Abstract:
:Brain arteriovenous malformations (BAVMs) are an important cause of intracerebral hemorrhage (ICH) in young adults. Biological predictors of future ICH risk are lacking, and controversy exists over previous studies of natural history risk among predominantly ruptured BAVM cohorts. Recent studies have suggested that the majority of BAVMs are now diagnosed as unruptured lesions, and that the risk according to natural history among these lesions may be less than previously assumed. In the first part of this review, the authors discuss available data on the natural history of BAVMs and highlight the need for future studies that aim to develop surrogate biomarkers of disease progression that accurately predict future risk of ICH in BAVMs. The etiology of BAVM remains unknown. Recent studies have suggested a role for genetic factors in the pathogenesis of sporadic BAVM, which is further supported by reports of familial occurrence of BAVM and association with known systemic genetic disorders (such as Osler-Weber-Rendu disease, Sturge-Weber disease, and Wyburn-Mason syndrome). Molecular characterization of BAVM tissue demonstrates a highly angiogenic milieu with evidence of increased endothelial cell turnover. Taken together with a number of reports of de novo BAVM formation, radiographic growth after initial BAVM diagnosis, and regrowth after successful treatment of BAVM, these findings challenge the long-held assumption that BAVMs are static lesions of congenital origin. In the second part of this review, the authors discuss available data on the origins of BAVM and offer insights into future investigations into genetics and endothelial progenitor cell involvement in the pathogenesis of BAVM. Current treatment options for BAVM focus on removal or obliteration of the lesion in an attempt to protect against future ICH risk, including microsurgical resection, endovascular embolization, and stereotactic radiosurgery (SRS). In the third part of this review, the authors discuss available data on SRS in BAVMs and highlight the need for future studies on the radiobiology of BAVMs, especially in regard to biomarker detection for tracking SRS response during the latency period. Insights from future investigations in BAVM may not only prove important for the development of novel therapies and relevant biomarkers for BAVM, but could also potentially benefit a variety of other disorders involving new vessel formation in the CNS, including stroke, tumors, moyamoya disease, and other cerebrovascular malformations.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Achrol AS,Guzman R,Varga M,Adler JR,Steinberg GK,Chang SDdoi
10.3171/2009.2.FOCUS0926subject
Has Abstractpub_date
2009-05-01 00:00:00pages
E9issue
5issn
1092-0684journal_volume
26pub_type
杂志文章,评审abstract::In an effort to make thoracic discectomy simple and less invasive while using direct visualization, a 70 degrees -angled lens endoscope has been adopted to visualize the ventral aspect of the spinal cord dura mater during microsurgical thoracic discectomy via a transpedicular approach. The patient is positioned in a 6...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1998.4.2.8
更新日期:1998-02-15 00:00:00
abstract::Resection of insular tumors in the dominant hemisphere poses a significant risk of postoperative motor and language deficits. The authors present a case in which intraoperative awake mapping and multi-modal imaging was used to help preserve function while resecting a dominant insular glioma. The patient, a 55-year-old...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.10.FocusVid.18259
更新日期:2018-10-01 00:00:00
abstract::In this article, the author provides a brief description of the role of hypoxia in the tumorigenesis of gliomas and suggests potential ways of exploiting this role to design treatment modalities. Tumor hypoxia predicts the likelihood of metastases, tumor recurrence, resistance to chemotherapy and radiation therapy, in...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2006.20.4.16
更新日期:2006-04-15 00:00:00
abstract:OBJECTIVE:The authors aimed to compare the efficacy of lumbar vertebral body Hounsfield units (HUs) and pedicle HUs at predicting pedicle screw loosening. METHODS:The authors retrospectively assessed 143 patients with L3-5 instrumentation. The patients were classified into one of two groups based on the status of thei...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.5.FOCUS20249
更新日期:2020-08-01 00:00:00
abstract::In the treatment of acoustic neuroma, operative results have improved greatly during recent years, with high rates of functional cranial nerve preservation. Because of this, it has become more important to consider issues of patient satisfaction and quality of life (QOL) following treatment for these lesions. The auth...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:1998-09-15 00:00:00
abstract::Cervical dural arteriovenous fistulas (dAVFs) are a rare cause of intracranial subarachnoid hemorrhage (SAH) but should be considered when other sources are not found. Subarachnoid hemorrhage caused by dAVF is thought to occur as a result of venous hypertension in most cases. The clinical presentation, acute onset of ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC.2009.26.1.E4
更新日期:2009-01-01 00:00:00
abstract::Neuroimaging is an indispensable tool in the workup and management of patients with neurological disorders. Arterial spin labeling (ASL) is an imaging modality that permits the examination of blood flow and perfusion without the need for contrast injection. Noninvasive in nature, ASL provides a feasible alternative to...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2019.9.FOCUS19567
更新日期:2019-12-01 00:00:00
abstract::Direct cerebral revascularization is an important procedure in the treatment of certain complex aneurysms and skull base tumors when acute sacrifice of the internal carotid artery is required. It likely remains an appropriate treatment in a small subgroup of patients with cerebral ischemia refractory to maximal medica...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:
更新日期:2003-03-15 00:00:00
abstract::OBJECTIVE The treatment of cervical spinal metastases represents a controversial issue regarding the type, extent, and invasiveness of interventions. In the lumbar and thoracic spine, kypho- and vertebroplasties have been established as minimally invasive procedures for patients with metastases to the vertebral bodies...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.5.FOCUS17175
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:Incidental aneurysms pose a challenge for physicians, who need to weigh the rupture risk against the risks associated with treatment and its complications. A statistical model could potentially support such treatment decisions. A recently developed aneurysm rupture probability model performed well in the US d...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.4.FOCUS19145
更新日期:2019-07-01 00:00:00
abstract::Complex posterior circulation aneurysms are formidable lesions with an abysmal natural history. Their management continues to present a challenge to both endovascular and open microsurgical approaches. Affording an expansive, combined supra- and infratentorial exposure, the petrosal approaches are well suited for thes...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2012.6.FOCUS12131
更新日期:2012-08-01 00:00:00
abstract::The surgical management of compressive cervical ossification of the posterior longitudinal ligament (OPLL) can be challenging. Traditionally, approach indications for decompression of cervical spondylotic myelopathy have been used. However, the postoperative complication profile after cervical OPLL decompression is un...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.1.FOCUS10278
更新日期:2011-03-01 00:00:00
abstract::In addition to standard management for the treatment of the acute phase of spinal cord injury (SCI), implementation of novel neuroprotective interventions offers the potential for significant reductions in morbidity and long-term health costs. A better understanding of the systemic changes after SCI could provide insi...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2018.12.FOCUS18206
更新日期:2019-03-01 00:00:00
abstract:OBJECT:Cerebrovascular pressure reactivity is the ability of cerebral vessels to respond to changes in transmural pressure. A cerebrovascular pressure reactivity index (PRx) can be determined as the moving correlation coefficient between mean intracranial pressure (ICP) and mean arterial blood pressure. METHODS:The au...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC.2008.25.10.E2
更新日期:2008-10-01 00:00:00
abstract::OBJECTIVE Traumatic brain injury (TBI) in children is a significant public health concern estimated to result in over 500,000 emergency department (ED) visits and more than 60,000 hospitalizations in the United States annually. Sports activities are one important mechanism leading to pediatric TBI. In this study, the ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.1.FOCUS15612
更新日期:2016-04-01 00:00:00
abstract::Herpes simplex encephalitis is a common viral encephalitis associated with significant morbidity and mortality if not diagnosed and treated early. Neurosurgery may be an impetus for viral reactivation, either from direct nerve manipulation or high-dose steroids often administered during cases. The authors present the ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2019.5.FOCUS19281
更新日期:2019-08-01 00:00:00
abstract::Correction of rigid scoliotic deformities involving the thoracic spine has required that a thoracotomy be performed to obtain anterior release to mobilize the deformity, as well as placement of corrective spinal instrumentation either via a separate posterior or anterior thoracic approach. To the best of the author's ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1999.7.5.2
更新日期:1999-11-15 00:00:00
abstract::Giant cerebral aneurysms may be treated through a variety of options, including aneurysm trapping with concurrent bypass. This video describes the case of a large, recurrent, left middle cerebral artery aneurysm that was treated using a high flow, radial artery bypass graft, from the external carotid artery to the lef...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.V1.FOCUS14548
更新日期:2015-01-01 00:00:00
abstract::Epidermoid cysts or tumors comprise 1% of intracranial tumors with a predilection for the cerebellopontine angle or parasellar cisterns. These tumors are derived from an ectopic ectodermal implant seeded between fusing ectodermal surfaces. This results in a benign proliferation of stratified squamous epithelium along ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.1.FocusVid.15466
更新日期:2016-01-01 00:00:00
abstract::Spine surgery carries an inherent risk of damage to critical neural structures. Intraoperative neurophysiological monitoring (IONM) is frequently used to improve the safety of spine surgery by providing real-time assessment of neural structures at risk. Evidence-based guidelines for safe and efficacious use of IONM ar...
journal_title:Neurosurgical focus
pub_type: 杂志文章,meta分析,评审
doi:10.3171/2012.9.FOCUS12235
更新日期:2012-11-01 00:00:00
abstract::Brain-computer interfaces (BCIs) provide a way for the brain to interface directly with a computer. Many different brain signals can be used to control a device, varying in ease of recording, reliability, stability, temporal and spatial resolution, and noise. Electrocorticography (ECoG) electrodes provide a highly rel...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.4.FOCUS20185
更新日期:2020-07-01 00:00:00
abstract::OBJECTIVE Reservoirs integrated into hydrocephalus shunts are commonly used for the removal of CSF and for intra-ventricular pressure measurement. Pumping with the reservoir to diagnose shunt sufficiency is still a matter of controversy. The authors describe an improved flushing device and its characteristic features ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.6.FOCUS15540
更新日期:2016-09-01 00:00:00
abstract::Laser interstitial thermal therapy (LITT) is a minimally invasive procedure used to treat a variety of intracranial lesions. Utilization of robotic assistance with stereotactic procedures has gained attention due to potential for advantages over conventional techniques. The authors report the first case in which robot...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.4.FOCUS1622
更新日期:2016-10-01 00:00:00
abstract:OBJECT:The purpose of this study was to elucidate the anatomy of the trigeminal nerve (cranial nerve [CN] V), Meckel cave (MC), and lateral wall of the cavernous sinus (CS). METHODS:Ten fresh cadaver heads (20 sides) and 2 middle fossa embalmed specimens were removed, decalcified, sectioned, stained, and studied micro...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC.2008.25.12.E2
更新日期:2008-01-01 00:00:00
abstract::The authors describe the case of a boy with Muenke syndrome, an autosomal dominant disorder associated with craniosynostosis. The family history was significant for syndromic craniosynostosis in the patient's maternal grandmother, who died in adulthood after a craniofacial reconstruction. The patient, her grandson, un...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.2.FOCUS151
更新日期:2015-05-01 00:00:00
abstract::Peritumoral cysts (those arising immediately adjacent to the tumor mass) are frequently associated with benign and malignant tumors of the brain and spinal cord (syringomyelia). The cystic component of central nervous system (CNS) tumors and associated peritumoral cysts are often the cause of clinical symptoms. Becaus...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2007.22.5.10
更新日期:2007-05-15 00:00:00
abstract::OBJECTIVE The object of this study was to determine the percentage of high-dose (1800-2600 cGy) single-fraction stereotactic radiosurgery (SF-SRS) treatments to the spine that result in peripheral nervous system (PNS) injury. METHODS All patients treated with SF-SRS for primary or metastatic spine tumors between Janua...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.11.FOCUS16348
更新日期:2017-03-01 00:00:00
abstract:OBJECT:Bell palsy remains the most common cause of facial paralysis. Unfortunately, this term is often erroneously applied to all cases of facial paralysis. METHODS:The authors performed a retrospective review of data obtained in 11 patients who were treated at a university-based referral practice between July 1988 an...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2002.12.5.3
更新日期:2002-05-15 00:00:00
abstract::Over the last decade, the analysis of genetic defects in primary tumors has been central to the identification of molecular events and biological pathways involved in the pathogenesis of medulloblastoma, the most common malignant brain tumor of childhood. Despite this, understanding of the molecular basis of the major...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2005.19.5.11
更新日期:2005-11-15 00:00:00
abstract:Objective:The aim of this study was to investigate the diagnostic potential of the inflammatory markers interleukin-6 (IL-6), total leukocyte count (TLC), and protein in the CSF and IL-6, C-reactive protein, and white blood cell count in the serum for the early diagnosis of ventriculitis in patients with traumatic brai...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.8.FOCUS19407
更新日期:2019-11-01 00:00:00