Search Results

You are looking at 1 - 10 of 65 items for :

  • By Author: Barnett, Gene H. x
Clear All
Full access

Sarel J. Vorster and Gene H. Barnett

Although surgical resection of brain tumors has been performed for over a century, complications still occur with distressing frequency.

The authors propose a simple preoperative grading scheme to assess surgical risk for resection of primary and secondary intraaxial supratentorial brain tumors.

The authors retrospectively reviewed the clinical records, neuroimaging studies, and outcomes of 224 surgeries performed in 207 patients from January 1993 to December 1995 at the Cleveland Clinic Foundation Brain Tumor Center. Subsequently, they considered and statistically analyzed multiple variables related to the patients and their lesions. Surgical risk was defined as any complication occurring within 30 days postoperatively, and was divided into transient operative complications, transient medical complications, and new sustained neurological deficits. Length of stay was also recorded. The overall incidence of complications was 10.6% and the mortality rate was 2.7%, with a median hospital stay of 3 days. Patient age greater than 60 years (p < 0.001), preoperative Karnofsky Performance Scale scores of 50 or less (p < 0.03), previous irradiation (p < 0.001), tumor location in eloquent regions (p < 0.03), and depth of tumor invasion (p < 0.001) independently predicted complicated outcome or increased length of stay. Finally, the authors derived a simple five-tier grading scheme in which these patient risk factors are added together to obtain a grade of I to V that corresponds to outcome and length of hospital stay.

This grading scheme may be used to identify patients at higher risk and facilitate comparison of results between institutions and individual surgeons.

Restricted access

Issam A. Awad and Gene H. Barnett

evaluation by the Neurology Service, MR imaging of the spine was performed and the Neurosurgery Service was consulted. The MR image ( Fig. 1 ) and a review of the MR study performed 6 months earlier revealed no evidence of hemorrhage or cord compression. However, there was a serpentine signal-void area at the T6–9 level consistent with AVM. Fig. 1. Lateral midsagittal T 2 -weighted magnetic resonance image of the cervicothoracic spine. There is no evidence of hemorrhage or cord compression. Note the serpentine signal-void areas on the dorsal aspect of the spinal

Restricted access

Solitary fibrous tumor of the meninges

Case report and review of the literature

Richard A. Prayson, James T. McMahon and Gene H. Barnett

patients who had at least 1 year of follow-up review; however, one patient had a local recurrence of a subtotally resected neoplasm 5 years later. Similar to our case, the tumors in that study exhibited diffusely positive staining for both vimentin and CD34 and showed negative staining for S-100 protein, desmin, and EMA. Two of four tumors displayed a positive reaction for estrogen receptors by immunostaining and five of five tumors showed a positive reaction for progesterone receptors. Ultrastructural study of two tumors was reported in that study and showed evidence of

Free access

Symeon Missios, Kimon Bekelis and Gene H. Barnett

radiosurgeryresistant metastases, 9 , 20 as well as the ablation of lesions such as epileptogenic foci 55 and radiation necrosis. 23 , 39 In this review, we aim to critically analyze the literature to describe the advent of LITT as a neurosurgical, laser excision tool, including its development, use, indications, and efficacy as it relates to neurosurgical applications. Biological Effects of Laser Therapy Laser electromagnetic radiation (EMR) has been the most frequently used source of illumination in the treatment of cancer. In tumors it relies on the principle of using

Free access

Gene H. Barnett, Clark C. Chen, Robert E. Gross and Andrew E. Sloan

L aser interstitial thermotherapy (LITT), sometimes referred to as stereotactic laser ablation or SLA, is a minimally invasive approach that uses thermal energy delivered by a laser to ablate tissue. While this approach is not new, recent advances in technology and near real-time thermography have generated renewed interest in this technology for the treatment of diseases of the brain and spine. This issue of Neurosurgical Focus reviews recent technical advances as well as new applications for this technology for spinal (Tatsui et al.) and intracranial

Restricted access

Trigeminal nerve schwannoma with ancient change

Case report and review of the literature

Kene Ugokwe, Narendra Nathoo, Richard Prayson and Gene H. Barnett

neurilemmoma (schwannoma): Acta Pathol Microbiol Scand 85 : 812 – 818 , 1977 Dahl I: Ancient neurilemmoma (schwannoma): Acta Pathol Microbiol Scand 85: 812–818, 1977 4. Darwish BS , Balakrishnan V , Maitra R : Intramedullary ancient schwannoma of the cervical spinal cord: case report and review of the literature. J Clin Neurosci 9 : 321 – 323 , 2002 Darwish BS, Balakrishnan V, Maitra R: Intramedullary ancient schwannoma of the cervical spinal cord: case report and review of the literature. J Clin Neurosci 9

Restricted access

Narendra Nathoo, Marc R. Mayberg and Gene H. Barnett

effect of various substances on intracranial pressure and a comprehensive review of an extended family from Pennsylvania whose members had hereditary bilateral acoustic neuromas. In 1930, with Frazier as coauthor, he reported a field survey of five generations of a family in which central neurofibromatosis was found, showing clearly mendelian dominant-type inheritance. 38 They performed surgery on a seventh-generation family member 54 and finally managed to convince Dr. Eldridge of the National Institutes of Health to study this family. 73 This was the first report

Restricted access

Gene H. Barnett, David W. Miller and Joseph Weisenberger

target/trajectory guidance software was written to augment the usual localization and orientation functions of SNSs. 7 The techniques and our experience in 218 cases in which SNSs were used, some of which have been reported previously, 7 are presented in this article. Clinical Material and Methods Before the device received approval from the United States Food and Drug Administration for these applications, surgery was performed only after the patient consented to an investigation approved by the Cleveland Clinic Foundation Institutional Review Board. Instrumentation

Restricted access

Amer Khalil, Alejandro M. Spiotta and Gene H. Barnett

and manuscript preparation include the following. Conception and design: Barnett. Acquisition of data: Khalil. Analysis and interpretation of data: all authors. Drafting the article: Khalil. Critically revising the article: Barnett, Spiotta. Reviewed final version of the manuscript and approved it for submission: all authors. Study supervision: Barnett. Acknowledgment The authors are grateful to Christine Moore for help in preparing this manuscript. This article contains some figures that are displayed in color online but in black and white in the print

Restricted access

Narendra Nathoo, Frederick K. Lautzenheiser and Gene H. Barnett

Crile reviewed a variety of drugs in the treatment of shock and concluded that only adrenalin, saline, and the use of the pneumatic suit provided any benefit. Through animal experiments, he demonstrated the importance of measuring peripheral and central venous pressure and learned that blood became acidotic with shock, leading to his advice on the use of bicarbonate solution. For this research, he won the Cartwright Prize for the second time. He continued his research efforts in surgery-related shock and published monographs on Hemorrhage and Transfusion (1909), 14