摘要:

&NA;The prognosis for patients with nonseminomatous germ cell tumor of the testis is good, even when extensive metastatic disease is present, because this tumor is very sensitive to chemotherapy with cisplatin, vinblastine, and bleomycin (PVB). If a metastasis occurs in the brain, however, the prognosis is poor because the blood‐brain barrier limits the entrance of these drugs into the brain and creates a sanctuary for tumor. The current treatment for a brain metastasis is either standard PVB chemotherapy plus whole brain radiation therapy or a rigorous chemotheraputic regimen that penetrates the blood‐brain barrier better than PVB. Surgery is seldom used for brain metastasis, largely because of the poor results with surgical debulking in noncentral nervous system disease. This is the report of a patient with disseminated nonseminomatous germ cell tumor and multiple large brain metastases, who was treated with surgery, PVB, and whole brain radiation therapy and cured. Evidence is presented to support a role for surgical debulking in patients with large brain metastasis. (Neurosurgery25:814—819, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;A 21‐year‐old man with an oligodendroglioma in the anterior horn of the right lateral ventricle complained of sexual dysfunction and showed lowered concentrations of serum testosterone (1.1 ng/ml) with normal pituitary function. Human chorionic gonadotropin testing revealed a good testosterone response (1.1 to 4.9 ng/ml) and a clomiphene test revealed no gonadotropin response. Pulsatile secretion of luteinizing hormone (LH) was absent preoperatively. After removal of the tumor, serum concentration of testosterone increased to the normal range, LH pulsatility appeared, and the patient had no complaints of sexual dysfunction. In this patient, the loss of LH pulsatility responsible for his hypogonadism was caused by the lateral ventricle tumor compressing the surrounding structures, and this was corrected by tumor resection. (Neurosurgery25:820‐823, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Four cases of vertex epidural hematomas are presented to illustrate the unique management problems which set them apart from their more common counterparts located over the temporal convexity. Diagnosis requires a high degree of suspicion as vertex epidural hematomas are often missed by conventional horizontal scanning. Coronal computed tomographic scanning should be undertaken in all suspected cases. Clinical symptoms exceeding the small volume of clot may be present due to venous obstruction and disruption of cerebrospinal fluid absorption. Evacuation of the clot usually leads to clinical improvement. (Neurosurgery25:824‐828, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;A unique case of bilateral extradural hematomas in an infant is reported. Relevant aspects of the patient's history, including the absence of any known trauma and the presence of an underlying coagulopathy are discussed. The radiographic and operative findings of this case are presented, and an explanation of the mechanism of the hematomas is offered. (Neurosurgery25:828‐830, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Two cases of calvarial tuberculosis associated with neurological involvement are presented. The radiological features and therapeutic management are discussed and the literature is reviewed. (Neurosurgery25:830‐833, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;A case of extrusion of a peritoneal shunt catheter from the thigh is reported. The literature is reviewed and the frequent involvement of Raimondi catheters in extrusion is discussed. (Neurosurgery25:833‐835. 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;The sciatic nerve is by far the most common nerve accidentally injured during intramuscular injection. Despite its close proximity to the sciatic nerve, however, injury to the posterior femoral cutaneous nerve is apparently quite rare. In this report, clinical features of a patient with isolated injection injury to the posterior femoral cutaneous nerve are described. (Neurosurgery25:835‐838, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;A ventricular catheter and connected subcutaneous reservoir (ventricular access reservoir) allows easy, repeated access to the cerebrospinal fluid for a multitude of purposes. In situations in which the ventricles are small or displaced, insertion of a ventricular catheter may be difficult. Multiple passes to cannulate the ventricle may damage the brain and manipulation of the catheter and reservoir may cause migration of the catheter, possibly compromising its function. A stereotactic method for insertion of ventricular access reservoirs using a device that attaches to the Brown‐Roberts‐Wells stereotactic system has been developed. With this device the catheter and reservoir are guided into place as a single unit, utilizing a guide attached to the Brown‐Roberts‐Wells frame. This technique has been useful in inserting ventricular access reservoirs into patients with small ventricles or in whom there is some abnormality of the brain or skull that renders classical landmarks for ventricular cannulation useless. (Neurosurgery25:839‐842, 1989)

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1989

数据来源: OVID