JHN Journal最新文献

{"title":"Deep Brain Stimulation: Awake and Asleep Options","authors":"Chengyuan Wu, A. Sharan","doi":"10.29046/JHNJ.011.2.001","DOIUrl":"https://doi.org/10.29046/JHNJ.011.2.001","url":null,"abstract":"“Good stereotactic surgery for movement disorders can be performed with or without the microelectrode, and poor surgical results can occur both with and without the microelectrode.” – Dr. Roy Bakay1 A BRIEF HISTORY OF DBS AND NEUROIMAGING Stereotactic neurosurgery is founded on the ability to accurately localize and safely access targets within the brain in a minimally-invasive manner. The stereotactic method was first described in 1908 by Sir Victor Horsley and Robert Clarke at University College London, where they developed an apparatus for animal experimentation that allowed them to establish a threedimensional Cartesian coordinate system for targeting. At that time, however, x-rays were the only available form of imaging the human body and as such, localizing intracranial targets relied on a combination of knowledge from anatomical atlases and the visualization of a few intracranial landmarks such as the pineal gland or the foramen of Monroe. These landmarks could be visualized by filling the ventricles with air (pneumoencephalogram) or a contrast medium (ventriculogram) [Figure 1]. In 1947, Ernst Spiegel and Henry Wycis created the first human stereotactic frame that allowed for lesioning of deep brain nuclei for the treatment of psychiatric disease.2","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"63 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123126832","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":"Evidence for Surgical Management of Facial Pain and Headache","authors":"Shannon W. Clark, Chengyuan Wu","doi":"10.29046/jhnj.011.2.010","DOIUrl":"https://doi.org/10.29046/jhnj.011.2.010","url":null,"abstract":"50 Headache and facial pain are a commonly encountered wide spectrum of complex medical conditions. Unfortunately, aside from treating trigeminal neuralgias, interest in surgical management of facial pain and headache from the neurosurgical community has been historically low. The reasons for this are multifactorial and include waning reimbursement, lack of evidence to support a number of pain procedures, and the absence of pain education in neurosurgical residency programs. In this article, we present surgical therapies currently available for headache and facial pain and review the published evidence for commonly performed neurosurgical treatments for craniofacial pains.","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128839226","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":"Advancements in Stereotactic Epilepsy Surgery: Stereo-EEG, Laser Interstitial Thermotherapy, and Responsive Neurostimulation","authors":"Michael J. Lang, Ameet Md Chitale, A. Sharan, Chengyuan Wu","doi":"10.29046/JHNJ.011.2.005","DOIUrl":"https://doi.org/10.29046/JHNJ.011.2.005","url":null,"abstract":"32 has found distinct advantages with SEEG in terms of safety and patient comfort for large bihemispheric implantations and in patients with prior history of craniotomy. Finally, SEEG allows for the generation of a four dimensional picture of epileptogenic zone and spread patterns, which is not reliably achieved with cortical surface recording techniques. As such, our center is actively pursuing SEEG-based white-matter recording guided by functional imaging to further define cerebral networks and spread patterns in epilepsy.","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123994464","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":"Advances in Functional Spine Neuroimaging","authors":"Feroze Mohamed, Chris Conklin, S. Saksena, M. Alizadeh, D. Middleton","doi":"10.29046/JHNJ.011.2.008","DOIUrl":"https://doi.org/10.29046/JHNJ.011.2.008","url":null,"abstract":"Several imaging modalities are currently being used to obtain diagnostic information in patient with spinal cord injuries. Among them, magnetic resonance imaging, computed tomography myelography, and plain radiography are the most widely used. Magnetic resonance imaging or MRI is a non-invasive imaging method that uses magnetic fields and radio frequency (RF) waves and provides soft tissue contrast of the spinal cord and surrounding tissues within the spinal canal. On the other hand, computed tomography or CT is based on x-rays, to provide excellent bone contrast, and is the first line of diagnostic imaging performed following a traumatic injury in both adults and kids to evaluate for fractures and spinal subluxation. Subsequently, MRI is performed to evaluate for the presence of spinal cord compression, spinal cord edema and/or hemorrhage, epidural/subdural hemorrhage, prevertebral edema, and ligamentous injury. Although still not widely available, in addition to providing good structural information, MRI has evolved in the recent years to provide functional characteristics of the spinal cord. These include information such as diffusion of the water molecules within the spinal cord providing functional information of white matter based on diffusion tensor imaging (DTI), and neuronal activation sites within the gray matter of the spinal cord based on Blood oxygenation level dependant (BOLD) imaging. In our center at Jefferson we are utilizing these functional neuroimaging biomarkers to potentially help us to understand the mechanisms of spinal cord injury (SCI) as well as guide and track changes of new therapeutic procedures. In the following sections we will discuss the methodologies underlying these techniques.","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126587401","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":"Continuous EEG Monitoring in Critical Care","authors":"A. Fernandez","doi":"10.29046/JHNJ.011.1.002","DOIUrl":"https://doi.org/10.29046/JHNJ.011.1.002","url":null,"abstract":"","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131534479","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":"Prevention and Management of Bleeding During Endoscopic Approaches to Skull Base Pathologies","authors":"James J. Evans, P. Amenta, A. Mansouri, C. Farrell, M. Rosen, G. Nyquist","doi":"10.29046/JHNJ.010.2.003","DOIUrl":"https://doi.org/10.29046/JHNJ.010.2.003","url":null,"abstract":"Recommended Citation Evans, MD, James J.; Amenta, MD, Peter S; Mansouri, MD, Alireza; Farrell, MD, Christopher J; Rosen, MD, Marc R.; and Nyquist, MD, Gurston G. (2015) \"Prevention and Management of Bleeding During Endoscopic Approaches to Skull Base Pathologies,\" JHN Journal: Vol. 10 : Iss. 2 , Article 6. DOI: https://doi.org/10.29046/JHNJ.010.2.003 Available at: https://jdc.jefferson.edu/jhnj/vol10/iss2/6","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126494725","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":"Endonasal Vascularized Flaps For Cranial Base Reconstruction","authors":"H. Do, A. Farag, V. Kshettry, G. Nyquist, M. Rosen, James J. Evans, C. Farrell","doi":"10.29046/JHNJ.010.2.004","DOIUrl":"https://doi.org/10.29046/JHNJ.010.2.004","url":null,"abstract":"","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128417464","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 Rare Case of a Systemic Non-Langerhans Histiocytosis Presenting with Diabetes Insipidus and a Tentorial Mass","authors":"G. Barros, K. Krupa, Kristin Krupa, Ravi Madineni, L. Kenyon, C. Farrell","doi":"10.29046/JHNJ.010.1.004","DOIUrl":"https://doi.org/10.29046/JHNJ.010.1.004","url":null,"abstract":"","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115078855","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":"Review of Concussion and Return-to-Play Guidelines in Sport","authors":"Michael J. Lang, A. Chitale, K. Judy","doi":"10.29046/JHNJ.008.1.001","DOIUrl":"https://doi.org/10.29046/JHNJ.008.1.001","url":null,"abstract":"","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129365583","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":"Fractionated Stereotactic Radiosurgery Alone for the Treatment of a Papillary Craniopharygioma","authors":"Tyler J. Kenning, James J. Evans","doi":"10.29046/JHNJ.007.1.005","DOIUrl":"https://doi.org/10.29046/JHNJ.007.1.005","url":null,"abstract":"The use of radiation treatment (RT) is usually reserved for residual or recurrent craniopharyngiomas, and the role of RT alone and not as an adjunctive therapy to surgery has not been clearly defined. The authors describe a case of a 50-year-old man presenting with a large suprasellar craniopharyngioma with extension into the third ventricle, producing acute hydrocephalus. A ventriculoperitoneal shunt was performed concurrently with an endoscopic biopsy. Treatment with fractionated stereotactic radiosurgery (FSR) resulted in near resolution of the lesion with no evidence of recurrence over six years. A review of RT for the treatment of craniopharyngiomas without surgical resection is performed. Introduction Craniopharyngiomas are histologically benign extraaxial epithelial tumors that arise form embryologic remnants of Rathke’s pouch.12 These rare lesions have an estimated incidence of 1.5 per million people per year, but comprise 10-15% of all pediatric brain tumors.7,21 Despite their benign histology, craniopharyngiomas cause significant morbidity from damage to the hypothalamus, optic apparatus, and endocrine system. Aggressive treatment is advocated, but the optimal treatment is often debated. Radical resection is often utilized as a first line treatment due to the frequently large size of these lesions at presentation and associated mass effect.6,24 Such surgery, however, can carry a high risk of morbidity with hypothalamic and endocrine dysfunction.26 For this reason, many favor subtotal resection with preservation of adjacent anatomical structures and adjuvant therapies for residual tumor.11,18 The use of radiotherapy in isolation for the treatment of craniopharyngiomas is infrequent. Case Report A 50-year-old man suffering from two months of headache and neck pain presented to the emergency department with a dramatic deterioration of his vision, limb paresis, and seizures. Cranial imaging demonstrated a 3.7 x 2.5 X 3.2 cm, solid suprasellar mass with extension into the third ventricle, producing acute hydrocephalus (Figures 1 and 2). Through a right frontal burrhole, placement of a ventriculoperitoneal shunt was performed concurrently with an endoscopic biopsy of the third ventricular mass tumor (Figure 3). Intraoperatively, a yellow-colored frond-like mass with a consistency similar to choroid plexus was seen filling the right foramen of Monro. Pathology was consistent with a papillary craniopharyngioma. The patient was subsequently treated with fractionated stereotactic radiosurgery (FSR) for a total of 54 Gy to the 88% isodose line in thirty 1.8 Gy fractions. Within a month of FSR completion, the tumor volume was reduced by nearly half and continued to diminish on each following imaging study. With six years of follow-up, the lesion continues to demonstrate near resolution with no recurrence and further treatment has not been necessary (Figure 4). Discussion The treatment of craniopharyngiomas is highly controversial. This controversy ","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"5 11-12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114038608","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}