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1.
脑深部病变立体定向活检方法的临床研究 总被引:1,自引:0,他引:1
1991年1月至1996年12月采用CT引导立体定向技术对386例脑深部和脑功能区病灶进行了活检手术,男232例,女154例,年龄4.5 ̄71岁,平均40.5%岁。病变位于离深部90例,鞍区74例,基底节区73例,三脑室后部46例,多发病灶45例,脑室内45例,脑23例,小脑半球19例,脑干内14例,斜坡2例。结果共有372例作出了病理诊断,活检阳性率为96.37%,其中肿瘤327例(肿瘤检出率8 相似文献
2.
CT引导立体定向脑深部病变活检术(附310例报告) 总被引:1,自引:0,他引:1
1991年1月至1995年9月采用CT引导立体定向技术对310例脑深部或脑功能区病灶进行了活检手术。病变位于鞍区62例,基底节区51例,第三脑室后部38例,大脑半球深部74例,脑室内21例,颅内多发性病灶38例,脑干内9例,小脑半球17例。活检总阳性率为96%,肿瘤检出率为85.8%。5例并发颅内出血(1.61%)。认为CT引导的立体定向脑深部病变活检是一种明确颅内占位病变的组织学诊断并利于采取最佳治疗措施的最可靠的方法。 相似文献
3.
CT或MRI引导立体定向活检方法的研究 总被引:1,自引:0,他引:1
目的:探讨用CT或MRI引导立体定向对脑深部病变进行活检手术的可行性和准确性。方法:用CT或MRI引导的脑立体定向地605例脑深部病变进行活检以期获得病变的组织学诊断,其中男357例,女248例,年龄:2.5-78岁,平均37.7岁,用CT引导立体定向活检515例,用MRI引导的定向活检90例。结果:522例(86.28%)获得脑肿瘤的病理组织,39例(6.44%)为炎性病理组织,其他病理组织23例(2.4%),16例(2.65%)未能提供病理学诊断,阳性诊断率97.35%,并发症发生13例(2.47%),死亡2例,死亡率为0.33%,结论:采用CT或MRI引导的立体定向脑深部病变活检是一种诊断准确率高,安全可靠,并发症少,创伤轻微,死亡率极低的手术方法,值得推广应用。 相似文献
4.
自1991年1月至1994年1月采用CT引导立体定向技术对241例脑深部或脑主要功能区病灶进行了活检手术。其中男153例,女88例;年龄平均34.8(5~70)岁。病变位于鞍区44例,基底神经核区43例,第三脑室后部35例,大脑半球深部55例,脑室内17例,颅内多发性病灶28例,脑干内6例,小脑半球13例。活检总阳性率为97.92%,肿瘤检出率为86.71%。3例并发颅内出血(1.24%),无手术死亡及其它严重并发症。认为CT引导的立体定向脑深部病变活检是一种明确颅内占位病变的组织学诊断并利于采取最佳治疗措施的最可靠的方法。 相似文献
5.
CT引导立体定向脑深部病变活检术 总被引:5,自引:0,他引:5
1991年1月至1995年9月采用CT引导立体定向技术对310例脑深部或脑功能欧美同灶进行了活检手术,病变位于鞍区62例,基底艽我,第三脑室后部38例,大脑半球深部74例,脑室内21例,颅内多发性病灶38例,脑干内9例,小脑半球17例。活检总阳性率为96%,肿瘤检出率为85.8%。5例并发颅内出血。 相似文献
6.
目的探讨立体定向活检术结合伽玛刀治疗脑深部胶质瘤的效果。方法利用立体定向活检术明确病灶性质后,伽玛刀治疗脑深部病灶26例,伽玛刀治疗剂量18-25Cy。结果26例脑深部病灶立体定向活检术后病理学诊断为胶质瘤;伽玛刀治疗后半年实体肿瘤控制有效率达88.5%(23/26)。结论对无明显颅内压增高的脑深部胶质瘤患者,立体定向活检术明确肿瘤性质后,减少手术带来的并发症;对体积稍大者采用剂量分割方法以提高肿瘤的处方剂量,从而使肿瘤控制率达到较好的水平。 相似文献
7.
报告对131例脑深部病变进行活检和治疗。病变位于丘脑和基底节36例,大脑半球75例,鞍区6例,小脑半球4例,桥小脑角1例,侧脑室内2例,Ⅲ脑室前部2例,松果体区5例。活检病理诊断准确率为96.9%,活检部位出血并发颅内血肿的发生率和死亡率为0.76%,同时讨论了立体定向手术入路,如何提高活检阳性率、后装治疗管放置及并发症的预防等问题。 相似文献
8.
CT引导立体定向脑深部病灶活检术(附241例临床分析) 总被引:2,自引:0,他引:2
自1991年1月至1994年1月采用CT引导立体定向技术对241例脑深部或脑主要功能区病灶进行了活检手术。其中男153例,女88例;年龄平均34.8(5~70)岁。病变位于鞍区44例.基底抻经核区43例.第三脑室后部35例,大脑半球深部55例,脑室内17例,颅内多发性病灶28例.脑干内6例、小脑半球13例。活检总阳性率为97.92%,肿瘤植出率为86.71%。3例并发颅内出血(1.24%),无手术死亡及其它严重并发症。认为CT引导的立体定向脑深部病变活检是一种明确颅内占位病变的组织学诊断并利于采取最佳治疗措施的最可靠的方法。 相似文献
9.
立体定向技术行脑深部病变131例活检和治疗的临床分析 总被引:1,自引:0,他引:1
报告对131例脑深部病进行活检和治疗,病变位于丘脑箕底节36例,大脑半球75例,鞍区6例,小脑半球4例,桥小脑角1例,侧脑室内2例,Ⅲ脑室前部2例,松果体区5例,活检病理诊断准确率为96.9%,活检部位出血并发颅内血肿的发和死亡率为0.76%,同时讨论了立体定向手术入路,如何提高活检阳性率,后装治疗放置及并发症的预防等问题。 相似文献
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11.
Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded. 相似文献
12.
Berkan Guleyupoglu Pedro Schestatsky Dylan Edwards Felipe Fregni Marom Bikson 《Journal of neuroscience methods》2013
Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES. 相似文献
13.
Hepatic Considerations in the Use of Antiepileptic Drugs 总被引:5,自引:4,他引:1
Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy. 相似文献
14.
Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology. 相似文献
15.
S. FELDMAN 《Epilepsia》1971,12(3):249-262
16.
Neonatal Seizures: Problems in Diagnosis and Classification 总被引:6,自引:5,他引:1
Eli M. Mizrahi 《Epilepsia》1987,28(S1):S46-S54
Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction. 相似文献
17.
David W. Chadwick 《Epilepsia》1987,28(S2):S12-S17
Summary: For decades, therapeutic tradition has promoted the concept of polypharmacy in the management of epilepsy. In recent years, however, studies have shown that, for most patients, monotherapy can provide comparable or better seizure control than administration of multiple anticonvulsants, while diminishing the potential for adverse reactions, drug interactions, and poor compliance. Valproate is an important monotherapeutic agent that is highly effective in the control of idiopathic primary and secondarily generalized epilepsies, and partial seizures that do not generalize. Comparative studies have found that valproate is at least as effective as phenytoin and carbamazepine in the treatment of generalized and partial seizures. Given the similar efficacy, other factors such as pharmacokinetics and side effects may therefore determine anticonvulsant selection for monotherapy. 相似文献
18.
Carbamazepine Efficacy and Utilization in Children 总被引:4,自引:3,他引:1
W. Edwin Dodson 《Epilepsia》1987,28(S3):S17-S24
Summary: Carbamazepine is effective for preventing partial and generalized tonic-clonic seizures in children. Although absence epilepsies are more common in children than adults, an estimated 80% of children with epilepsy have seizure types or epilepsies that are potentially responsive to carbamazepine. The differential diagnosis of ictal staring is an especially important issue in children because absence and atypical absence seizures are more prevalent in children than adults. Age-related pharmacokinetic differences and drug interactions are major considerations in children. On average, children have higher clearance rates of carbamazepine, shorter half-lives, and higher ratios of carbamazepine-10, 11-epoxide to carbamazepine than adults. In addition, children with severe epilepsy are more likely to require multiple-drug therapy, which can lead to complex drug interactions. When carbamazepine is administered along with valproate, drug protein binding interactions can cause intermittent side effects. 相似文献
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Erik R Kandel 《L'évolution Psychiatrique》2002,67(1):12
In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior. 相似文献
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