Aneurysmal and microaneurysmal "angiogram-negative" subarachnoid hemorrhage.


:The source of bleeding remains obscure in most cases of subarachnoid hemorrhage (SAH) with a negative angiogram. From January 1, 1989, to July 1, 1993, 40 patients were admitted to the Massachusetts General Hospital with angiogram-negative SAH; 9 of these patients underwent surgical exploration. In seven of these explorations, an arterial source of the hemorrhage was discovered. These arterial sources included three anterior communicating artery complex lesions, two middle cerebral artery lesions, one internal carotid artery aneurysm arising at the origin of the posterior communicating artery, and one vertebral/posterior inferior cerebellar artery aneurysm. Three of these seven lesions had small aneurysmal sacs, but the other four were microaneurysms too small to accept a surgical clip. No source of hemorrhage could be found during surgery on one patient with a perimesencephalic pattern of blood. Two of the four patients with a microaneurysmal source of hemorrhage had two episodes of SAH. We propose that microaneurysms are the source of a significant percentage of nonperimesencephalic angiogram-negative SAH and suggest that these lesions may represent a forme fruste of saccular aneurysms. These findings lead us to propose a protocol for the management of angiogram-negative SAH based on the distribution of blood as seen on the patient's first computed tomogram.






Tatter SB,Crowell RM,Ogilvy CS




Has Abstract


1995-07-01 00:00:00












  • Supraorbital-pterional approach to skull base lesions.

    abstract::A surgical approach to the skull base is described. It allows excellent exposure of the cranial base with minimal brain retraction. Deep lesions can be handled via subfrontal, transsylvian, or subtemporal routes during the same operation. This approach is most suitable for large lesions in the suprasellar, parasellar,...


    pub_type: 杂志文章


    authors: Al-Mefty O

    更新日期:1987-10-01 00:00:00

  • Neurosurgery at the University of Michigan.

    abstract::Neurosurgery at the University of Michigan was established as a specialty three-quarters of a century ago by Max Minor Peet. It developed under the successive leadership of Edgar Allan Kahn, Richard Coy Schneider, and Julian T. Hoff. Each has made unique contributions to the program, which has a strong tradition of te...


    pub_type: 传,历史文章,杂志文章


    authors: Hoff JT,Taren JA

    更新日期:1995-07-01 00:00:00

  • Cerebral arterial revascularization: the value of repeated angiography in selection of patients for operation.

    abstract::Three patients with occlusive cerebrovascular disease were evaluated for possible extracranial-intracranial arterial anastomosis. Cerebral angiography repeated at a later date revealed disappearance of the initial vascular stenosis or occlusion and development of extensive collateral circulation. It was concluded in t...


    pub_type: 杂志文章


    authors: Fox JL

    更新日期:1978-05-01 00:00:00

  • The use of electroencephalography and brain protection during operation for basilar aneurysms.

    abstract::Intraoperative monitoring with electroencephalography and the use of brain protection with steroids, phenytoin, mannitol, and pentobarbital or etomidate were evaluated in 15 patients undergoing operation for an aneurysm of the upper basilar artery. One patient harbored a basilar trunk aneurysm, 1 an aneurysm of the pr...


    pub_type: 杂志文章


    authors: Muizelaar JP

    更新日期:1989-12-01 00:00:00

  • Lysis of intraventricular blood clot with urokinase in a canine model: Part 3. Effects of intraventricular urokinase on clot lysis and posthemorrhagic hydrocephalus.

    abstract::Nine millilitres of preclotted autologous blood was injected into the ventricles of 10 adult mongrel dogs (control dogs) to create subtotal ventricular casts with solid clots. The neurological status and systemic fibrinolytic profiles were closely monitored, and the changes in clot and ventricular volumes were measure...


    pub_type: 杂志文章


    authors: Pang D,Sclabassi RJ,Horton JA

    更新日期:1986-10-01 00:00:00

  • Lateral positioning technique for the treatment of far-lateral targets with the Leksell gamma knife: technical note.

    abstract:OBJECTIVE:To describe a procedure for Leksell gamma knife (LGK) radiosurgery in a lateral position, for treatment of far-lateral intracranial lesions. METHODS:Positioning of the patient in the lateral decubitus position during LGK treatment switches the x and y axis coordinates. This increases the range of the x axis ...


    pub_type: 杂志文章


    authors: Massager N,Régis J,Porcheron D,Devriendt D,Desmedt F,Levivier M

    更新日期:2002-12-01 00:00:00

  • Pseudotumor syndrome resulting from a cerebral arteriovenous malformation: case report.

    abstract::We report a case of a cerebral arteriovenous malformation presenting as a pseudotumor cerebri syndrome. The lack of mass effect, hemorrhage, or hydrocephalus, in addition to angiographic evidence of high-flow and venous outflow restriction, implicate increased cerebral blood flow and venous hypertension as the mechani...


    pub_type: 杂志文章,评审


    authors: David CA,Peerless SJ

    更新日期:1995-03-01 00:00:00

  • The prognostic significance of Ki-67 labeling indices for oligodendrogliomas.

    abstract:OBJECTIVE:The prognostic significance of quantitative measurement of tumor proliferative activity was evaluated for oligodendroglial tumors. METHODS:Ki-67/MIB-1 immunochemistry was used to measure proliferative activity in 81 oligodendrogliomas and oligoastrocytomas. The relationship among survival, proliferation, his...


    pub_type: 杂志文章


    authors: Coons SW,Johnson PC,Pearl DK

    更新日期:1997-10-01 00:00:00

  • O-desulfated heparin improves outcome after rat cerebral ischemia/reperfusion injury.

    abstract:OBJECTIVE:Inflammatory cascades play a significant role in progressive neurological injury after transient cerebral ischemia. It has been demonstrated that heparin, a potent anticoagulant, also possesses anti-inflammatory properties that diminish postreperfusion damage after stroke. However, the potential for heparin t...


    pub_type: 杂志文章


    authors: Mocco J,Shelton CE,Sergot P,Ducruet AF,Komotar RJ,Otten ML,Sosunov SA,Macarthur RB,Kennedy TP,Connolly ES Jr

    更新日期:2007-12-01 00:00:00

  • Thromboxane synthase inhibitors induce apoptosis in migration-arrested glioma cells.

    abstract:OBJECTIVE:Because of the wide dissemination of malignant glioma cells by the time that malignant glioma is diagnosed, anti-invasive strategies that are designed to limit their further spread may be of little value unless mechanisms of the invasive cascade can be used to render invasive cells susceptible to cytoreductiv...


    pub_type: 杂志文章


    authors: Yoshizato K,Zapf S,Westphal M,Berens ME,Giese A

    更新日期:2002-02-01 00:00:00

  • Pheochromocytoma presenting as a skull metastasis with massive extracranial and intracranial extension.

    abstract::A case of metastatic pheochromocytoma is reported in which the diagnosis was determined on the basis of a painless scalp mass. Subsequent to biopsy and histological diagnosis, further investigations revealed a large skull lesion with intracranial extension, an adrenal mass, and various catecholamine abnormalities. The...


    pub_type: 杂志文章


    authors: Grabel JC,Gottesman RI,Moore F,Averbuch S,Zappulla R

    更新日期:1990-07-01 00:00:00

  • Percutaneous radiofrequency upper thoracic sympathectomy.

    abstract::Between June 1979 and May 1994, I performed 148 unilateral or bilateral sympathectomies on 247 limbs in 110 patients using a percutaneous radiofrequency technique, usually on an outpatient surgery basis. Patient ages ranged from 10 to 81 years, with 45 male and 65 female patients. Four patients had unsuccessfully unde...


    pub_type: 杂志文章


    authors: Wilkinson HA

    更新日期:1996-04-01 00:00:00

  • In situ bypass in the management of complex intracranial aneurysms: technique application in 13 patients.

    abstract:OBJECTIVE:Cerebral revascularization is an important part of the treatment of complex intracranial aneurysms that require deliberate occlusion of a parent artery. In situ bypass brings together intracranial donor and recipient arteries that lie parallel and in close proximity to one another rather than using an extracr...


    pub_type: 杂志文章


    authors: Quiñones-Hinojosa A,Lawton MT

    更新日期:2005-07-01 00:00:00

  • Relationship between flow cytometric features and clinical behavior of meningiomas.

    abstract::Meningiomas have a wide range of biological potential and clinical behavior. Histological findings are helpful in recognizing the malignant potential of a given tumor, but often fail to correlate with gross features, liability of recurrence, and extent of associated cerebral edema. To find alternate approaches to impr...


    pub_type: 杂志文章


    authors: Crone KR,Challa VR,Kute TE,Moody DM,Kelly DL Jr

    更新日期:1988-12-01 00:00:00

  • Efficacy of tissue plasminogen activator in the lysis of thrombosis of the cerebral venous sinus.

    abstract::Therapy for thrombo-occlusive disease of the cerebral venous sinuses remains controversial. Although several thrombolytic agents, such as urokinase and anticoagulants, are recommended for treatment, major significant risks include cerebral hemorrhage, especially in patients with venous infarction. Tissue plasminogen a...


    pub_type: 杂志文章


    authors: Alexander LF,Yamamoto Y,Ayoubi S,al-Mefty O,Smith RR

    更新日期:1990-04-01 00:00:00

  • A preliminary study of the prognostic value of proton magnetic resonance spectroscopic imaging in gamma knife radiosurgery of recurrent malignant gliomas.

    abstract:OBJECTIVE:The goal of this study was to investigate the use of proton magnetic resonance spectroscopic imaging as a prognostic indicator in gamma knife radiosurgery of recurrent gliomas. METHODS:Thirty-six patients with recurrent gliomas were studied with proton magnetic resonance spectroscopic imaging at the time of ...


    pub_type: 杂志文章


    authors: Graves EE,Nelson SJ,Vigneron DB,Chin C,Verhey L,McDermott M,Larson D,Sneed PK,Chang S,Prados MD,Lamborn K,Dillon WP

    更新日期:2000-02-01 00:00:00

  • Posterior interhemispheric approach: surgical technique, application to vascular lesions, and benefits of gravity retraction.

    abstract:OBJECTIVE:To review an experience with the posterior interhemispheric approach applied to vascular lesions in the posterior midline, to examine the effects of patient position and gravity retraction of the occipital lobe, and to identify circumstances requiring increased exposure by sectioning the falx and tentorium. ...


    pub_type: 杂志文章


    authors: Chi JH,Lawton MT

    更新日期:2006-07-01 00:00:00

  • Reactive expansive intracerebral process as a complication of endovascular coil treatment of an unruptured intracranial aneurysm: case report.

    abstract:BACKGROUND AND IMPORTANCE:As a consequence of the increased use of endovascular coiling of intracranial aneurysms, a growing number of case reports on complications are being reported. This article presents a case with a previously undescribed complication of coil treatment: a reactive, noninfectious process after coil...


    pub_type: 杂志文章


    authors: König M,Bakke SJ,Scheie D,Sorteberg W,Meling TR

    更新日期:2011-05-01 00:00:00

  • Oculomotor nerve repair using interposed nerve graft.

    abstract::A case of interposed nerve graft repair of an oculomotor nerve damaged during surgery for a laterally growing retrosellar pituitary adenoma is reported. The patient showed partial but functionally useful recovery of nerve function and was able to resume professional work. Only a few reports of end-to-end repair have b...


    pub_type: 杂志文章


    authors: Krajewski R

    更新日期:1992-04-01 00:00:00

  • Quality of life in patients 2 to 4 years after closed head injury.

    abstract::This study evaluated quality of life in 78 patients with closed head injury (CHI) 2 to 4 years postinjury. Using both interview data and mean data from the Sickness Impact Profile questionnaire, impaired quality of life was observed in the areas of psychosocial functioning, social role functioning, leisure activities,...


    pub_type: 杂志文章


    authors: Klonoff PS,Snow WG,Costa LD

    更新日期:1986-11-01 00:00:00

  • Posterior-only approach for en bloc sacrectomy: clinical outcomes in 36 consecutive patients.

    abstract:BACKGROUND:En bloc resection of primary sacral tumors has a demonstrated survival benefit. Total and high sacral amputations are traditionally performed by using a staged anterior and subsequent posterior approach. However, we have found that en bloc resection and biomechanical reconstruction of the spinal column is po...


    pub_type: 临床试验,杂志文章


    authors: Clarke MJ,Dasenbrock H,Bydon A,Sciubba DM,McGirt MJ,Hsieh PC,Yassari R,Gokaslan ZL,Wolinsky JP

    更新日期:2012-08-01 00:00:00

  • Mechanisms of whole blood-induced cerebral arterial contraction.

    abstract::Using rabbit cerebral arteries in an in vitro chamber, we examined the cerebral arterial contraction initiated by clotting whole blood. By using methysergide maleate and a novel thromboxane synthetase inhibitor, 1-carboxyheptylimidazole (1-CHI), we studied the contributions of both serotonin and the prostaglandin meta...


    pub_type: 杂志文章


    authors: Schumacher MA,Alksne JF

    更新日期:1981-09-01 00:00:00

  • Dissecting aneurysms of the bilateral vertebral arteries with subarachnoid hemorrhage: report of three cases.

    abstract:OBJECTIVE AND IMPORTANCE:Treatment of one side in cases of dissecting aneurysms of the bilateral vertebral arteries (VAs) with subarachnoid hemorrhage may result in dissection or rupture on the contralateral side. CLINICAL PRESENTATION:Three patients presented with dissecting aneurysms of the bilateral VAs with subara...


    pub_type: 杂志文章


    authors: Otawara Y,Ogasawara K,Ogawa A,Kogure T

    更新日期:2002-06-01 00:00:00

  • Patient-Level Factors Influencing Hospital Costs and Short-Term Patient-Reported Outcomes After Transsphenoidal Resection of Sellar Tumors.

    abstract:BACKGROUND:Identifying which factors influence treatment costs of transsphenoidal surgery for removal of sellar lesions can be complex. OBJECTIVE:To identify which patient-level factors are associated with higher costs and evaluate the relationship between expenditures and short-term patient-reported outcomes. METHOD...


    pub_type: 杂志文章


    authors: Guan J,Karsy M,Bisson EF,Couldwell WT

    更新日期:2018-10-01 00:00:00

  • Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Evaluation and Treatment of Patients with Thoracolumbar Spine Trauma: Surgical Approaches.

    abstract:QUESTION:Does the choice of surgical approach (anterior, posterior, or combined anterior-posterior) improve clinical outcomes in patients with thoracic and lumbar fractures? RECOMMENDATIONS:In the surgical treatment of patients with thoracolumbar burst fractures, physicians may use an anterior, posterior, or a combine...


    pub_type: 指南,杂志文章


    authors: Anderson PA,Raksin PB,Arnold PM,Chi JH,Dailey AT,Dhall SS,Eichholz KM,Harrop JS,Hoh DJ,Qureshi S,Rabb CH,Kaiser MG,O'Toole JE

    更新日期:2019-01-01 00:00:00

  • Beneficial effect of subsequent lesion procedures after nonresponse to initial cingulotomy for severe, treatment-refractory obsessive-compulsive disorder.

    abstract:BACKGROUND:Anterior cingulotomy (AC) can be an effective therapy for patients with severe obsessive-compulsive disorder who are refractory to traditional medical therapy. For patients who do not respond to AC, the benefit of additional lesion procedures vs continued medical management remains unknown. OBJECTIVE:To det...


    pub_type: 杂志文章


    authors: Bourne SK,Sheth SA,Neal J,Strong C,Mian MK,Cosgrove GR,Eskandar EN,Dougherty DD

    更新日期:2013-02-01 00:00:00

  • Primary osteogenic sarcoma of the skull: case report.

    abstract::A case of primary osteogenic sarcoma of the skull with metastases to the lungs, left diaphragm, 2nd lumbar and 1st sacral vertebral bodies, and both femoral heads was presented. A young man with a lump over his right parieto-occipital region since the age of 14 had noticed rapid growth of the mass after having experie...


    pub_type: 杂志文章


    authors: Wang YC,Shih CJ,Leu FJ,Tu YC

    更新日期:1981-09-01 00:00:00

  • Prognostic implications of p53 overexpression in supratentorial astrocytic tumors.

    abstract::The wild-type p53 gene is thought to play a critical role in tumor suppression and has been shown to reverse the transformed phenotype of tumor cells in vitro. Mutational inactivation of this aspect of p53 activity occurs frequently in many human neoplasms, including astrocytomas, and is thought to represent a critica...


    pub_type: 杂志文章


    authors: Chozick BS,Pezzullo JC,Epstein MH,Finch PW

    更新日期:1994-11-01 00:00:00

  • Severe cervical kyphotic deformities in patients with plexiform neurofibromas: case report.

    abstract::Two patients with cervical plexiform neurofibromas are presented. Each of these patients had severe cervical kyphosis and has undergone anterior decompression, anterior reconstruction, and posterior stabilization. We discuss the surgical management of cervical kyphotic deformities associated with plexiform neurofibrom...


    pub_type: 杂志文章


    authors: Ward BA,Harkey HL,Parent AD,McGuire RA Jr,Kendig RJ

    更新日期:1994-11-01 00:00:00

  • Aneurysms at a temporopolar artery origin from the internal carotid artery: report of two cases.

    abstract:OBJECTIVE AND IMPORTANCE:Origination of the temporopolar artery (TPA) from the supraclinoid internal carotid artery (ICA) represents a rare anatomic variation, and the presence of aneurysms at this uncommon site has never before been reported. CLINICAL PRESENTATION:Two patients presented with a sudden onset of headach...


    pub_type: 杂志文章


    authors: Alkadhi H,Schuknecht B,Imhof HG,Yonekawa Y

    更新日期:2003-05-01 00:00:00