lesions in the lumbar spine improved neurological and ambulatory function, significantly reducing axial spinal pain; results were comparable with those for other spinal regions. Analysis of results obtained in the present study suggests that outcomes are similar when the operative approach mirrors the anatomical distribution of disease. When lumbar vertebrectomy is necessary, however, anterior approaches minimize blood loss and wound-related complications.

Surgical treatment of cerebral metastases from lung cancer

1971 ◽  
Vol 35 (4) ◽  
pp. 416-420 ◽  
Author(s):  
Edwin E. MacGee
Keyword(s):  
Lung Cancer ◽  
Surgical Treatment ◽  
Operative Mortality ◽  
Cerebral Metastases ◽  
Cerebral Metastasis ◽  
Metastatic Lung Cancer ◽  
Content Type ◽  
Intracranial Surgery ◽  
Metastatic Lung ◽  
Fine Print

✓ Results in 27 cases of intracranial surgery for metastatic lung cancer are evaluated with regard to both the quality and duration of survival; 56% of the patients lived more than 1 year, with the longest survivor still living 32 months after operation. The operative mortality was 26%. These data suggest that intracranial surgery is worthwhile in patients with lung cancer when the cerebral metastasis is either solitary or single.

Crouzon's disease (craniofacial dysostosis)

1972 ◽  
Vol 37 (4) ◽  
pp. 434-441 ◽  
Author(s):  
Jack Kushner ◽  
Eben Alexander ◽  
Courtland H. Davis ◽  
David L. Kelly ◽  
Annetta Horwitz Kushner
Keyword(s):  
Surgical Treatment ◽  
Original Description ◽  
Content Type ◽  
Craniofacial Dysostosis ◽  
Fine Print

✓ This article discusses the nature and treatment of Crouzon's disease and reproduces a translation of part of Crouzon's original description. Six typical patients with this disease are presented, and the reasons for surgical treatment emphasized.

Surgery for Parkinson disease in the United States, 1996 to 2000: practice patterns, short-term outcomes, and hospital charges in a nationwide sample

2003 ◽  
Vol 99 (5) ◽  
pp. 863-871 ◽  
Author(s):  
Emad N. Eskandar ◽  
Alice Flaherty ◽  
G. Rees Cosgrove ◽  
Leslie A. Shinobu ◽  
Fred G. Barker
Keyword(s):  
Surgical Treatment ◽  
Parkinson Disease ◽  
Practice Patterns ◽  
The United States ◽  
Hospital Charges ◽  
Short Term ◽  
Content Type ◽  
The Us ◽  
Fine Print ◽  
Deep Brain

Object. The surgical treatment of Parkinson disease (PD) has undergone a dramatic shift, from stereotactic ablative procedures toward deep brain stimulaion (DBS). The authors studied this process by investigating practice patterns, mortality and morbidity rates, and hospital charges as reflected in the records of a representative sample of US hospitals between 1996 and 2000. Methods. The authors conducted a retrospective cohort study by using the Nationwide Inpatient Sample database; 1761 operations at 71 hospitals were studied. Projected to the US population, there were 1650 inpatient procedures performed for PD per year (pallidotomies, thalamotomies, and DBS), with no significant change in the annual number of procedures during the study period. The in-hospital mortality rate was 0.2%, discharge other than to home was 8.1%, and the rate of neurological complications was 1.8%, with no significant differences between procedures. In multivariate analyses, hospitals with larger annual caseloads had lower mortality rates (p = 0.002) and better outcomes at hospital discharge (p = 0.007). Placement of deep brain stimulators comprised 0% of operations in 1996 and 88% in 2000. Factors predicting placement of these devices in analyses adjusted for year of surgery included younger age, Caucasian race, private insurance, residence in higher-income areas, hospital teaching status, and smaller annual hospital caseload. In multivariate analysis, total hospital charges were 2.2 times higher for DBS (median $36,000 compared with $12,000, p < 0.001), whereas charges were lower at higher-volume hospitals (p < 0.001). Conclusions. Surgical treatment of PD in the US changed significantly between 1996 and 2000. Larger-volume hospitals had superior short-term outcomes and lower charges. Future studies should address long-term functional end points, cost/benefit comparisons, and inequities in access to care.

Westeinde Sciatica Trial: randomized controlled study of bed rest and physiotherapy for acute sciatica

2002 ◽  
Vol 96 (1) ◽  
pp. 45-49 ◽  
Author(s):  
Derk J. Hofstee ◽  
Johanna M. M. Gijtenbeek ◽  
Peter H. Hoogland ◽  
Hans C. van Houwelingen ◽  
Alfred Kloet ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Outcome Measures ◽  
Bed Rest ◽  
Control Treatment ◽  
Secondary Outcome ◽  
Content Type ◽  
Randomized Controlled ◽  
And Control ◽  
Acute Sciatica ◽  
Fine Print

Object. The authors conducted a study to compare the efficacies of three nonsurgical treatment strategies in patients with sciatica. Their hypothesis was that bed rest, physiotherapy, and continuation of activities of daily living (ADLs) (control treatment) are each of equivalent efficacy. Methods. This randomized controlled trial was designed for comparison of bed rest, physiotherapy, and continuation of ADLs. The setting was an outpatient clinic. General practitioners were asked to refer patients for treatment as soon as possible. The authors enrolled 250 patients (< 60 years of age) with sciatica of less than 1-month's duration and who had not yet been treated with bed rest or physiotherapy. Primary outcome measures were radicular pain (based on a visual analog pain scale [VAPS]) and hampered ADLs (Quebec Disability Scale [QDS]). Secondary outcome measures were the rates of treatment-related failure and surgical treatment. Measures were assessed at baseline and during follow up at 1, 2, and 6 months. Mean differences in VAPS and QDS scores between bed rest and control treatment were 2.5 (95% confidence interval [CI] −6.4 to 11.4) and −4.8 (95% CI −10.6 to 0.9) at 1 month and 0.9 (95% CI −8.7 to 10.4) and −2.7 (95% CI −9.9 to 4.4) at 2 months, respectively. The respective differences between physiotherapy and control treatment were 0.8 (95% CI −8.2 to 9.8) and −0.5 (95% CI −6.3 to 5.3) at 1 month and −0.3 (95% CI −9.4 to 10) and 0.0 (95% CI −7.2 to 7.3) at 2 months. The respective odds ratios for treatment failure and surgical treatment of bed rest compared with control treatment were 1.6 (95% CI 0.8–3.5) and 1.5 (95% CI 0.7–3.6) at 6 months. When physiotherapy was compared with control treatment, these ratios were 1.5 (95% CI 0.7–3.2) and 1.2 (95% CI 0.5–2.9) at 6 months, respectively. Conclusions. Bed rest and physiotherapy are not more effective in acute sciatica than continuation of ADLs.

Meningiomas arising from the falcotentorial junction

1995 ◽  
Vol 82 (5) ◽  
pp. 726-738 ◽  
Author(s):  
Shoji Asari ◽  
Tomohide Maeshiro ◽  
Susumu Tomita ◽  
Masamitsu Kawauchi ◽  
Nobuyoshi Yabuno ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Mr Imaging ◽  
Superior Sagittal Sinus ◽  
Posterior Part ◽  
Detailed Knowledge ◽  
Content Type ◽  
Sagittal Sinus ◽  
Adjacent Structures ◽  
Upward Gaze Palsy ◽  
Fine Print

✓ Meningiomas arising from the falcotentorial junction are extremely rare. The authors describe the clinical features, neuroimaging studies, and results of surgical treatment of meningiomas of the falcotentorial junction and clarify the characteristics of this lesion based on a review of the literature and seven patients treated at their institution. The most common symptoms resulted from intracranial hypertension. Upward-gaze palsy appeared in only one patient. Computerized tomography (CT) showed no specific findings, but there was no evidence of edema around the tumor. Magnetic resonance (MR) imaging revealed a round, smooth-bordered mass with a peritumoral rim, without edema, and showing marked contrast enhancement. The multiplanar capability of MR imaging delineated the relationship between the tumor and adjacent structures better than did CT. Detailed knowledge of the vascular structures, especially evidence of occlusion of the galenic venous system and the development of collateral venous channels, is critical for successful surgery; stereoscopic cerebral angiography is necessary to achieve this aim. The seven patients described developed five types of collateral venous channels: through the basal vein of Rosenthal to the petrosal vein, through the veins on the medial surface of the parietal and occipital lobes to the superior sagittal sinus, through superficial anastomotic veins, through veins of the posterior fossa to the transverse or straight sinus, and through the falcian veins to the superior sagittal sinus. The first three types mainly developed after occlusion of the galenic system. The tumors were removed through the occipital transtentorial approach with a large window at the posterior part of the falx. A favorable prognosis for patients undergoing surgical treatment of falcotentorial junction meningiomas can be expected if detailed neuroimaging studies and microsurgical techniques are used.

An analysis of follow-up results of 1000 intracranial saccular aneurysms with definitive surgical treatment

1979 ◽  
Vol 50 (2) ◽  
pp. 152-157 ◽  
Author(s):  
Takashi Yoshimoto ◽  
Keita Uchida ◽  
Uichi Kaneko ◽  
Takamasa Kayama ◽  
Jiro Suzuki
Keyword(s):  
Surgical Treatment ◽  
Postoperative Results ◽  
Content Type ◽  
Poor Condition ◽  
Follow Up Study ◽  
Normal Life ◽  
Definitive Surgery ◽  
Fine Print ◽  
Saccular Aneurysms

✓ The authors report a follow-up review of 1000 cases of intracranial definitive surgery for saccular aneurysms. The prognosis for such surgical cases is discussed. Postoperative results at least 6 months after discharge from the hospital were analyzed in 876 (93.3%) of the 939 surviving patients. The longest follow-up period was 14 years and 5 months, with an average of 3 years and 7 months. At the time of discharge, there were 543 excellent results, 186 good, 117 fair, 93 poor, and 61 deaths. The chief findings were as follows: 1) Most of the patients determined as “excellent” or “good” at discharge were able to return to normal life; most of the deaths or instances of worsened condition found in the follow-up study were due to new lesions. 2) Fully 62% of the cases determined as “fair” at discharge were found in an improved state at the follow-up study, having returned to normal life. 3) Only 19% of cases determined as “poor” at discharge had improved to the point where a return to normal life was possible, the majority having died or remaining in poor condition.

Intradural tuberculomas of the spinal cord

1981 ◽  
Vol 55 (2) ◽  
pp. 289-292 ◽  
Author(s):  
Hamit Z. Gökalp ◽  
Ertuğ Özkal
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Medical Care ◽  
Review Of The Literature ◽  
Content Type ◽  
Antituberculous Treatment ◽  
Fine Print

✓ The incidence of intradural tuberculoma of the spinal cord is rare, and is becoming rarer as medical care improves. Two cases of surgically treated intradural tuberculomas are presented, with a brief review of the literature. The authors recommend surgical treatment, which carries almost no risk of meningitis if antituberculous treatment is given postoperatively.

Routine intraoperative angiography during aneurysm surgery

2002 ◽  
Vol 96 (6) ◽  
pp. 988-992 ◽  
Author(s):  
Veronica L. Chiang ◽  
Phillipe Gailloud ◽  
Kieran J. Murphy ◽  
Daniele Rigamonti ◽  
Rafael J. Tamargo
Keyword(s):  
Surgical Treatment ◽  
False Negative ◽  
Anterior Communicating Artery ◽  
Parent Vessel ◽  
Vessel Occlusion ◽  
Intraoperative Angiography ◽  
Content Type ◽  
Negative Results ◽  
Parent Vessel Occlusion ◽  
Fine Print

Object. The routine use of intraoperative angiography as an aid in the surgical treatment of aneurysms is uncommon. The advantages of the ability to visualize residual aneurysm or unintended occlusion of parent vessels intraoperatively must be weighed against the complications associated with repeated angiography and prolonged vascular access. The authors reviewed the results of their routine use of intraoperative angiography to determine its safety and efficacy. Methods. Prospectively gathered data from all aneurysm cases treated surgically between January 1996 and June 2000 were reviewed. A total of 303 operations were performed in 284 patients with aneurysms; 24 patients also underwent postoperative angiography. Findings on intraoperative angiographic studies prompted reexploration and clip readjustment in 37 (11%) of the 337 aneurysms clipped. Angiography revealed parent vessel occlusion in 10 cases (3%), residual aneurysm in 22 cases (6.5%), and both residual lesion and parent vessel occlusion in five cases (1.5%). When compared with subsequent postoperative imaging, false-negative results were found on two intraoperative angiograms (8.3%) and a false-positive result was found on one (4.2%). Postoperative angiograms obtained in both false-negative cases revealed residual anterior communicating artery aneurysms. Both of these aneurysms also subsequently rebled, requiring reoperation. In the group that underwent intraoperative angiography, in 303 operations eight patients (2.6%) suffered complications, of which only one was neurological. Conclusions. In the surgical treatment of intracranial aneurysms, the use of routine intraoperative angiography is safe and helpful in a significant number of cases, although it does not replace careful intraoperative inspection of the surgical field.

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