Background Although objective assessment of perioperative imaging provides a rigorous evaluation method of neurosurgical techniques in epilepsy, its use remains far from mainstream. Open surgery remains the gold standard for treatment of mesial temporal lobe epilepsy (MTLE); however, stereotactic laser ablation is a promising minimally invasive alternative. Nevertheless, the variables that may affect seizure outcome in stereotactic laser amygdalohippocampectomy (SLAH) remain unclear. While an objective endpoint such as ablated mesial temporal volumes may be significant, a standard methodology for calculating such volumes has yet to be proposed.
{"title":"A Methodology for Systematic Volumetric Analysis of Perioperative Cranial Imaging in Neurosurgical Patients","authors":"K. Atsina, R. Gorniak, A. Sharan, Chengyuan Wu","doi":"10.29046/JHNJ.011.2.002","DOIUrl":"https://doi.org/10.29046/JHNJ.011.2.002","url":null,"abstract":"Background Although objective assessment of perioperative imaging provides a rigorous evaluation method of neurosurgical techniques in epilepsy, its use remains far from mainstream. Open surgery remains the gold standard for treatment of mesial temporal lobe epilepsy (MTLE); however, stereotactic laser ablation is a promising minimally invasive alternative. Nevertheless, the variables that may affect seizure outcome in stereotactic laser amygdalohippocampectomy (SLAH) remain unclear. While an objective endpoint such as ablated mesial temporal volumes may be significant, a standard methodology for calculating such volumes has yet to be proposed.","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117332871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ba Daniel Moadel, G. Doucet, D. Pustina, R. Rider, Ba Nathan Taylor, P. Barnett, M. Sperling, A. Sharan, J. Tracy
Recommended Citation Moadel, BA, Daniel; Doucet, PhD, Gaelle Eve; Pustina, PhD, Dorian; Rider, PhD, Robert; Taylor, BA, Nathan; Barnett, MS, Paul; Sperling, MD, Michael R.; Sharan MD, Ashwini; and Tracy, PhD, Joseph l. (2015) "Emotional/Psychiatric Symptom Change and Amygdala Volume After Anterior Temporal Lobectomy," JHN Journal: Vol. 10 : Iss. 1 , Article 4. DOI: https://doi.org/10.29046/JHNJ.010.1.003 Available at: https://jdc.jefferson.edu/jhnj/vol10/iss1/4
Moadel，文学士，Daniel;杜塞博士，盖尔·伊夫;普京娜博士，多里安人;莱德博士，罗伯特;泰勒，文学士，内森;巴奈特，MS，保罗;斯珀林，医学博士，迈克尔r;Sharan MD, Ashwini;和Tracy博士，Joseph l. (2015)“前颞叶切除术后情绪/精神症状改变与杏仁核体积”，《中华医学会期刊》第10卷第1期，第4篇。DOI: https://doi.org/10.29046/JHNJ.010.1.003可在:https://jdc.jefferson.edu/jhnj/vol10/iss1/4
{"title":"Emotional/Psychiatric Symptom Change and Amygdala Volume After Anterior Temporal Lobectomy","authors":"Ba Daniel Moadel, G. Doucet, D. Pustina, R. Rider, Ba Nathan Taylor, P. Barnett, M. Sperling, A. Sharan, J. Tracy","doi":"10.29046/JHNJ.010.1.003","DOIUrl":"https://doi.org/10.29046/JHNJ.010.1.003","url":null,"abstract":"Recommended Citation Moadel, BA, Daniel; Doucet, PhD, Gaelle Eve; Pustina, PhD, Dorian; Rider, PhD, Robert; Taylor, BA, Nathan; Barnett, MS, Paul; Sperling, MD, Michael R.; Sharan MD, Ashwini; and Tracy, PhD, Joseph l. (2015) \"Emotional/Psychiatric Symptom Change and Amygdala Volume After Anterior Temporal Lobectomy,\" JHN Journal: Vol. 10 : Iss. 1 , Article 4. DOI: https://doi.org/10.29046/JHNJ.010.1.003 Available at: https://jdc.jefferson.edu/jhnj/vol10/iss1/4","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"329 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115457747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Case Report and Overview of Familial Cerebral Cavernous Malformation Pathogenesis in an Adult Patient","authors":"B. Arul, O. Khanna, M. Gooch","doi":"10.29046/JHNJ.013.2.003","DOIUrl":"https://doi.org/10.29046/JHNJ.013.2.003","url":null,"abstract":"","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125356262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective and Importance: To describe the clinical presentation and neuropathological findings of metastatic cerebral aneurysms of bronchogenic origin. Metastatic bronchogenic cerebral aneurysms are exceptionally rare and have only been reported in association with high grade hemorrhage. Clinical Presentation: One patient presenting with a history of headache, speech difficulty, left-sided “numbness”, left seventh nerve palsy and left hemiparesis was found to have intraparenchymal and subarachnoid hemorrhage with an aneurysm of the right distal Sylvian middle cerebral artery. Intervention: Pterional craniotomy with excision of mycotic segment. Surgical specimen sent to pathology for routine histology and immunohistochemistry. Conclusion: Patients with metastatic cerebral aneuryms of bronchogenic origin usually present with subarachnoid hemorrhage, contrary to prior observations that “hemorrhage from neoplasia-induced aneurysms is paradoxically rare.” A tumor embolus should be considered in the differential diagnosis of a mycotic aneurysm. Cerebral aneurysms have been reported as a complication of primary extracranial neoplasms. The preponderance of such cases has been associated with cardiac myxomas and choriocarcinomas. Olmsted and McGee5 report approximately a 45% systemic embolization rate, half of which may be cerebral, in patients with left atrial myxoma. Weir et al.7 described mycotic aneurysms from choriocarcinoma as specifically being distal, lobulated, and fusiform. Pullar et al.6 reported a series of eight cases of metastatic cerebral aneurysms secondary to choriocarcinoma. There have only been four reported cases of metastatic cerebral aneurysm of bronchogenic origin1-4 The first case was described in 1982 by Ho2. Ho described a fatal intracerebral hemorrhage associated with an aneurysm in the medial aspect of the occipital lobe. Histologically, the lumen of the vessel contained collections of neoplastic cells that had invaded the vessel wall and destroyed the native cytoarchitecture. Kochi et al.3 described an intracerebral hematoma from rupture of a metastatic cerebral bronchogenic aneurysm in a cortical branch of the left posterior temporal artery. Murata et al.4 reported intracerebral hematoma from rupture of a metastatic cerebral bronchogenic aneurysm from a cortical branch of the posterior cerebral artery. Gliemroth et al.1 reported recurrent and fatal subarachnoid hemorrhage from rupture of a metastatic cerebral bronchogenic aneurysm of the anterior inferior cerebellar artery. This patient also developed a mycotic neoplastic aneurysm in the contralateral anterior inferior cerebellar artery. Previous reports* of metastatic cerebral aneurysms postulated a low rate of hemorrhage. The four cases reported to date of metastatic cerebral bronchogenic aneurysm and our case, representing the fifth, have all presented with high grade subarachnoid hemorrhage. Case Report A 43-year-old female with a history of hypertension, asthma, intraven
{"title":"A Metastatic Middle Cerebral Artery Aneurysm Caused by an Intraluminal Bronchogenic Tumor Embolus","authors":"C. Randazzo, A. Sharan","doi":"10.29046/JHNJ.004.3.006","DOIUrl":"https://doi.org/10.29046/JHNJ.004.3.006","url":null,"abstract":"Objective and Importance: To describe the clinical presentation and neuropathological findings of metastatic cerebral aneurysms of bronchogenic origin. Metastatic bronchogenic cerebral aneurysms are exceptionally rare and have only been reported in association with high grade hemorrhage. Clinical Presentation: One patient presenting with a history of headache, speech difficulty, left-sided “numbness”, left seventh nerve palsy and left hemiparesis was found to have intraparenchymal and subarachnoid hemorrhage with an aneurysm of the right distal Sylvian middle cerebral artery. Intervention: Pterional craniotomy with excision of mycotic segment. Surgical specimen sent to pathology for routine histology and immunohistochemistry. Conclusion: Patients with metastatic cerebral aneuryms of bronchogenic origin usually present with subarachnoid hemorrhage, contrary to prior observations that “hemorrhage from neoplasia-induced aneurysms is paradoxically rare.” A tumor embolus should be considered in the differential diagnosis of a mycotic aneurysm. Cerebral aneurysms have been reported as a complication of primary extracranial neoplasms. The preponderance of such cases has been associated with cardiac myxomas and choriocarcinomas. Olmsted and McGee5 report approximately a 45% systemic embolization rate, half of which may be cerebral, in patients with left atrial myxoma. Weir et al.7 described mycotic aneurysms from choriocarcinoma as specifically being distal, lobulated, and fusiform. Pullar et al.6 reported a series of eight cases of metastatic cerebral aneurysms secondary to choriocarcinoma. There have only been four reported cases of metastatic cerebral aneurysm of bronchogenic origin1-4 The first case was described in 1982 by Ho2. Ho described a fatal intracerebral hemorrhage associated with an aneurysm in the medial aspect of the occipital lobe. Histologically, the lumen of the vessel contained collections of neoplastic cells that had invaded the vessel wall and destroyed the native cytoarchitecture. Kochi et al.3 described an intracerebral hematoma from rupture of a metastatic cerebral bronchogenic aneurysm in a cortical branch of the left posterior temporal artery. Murata et al.4 reported intracerebral hematoma from rupture of a metastatic cerebral bronchogenic aneurysm from a cortical branch of the posterior cerebral artery. Gliemroth et al.1 reported recurrent and fatal subarachnoid hemorrhage from rupture of a metastatic cerebral bronchogenic aneurysm of the anterior inferior cerebellar artery. This patient also developed a mycotic neoplastic aneurysm in the contralateral anterior inferior cerebellar artery. Previous reports* of metastatic cerebral aneurysms postulated a low rate of hemorrhage. The four cases reported to date of metastatic cerebral bronchogenic aneurysm and our case, representing the fifth, have all presented with high grade subarachnoid hemorrhage. Case Report A 43-year-old female with a history of hypertension, asthma, intraven","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127349578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Spinal Cord Arteriovenous Malformations (SCAVMs) are rare vascular lesions. AVMs of the cervical spinal cord are a small proportion of these. SCAVMs are generally classified into four categories based on location and structure. They may cause significant neurologic symptoms by direct mass effect or venous congestion. Surgery of these lesions may be associated with considerable morbidity and thus a multimodality approach using endovascular and radiosurgery techniques is required.Spinal Cord AVMs are rare lesions, only one-tenth as common as their cranial counterparts 1 . They may clinically present with progressive symptoms from direct mass effect or venous hypertension or acutely after hemorrhage. In 1992, Anson and Spetzler, published the most widely used classification of SCAVMs (Table 1) 2 .Type II or Glomus AVMs typically have multiple arterial feeders and drain into a venous plexus around the spinal cord. They can be particularly difficult to treat because they are intramedullary, within the spinal cord parenchyma. The mortality rate related to Type II AVMs has been reported as close to 18%. After initial hemorrhage, the rebleed rate is 10% within the first month and 40% within the first year
{"title":"Ventral Intramedullary Cervical Spinal Cord AVM","authors":"Sanjay Yadla, P. Jabbour, R. Rosenwasser","doi":"10.29046/JHNJ.004.3.008","DOIUrl":"https://doi.org/10.29046/JHNJ.004.3.008","url":null,"abstract":"Abstract Spinal Cord Arteriovenous Malformations (SCAVMs) are rare vascular lesions. AVMs of the cervical spinal cord are a small proportion of these. SCAVMs are generally classified into four categories based on location and structure. They may cause significant neurologic symptoms by direct mass effect or venous congestion. Surgery of these lesions may be associated with considerable morbidity and thus a multimodality approach using endovascular and radiosurgery techniques is required.Spinal Cord AVMs are rare lesions, only one-tenth as common as their cranial counterparts 1 . They may clinically present with progressive symptoms from direct mass effect or venous hypertension or acutely after hemorrhage. In 1992, Anson and Spetzler, published the most widely used classification of SCAVMs (Table 1) 2 .Type II or Glomus AVMs typically have multiple arterial feeders and drain into a venous plexus around the spinal cord. They can be particularly difficult to treat because they are intramedullary, within the spinal cord parenchyma. The mortality rate related to Type II AVMs has been reported as close to 18%. After initial hemorrhage, the rebleed rate is 10% within the first month and 40% within the first year","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121323679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Endovascular Neurosurgery: A History of Electricity, Balloons, Wires and Glue","authors":"Fernando Gonzalez, M. Maltenfort","doi":"10.29046/JHNJ.004.4.004","DOIUrl":"https://doi.org/10.29046/JHNJ.004.4.004","url":null,"abstract":"","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128342584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Extending a previous Phase I study, we report the results of a second Phase I autologous tumor cell vaccination trial for patients with recurrent glioblastomas (IND 14379-101, NCT01550523). Methods: Following surgery, subjects were treated by 24 hour implantation in the rectus sheath of ten biodiffusion chambers containing irradiated autologous tumor cells and IGF-1R AS ODN with the objective of stimulating tumor immunity. Patients were monitored for safety, clinical and radiographic as well as immune responses. Results: There were no Grade 3 toxicities related to protocol treatment and overall median survival from initial diagnosis was 91.4 weeks. Two protocol survival cohorts with median survivals of 48.2 and 10 weeks were identified and predicted by our pre-treatment assessments of immune function, corroborated by post-vaccination pro-inflammatory cytokine profiles. Longer survival subjects had imaging findings including transient elevations in cerebral blood volume (rCBV) and sustained elevations of apparent diffusion coefficient (ADC) interpreted as transient hyperemia and cell loss. Conclusions: The vaccine paradigm was well-tolerated with a favorable median survival. Our data support this as a novel treatment paradigm that promotes anti-tumor immunity.
背景:在之前的I期研究的基础上，我们报告了针对复发性胶质母细胞瘤患者的第二项I期自体肿瘤细胞疫苗接种试验的结果(IND 14379-101, NCT01550523)。方法:手术后，将10个生物扩散室植入直肌鞘24小时，其中含有辐照的自体肿瘤细胞和IGF-1R AS ODN，目的是刺激肿瘤免疫。对患者的安全性、临床和放射学以及免疫反应进行监测。结果:没有与方案治疗相关的3级毒性，从初次诊断开始的总中位生存期为91.4周。我们通过治疗前免疫功能评估确定和预测了两个方案生存队列，中位生存期为48.2周和10周，接种后促炎细胞因子谱证实了这一点。存活时间较长的受试者的影像学表现包括脑血容量(rCBV)的短暂升高和表观扩散系数(ADC)的持续升高，解释为短暂充血和细胞损失。结论:疫苗模式耐受性良好，中位生存期较好。我们的数据支持这是一种促进抗肿瘤免疫的新治疗模式。
{"title":"Phase 1 Trial of Vaccination with Autologous Tumor Cells and Antisense Directed Against the Insulin Growth Factor Type 1 Receptor (IGF-1R AS ODN) in Patients with Recurrent Glioblastoma","authors":"D. Andrews, K. Judy, L. Harshyne, D. Hooper","doi":"10.29046/JHNJ.013.1.002","DOIUrl":"https://doi.org/10.29046/JHNJ.013.1.002","url":null,"abstract":"Background: Extending a previous Phase I study, we report the results of a second Phase I autologous tumor cell vaccination trial for patients with recurrent glioblastomas (IND 14379-101, NCT01550523). Methods: Following surgery, subjects were treated by 24 hour implantation in the rectus sheath of ten biodiffusion chambers containing irradiated autologous tumor cells and IGF-1R AS ODN with the objective of stimulating tumor immunity. Patients were monitored for safety, clinical and radiographic as well as immune responses. Results: There were no Grade 3 toxicities related to protocol treatment and overall median survival from initial diagnosis was 91.4 weeks. Two protocol survival cohorts with median survivals of 48.2 and 10 weeks were identified and predicted by our pre-treatment assessments of immune function, corroborated by post-vaccination pro-inflammatory cytokine profiles. Longer survival subjects had imaging findings including transient elevations in cerebral blood volume (rCBV) and sustained elevations of apparent diffusion coefficient (ADC) interpreted as transient hyperemia and cell loss. Conclusions: The vaccine paradigm was well-tolerated with a favorable median survival. Our data support this as a novel treatment paradigm that promotes anti-tumor immunity.","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132915488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Zussman, A. Flanders, R. Rosenwasser, P. Jabbour
{"title":"Behind the Technology: CT Perfusion in the Setting of Acute Stroke Management","authors":"B. Zussman, A. Flanders, R. Rosenwasser, P. Jabbour","doi":"10.29046/JHNJ.005.2.001","DOIUrl":"https://doi.org/10.29046/JHNJ.005.2.001","url":null,"abstract":"","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"515 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132592429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ba Bs Brian Nasca, Matthew J. Viereck, N. Chalouhi, P. Jabbour, R. Rosenwasser, S. Tjoumakaris
{"title":"Stereotactic Radiosurgery for Management of Cavernous Malformations","authors":"Ba Bs Brian Nasca, Matthew J. Viereck, N. Chalouhi, P. Jabbour, R. Rosenwasser, S. Tjoumakaris","doi":"10.29046/JHNJ.010.1.002","DOIUrl":"https://doi.org/10.29046/JHNJ.010.1.002","url":null,"abstract":"","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128278379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：