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A Case Report of Early Surgical Intervention for Diffuse Idiopathic Skeletal Hyperostosis of the Cervical Spine: Challenges in Management 早期手术治疗弥漫性特发性颈椎骨性肥厚1例报告:管理上的挑战
Pub Date : 2023-08-05 DOI: 10.32598/irjns.9.14
M. Shafizad, Pooria Sobhanian, E. Ghadirzadeh, Rostam Poormousa, G. Godazandeh
Background and Importance: Diffuse idiopathic skeletal hyperostosis (DISH) can compress the trachea and esophagus when located in the cervical spine. In this report, we investigated whether it is preferable to perform the early surgical intervention in symptomatic patients or to wait and administer supportive care and perform late surgical intervention regardless of whether symptoms progress or not. Case Presentation: We present the case of a 70-year-old patient with diffuse idiopathic skeletal hyperostosis (DISH) causing significant dysphagia and unilateral vocal cord paresis, resulting in dyspnea and stridor. Imaging diagnostics revealed large osteophytes anterior to the cervical spine from C3 to C6 compressing the cervical spine. Significant clinical improvement was observed following the anterior resection of the patient's osteophytes. Conclusion: In order to achieve higher success and less recurrence, it is preferable to perform surgical intervention earlier in the disease's progression. However, more studies are necessary to confirm this because most of the present results are from case report articles and have less evidence.
背景和重要性:弥漫性特发性骨骼肥大(DISH)位于颈椎时会压迫气管和食道。在本报告中,我们调查了对有症状的患者进行早期手术干预,还是等待并给予支持性护理并进行晚期手术干预,无论症状是否进展。病例介绍:我们报告了一例70岁的弥漫性特发性骨骼肥大(DISH)患者,该患者导致严重的吞咽困难和单侧声带麻痹,导致呼吸困难和喘鸣。影像学诊断显示C3至C6颈椎前方有大块骨赘压迫颈椎。在对患者的骨赘进行前切除后,观察到显著的临床改善。结论:为了获得更高的成功率和更少的复发,最好在疾病进展的早期进行手术干预。然而,需要更多的研究来证实这一点,因为目前的大多数结果都来自病例报告文章,证据较少。
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引用次数: 0
Single Surgeon Experience of Adjacent Segment Disease and Related Risk Factors Following Posterior Decompression and Fusion in Lumbar Degenerative Disorders 腰椎退行性疾病后路减压融合术后相邻节段疾病的单一外科经验及相关危险因素
Pub Date : 2023-08-05 DOI: 10.32598/irjns.9.10
Kaveh Haddadi, Abdolrasool Alaee, Anoushe Ghafari, M. Khademloo
Background and Aim: This study aims to evaluate the frequency of adjacent segment disease (ASD) and its risk factors following posterior decompression and fusion in lumbar degenerative disorders. Methods and Materials/Patients: This retrospective cohort study was performed by reviewing the records of patients with spinal degeneration disorders who underwent lumbar fusion surgery and needed reoperation from 2013 to 2019. The participants were divided into two groups, including patients with ASD and non-ASD patients, and were compared in terms of age, sex, BMI, smoking, fusion level, surgical indications, follow-up times, laminectomy, cross-link device usage, imaging findings, fusion terminating in L1, L5 and S1, and reoperation. Results: Out of a total of 277 candidates, 181 met the inclusion criteria. In terms of gender distribution, 43.3% of the participants were male and 56.7% were female. The median age was 54 years in the ASD group and 48 years in the non-ASD group. The median follow-up of the patients was six years in the ASD group and five years in the non-ASD group. Forty patients (22.1%) developed ASD during this period. The final analysis showed a significant relationship between age, sex, indication for reoperation, repeated surgery, laminectomy, cross-link device use, imaging findings, and fusion terminating in L1. Conclusion: High body mass index, aging, lumbar spinal canal stenosis, reoperation, laminectomy at the upper fusion unit, cross-link device use, lumbar canal stenosis in imaging, and fusion to L1 vertebrae are considered risk factors for ASD.
背景与目的:本研究旨在评估腰椎退行性疾病后路减压融合术后邻段疾病(ASD)的发生频率及其危险因素。方法和材料/患者:本回顾性队列研究回顾了2013 - 2019年行腰椎融合术并需要再次手术的脊柱退行性疾病患者的记录。参与者分为两组,包括ASD患者和非ASD患者,并在年龄,性别,BMI,吸烟,融合水平,手术指征,随访时间,椎板切除术,交联装置使用,影像学表现,L1, L5和S1融合终止以及再手术方面进行比较。结果:277例患者中,有181例符合纳入标准。从性别分布来看,男性占43.3%,女性占56.7%。ASD组的中位年龄为54岁,非ASD组的中位年龄为48岁。ASD组患者的中位随访时间为6年,非ASD组为5年。40名患者(22.1%)在此期间发展为ASD。最终分析显示年龄、性别、再手术指征、重复手术、椎板切除术、交联装置的使用、影像学表现和L1融合终止之间存在显著关系。结论:高体重指数、衰老、腰椎管狭窄、再手术、椎板切除术、使用交联装置、影像学腰椎管狭窄、L1椎体融合是ASD的危险因素。
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引用次数: 0
The Effect of Curcumin on the Recovery of Severe Traumatic Brain Injury: A Double-blind Randomized Controlled Trial 姜黄素对重型颅脑损伤恢复的影响:一项双盲随机对照试验
Pub Date : 2023-07-15 DOI: 10.32598/irjns.9.3
M. Saatian, Masoome Rostayi, E. Jalili, Sara Ataei, A. Poormohammadi, M. Farhadian, A. Abdoli
Background and Aim: Traumatic brain injury (TBI) is one of the critical causes of death in trauma patients. In this study, the effect of nanocurcumin on the outcome of severe TBI was investigated for the first time in humans. Methods and Materials/Patients: This randomized, double-blind, and paralleled controlled study included 128 patients aged from 18 to 70 years with severe brain trauma. Patients were randomly assigned to control group (standard care treatment+placebo) and intervention group (standard care treatment+oral nanocurcumin). Changes in the level of consciousness, cerebral edema, kidney function, liver enzymes, sodium and potassium electrolytes, and brain function were followed up and compared until 6 months after discharge. Results: The Mean±SD in the intervention (14.44±31.86 years) and control patients (14.86±33.34 years) had no significant difference (P=0.543). Both groups were similar in terms of gender (P=0.669). The average level of consciousness in the intervention group increased by about 3 units (P=0.004) and more than 2 units (P=0.002) at discharge compared with the control group. By comparing the optimal performance of patients in the first (P=0.389) trimester and second (P=0.309) trimester after discharge, no significant difference was observed between the intervention and control groups. The amount of brain edema caused by severe brain trauma on the seventh day of treatment in the intervention group was lower than that in the control group (P=0.038). Conclusion: Administrating oral nanocurcumin supplement in patients with severe brain trauma along with their routine treatment is effective in improving brain edema and their level of consciousness without causing coagulation, and liver and kidney complications. These findings are not only statistically significant but also clinically vital.
背景与目的:创伤性脑损伤(TBI)是创伤患者死亡的重要原因之一。在这项研究中,首次在人类中研究了纳米姜黄素对严重TBI结果的影响。方法和材料/患者:这项随机、双盲、平行对照研究包括128名年龄在18-70岁之间的严重脑损伤患者。患者被随机分为对照组(标准护理治疗+安慰剂)和干预组(标准治疗+口服纳米姜黄素)。随访并比较意识水平、脑水肿、肾功能、肝酶、钠和钾电解质以及脑功能的变化,直到出院后6个月。结果:干预组(14.44±31.86岁)和对照组(14.86±33.34岁)的平均±SD无显著差异(P=0.543)。两组在性别上相似(P=0.669)。干预组出院时的平均意识水平比对照组提高了约3个单位(P=0.004)和2个单位以上(P=0.002)。通过比较患者出院后妊娠早期(P=0.389)和中期(P=0.309)的最佳表现,干预组和对照组之间没有观察到显著差异。干预组治疗第7天严重脑损伤引起的脑水肿量低于对照组(P=0.038),以及肝脏和肾脏并发症。这些发现不仅具有统计学意义,而且在临床上具有重要意义。
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引用次数: 0
Estimating Hemodynamic Significant Deformations of Brachiocephalic Arteries Using CT Perfusion CT灌注评估腕头动脉血流动力学显著畸形
Pub Date : 2023-07-15 DOI: 10.32598/irjns.9.7
V. Krylov, E. Grigorieva, Natalia P. Polunina, V.V. Lukyanchikov, V. Dalibaldyan
Background and Aim: The cause of most strokes is associated with the pathology of the carotid arteries. Many modern researchers suggest preventive surgery in the presence of arterial deformity to prevent strokes. The hemodynamic significance of carotid deformities is determined by morphological and functional disorders at the level of tortuosity, the reaction of cerebral blood flow is not often considered. Here, we assume that cerebral autoregulation in tortuosity can be different. Methods and Materials/Patients: A total of 64 patients (31-75 years old) with 110 carotid deformities were analyzed. Duplex color mapping, computed tomography angiography of carotid arteries, and computed tomography perfusion were performed by estimating the absolute and average values of cerebral blood flow (mL/100 g/min), cerebral blood volume (mL/100 g), Mean transit time (MTT) (s) in similar areas of the cortex. In 6 patients, the acetazolamide challenge test was used to evaluate the autoregulatory disturbances. Results: According to computed tomography angiography and duplex color mapping, 18(28.1%) patients had unilateral tortuosity, and 46(71.9%) patients had bilateral tortuo s ity. Hemodynamically significant deformities were detected in 33 cases (30% of tortuosity). In 54 cases (49% of tortuosity), the deformities were accompanied by carotid stenosis. Perfusion disorders were detected in 23 of 64 patients (35.9%). In the majority of cases (75% of all perfusion disorders), hypoperfusion was diagnosed on the side corresponding to the maximum degree of stenosis, regardless of the location of the tortuosity. Neurologically significant hypoperfusion, compensated by collateral blood flow revealed only in 7.8% of cases of hemodynamic significant internal carotid artery deformity without concomitant atherosclerosis. Conclusion: The decision on surgical correction of carotid artery tortuosity should be made while considering both local changes in hemodynamics and proven violations of autoregulation of cerebral blood flow, especially in patients with concomitant carotid stenosis.
背景和目的:大多数中风的病因与颈动脉的病理学有关。许多现代研究人员建议在动脉畸形的情况下进行预防性手术以预防中风。颈动脉畸形的血液动力学意义是由扭曲程度的形态和功能紊乱决定的,脑血流的反应通常不被考虑。在这里,我们假设大脑在曲折中的自动调节可能是不同的。方法和材料/患者:对64例(31-75岁)颈动脉畸形患者110例进行分析。通过估计大脑皮层相似区域的脑血流量(mL/100 g/min)、脑血容量(mL/100 g)、平均转运时间(MTT)的绝对值和平均值,进行双色标测、颈动脉计算机断层摄影血管造影和计算机断层摄影灌注。在6名患者中,乙酰唑胺激发试验用于评估自身调节障碍。结果:根据计算机断层造影和双色标测,单侧迂曲18例(28.1%),双侧迂曲46例(71.9%)。在33例(30%的弯曲)中检测到血液动力学上显著的畸形。在54例(49%的扭曲)中,畸形伴有颈动脉狭窄。64例患者中有23例(35.9%)检测到灌注障碍。在大多数病例(占所有灌注障碍的75%)中,无论弯曲的位置如何,都在对应最大狭窄程度的一侧诊断为灌注不足。在没有伴随动脉粥样硬化的血液动力学显著颈内动脉畸形病例中,只有7.8%的病例显示出神经系统显著的低灌注,并由侧支血流补偿。结论:在决定颈动脉弯曲的手术矫正时,应同时考虑血流动力学的局部变化和已证实的违反脑血流自动调节的行为,尤其是在伴有颈动脉狭窄的患者中。
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引用次数: 0
The Attitude of Neurosurgeons Toward Telemedicine During COVID-19 Pandemic 新冠肺炎大流行期间神经外科医生对远程医疗的态度
Pub Date : 2023-06-25 DOI: 10.32598/irjns.9.5
H. Ebrahimi, Hesam Azimi, Z. Kolahchi, Z. Gholami, Shahin Nasseri, Maryam Adib, A. Amirjamshidi, M. Shirani Bidabadi, A. Pour-Rashidi
Background and Aim: Telemedicine can be considered a primary modality of patient care for non-emergent conditions in the COVID-19 era. The usage and expansion of telemedicine are important and inevitable issues. We decided to investigate the neurosurgeons’ perspective on telemedicine in the treatment and follow-up of neurosurgical patients during the COVID-19 period. Methods and Materials/Patients: This cross-sectional study was carried out in the Department of Neurosurgery, Tehran, from June 2021 to July 2021. An internet-based questionnaire was distributed among all postgraduate and assistant neurosurgeons at the Tehran University of Medical Sciences. Statistical analysis was performed using SPPS (IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp; 2016). Results: This study was performed among 74 neurosurgeons who were mainly male (89.2%). Their mean age was 33.16±5.69 years (ranging from 27 to 62 years), and telemedicine has not been used previously in 37 precipitants (50%). Most precipitants preferred telemedicine for follow-up (93.24%). The common reasons for unimplemented telemedicine were determined by insurance and repayment obstacles (58.11%). Most of the participants believed that telemedicine should first be adapted to working condition and local setting, then it can be applied more in the future. Eventually, the effectiveness of telemedicine was controversial, according to most neurosurgeons’ replies. Conclusion: This study indicated neurosurgeons’ preference for telemedicine. They considered it a comfortable alternative. However, the effectiveness of telemedicine is controversial as it should be adapted first and then used extensively for future purposes. It is also suggested that future studies compare the results of this research with those of studies performed after the COVID-19 outbreak.
背景和目的:在新冠肺炎时代,远程医疗可以被视为非紧急情况下的主要患者护理方式。远程医疗的使用和扩展是重要且不可避免的问题。我们决定调查新冠肺炎期间神经外科医生对远程医疗在神经外科患者治疗和随访中的看法。方法和材料/患者:这项横断面研究于2021年6月至2021年7月在德黑兰神经外科进行。在德黑兰医学科学大学的所有研究生和助理神经外科医生中分发了一份基于互联网的问卷。使用SPPS(IBM SPSS Statistics for Windows,版本24.0。纽约州Armonk:IBM公司;2016)。结果:本研究在74名神经外科医生中进行,他们主要是男性(89.2%)。他们的平均年龄为33.16±5.69岁(从27岁到62岁不等),37名患者(50%)以前没有使用过远程医疗。大多数患者更喜欢远程医疗进行随访(93.24%)。未实施远程医疗的常见原因是保险和还款障碍(58.11%)。大多数参与者认为远程医疗应首先适应工作条件和当地环境,然后才能在未来得到更多应用。根据大多数神经外科医生的回答,远程医疗的有效性最终引起了争议。结论:本研究表明神经外科医生对远程医疗的偏好。他们认为这是一个舒适的选择。然而,远程医疗的有效性存在争议,因为它应该首先进行调整,然后广泛用于未来的目的。还建议未来的研究将这项研究的结果与新冠肺炎爆发后的研究结果进行比较。
{"title":"The Attitude of Neurosurgeons Toward Telemedicine During COVID-19 Pandemic","authors":"H. Ebrahimi, Hesam Azimi, Z. Kolahchi, Z. Gholami, Shahin Nasseri, Maryam Adib, A. Amirjamshidi, M. Shirani Bidabadi, A. Pour-Rashidi","doi":"10.32598/irjns.9.5","DOIUrl":"https://doi.org/10.32598/irjns.9.5","url":null,"abstract":"Background and Aim: Telemedicine can be considered a primary modality of patient care for non-emergent conditions in the COVID-19 era. The usage and expansion of telemedicine are important and inevitable issues. We decided to investigate the neurosurgeons’ perspective on telemedicine in the treatment and follow-up of neurosurgical patients during the COVID-19 period. Methods and Materials/Patients: This cross-sectional study was carried out in the Department of Neurosurgery, Tehran, from June 2021 to July 2021. An internet-based questionnaire was distributed among all postgraduate and assistant neurosurgeons at the Tehran University of Medical Sciences. Statistical analysis was performed using SPPS (IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp; 2016). Results: This study was performed among 74 neurosurgeons who were mainly male (89.2%). Their mean age was 33.16±5.69 years (ranging from 27 to 62 years), and telemedicine has not been used previously in 37 precipitants (50%). Most precipitants preferred telemedicine for follow-up (93.24%). The common reasons for unimplemented telemedicine were determined by insurance and repayment obstacles (58.11%). Most of the participants believed that telemedicine should first be adapted to working condition and local setting, then it can be applied more in the future. Eventually, the effectiveness of telemedicine was controversial, according to most neurosurgeons’ replies. Conclusion: This study indicated neurosurgeons’ preference for telemedicine. They considered it a comfortable alternative. However, the effectiveness of telemedicine is controversial as it should be adapted first and then used extensively for future purposes. It is also suggested that future studies compare the results of this research with those of studies performed after the COVID-19 outbreak.","PeriodicalId":53336,"journal":{"name":"Iranian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42025790","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}
引用次数: 0
Solitary Fibrous Tumor One Year After Posterior Cervical Laminectomy 颈椎后椎板切除术后1年孤立性纤维性肿瘤
Pub Date : 2023-06-25 DOI: 10.32598/irjns.9.9
Amirmohammad Mahabadi, Navid Askariardehjani, M. Rezvani, Mehdi Shafiei, Mehdi Mahmoodkhani
Background and importance: Cervical laminectomy and fixation (PCF) is a surgery used in the treatment of symptomatic patients who are resistant to medical therapy, though it can have serious complications affecting patient outcomes. Case Presentation: This case report describes a rare occurrence of a solitary fibrous tumor (SFT) at the site of a previous cervical laminectomy in a 45-year-old female patient. Following non-surgical treatment for paresthesia and weakness in the upper limbs due to cervical stenosis, the patient underwent cervical laminectomy from C3-6 without instrumentation. Conclusion: One year after surgery, the patient presented with severe pain and swelling at the surgical site, and radiological evaluation revealed a large mass in the para-vertebral muscular layer. The mass was removed, and microscopic evaluation revealed a typical SFT. The patient underwent an extension of laminectomy and fusion with lateral mass screw, and follow-up at six months showed no recurrence of the tumor.
背景和重要性:颈椎椎板切除术和固定术(PCF)是一种用于治疗对药物治疗有症状的患者的手术,尽管它可能会产生严重的并发症影响患者的预后。病例介绍:本病例报告描述了一位45岁女性患者在既往宫颈椎板切除术部位发生的罕见的单发纤维性肿瘤(SFT)。在对颈椎狭窄引起的感觉异常和上肢无力进行非手术治疗后,患者接受了C3-6颈椎椎板切除术,未使用器械。结论:术后1年,患者出现手术部位剧烈疼痛和肿胀,影像学检查显示椎旁肌肉层有大肿块。肿块被切除,镜下检查显示为典型的SFT。患者接受了扩展椎板切除术和侧块螺钉融合,6个月的随访显示肿瘤未复发。
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引用次数: 0
Chronic Pain and Psychological Interventions: A Systematic Review 慢性疼痛与心理干预:系统综述
Pub Date : 2023-06-25 DOI: 10.32598/irjns.9.8
F. Karimian, S. Saadat, M. Hosseininezhad
Background and Aim: Chronic pain is an emotional experience with unpleasant psychological consequences for individuals and society. This research aims to systematically review the psychological interventions implemented in people suffering from chronic pain. Methods and Materials/Patients: In this systematic review, the following keywords were searched in PubMed, Scopus, and Google Scholar databases: Chronic pain, psychological interventions, psychotherapy, psychology, clinical trials, and randomized clinical trials. The time span for the search was from January 2018 to December 2022. From a total of 2785 articles, 20 articles by 2078 contributors were selected for this review. Results: Cognitive behavioral therapy ranks first among psychological interventions for people with chronic pain. Also, to improve the quality of life and psychological health of these individuals from other psychological interventions, such as acceptance and commitment therapy, the mindfulness method has been used. This treatment has been effective in relieving pain, controlling pain, reducing stress and depression, and improving the quality of life. Using a randomized controlled trial design and follow-up were the strengths of these studies. Conclusion: The findings suggest that psychological interventions had the greatest impact on pain relief, quality of life, depression, and stress, respectively. Accordingly, it is proposed to use psychological interventions in addition to medical treatment.
背景和目的:慢性疼痛是一种情绪体验,对个人和社会造成不愉快的心理后果。本研究旨在系统地回顾在慢性疼痛患者中实施的心理干预措施。方法和材料/患者:在这篇系统综述中,在PubMed、Scopus和Google Scholar数据库中搜索了以下关键词:慢性疼痛、心理干预、心理治疗、心理学、临床试验和随机临床试验。搜索时间跨度为2018年1月至2022年12月。从总共2785篇文章中,选择了2078位撰稿人的20篇文章进行本次审查。结果:认知行为疗法在慢性疼痛患者的心理干预中排名第一。此外,为了通过其他心理干预措施,如接受和承诺疗法,提高这些人的生活质量和心理健康,已经使用了正念方法。这种治疗方法在缓解疼痛、控制疼痛、减轻压力和抑郁以及提高生活质量方面是有效的。采用随机对照试验设计和随访是这些研究的优势。结论:研究结果表明,心理干预对疼痛缓解、生活质量、抑郁和压力的影响最大。因此,建议在医疗之外使用心理干预。
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引用次数: 0
Optic Pathway Glioma Treatment: A Mini-review of the Current Literature 视神经胶质瘤的治疗:当前文献综述
Pub Date : 2023-06-25 DOI: 10.32598/irjns.9.4
A. Iranmehr
Background and Aim: Optic pathway glioma (OPG) is a chronic condition that needs a multidisciplinary management strategy. Most of these tumors are observed in the pediatric population and the tumor tends to stabilize after the child’s growth. This benign course can be observed mostly in neurofibromatosis 1 (NF1) patients, which are about half of the pediatric patients. Methods and Materials/Patients: The current literature in PubMed and Scopus databases was searched. The recent data regarding OPG and treatment options were reviewed to design this narrative mini-review. Results: The brief data extracted from 17 articles, cited in the reference list, were included in the study. Conclusion: Chemotherapy is the first and best treatment modality for patients with OPG. It is more useful at younger ages because it has lower rates of complications and cancer in the future compared with radiotherapy, the treatment of choice in previous decades for these patients. However, in recent practice, it has been substituted by chemotherapy because of its serious adverse effects on the pediatric population. Neurosurgical treatments for OPG are used for three main purposes, third ventricle obstruction-related hydrocephalus, biopsy, and tissue diagnosis for cases with an uncertain diagnosis, and tumor decompression due to mass effect on vital structures. Surgical decompression is not considered the first-line treatment in OPG. It can be used for patients with progressive exophthalmos with ipsilateral blindness or patients with refractory pain after adjuvant treatment. This short review discusses the main aspects of OPG treatment modalities.
背景与目的:视神经胶质瘤(OPG)是一种慢性疾病,需要多学科治疗策略。这些肿瘤大多在儿童人群中观察到,肿瘤在儿童生长后趋于稳定。这种良性过程主要见于1型神经纤维瘤病(NF1)患者,约占儿科患者的一半。方法和材料/患者:检索PubMed和Scopus数据库中的现有文献。我们回顾了最近关于OPG和治疗方案的数据,以设计这篇叙述性的小型综述。结果:从文献列表中引用的17篇文章中提取的简要数据被纳入研究。结论:化疗是OPG患者的首选和最佳治疗方式。它在年轻人中更有用,因为与放射治疗相比,它在未来的并发症和癌症发生率更低,放射治疗是过去几十年这些患者的治疗选择。然而,在最近的实践中,由于其对儿科人群的严重不良影响,它已被化疗所取代。OPG的神经外科治疗主要有三个目的:第三脑室梗阻相关的脑积水,对诊断不确定的病例进行活检和组织诊断,以及由于肿块对重要结构的影响而进行肿瘤减压。手术减压不被认为是OPG的一线治疗方法。可用于进行性突眼伴同侧盲或辅助治疗后难治性疼痛患者。这篇简短的综述讨论了OPG治疗方式的主要方面。
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引用次数: 0
Intradural Extramedullary Capillary Hemangioma of Spinal Cord: A Case Report and an Updated Review 脊髓硬膜内髓外毛细血管瘤1例报告及最新回顾
Pub Date : 2023-06-25 DOI: 10.32598/irjns.9.6
S. Pandey, N. Chore, Pankaj Kumar, Achal Saxena
Background and Importance: Capillary hemangiomas are benign tumors found on the skin and soft tissues. They rarely present as an intradural spinal tumor. Common differential diagnosis methods are schwannoma, hemangioblastoma, metastasis, and paragangliomas. Case Presentation: We report a case of a 38-year-old female with complaints of lower backache with radiation to lower limbs, in which the magnetic resonance imaging revealed an intradural tumor compressing the cauda equina nerve roots, arising from the L3 level. The patient underwent L2-L3 laminectomy with tumor excision with the preservation of nerve roots. Conclusion: Histopathology suggested capillary hemangioma and the patient improved symptomatically and no recurrence has been reported to date.
背景和重要性:毛细血管瘤是皮肤和软组织的良性肿瘤。它们很少表现为硬脊膜内肿瘤。常见的鉴别诊断方法有神经鞘瘤、血管母细胞瘤、转移瘤和副神经节瘤。病例介绍:我们报告一例38岁女性,主诉腰痛伴下肢放射,磁共振成像显示一硬膜内肿瘤压迫马尾神经根,起源于L3水平。患者行L2-L3椎板切除术,切除肿瘤,保留神经根。结论:组织病理学提示为毛细血管瘤,患者症状好转,无复发报道。
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引用次数: 0
Brain Mapping in Neurosurgery 神经外科中的脑制图
Pub Date : 2023-04-11 DOI: 10.32598/irjns.specialissue.e4
Background and Aim: Brain mapping is the study of the anatomy and function of the Central Nervous System (CNS). Brain mapping has many techniques and these techniques are permanently changing and updating. From the beginning, brain mapping was invasive and for brain mapping, electrical stimulation of the exposed brain was needed. However, nowadays brain mapping does not require electrical stimulation and often does not require any complex involvement of patients. To perform brain mapping, functional and structural neuroimaging has an essential role. The techniques for brain mapping include noninvasive techniques (structural and functional magnetic resonance imaging [fMRI], diffusion MRI [dMRI], magnetoencephalography [MEG], electroencephalography [EEG], positron emission tomography [PET], near-infrared spectroscopy [NIRS] and other non-invasive scanning techniques) and invasive techniques (direct cortical stimulation [DCS] and intracarotid amytal test [IAT] or wada test). Methods and Materials/Patients: This is a narrative study on brain mapping in neurosurgery. To provide up-to-date information on brain mapping in neurosurgery, we precisely reviewed brain mapping and neurosurgery articles. Using the keywords “brain mapping”, “neurosurgery”, “brain mapping techniques”, and “benefits of brain mapping”, all of the related articles were obtained from Google Scholar, PubMed, and Medline and were precisely studied. Results: To perform an effective and safe neurosurgical intervention, precise information about the structural and functional anatomy of the brain is obligatory. Based on the information on brain mapping, the selection of suitable patients for the operation, the plan of appropriate operative approach, and good surgical results can be acquired. To provide this information, we can use brain mapping techniques that were formerly applied in neuroscientific brain mapping efforts with noninvasive techniques, such as fMRI, MEG, dMRI, PET, etc and invasive techniques, such as DCS, IAT, etc. Conclusion: Functional brain mapping is a constantly evolving fact in neurosurgery. All stages in obtaining a functional image are complex and need knowledge of the basic physiologic and imaging features.
背景和目的:脑标测是对中枢神经系统(CNS)解剖和功能的研究。大脑映射有许多技术,这些技术正在永久地改变和更新。从一开始,大脑绘图就具有侵入性,对于大脑绘图,需要对暴露的大脑进行电刺激。然而,如今的大脑绘图不需要电刺激,通常也不需要患者的任何复杂参与。为了进行大脑绘图,功能和结构神经成像具有重要作用。脑标测技术包括非侵入性技术(结构和功能磁共振成像[fMRI]、扩散MRI[dMRI]、脑磁图[MEG]、脑电图[EG]、正电子发射断层扫描[PET]、近红外光谱[NIRS]和其他非侵入性扫描技术)和侵入性技术(直接皮层刺激[DCS]和颈动脉内肌试验[IAT]或wada试验)。方法和材料/患者:这是一项关于神经外科脑标测的叙述性研究。为了提供神经外科脑标测的最新信息,我们精确地回顾了脑标测和神经外科文章。使用关键词“脑映射”、“神经外科”、“脑映射技术”和“脑映射的好处”,所有相关文章都来自Google Scholar、PubMed和Medline,并进行了精确的研究。结果:为了进行有效和安全的神经外科干预,必须提供关于大脑结构和功能解剖的精确信息。根据脑图信息,可以选择合适的手术患者,制定合适的手术方法计划,并获得良好的手术效果。为了提供这些信息,我们可以使用以前应用于神经科学脑标测工作的脑标测技术,包括非侵入性技术,如fMRI、MEG、dMRI、PET等,以及侵入性技术(如DCS、IAT等)。结论:功能性脑标测在神经外科是一个不断发展的事实。获得功能图像的所有阶段都很复杂,需要了解基本的生理和成像特征。
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Iranian Journal of Neurosurgery
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