ISSN:1050-6438    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1050-6438    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Summary:Contemporary surgical techniques to treat trigeminal neuralgia include microvascular decompression to correct the etiology and percutaneous techniques such as radiofrequency thermocoagulation, balloon compression, and glycerol rhizotomy to treat the symptomatology. The development of each technique is reviewed together with a brief description of the current application of these techniques. Epidemiological figures are given and prognostic factors are discussed. Early and long-term results as well as the mortality and morbidity figures on over 10,000 cases reported in the world literature are tabulated for ease of comparison. Pros and cons of each surgical technique are also discussed. There is no rigid algorithm in the surgical management of patients with trigeminal neuralgia. The significance and current application of neuroradiological tools in the diagnosis of the etiology, especially the vascular compression, is highlighted in detail. We believe that with more widespread application of sophisticated magnetic resonance techniques, the surgical treatment of trigeminal neuralgia will be more specific and therefore more appropriate, whereas a significant number of patients will still have to be treated with percutaneous techniques because of their low morbidity.

ISSN:1050-6438    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Summary:The literature on the diagnosis and treatment of minor closed head injury (CHI) in the computed tomography (CT) scan era was reviewed. Working definitions were developed for the categories of minor CHI (minimal, mild, and moderate), and the natural history of each category was reviewed. The risks of intracranial complications and surgical lesions were calculated for each category. For minimal CHI, they are almost no risks, for mild CHI, the risks are 15% and 2.5%, respectively. Patients with moderate CHI can expect an intracranial lesion rate of 30%; 8% require neurosurgical intervention. Additional evidence was documented from the literature to allow comparisons among various treatment options with reference to clinical outcomes. It is concluded that most patients with minimal CHI can be safely discharged from the Emergency Department (ED) unless risk factors, which might indicate the need for CT scanning or hospitalization, are present. Those having mild CHI should have urgent CT scanning; patients in whom the scan is normal can be safely discharged from the ED. Moderate CHI requires both hospital admission and urgent CT scanning. Based on the natural history evidence of similar risk in children and adolescents, the same recommendations are made in the pediatric age group with minor CHI. Cost factors and the public health impact of this management scheme are discussed.

ISSN:1050-6438    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Summary:Pediatric brain tumors differ from adult brain tumors in several important ways: (a) the tumor types and sites differ, with low-grade gliomas being more common than high-grade, and posterior fossa tumors occurring as commonly as supratentorial tumors; (b) the extent of resection is an important determinant of outcome for many tumor types; (c) chemotherapy is often used postoperatively to defer and occasionally to avoid irradiation; and (d) the prognosis is substantially better for many tumor types. Extent of resection appears to correlate with prognosis for children with supratentorial low-grade and highgrade gliomas and primitive neuroectodermal tumors (PNETs), and for those with infratentorial astrocytomas, ependymomas and some medulloblastomas. Postoperative staging is important for children with supratentorial malignant gliomas or PNETs, those with germ cell tumors and those with posterior fossa ependymomas and medulloblastomas. Chemotherapy is now commonly administered prior to postoperative irradiation for children with malignant tumors, and is used to delay significantly or avoid radiotherapy for children younger than 3 years old and for patients with low-grade gliomas, especially those in the optic chiasm and hypothalamus. Because of the risks of conventional external beam irradiation, increasing numbers of tumors are being treated with focused irradiation, using either stereotactic radiosurgery or intracavitary irradiation. The prognosis of children with malignant gliomas and medulloblastomas has improved.

ISSN:1050-6438    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Summary:Using our experience with surgical treatment in 600 cases of moyamoya disease, the pre- and postoperative symptoms and findings on electroencephalogram, radioisotope angiography, cerebral blood flow study, and angiography are compared, and the perioperative changes in the pathophysiology of this disease are demonstrated.

ISSN:1050-6438    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1050-6438    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1050-6438    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1050-6438    

出版商:OVID    

年代:1996

数据来源: OVID