Abstract:
OBJECTIVE AND IMPORTANCE:The presence of a residual arteriovenous malformation (AVM) on postoperative angiograms is typically an indication for prompt return to the operating room to complete resection, because of the risk of early hemorrhage. This approach, however, may involve risks of neurological deficits when the residual AVM is in eloquent cortex. We present a case of complete thrombosis of a residual AVM after surgery. This residual AVM tissue was located in eloquent cortex. Complete spontaneous thrombosis of residual AVMs after surgery has only rarely been reported. This phenomenon raises questions regarding the most appropriate management for residual AVMs in eloquent cortex. CLINICAL PRESENTATION:The patient was a 43-year-old, right-handed, male patient with an AVM centered in the left precentral gyrus. The patient presented with medically intractable seizures and progressive right hemiparesis. After AVM resection, angiography revealed a residual AVM with early venous drainage. Angiography performed 1 week later demonstrated a persisting AVM nidus without early venous drainage. Angiography performed 3 months later demonstrated complete thrombosis of the residual AVM. INTERVENTION:The patient has been monitored for more than 1 year, without additional symptoms or therapy. CONCLUSION:We continue to advocate prompt return to the operating room when postoperative angiography reveals a residual AVM with persistent shunting. When the residual AVM is in eloquent cortex and is small, with a single draining vein, however, observation of the patient (with strict blood pressure control) and repeat angiography after 1 week represent an alternative strategy that is supported by this case report. As this case demonstrates, it is possible for small residual AVMs to thrombose. This may avert the need for reoperation for residual AVMs in eloquent cortex, with the potential for neurological deficits.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Bendok BR,Getch CC,Ali MJ,Parish T,Batjer HHdoi
10.1097/00006123-200205000-00038keywords:
subject
Has Abstractpub_date
2002-05-01 00:00:00pages
1142-5; discussion 1145-6issue
5eissn
0148-396Xissn
1524-4040journal_volume
50pub_type
杂志文章,评审相关文献
NEUROSURGERY文献大全abstract:OBJECTIVE:The beaten copper appearance of the cranium, as well as other cranial radiographic and computed tomographic findings in children with craniosynostosis, is often interpreted by clinicians as evidence of elevated intracranial pressure (ICP). However, a correlation between radiological findings and ICP measureme...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199610000-00007
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVE:Stereotactic radiosurgery is a commonly used treatment method in the management of metastatic brain tumors. When lesions enlarge after radiosurgery, it may represent tumor regrowth, radiation necrosis, or both. The purpose of this study was to determine whether standard magnetic resonance imaging (MRI) sequen...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000333263.31870.31
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:Uncoupling of cerebral blood flow (CBF) and oxidative metabolism is observed after severe head injury in comatose patients; however, the mechanism(s) involved remain undefined. Adenosine can produce cerebral vasodilation and reduce neuronal activity and is a possible mediator of uncoupling. We hypothesized th...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199712000-00010
更新日期:1997-12-01 00:00:00
abstract::Regional brain tissue catecholamine concentrations were measured in 5 control rats and in 10 rats 72 hours after experimental subarachnoid hemorrhage (SAH). Catecholamine levels were determined in the cerebral hemispheres, brain stem, and cerebellum of each animal using a radioenzymatic assay. Three days after SAH, th...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198609000-00005
更新日期:1986-09-01 00:00:00
abstract::We report a case of isolated intramedullary sarcoidosis. The patient developed progressive signs that indicated a spinal tumor, which were investigated with contrast-enhanced magnetic resonance imaging scans. Magnetic resonance imaging clearly revealed an intramedullary lesion, but the diagnosis of sarcoidosis was mad...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1097/00006123-199108000-00020
更新日期:1991-08-01 00:00:00
abstract:BACKGROUND:The relationships between lipoprotein-associated phospholipase A2 (Lp-PLA2) level, vasospasm, and clinical outcome of patients with aneurysmal subarachnoid hemorrhage (aSAH) are still unclear. OBJECTIVE:To identify the associations between admission Lp-PLA2 and vasospasm following subarachnoid hemorrhage an...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyz041
更新日期:2020-01-01 00:00:00
abstract::Flow diversion is a safe and effective treatment for many types of brain aneurysms. Even so, there remain some aneurysms that persist despite initial treatment. In studies with the longest follow-up (5 yr), at least 5% of aneurysms persist with this treatment modality. As the cumulative experience and clinical indicat...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyz305
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Various methods have been used to report the tumor diameter of vestibular schwannomas. To clarify the most appropriate method to represent the tumor volume, tumor diameters according to various measuring methods were statistically compared with the actual tumor volume. METHODS:Tumor volume was measured by th...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000080062.61335.a5
更新日期:2003-09-01 00:00:00
abstract::Propionibacterium acnes was isolated in pure culture from brain abscesses that occurred in two patients after intracranial surgery. Although such infections are usually associated with cerebrospinal fluid shunts and other foreign bodies, these cases clearly demonstrate the pathogenicity of this anaerobic diphtheroid i...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1097/00006123-198907000-00026
更新日期:1989-07-01 00:00:00
abstract::External ventricular drainage (EVD) was used before and after posterior fossa operations in 62 children and adolescents. In all cases, the removal of the tumor (midline in 47 and laternal in 15) was attempted; total removal was achieved in 41. The overall mortality was 6.5% (4 patients). Only 25% of the survivors need...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract:OBJECTIVE:Chronic subdural hematoma (CSH) is characterized by pathological vascularization of the parietal membrane. Plasma leakage from immature vessels may be involved in hematoma enlargement and recurrence. We tested the hypothesis that the antiangiogenic side-effect of angiotensin converting enzyme (ACE)-inhibitor ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000298907.56012.E8
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:Ensuring adequate cerebral oxygenation and perfusion is of fundamental importance in the treatment of patients with acute cerebral disorders. Online continuous monitoring of brain oxygenation is possible with a parenchymal microelectrode that measures local brain oxygen tension. The ultimate question is wheth...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200004000-00018
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVES:To determine if a window of time could be defined during which angioplasty would be most effective in reversing neurological decline and ultimately improving outcome. METHODS:Of a group of 466 patients, 93 underwent endovascular management of clinical vasospasm that was medically refractory. Eighty-four of ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199905000-00022
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVE:Hyperbaric oxygenation is a rarely used method of treatment for steroid-refractory radiation-induced edema after stereotactic radiosurgery. We present its successful implementation for a radiosurgical complication after the treatment of a deep, large arteriovenous malformation. We also review the literature o...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000255343.41206.6F
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:A systematic follow-up of infants with an obstetric brachial plexus lesion of C5 and C6 or the superior trunk showing satisfactory spontaneous recovery of shoulder and arm function except for voluntary shoulder exorotation, who underwent an accessory to suprascapular nerve transfer to improve active shoulder ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000232988.46219.E4
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:We developed an animal model to evaluate vascular trauma induced by endovascular devices that are proposed for the treatment of cerebrovascular diseases. METHODS:The model was constructed in six domestic swine by elongating the common carotid artery using interpositional grafts. Balloon catheters (n = 3), st...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000119759.56437.f5
更新日期:2004-05-01 00:00:00
abstract::An unusual case of a chronic posttraumatic lumbar intradural arachnoid cyst causing compression of the cauda equina is reported. The etiological, pathological, and clinical features are discussed. Emphasis is placed on the importance of a correct interpretation of radiological findings. ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198704000-00024
更新日期:1987-04-01 00:00:00
abstract:OBJECTIVE:The recent successful development of chronic stimulation of the motor cortex as a treatment for neuropathic and central pain does not exclude the possibility of eventual side effects, such as epileptic seizure or a lowering of the epileptic threshold. This study evaluates the behavioral and electroencephalogr...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199908000-00030
更新日期:1999-08-01 00:00:00
abstract::Clinical recovery after central nervous system (CNS) trauma or ischemia may be limited by a neural injury process that is triggered and perpetuated at the cellular level, rather than by a lesion amenable to surgical repair. It is widely thought that one such process, a fundamental pathological mechanism initiated by C...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1097/00006123-199606000-00028
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Intraoperative neurophysiological monitoring, including upper- and lower-extremity somatosensory evoked potentials (SSEPs), has been used to identify and prevent injury to neurovascular structures during conventional skull base surgery. The expanded endonasal approach (EEA) is a novel minimally invasive appr...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e31821606e4
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:For adult meningiomas, the staining index (SI) for the anti-Ki-67 monoclonal antibody MIB-1 is well correlated with histological atypia and tumor recurrence. MIB-1 SIs for meningiomas in the pediatric population have not been previously reported. Meningiomas tend to be more histologically aggressive and to re...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200103000-00027
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:The synergistic effect of clonidine with bupivacaine, well established in peripheral nerve blocks, remains controversial in local field block for postoperative analgesia. OBJECTIVE:To investigate the potential analgesic benefit of adding clonidine to bupivacaine during preincisional field block in posterior...
journal_title:Neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.1093/neuros/nyx313
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:Basilar cranial fractures have been associated with injury to the carotid artery. We sought to determine whether fracture through the carotid canal was a significant risk factor for carotid injury. METHODS:A retrospective chart review was performed, and 230 patients with basilar cranial fractures were identi...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199706000-00012
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Internal drainage of cerebrospinal fluid to the abdominal cavity via a ventriculoperitoneal shunt (VPS) is a common procedure for therapy of obstructive hydrocephalus; because this condition is often caused by brain tumors blocking the natural cerebrospinal fluid pathways, the VPS as an artific...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1097/00006123-199806000-00118
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:Carotid-cavernous fistulae are uncommon but well-documented sequelae of craniofacial trauma. A rare subset may arise from the posterior communicating artery instead of from the carotid artery proper. The presentation is similar to that of carotid-cavernous fistulae, with ocular pain, chemosis, and proptosis b...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000043817.55770.f8
更新日期:2003-02-01 00:00:00
abstract::Arteriovenous malformation (AVM) draining vein pressure (DVP) may have an influence on both the natural history of the disease and treatment outcome. The purposes of this study were to assess the relationship between DVP and other clinical and physiological variables and to characterize the transmission of arterial pr...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199409000-00005
更新日期:1994-09-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to assess the reliability of the aspect ratio (AR) (i.e., aneurysm depth to aneurysm neck) in predicting aneurysm rupture. It has been shown that the AR is a key factor in predicting intraaneurysmal blood flow and aneurysm rupture. METHODS:Seventy-five patients with subarachnoid hem...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000124482.03676.8b
更新日期:2004-06-01 00:00:00
abstract::The aim of the present study was to evaluate the influence of previous treatment on outcome and sensory disturbance after a retrogasserian glycerol injection for trigeminal neuralgia. Ninety-nine patients with trigeminal neuralgia underwent a retrogasserian glycerol rhizotomy. Fifty-three of those patients experienced...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199502000-00009
更新日期:1995-02-01 00:00:00
abstract::Treatment of syringomyelia remains a difficult and controversial problem. However, the recent advent of magnetic resonance imaging (MRI) and intraoperative ultrasound allows a more precise approach to the diagnosis and management of this disorder. Experience with 27 cases of syringomyelia has shown that MRI is superio...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198704000-00016
更新日期:1987-04-01 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of the telovelar approach with tonsillar manipulation for approaching the recesses of the fourth ventricle. METHODS:A telovelar approach was performed in 8 injected cadaveric heads. Areas of exposure were measured for the superolateral and lateral recesses. Horizontal angles were...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000348558.35921.4E
更新日期:2010-03-01 00:00:00