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T : 목차정보

World neurosurgery 210건

  1. [해외논문]   Poor Brain–Tumor Interface–Related Edema Generation and Cerebral Venous Decompensation in Parasagittal Meningiomas  

    Yin, Tengkun (Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China ) , Zhang, Jianhe (Department of Neurosurgery, Fuzhou General Hospital, Fuzhou, China ) , Zhang, Hao (Department of Neurosurgery, Fuzhou General Hospital, Fuzhou, China ) , Zhao, Qingshuang (Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China ) , Wei, Liangfeng (Department of Neurosurgery, Fuzhou General Hospital, Fuzhou, China ) , Wang, Shousen (Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China)
    World neurosurgery v.115 ,pp. e544 - e551 , 2018 , 1878-8750 ,

    초록

    Background Parasagittal meningioma (PSM) has a high incidence of peritumoral edema and unclear pathogenesis. The venous compression theory has been proposed as a pathomechanism; however, this is controversial, and the various edema patterns have not been recognized. Objective We sought to establish the relationship between venous circulation status with different edema patterns in PSM and the neurologic outcomes of these different patterns. Methods We performed a retrospective study of 60 consecutive patients who underwent surgical treatment for PSM. Patients were divided into 3 groups: no edema, poor brain–tumor interface–related edema (PIRE), and strong brain–tumor interface–related edema (SIRE). Single-blinded observers scored venous circulation for each patient based on the degree of superior sagittal sinus (SSS) occlusion, the number of involved cortical veins, and venous collateral grade. PIRE and SIRE were analyzed using multivariate analysis. Finally, we evaluated the functional independence and mobility score for every patient. Results The PIRE group showed the highest rate of cerebral venous decompensation at 75% (n = 15) compared with 38.5% (n = 5) in the SIRE group and 22.2% (n = 6) in the no-edema group. We observed a significant correlation between venous decompensation and PIRE generation on multivariate analysis ( P = 0.029). The PIRE group showed the worst immediate functional status, and the SIRE group had the best improvement in complete dependence rate (23%) at late evaluation. Conclusions The generation of PIRE, but not SIRE, may depend on venous decompensation in PSM. PIRE generation is predictive of worse neurologic outcome. Future studies into the pathogenesis of peritumoral edema should distinguish the different edema patterns. Highlights We established a role between venous circulation and parasagittal meningiomas. Venous decompensation is the highest in poor tumor boundary related edema. Poor brain–tumor interface–related edemas predict a worse neurologic outcome.

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  2. [해외논문]   Effectiveness of Positron Emission Tomography/Computed Tomography as a Guide for Palliative Radiation Therapy for Spinal Metastases  

    Almeida, Neil D. (Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA ) , Adams, Crystal (Department of Neurological Surgery, George Washington University Hospital, Washington, DC, USA ) , Davis, Gregory L. (Department of Neurological Surgery, George Washington University Hospital, Washington, DC, USA ) , Starke, Robert M. (Department of Neurological Surgery, University of Miami, Miami, Florida, USA ) , Buro, Justin (Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA ) , Nasr, Nadim (Department of Radiation Oncology, Virginia Hospital Center, Arlington, Virginia, USA ) , McRae, Don (Department of Radiation Oncology, Virginia Hospital Center, Arlington, Virginia, USA ) , Cernica, George (Department of Radiation Oncology, Virginia Hospital Center, Arlington, Virginia, USA ) , Caputy, Anthony (Department of Neurological Surgery, George Washington University Hospital, Washington, DC, USA ) , Hong, Robert (Department of Radiation Oncology, Virginia Hospital Center, Arlington, Virginia, USA ) , Sherman, Jonathan (Department of Neurological Surgery, George W)
    World neurosurgery v.115 ,pp. e67 - e72 , 2018 , 1878-8750 ,

    초록

    Objective As back pain is the presenting symptom in 95% of patients with epidural spinal metastases, appropriately identifying and treating the most symptomatic levels can provide significant palliation. The purpose of this study was to analyze the ability of combined positron emission tomography (PET)/computed tomography (CT) to identify spinal metastases with high metabolic activity and guide radiotherapy. We sought to correlate improvement in back pain with reduction in standard uptake value (SUV) after treatment. Methods Retrospective review was performed of 72 patients with spinal metastases treated with stereotactic ablative radiation therapy at a single center between 2002 and 2014. PET/CT was used to calculate SUVs for spinal metastases, and treatment planning was based on PET/CT results. Preoperative and postoperative pain levels were assessed in all patients. Results Reduction in pain scores was found in 78% of treated patients. A significant reduction in pain was identified in patients with >5 metastases compared with fewer lesions ( P Conclusions PET/CT was shown to be a useful adjunct in radiation treatment planning with change in SUV correlating with symptomatic improvement. This study paves the way for future prospective studies to further assess utility and cost-effectiveness of this imaging modality in radiation treatment planning for spinal metastases. Highlights Symptomatic spinal metastases affect nearly 10% of all cancer patients with axial back pain being the primary symptom. Patients commonly present with multiple spinal metastases, and the pain generator can be difficult to localize. PET/CT can identify metastatic lesions with highest SUV correlating with highest metabolic activity. Lesions identified on PET/CT can be treated with stereotactic radiosurgery for palliative pain relief. PET/CT can also be used to monitor for tumor recurrence after treatment with radiosurgery.

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  3. [해외논문]   Deep Sequencing of Small RNAs in Blood of Patients with Brain Arteriovenous Malformations  

    Chen, Yong (Department of Neurosurgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Sichuan, China ) , Li, Zhili (Department of Neurosurgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Sichuan, China ) , Shi, Yi (Key Laboratory of SiChuan Province in Human Disease Gene Study, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Sichuan, China ) , Huang, Guangfu (Department of Neurosurgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Sichuan, China ) , Chen, Longyi (Department of Neurosurgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Sichuan, China ) , Tan, Haibin (Department of Neurosurgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Sichuan, China ) , Wang, Zhenyu (Department of Neurosurgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Sichuan, China ) , Yin, Cheng (Department of Neurosurgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Sichuan, Chin) , Hu, Junting
    World neurosurgery v.115 ,pp. e570 - e579 , 2018 , 1878-8750 ,

    초록

    Background Deregulation of circulating microRNAs (miRNAs) is always associated with development and progression of human diseases. We aimed to assess whether patients with brain arteriovenous malformations (BAVMs) possess a distinct miRNA signature compared with healthy subjects. Methods Three patients with unruptured BAVMs and 3 normal control subjects were recruited as case and control groups. Peripheral blood was collected, and miRNA signature was obtained by next-generation sequencing, followed by comparative, functional, and network analyses. Quantitative reverse transcription polymerase chain reaction was performed to validate expression of specific miRNAs. Results Deep sequencing detected 246 differentially expressed miRNAs in blood samples of patients with BAVMs compared with normal control subjects. For the top 5 miRNAs, 946 target genes were predicted, and a BAVM-specific miRNA-target gene regulatory network was constructed. Functional annotation suggested that 15 of the predicted miRNA-targeted genes were involved in vascular endothelial growth factor signaling, in which 3 critical miRNAs were involved: miR-7-5p, miR-199a-5p, and miR-200b-3p. Conclusions We explored the miRNA expression signature of BAVMs, which will provide an important foundation for future studies on the regulation of miRNAs involved in BAVMs. Highlights We obtained the global miRNA expression profile in peripheral blood samples from BAVMs. Mitogen-activated protein kinase, Wnt, and VEGF signaling were involved in the process of BAVMs. miR-7-5p, miR-199a-5p, and miR-200b-3p may be potential diagnostic biomarkers of BAVMs.

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  4. [해외논문]   Radiologic Anatomy of the Lumbar Interlaminar Window and Surgical Considerations for Lumbar Interlaminar Endoscopic and Microsurgical Disc Surgery  

    Sakç (Department of Radiology, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey ) , ı, Zakir (Department of Neurosurgery, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey ) , Ö (Department of Radiology, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey ) , nen, Mehmet Reş (Department of Radiology, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey ) , id (Department of Neurosurgery, Nobiom Center, Istanbul, Turkey ) , Fidan, Elif (Department of Neurosurgery, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey) , Yaş , ar, Yunus , Uluğ , , Hikmet , Naderi, Sait
    World neurosurgery v.115 ,pp. e22 - e26 , 2018 , 1878-8750 ,

    초록

    Objective The interlaminar window is the most important corridor during both interlaminar approaches to intervertebral discs. The aim of this study was to measure radiologic parameters related to endoscopic and microsurgical interlaminar discectomy. Methods Measured parameters included lateral recess line (LRL) width, distance between LRL and endplates of upper intervertebral disc, superior and lateral angles of interlaminar window, interlaminar height, and interpedicular distance via optimized coronal oblique projection computed tomography images. Measurements were performed at L2, L3, L4, and L5 levels. Results LRL was found to be 16.3 ± 3.4 mm, 17.3 ± 3.3 mm, 21.7 ± 3.4 mm, and 27.7 ± 4.0 mm at L2, L3, L4, and L5. The distances between LRL and both upper endplates decreased from L2 to L5. Distance between LRL and upper endplate of same vertebra and between LRL and lower endplate of upper vertebra was measured. Interlaminar window height decreased from L2 to L5 levels (from 14.0 ± 4.1 mm to 11.1 ± 2.4 mm). Conclusions This study showed that width of LRL increases in lower lumbar segments, and height of interlaminar window increases in upper lumbar segments. This study also revealed that intervertebral disc is located cranial to LRL at L2-3, L3-4, and L4-5 levels and is located caudal to LRL at L5-S1 level. The results of this study may help surgical planning in both endoscopic and microscopic interlaminar surgery. Highlights Lumbar endoscopic discectomy has been popular in recent years. Successful results after L5-S1 endoscopic interlaminar discectomy led surgeons to explore the procedure for other IVD levels. Position of interlaminar window should be taken into account during microdiscectomy and interlaminar endoscopic discectomy.

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  5. [해외논문]   Risk Factors for In-Hospital Seizures and New-Onset Epilepsy in Coil Embolization of Aneurysmal Subarachnoid Hemorrhage  

    Nathan, Suresh K. (To whom correspondence should be addressed: Parthasarathy D. Thirumala, M.D., M.S.) , Brahme, Indraneel S. , Kashkoush, Ahmed I. , Anetakis, Katherine , Jankowitz, Brian T. , Thirumala, Parthasarathy D.
    World neurosurgery v.115 ,pp. e523 - e531 , 2018 , 1878-8750 ,

    초록

    Objective This study aimed to determine risk factors for inpatient seizures and long-term epilepsy in patients receiving coil embolization for aneurysm-associated subarachnoid hemorrhage. Methods A retrospective chart review was conducted for patients admitted to the University of Pittsburgh Medical Center from 2010 to 2014 for subarachnoid hemorrhage. Only patients with coil embolization were included. Variables such as subdural hematoma, cerebral infarction, postoperative vasospasm, cerebral edema, and mass effect were collected. After discharge, patients were followed up to determine whether epilepsy had developed. The χ 2 test was used to assess univariate associations. Multivariable associations were assessed with a binary logistic regression model. Results The study included 175 patients, of whom 16 (9.1%) of the patients had seizures while they were inpatients. Five out of 73 patients met the criteria for epilepsy at follow-up. None of the patients with epilepsy after discharge had electrographic seizures while hospitalized. Vasospasm (odds ratio [OR] 6.88, 95% confidence interval [CI] 1.81–26.25), and Hunt and Hess grade 5 (OR 26.16, 95% CI 3.95–173.49) were significantly associated with in-hospital seizures in a multivariable analysis. Epileptiform discharges on electroencephalogram (EEG) were significantly associated with mass effect findings on brain imaging (OR 3.5, CI 1.05–11.69). Conclusion Hunt and Hess grade 5 and vasospasm are independent risk factors for in-hospital seizures. In addition, mass effect is an independent risk factor for epileptiform discharges on EEG. Patients with these risk factors may benefit from continuous EEG. Our results may indicate that there is no association between electrographic seizures and development of epilepsy. Highlights Hunt and Hess grade 5 and vasospasm are risk factors for in-hospital seizures. Mass effect is a risk factor for epileptiform discharges on electroencephalogram (EEG). Patients with Hunt and Hess grade 5 and vasospasm, mass effect, would benefit from EEG.

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    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  6. [해외논문]   Contents  


    World neurosurgery v.115 ,pp. i - xvi , 2018 , 1878-8750 ,

    초록

    Objective This study aimed to determine risk factors for inpatient seizures and long-term epilepsy in patients receiving coil embolization for aneurysm-associated subarachnoid hemorrhage. Methods A retrospective chart review was conducted for patients admitted to the University of Pittsburgh Medical Center from 2010 to 2014 for subarachnoid hemorrhage. Only patients with coil embolization were included. Variables such as subdural hematoma, cerebral infarction, postoperative vasospasm, cerebral edema, and mass effect were collected. After discharge, patients were followed up to determine whether epilepsy had developed. The χ 2 test was used to assess univariate associations. Multivariable associations were assessed with a binary logistic regression model. Results The study included 175 patients, of whom 16 (9.1%) of the patients had seizures while they were inpatients. Five out of 73 patients met the criteria for epilepsy at follow-up. None of the patients with epilepsy after discharge had electrographic seizures while hospitalized. Vasospasm (odds ratio [OR] 6.88, 95% confidence interval [CI] 1.81–26.25), and Hunt and Hess grade 5 (OR 26.16, 95% CI 3.95–173.49) were significantly associated with in-hospital seizures in a multivariable analysis. Epileptiform discharges on electroencephalogram (EEG) were significantly associated with mass effect findings on brain imaging (OR 3.5, CI 1.05–11.69). Conclusion Hunt and Hess grade 5 and vasospasm are independent risk factors for in-hospital seizures. In addition, mass effect is an independent risk factor for epileptiform discharges on EEG. Patients with these risk factors may benefit from continuous EEG. Our results may indicate that there is no association between electrographic seizures and development of epilepsy. Highlights Hunt and Hess grade 5 and vasospasm are risk factors for in-hospital seizures. Mass effect is a risk factor for epileptiform discharges on electroencephalogram (EEG). Patients with Hunt and Hess grade 5 and vasospasm, mass effect, would benefit from EEG.

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    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  7. [해외논문]   The Effect of Underlying Liver Disease on Perioperative Outcomes Following Craniotomy for Tumor: An American College of Surgeons National Quality Improvement Program Analysis  

    Goel, Nicholas J. (Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA ) , Abdullah, Kalil G. (Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA ) , Choudhri, Omar A. (Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA ) , Kung, David K. (Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA ) , Lucas, Timothy H. (Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA ) , Chen, H. Isaac (Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA)
    World neurosurgery v.115 ,pp. e85 - e96 , 2018 , 1878-8750 ,

    초록

    Background The association between underlying liver disease and poor surgical outcomes has been well documented across a wide variety of surgical disciplines. However, little is known about the importance of liver disease in neurosurgery. In this report, we assess the independent effect of liver disease on perioperative outcomes in patients undergoing craniotomy for tumor. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for patients undergoing craniotomy for tumor from 2006 to 2015. Presence and severity of underlying liver disease was assessed with the aspartate aminotransferase-to-platelet ratio index and the Model for End-Stage Liver Disease-Sodium scores, computed from preoperative laboratory values. Results Among 11,897 patients, mild and advanced disease was identified in 2.4% and 1.9% of patients, respectively. Rates of 30-day mortality were 4.5% and 15.8% in these patients, compared with 3.1% in patients with healthy livers. The 30-day complication rate was 40.3%, 28.0%, and 19.8% in patients with advanced, mild, and no liver disease, respectively. In multivariate analysis, the presence of any liver disease (mild or advanced) was independently associated with mortality (OR = 2.46; 95% confidence interval [CI], 1.68–3.59; P P = 0.001), and length of hospital stay over 10 days (OR, 1.35; 95% CI, 1.07–1.70; P = 0.012), when compared with 13 covariates. Liver disease showed the strongest independent association with mortality of all risk factors analyzed. Conclusions Liver disease is an independent predictor of poor 30-day outcomes following craniotomy for tumor. Consideration of underlying liver function can have a role in surgical decision making and postoperative care for these patients. Highlights Underlying liver disease was discovered in 4.3% of patients undergoing craniotomy. Liver disease independently predicts greater morbidity and length of hospital stay. Among 13 risk factors, liver disease is the strongest predictor of 30-day mortality.

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  8. [해외논문]   Intracranial Arterial Fenestration and Risk of Aneurysm: A Systematic Review and Meta-Analysis  

    Guo, Xiang (Department of Medical Imaging, the Affiliated Hospital of Jining Medical University, Jining, China ) , Gao, Lingyun (Department of Medical Imaging, the Affiliated Hospital of Jining Medical University, Jining, China ) , Shi, Zhitao (Department of Medical Imaging, the Affiliated Hospital of Jining Medical University, Jining, China ) , Liu, Deguo (Department of Medical Imaging, the Affiliated Hospital of Jining Medical University, Jining, China ) , Wang, Yuhong (Department of Medical Imaging, the Affiliated Hospital of Jining Medical University, Jining, China ) , Sun, Zhanguo (Department of Medical Imaging, the Affiliated Hospital of Jining Medical University, Jining, China ) , Chen, Yueqin (Department of Medical Imaging, the Affiliated Hospital of Jining Medical University, Jining, China ) , Chen, Weijian (Department of Medical Imaging, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China ) , Yang, Yunjun (Department of Medical Imaging, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China)
    World neurosurgery v.115 ,pp. e592 - e598 , 2018 , 1878-8750 ,

    초록

    Background Previous studies have been inconsistent regarding risk for intracranial aneurysm related to intracranial arterial fenestration. We conducted a meta-analysis to examine the association between intracranial arterial fenestration and risk of aneurysm. Methods We performed a systematic review of PubMed and Embase through August 2017 for potentially relevant articles. Summary odds ratios with 95% confidence intervals were pooled using a random-effects model. Results Of 446 articles found, 7 were selected for meta-analysis. Pooled odds ratios revealed an increased risk of aneurysm owing to fenestration of 1.50 (95% confidence interval, 0.61–3.71; P = 0.38). Subgroup analyses based on the population presenting with various indications suggested that pooled odds ratios indicated a significant increase in risk for aneurysm of 2.43 (95% confidence interval, 1.04–5.69; P = 0.04). Conclusions Our findings indicate that intracranial arterial fenestration may be associated with increased risk for aneurysm formation. Highlights Pooled OR indicated a significantly increased aneurysm risk owing to fenestration. There was no significant relationship between fenestration and aneurysm in patients with sSAH. Fenestration may be a marker of aneurysm formation in the general population.

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    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  9. [해외논문]   Surgical Treatment of Lower Cervical Fracture-Dislocation with Spinal Cord Injuries by Anterior Approach: 5- to 15-Year Follow-Up  

    Gao, Wenjie (To whom correspondence should be addressed: Biao Wang or Lingbo Kong, M.D. ) , Wang, Biao (To whom correspondence should be addressed: Biao Wang or Lingbo Kong, M.D.) , Hao, Dingjun , Zhu, Ziqi , Guo, Hua , Li, Hui , Kong, Lingbo
    World neurosurgery v.115 ,pp. e137 - e145 , 2018 , 1878-8750 ,

    초록

    Background Lower cervical fracture-dislocations frequently occur with spinal cord injuries. There is no clear consensus on best treatment option. Anterior approach surgery with direct decompression and reduction has become widely accepted. We assessed clinical outcomes of anterior approach surgery in a retrospective cohort study. Methods From January 2001 to January 2011, 312 patients with lower cervical spine fracture-dislocation with spinal cord injuries who were treated by the anterior approach were retrospectively analyzed. Of 312 patients, 218 (70%; 121 men and 97 women) met inclusion criteria. Clinical efficacy was evaluated using Odom's criteria and statistical analysis based on Cobb angle of kyphosis and Neck Disability Index and Japanese Orthopedic Association scores. Neurofunctional recovery of patients was assessed by the American Spinal Injury Association system. Results Average follow-up was 8.9 ± 2.9 years (range, 5–15 years). Kyphosis angle and Neck Disability Index and Japanese Orthopaedic Association scores were significantly changed from preoperative values of 10.6° ± 8.9° and 39.7 ± 4.3 and 7.6 ± 2.4 to last follow-up values of −5.2° ± 8.6° and 10.8 ± 4.6 and 15.6 ± 1.2 ( P Conclusions For lower cervical fracture-dislocation with spinal cord injuries, satisfactory clinical outcomes can be obtained with an anterior approach. The anterior approach restored normal cervical spine structure and promoted functional recovery to achieve a good long-term curative effect. Highlights There is no clear consensus on the best treatment option for lower cervical fracture-dislocation. In recent years, anterior approach surgery with direct decompression and reduction has been widely accepted. We assessed clinical outcomes of anterior approach surgery in a retrospective cohort study. The anterior approach restored normal cervical spine structure and promoted functional recovery. Satisfactory clinical outcomes can be obtained for lower cervical fracture-dislocation with spinal cord injuries.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

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  10. [해외논문]   Factors Related to the Clinical Outcomes of Surgery for Extra–Temporal Lobe Epilepsy: Long-Term Follow-Up Results  

    Hwang, Yoon Ha (Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea ) , Jung, Na Young (Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea ) , Park, Chang Kyu (Department of Neurosurgery, Kyung Hee University College of Medicine, Seoul, Korea ) , Chang, Won Seok (Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea ) , Jung, Hyun Ho (Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea ) , Chang, Jin Woo (Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea)
    World neurosurgery v.115 ,pp. e645 - e649 , 2018 , 1878-8750 ,

    초록

    Background Compared with temporal lobe epilepsy, the surgical outcome in extra–temporal lobe epilepsy (ETLE) is unsatisfactory. However, advances in diagnostic and surgical techniques have led to improved prognosis. This study investigated the outcomes and prognostic factors of ETLE based on long-term follow-up of patients undergoing surgical treatment for ETLE at a single institution. Methods We retrospectively reviewed medical records of 58 patients with refractory ETLE who underwent resection between 2003 and 2015. Clinical outcome was evaluated by Engel classification. Parameters analyzed as prognostic factors were clarity of the lesion on magnetic resonance imaging, completeness of resection, and histologic diagnoses. Results Of 58 patients (62.1%), 36 had a seizure-free state (Engel I) after surgery over a mean follow-up of 58 months. The most common pathology was cortical dysplasia (27 patients; 46.5%). In univariate analysis, only complete resection was a statistically significant prognostic factor ( P = 0.001). Conclusions Surgery is effective treatment for ETLE (79.4%, Engel I and II). Complete resection predicts more satisfactory results in patients with intractable ETLE. Highlights Complete resection is associated with improved ETLE outcomes. Abnormality on MRI might not be significantly related to surgical outcomes. Presurgical evaluation, using a multidisciplinary approach, is vital for ETLE surgery.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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