摘要:

Summary:Epilepsy is the most common neurologic disorder in childhood and the majority of patients with convulsive disorders will have had the onset of their seizures during childhood. Since many children will outgrow their seizures or will be adequately treated with medication, there has been a reluctance to sending children for surgical evaluation and intervention with the hope that the natural history and seizures will be self-limited. Intractable seizures during childhood have been shown to lead to intellectual and psychosocial decline and affect the child's normal development. Surgery is an alternative treatment when medical treatment fails. The goal of early surgical intervention is not only to stop the intractable seizures, but to prevent further brain injury and/or interference from either the underlying abnormality causing the seizures, the seizures themselves, or the often toxic levels of antiepileptic drugs (AEDs) required for even some modicum of seizure control. This review will focus on the evaluative methods and surgical options available for the treatment of intractable epilepsy as it relates to children.

ISSN:1050-6438    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Summary:With 500,000 new strokes occurring annually in the United States, 145,000 deaths result. Stroke remains the third leading cause of death in the United States after cardiovascular disease and cancer, but it is also a leading cause of long-term physical and intellectual disability. Billions of dollars are lost in productivity and health-care resources. The total annual economic cost of stroke in this nation was estimated to be $18 billion in 1993 (1). Of every 100 patients surviving a stroke, 10 will be unimpaired, 40 will have mild residual disability interfering with activities of daily living and employment, 40 will be left with disability requiring dependent care, and 10 will require institutionalization (2). Given the inadequacies of current available treatment for established infarction, our major effort must be directed toward stroke prevention through risk factor modification and proper application of appropriate medical and surgical therapies.Risk factors for stroke include hypertension, smoking, diabetes mellitus, cardiac disease, hyperlipidemia, transient ischemic attacks, and previous stroke. Sixty percent of all strokes are due to occlusion of a major brain vessel by thrombosis or embolism; data suggest that at least 60% are attributable to carotid disease (3).

ISSN:1050-6438    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Summary:Surgery of the cerebellopontine angle endangers critical neurovascular structures. The variety of lesions found in this region further complicates surgical resection. The individual features of the different tumor types distort the cranial nerves in unique ways, each posing a different challenge in the effort to preserve function. Advances in the fields of microsurgery, neuroradiology, and cranial nerve monitoring have improved the rate of cranial nerve preservation considerably. This review will address the various neoplastic lesions found in this area and the current modalities used to maximize cranial nerve preservation. Emphasis is placed on surgical technique and monitoring as they undoubtedly play the most important role in efforts to preserve these structures. The success rates of those surgeons performing the largest number of these procedures is also discussed in an effort to delineate current, accepted practice.

ISSN:1050-6438    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Summary:The demonstration that the central nervous system (CNS) is not completely isolated from the immune system by the blood-brain barrier has provided evidence that the CNS is subject to the same immune surveillance as other tissues in the body, albeit the nature and efficacy of this surveillance may differ significantly. In this article we review the current understanding of lymphocyte trafficking to the CNS under normal and pathological conditions. Specifically, we examine basic concepts of immunity and immune surveillance, the anatomic and physiologic relationship between the CNS and the lymphatic system, the important functions of antigens and cytokines in directing lymphocyte migration, and the role of cellular adhesion molecules in lymphocyteendothelium interactions. We conclude with an overview of how these phenomena contribute to lymphocyte trafficking in multiple sclerosis and malignant glioma, in which an infiltration of lymphocytes is suspected to significantly contribute to their pathophysiology.

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