Abstract：
:Cerebral vasospasm is a cause of significant morbidity and mortality in patients with subarachnoid hemorrhage (SAH). Most cases of vasospasm can be managed medically. Medical strategies for treatment include hemodynamic augmentation to improve cerebral perfusion pressure and medical therapy to prevent or reduce cerebral vasospasm. In patients with acute neurological deterioration, imaging assessment is essential to triage those patients appropriate for aggressive medical or endovascular therapy. Such imaging assessment can be performed with many radiologic techniques such as transcranial Doppler, computed tomography (CT), magnetic resonance imaging, and single-photon emission CT (SPECT). Advanced CT applications like CT angiography and CT perfusion are gaining popularity and playing an increasingly important role in the decision making. Endovascular techniques for treatment of vasospasm include intra-arterial administration of vasodilators and intracranial angioplasty. This article discusses the use of these endovascular techniques in the management of vasospasm and provides a current review of literature. Sustained efficacy of intra-arterial vasodilators is less well established at this time, and repeated treatments may be necessary. Balloon angioplasty is an effective technique in treating vasospasm and results in durable clinical improvement. It should be used judiciously, however, given a small risk of vessel rupture associated with intracranial angioplasty. The goal of angioplasty should be improvement of vessel caliber to augment flow rather than to achieve a picture-perfect result.
journal_name
Neurosurg Clin N Amjournal_title
Neurosurgery clinics of North Americaauthors
McGuinness B,Gandhi Ddoi
10.1016/j.nec.2009.10.007subject
Has Abstractpub_date
2010-04-01 00:00:00pages
281-90issue
2eissn
1042-3680issn
1558-1349pii
S1042-3680(09)00116-8journal_volume
21pub_type
杂志文章,评审abstract：:The extracranial vasculature is subject to a vast array of disease processes including atherosclerosis, dissection, inflammation, and mechanical compression. Our current understanding of the pathogenesis of these diseases is discussed. ...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：2000-04-01 00:00:00
abstract：:Glioblastoma multiforme is a malignant, relentless brain cancer with no known cure, and standard therapies leave significant room for the development of better, more effective treatments. Immunotherapy is a promising approach to the treatment of solid tumors that directs the patient's own immune system to destroy tumo...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2009.09.001
更新日期：2010-01-01 00:00:00
abstract：:The major changes in health care delivery today further cloud the perspectives of patient autonomy, participation, and justice and the ideals of the virtuous practice of medicine. A Workable Integrative Negotiation approach with COAST permeating the medical setting and health agenda, however, can help promote effectiv...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-10-01 00:00:00
abstract：:Malignant large artery stroke is associated with high mortality of 70% to 80% with best medical management. Decompressive craniectomy (DC) is a highly effective tool in reducing mortality. Convincing evidence has accumulated from several randomized trials, in addition to multiple retrospective studies, that demonstrat...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2017.02.010
更新日期：2017-07-01 00:00:00
abstract：:When medical treatment for trigeminal neuralgia fails or is limited by significant side effects, neurosurgeons need to inform their patients of all the available treatment options. The best treatment for the patient depends on the age of the patient, medical comorbidities, and the risks the patient is willing to assum...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2004.03.002
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abstract：:The pelvic incidence defines the amount of lordosis required in the lumbar spine, and a lumbar lordosis within 11° of the pelvic incidence defines alignment of the lumbo-pelvic region. Pelvic tilt is a compensatory mechanism that allows patients to achieve sagittal balance in the setting of decreased lumbar lordosis w...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2018.03.003
更新日期：2018-07-01 00:00:00
abstract：:Cervical spina bifida, either occult or overt, is relatively uncommon. These lesions tend to be associated with other abnormalities of the central nervous system and spine. For the occult dysraphic lesions, a Klippel-Feil syndrome is a particular association, especially the type I variety. For the spina bifida cystica...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-04-01 00:00:00
abstract：:The indications for the surgical management of supratentorial cavernous malformations are outlined and the results following operation are presented in this article. Surgery is indicated for most patients who present with seizures, neurologic deficit, or headache. The surgical approaches to lesions in the cerebrum are...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1999-07-01 00:00:00
abstract：:In the normal growth of the cranial base, an outline of prenatal development stressed the common vertebrate plan, the patterning of mesenchymal tissues formed from and influenced by migrating neural crest cells. Details are given of the sequences of chondrification and ossification. Postnatal growth is approached in t...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-07-01 00:00:00
abstract：:For nearly a century, neurosurgeons have been involved in the use of therapeutic radiation. Long before there was a separate discipline of radiology or radiation therapy, pioneers such as Cushing and Frasier explored the effects of X-rays and radium on patients with brain tumors and arteriovenous malformations. This i...
journal_title：Neurosurgery clinics of North America
pub_type： 历史文章,杂志文章
doi：
更新日期：2001-01-01 00:00:00
abstract：:Cerebral venous sinus (sinovenous) thrombosis (CSVT) in childhood is a rare, but underrecognized, disorder, typically of multifactorial etiology, with neurologic sequelae apparent in up to 40% of survivors and mortality approaching 10%. There is an expanding spectrum of perinatal brain injury associated with neonatal ...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2010.03.006
更新日期：2010-07-01 00:00:00
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journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章
doi：
更新日期：1996-04-01 00:00:00
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journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2008.07.023
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journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2016.08.005
更新日期：2017-01-01 00:00:00
abstract：:Skull base metastases (SBM) are rare among all tumors affecting the base of the skull. Because of their rarity, they have received limited attention in the published medical literature. Several clinical syndromes associated with SBM have been described. Knowledge of these syndromes and maintenance of a high index of s...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2010.08.005
更新日期：2011-01-01 00:00:00
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journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-07-01 00:00:00
abstract：:The development of radiologic criteria for the assessment of response to treatment in high-grade gliomas (HGGs) has evolved considerably over the past few decades since the original response criteria based on computed tomography imaging. Accuracy and objectivity in the assessment of response to treatment of HGGs is ne...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2012.01.006
更新日期：2012-04-01 00:00:00
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journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
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journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1996-07-01 00:00:00
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journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1993-07-01 00:00:00
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journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
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journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
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journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章
doi：
更新日期：2001-07-01 00:00:00
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journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s1042-3680(02)00010-4
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journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.nec.2019.08.007
更新日期：2020-01-01 00:00:00
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journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s1042-3680(02)00002-5
更新日期：2002-04-01 00:00:00
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journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：2000-07-01 00:00:00
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journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-04-01 00:00:00
abstract：:Clival, petroclival, and foramen magnum meningiomas are challenging lesions to manage independently of the selected surgical approach. The expanded endoscopic endonasal approach (EEA) provided a safe alternative on the armamentarium of skull base approaches. There is a paucity of literature regarding endoscopic manage...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章,评审
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abstract：:This anatomic and clinical study describes a transsacral, percutaneous approach for fixation and fusion of the L5-S1 disc. A tunnel is created into the L5-S1 disc from this approach, permitting disc removal, bone grafting, and placement of two nine-millimeter diameter titanium screws into the body of L5. There were no...
journal_title：Neurosurgery clinics of North America
pub_type： 杂志文章
doi：
更新日期：1996-01-01 00:00:00
