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https://www.readbyqxmd.com/read/29332081/radiosurgical-subthalamic-nucleotomy
#1
Jean Régis, Romain Carron, Tatiana Witjas
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is the reference technique in Parkinson's disease (PD) at different stages of complications. Some patients cannot afford DBS due to anticoagulation or comorbidities or due to pecuniary reasons. Radiosurgery is a minimally invasive stereotactic technique, with no craniotomy and subsequently no risk of bleeding or infection. Its good safety efficacy profile has been established in the treatment of tremor, and the postoperative care issues are simple with a much shorter hospital stay (mean 48 h)...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332078/magnetic-resonance-guided-high-intensity-focused-ultrasound-for-treating-movement-disorders
#2
Young Goo Kim, Eun Jung Kweon, Won Seok Chang, Hyun Ho Jung, Jin Woo Chang
Transcranial magnetic resonance-guided focused ultrasound (MRgFUS) surgery has recently gained favor as a novel, noninvasive alternative to conventional neurosurgery. In contrast to traditional ablative interventions, transcranial MRgFUS surgery is entirely imaging-guided and uses continuous temperature measurements at the target and surrounding tissue taken in real-time. Unlike Gamma Knife radiosurgery, MRgFUS surgery can make a lesion immediately and does not use ionizing radiation. Moreover, since no metallic device is implanted, MR imaging-based diagnosis is not restricted throughout life...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332069/the-history-of-movement-disorder-brain-surgery
#3
L Dade Lunsford, Ajay Niranjan
The first surgical procedures for abnormal movement disorders began in the 1930s, when surgeons first proposed ablative techniques of the caudate nucleus or transection of motor (pyramidal) pathways to reduce involuntary movements in patients with Parkinson's related tremor. During the 50-year interval between 1945 and 1995, the development of precise intracranial guiding devices, brain maps, and advanced imaging led to the refinement of appropriate deep brain targets affecting extrapyramidal pathways. Lesional surgery and subsequent neuroaugmentation using deep brain stimulation extended the role of deep brain surgery for a wider group of patients with tremor, rigidity, dyskinesia, and other involuntary movement disorders...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29331746/canadian-neurosurgery-educators-views-on-stereotactic-radiosurgery-in-residency-training
#4
Nardin Samuel, Justine Philteos, Naif M Alotaibi, Christopher Ahuja, Alireza Mansouri, Abhaya V Kulkarni
OBJECTIVE: Despite the increasing prominence of stereotactic radiosurgery (SRS) in treating intracranial and spinal pathologies, there is currently a dearth of exposure to this modality in neurosurgical residency. To address this gap, the aim of this study is to assess neurosurgery educators' views regarding the current state of SRS exposure, and to identify potential approaches to improve residency education in this domain. METHODS: Qualitative thematic analysis and constructivist grounded theory methodology were employed...
January 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29328001/gamma-knife-radiosurgery-of-saccular-aneurysms-in-a-rabbit-model
#5
Mark D Meadowcroft, Timothy K Cooper, Sebastian Rupprecht, Thaddeus C Wright, Elizabeth E Neely, Michele Ferenci, Weimin Kang, Qing X Yang, Robert E Harbaugh, James R Connor, James McInerney
OBJECTIVE Intracranial aneurysms are vascular abnormalities associated with neurological morbidity and mortality due to risk of rupture. In addition, many aneurysm treatments have associated risk profiles that can preclude the prophylactic treatment of asymptomatic lesions. Gamma Knife radiosurgery (GKRS) is a standard treatment for trigeminal neuralgia, tumors, and arteriovenous malformations. Aneurysms associated with arteriovenous malformations have been noted to resolve after treatment of the malformation...
January 12, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29327172/identifying-candidates-for-gamma-knife-radiosurgery-among-elderly-patients-with-brain-metastases
#6
Tae Hoon Roh, Mi Sun Choi, Namkyu You, Donghwan Jeong, Ae Hwa Jang, Mi Ra Seo, Sang Ryul Lee, Se-Hyuk Kim
We investigated the outcomes of gamma knife radiosurgery (GKRS) for elderly patients (≥ 65 years) with brain metastases, and identified survival-associated factors. We retrospectively analyzed data from 115 patients treated with GKRS for 1-15 brain metastases. The median patient age was 72 years; most primary tumors were pulmonary (n = 83). The mean lesion volume was 2.1 ± 4.8 mL. A mean dose of 19.3 Gy was delivered to the mean 63.9% isodose line. The median overall survival (OS) was 5.3 months (95% confidence interval [CI] 3...
January 11, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29327171/efficacy-of-adjuvant-radiotherapy-in-the-intracranial-hemangiopericytoma
#7
Seung Hyuck Jeon, Sung-Hye Park, Jin Wook Kim, Chul-Kee Park, Sun Ha Paek, Il Han Kim
We retrospectively evaluated an efficacy of adjuvant radiotherapy (RT) in the intracranial hemangiopericytoma (HPC) and analyzed prognostic factors influencing treatment outcomes. Among 49 patients diagnosed as localized intracranial HPC between 1995 and 2016, 31 patients received adjuvant RT after surgery; 26 with fractionated RT and 5 with stereotactic radiosurgery using Gamma Knife. After gross total resection (GTR) (n = 32) and subtotal resection (STR) (n = 17), histopathological grade was confirmed to be grade II (n = 9) or grade III (n = 40)...
January 11, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29326012/stereotactic-body-radiotherapy-sbrt-for-patients-with-locally-advanced-pancreatic-cancer-a-single-center-experience
#8
Raphaël Jumeau, Guila Delouya, David Roberge, David Donath, Dominic Béliveau-Nadeau, Marie-Pierre Campeau
INTRODUCTION: Despite advances in treatment, notably in systemic therapy, the prognosis of pancreatic adenocarcinoma (PADC) remains dismal. Stereotactic body radiotherapy (SBRT) is an emerging tool in the complex management of PADC. We review outcomes of SBRT for PADC at our institution. METHODS: We reviewed patients treated with SBRT for either unresectable PADC or locally recurrent PADC after surgery. Treatment was delivered using a robotic radiosurgery system with respiratory tracking...
December 21, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29325944/hemorrhagic-cavernous-sinus-hemangioma-with-sudden-onset-abducens-palsy-case-report
#9
Fumihiko Nishimura, Park Young-Su, Ichiro Nakagawa, Shuichi Yamada, Hiroyuki Nakase, Yasushi Nagatomo
BACKGROUND: We report a rare case of hemorrhagic cavernous sinus hemangioma with sudden onset of abducens palsy. CASE DESCRIPTIONS: Sudden onset of diplopia occurred in a 49-year-old female. Head computed tomography (CT) findings revealed a high density mass in the right cavernous sinus with protrusion to the sphenoid sinus. Endoscopic endonasal surgery was performed, though early recurrence was noted. A gamma knife surgical procedure was then performed to prevent early recurrence after histopathological confirmation of cavernous sinus hemangioma...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29318507/mid-term-prognosis-of-non-functioning-pituitary-adenomas-with-high-proliferative-potential-really-an-aggressive-variant
#10
Yoshikazu Ogawa, Hidefumi Jokura, Kuniyasu Niizuma, Teiji Tominaga
Pituitary adenomas with high proliferation rate and rapid growth are well known, but the clinical characteristics, prognosis, and treatment algorithm remain unclear. The clinical characteristics and mid-term prognosis of patients with non-functioning pituitary adenomas with high proliferative potential were retrospectively investigated. This study identified 53 patients with Ki-67 labeling index of > 3% among 845 patients with non-functioning pituitary adenoma (6.3%) initially treated by surgery. Prophylactic treatment was not applied for patients with residual tumor, but salvage treatment was performed if tumor progression was identified within the follow-up period...
January 9, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29315459/pretherapeutic-functional-neuroimaging-predicts-tremor-arrest-after-thalamotomy
#11
C Tuleasca, E Najdenovska, J Régis, T Witjas, N Girard, J Champoudry, M Faouzi, J-P Thiran, M Bach Cuadra, M Levivier, D Van De Ville
OBJECTIVE: Essential tremor (ET) represents the most common movement disorder. Drug-resistant ET can benefit from standard stereotactic procedures (deep brain stimulation or radiofrequency thalamotomy) or alternatively minimally invasive high-focused ultrasound or radiosurgery. All aim at same target, thalamic ventro-intermediate nucleus (Vim). METHODS: The study included a cohort of 17 consecutive patients, with ET, treated only with left unilateral stereotactic radiosurgical thalamotomy (SRS-T) between September 2014 and August 2015...
January 7, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29315192/long-term-hearing-preservation-outcomes-for-small-vestibular-schwannomas-retrosigmoid-removal-versus-observation
#12
Weidong Zhu, Hongsai Chen, Huan Jia, Yongchuan Chai, Jie Yang, Zhaoyan Wang, Hao Wu
OBJECTIVE: Management of small vestibular schwannomas (VSs) consists of three options: serial observation, radiosurgery, and microsurgery. The authors reported the long-term hearing outcomes after retrosigmoid tumor removal in 110 patients and hearing follow-up outcomes in 160 serial observation patients with small VSs to explore the appropriate management strategy and predictive factors of hearing preservation for small VSs. STUDY DESIGN: Retrospective study. SETTING: Tertiary referral center...
February 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29315190/audiological-outcomes-in-growing-vestibular-schwannomas-managed-either-conservatively-or-with-stereotactic-radiosurgery
#13
Thomas Daniel Milner, Richard R Locke, Georgios Kontorinis, John A Crowther
OBJECTIVE: Recent studies have suggested good hearing preservation following stereotactic radiosurgery (STRS) in patients with vestibular schwannomas (VS). This study aims to assess audiological outcomes in patients with growing VS treated either with STRS, or managed conservatively. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary referral center. PATIENTS: Out of 540 patients with VS, 69 patients with growing VS fulfilled the inclusion criteria; 24 treated conservatively and 45 with STRS...
February 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29314093/hospice-care-in-medicare-patients-with-primary-liver-cancer-the-impact-on-resource-utilisation-and-mortality
#14
N Fukui, P Golabi, M Otgonsuren, L de Avila, H Bush, Z M Younossi
BACKGROUND: Few studies have assessed the impact of hospice care in patients with primary liver cancer. AIM: To examine the determinants of hospice care and its effects on resource utilisation and survival among Medicare beneficiaries with primary liver cancer. METHODS: We utilised the Surveillance, Epidemiology and End result Registry (SEER) database from 2002 to 2009 for this cross-sectional study. A total of 3385 patients with primary liver cancer were included...
January 3, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29309683/congress-of-neurological-surgeons-systematic-review-and-evidence-based-guidelines-on-hearing-preservation-outcomes-in-patients-with-sporadic-vestibular-schwannomas
#15
Matthew L Carlson, Esther X Vivas, D Jay McCracken, Alex D Sweeney, Brian A Neff, Neil T Shepard, Jeffrey J Olson
Question 1: What is the overall probability of maintaining serviceable hearing following stereotactic radiosurgery utilizing modern dose planning, at 2, 5, and 10 yr following treatment? Recommendation: Level 3: Individuals who meet these criteria and are considering stereotactic radiosurgery should be counseled that there is moderately high probability (>50%-75%) of hearing preservation at 2 yr, moderately high probability (>50%-75%) of hearing preservation at 5 yr, and moderately low probability (>25%-50%) of hearing preservation at 10 yr...
December 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29309637/congress-of-neurological-surgeons-systematic-review-and-evidence-based-guidelines-on-the-role-of-radiosurgery-and-radiation-therapy-in-the-management-of-patients-with-vestibular-schwannomas
#16
Isabelle M Germano, Jason Sheehan, Johnathan Parish, Tyler Atkins, Anthony Asher, Constantinos G Hadjipanayis, Stuart H Burri, Sheryl Green, Jeffrey J Olson
Question: What are the indications for stereotactic radiosurgery (SRS) treatment vs observation for patients with intracanalicular vestibular schwannomas without evidence of radiographic progression? Recommendation: Level 3: If tinnitus is not observed at presentation, it is recommended that intracanalicular vestibular schwannomas and small tumors (<2 cm) without tinnitus be observed as observation does not have a negative impact on tumor growth or hearing preservation compared to treatment...
December 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29309635/letter-radiation-induced-changes-after-stereotactic-radiosurgery-for-brain-arteriovenous-malformations
#17
Zengpanpan Ye, Xiaolin Ai, Chao You
No abstract text is available yet for this article.
December 22, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29309632/congress-of-neurological-surgeons-systematic-review-and-evidence-based-guidelines-on-surgical-resection-for-the-treatment-of-patients-with-vestibular-schwannomas
#18
Constantinos G Hadjipanayis, Matthew L Carlson, Michael J Link, Tarek A Rayan, John Parish, Tyler Atkins, Anthony L Asher, Ian F Dunn, C Eduardo Corrales, Jamie J Van Gompel, Michael Sughrue, Jeffrey J Olson
QUESTION 1: What surgical approaches for vestibular schwannomas (VS) are best for complete resection and facial nerve (FN) preservation when serviceable hearing is present? RECOMMENDATION: There is insufficient evidence to support the superiority of either the middle fossa (MF) or the retrosigmoid (RS) approach for complete VS resection and FN preservation when serviceable hearing is present. QUESTION 2: Which surgical approach (RS or translabyrinthine [TL]) for VS is best for complete resection and FN preservation when serviceable hearing is not present? RECOMMENDATION: There is insufficient evidence to support the superiority of either the RS or the TL approach for complete VS resection and FN preservation when serviceable hearing is not present...
December 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29307352/neurocognitive-aspects-of-brain-metastasis
#19
Jeffrey S Wefel, Michael W Parsons, Vinai Gondi, Paul D Brown
Brain metastases are common, occurring in approximately 20% of cancer patients. One of the biggest concerns for these patients and their families is neurocognitive decline. Neurocognitive issues in this patient population are complex and many patients have neurocognitive impairment due to systemic therapies even before they develop brain metastases. The development of brain metastases as well as the treatment of these tumors can cause decline in neurocognitive function. Diffuse treatments such as whole-brain radiotherapy are more frequently associated with neurocognitive decline than focal interventions such as radiosurgery, surgical resection, and implantable chemotherapy wafers...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29307350/brain-metastases-radiosurgery
#20
Amparo Wolf, Douglas Kondziolka
Stereotactic radiosurgery has revolutionized the management of brain metastases. It delivers focused, highly conformal, ionizing radiation to a tumor delineated using high-resolution imaging, with low toxicity to adjacent brain structures. Randomized controlled and prospective trials have demonstrated a survival advantage and high local control rates after stereotactic radiosurgery for metastatic disease to the central nervous system, including for up to 10 brain metastases. Its minimal-access nature makes it an attractive alternative to surgical resection...
2018: Handbook of Clinical Neurology
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