Abstract:
BACKGROUND:Scalp arteriovenous malformation (SAVM) is primarily treated by surgery and reports on endovascular treatment are scarce. We report the results of an endovascular-first approach in the treatment of SAVM. We also have proposed a simple dichotomized classification using the angiographically determined morphology findings and discussed its effect on therapeutic decision-making and outcomes. METHODS:A consecutive series of 25 patients with SAVM treated by initial or endovascular-only methods were included in the final analysis. The SAVM was categorized as a plexiform or fistulous type according to the angiographic morphology. The demographic data, treatment variables, and final clinical outcomes were analyzed and correlated with the proposed classification. RESULTS:Of the 25 patients, 21 were treated with n-butyl cyanoacrylate (n-BCA) and 3 with liquid ethylene vinyl alcohol. One patient had been treated initially with polyvinyl alcohol particles and later with n-BCA. Overall, complete or near complete obliteration (>90%) was achieved in 72%. Surgical excision was performed in 76%, most often after n-BCA embolization. Fistulous-type SAVMs required greater n-BCA concentrations (median, 33% vs. 20%; P = 0.024) and achieved greater rates of complete or near-complete obliteration (90% vs. 63%). Two patients with fistulous-type SAVMs treated with liquid ethylene vinyl alcohol showed complete resolution, and further treatment was not necessary. Overall, regardless of the embolic material used, the fistulous type demonstrated a significantly greater rate of complete obliteration (75% vs. 33%; P = 0.041) compared with plexiform type. CONCLUSION:High rates of complete and durable obliteration of SAVM are achievable with endovascular embolization. The proposed simplified classification is easy to implement and can aid in choosing the appropriate embolic agent and predicting the therapeutic outcome.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Gopinath M,Malik V,Sankara Sarma P,Rajan JE,Kannath SKdoi
10.1016/j.wneu.2018.09.092subject
Has Abstractpub_date
2019-01-01 00:00:00pages
e277-e286eissn
1878-8750issn
1878-8769pii
S1878-8750(18)32138-7journal_volume
121pub_type
杂志文章abstract:OBJECTIVE:Currently, no spinal classification system has achieved universal acceptance. Therefore, it is important to choose a reliable classification within clinical practice. The objective of this study was to determine and compare the intraobserver and interobserver agreement of the Load Sharing Classification (LSC)...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.138
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:External ventricular drains (EVDs) historically have a high rate of infection, and EVD infections are a cause of significant morbidity and mortality. We have shown previously that a simple infection control protocol reduced the rate of EVD infections during a 3-year period, and the present study examines whet...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.12.042
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:Various authors have described the morphology of the alar ligaments; however, there are no reports of a cadaveric study focusing on their attachments onto the dens. The purpose of this study was to use fresh cadaveric specimens to describe in detail different attachment patterns of the alar ligaments onto the...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.07.186
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:After showing the success of mechanical thrombectomy (MT) in treating large-vessel occlusion stroke, the target population has been expanded to include patients with smaller and more distal vessels including the M2 segment of the middle cerebral artery. We compared the procedural and clinical outcomes of pat...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.175
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Surgical treatment of patients with atlantoaxial instability caused by pathologic changes of the skull base and craniovertebral junction combined with anterior compression of the brain stem is still associated with substantial technical difficulties and remains a matter of debate. Currently, anterior stabili...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.09.124
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The nomenclature adopted for endoscopic medial maxillectomies (EMMs) is exceedingly heterogeneous. The aim of this study was to objectively measure surgical exposure in a preclinical anatomic setting to validate a classification for modular EMMs. MATERIALS AND METHODS:Computed tomography was used to scan 6 ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.12.094
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:Spontaneous spinal subdural hematoma (SSSDH) is exceedingly rare, with significant morbidity in most patients. Acute neurologic deficit in the context of a SSSDH is considered a neurosurgical emergency. We performed a literature review and compared the results with our institutional experience to evaluate the...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.10.096
更新日期:2020-10-24 00:00:00
abstract:BACKGROUND:Salivary duct carcinoma (SDC) is a rare parotid tumor that often develops as a rapidly growing mass with a poor prognosis. It has a high rate of distant metastases, sometimes with infiltration along nerves. We describe a case of SDC that originated outside the cranium and extended into the cranium along the ...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.05.180
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:Recently, the neuronavigation system (NS) has become an essential intraoperative tool for many neurosurgical procedures, allowing for precise lesion localization. It is particularly important to avoid errors during the navigation process. Here we report a novel technique using palatal positioning of the patie...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.221
更新日期:2018-08-01 00:00:00
abstract::Neurotechnology is set to expand rapidly in the coming years as technological innovations in hardware and software are translated to the clinical setting. Given our unique access to patients with neurologic disorders, expertise with which to guide appropriate treatments, and technical skills to implant brain-machine i...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2020.11.028
更新日期:2020-11-13 00:00:00
abstract::Rare anomalous courses of vertebral arteries in the craniovertebral junction may compress the spinal cord causing myelopathy. We report here the severest form of this pathologic condition successfully treated with transposition of bilateral vertebral artery using Gore-Tex tapes. A 73-year-old man presented with progre...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.10.050
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Although reoperation likely confers survival benefit for glioblastoma, whether the extent of resection (EOR) of the reoperation affects survival outcome has yet to be thoroughly evaluated in the current temozolomide (TMZ) era. The aim of this meta-analysis was to pool the current literature and evaluate the ...
journal_title:World neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.wneu.2019.03.250
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Awake craniotomy is a technique used to maximize resection of lesions in eloquent areas of the brain and preserve function. Although its use in high-income centers is well documented for tumors and vascular lesions, reports of its use in low-middle-income countries are limited. There are no published series ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.10.070
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Brain aneurysms (BAs) are the most common intracranial vascular condition, with an overall incidence of 1%-2%. Among the common causes of their initial formation and growth, the role of radiation therapy (RT) has been reported in some studies. The aim of the present study is to report the most relevant featu...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.09.157
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Visual loss can be encountered in the immediate, early, or even delayed postoperative period after resection of skull base meningiomas involving the optic apparatus. Various mechanisms for visual loss can include mechanical injury, vascular insult, optic nerve and chiasm edema, and vasospasm of the blood sup...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.06.052
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Stiff neck or nuchal rigidity is a significant clinical sign of neurologic disease. It is commonly associated with meningitis, subarachnoid hemorrhage, and posterior fossa tumors. It may also occur as a result of tonsillar impaction following pressure in the infratentorial compartment from an expanding poste...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.02.230
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Intracranial solitary fibrous tumor (SFT) is a rare occurrence and involvement of the fourth ventricle rarely reported. Because of its rarity, some characteristics of intracranial SFT seem to still remain uncertain. CASE DESCRIPTION:This study describes a very rare case of intracranial SFT in a 55-year-old ...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.07.052
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:Surgical robotics present new and unique opportunities for the training and practice of neurosurgery, beyond the promise of the minimally invasive paradigm. METHODS:Robotic systems have been developed that simulate the sight, sound, and touch of surgery allowing surgical training to evolve past an apprentice...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2010.04.005
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Severe complications after reperfusion therapy for acute major vessel occlusion are not well described. We present an extremely rare case of a patient with rapid malignant brain swelling subacutely after acute ischemic stroke. CASE DESCRIPTION:An 84-year-old man underwent reperfusion therapy for acute left ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.07.151
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Idiopathic spinal cord herniation is a rare condition that involves spinal cord herniation through a defect in the ventral dura. CASE DESCRIPTION:We present a case of a 61-year-old woman who initially presented in 2016 with an approximately 1-year history of burning right lower extremity pain and gait insta...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.05.219
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Although carotid artery stenting (CAS) has been widely acknowledged as an effective alternative option for patients at high risk of carotid endarterectomy, embolic stroke is a major complication of CAS. Several reports have emphasized that distal protection filter alone is associated with a high risk of embo...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.05.028
更新日期:2020-09-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.02.135
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Intracranial pressure monitoring remains the foundation for prevention of secondary injury after traumatic brain injury and is most commonly performed using an external ventricular drain or intraparenchymal pressure monitor. The Integra Flex ventricular catheter combines an external ventricular catheter with...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.07.213
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Spinal cord herniation (SCH) is rare, is mostly idiopathic, and occurs predominantly in the thoracic spine. SCH is less common in the cervical spine and has been reported after posterior cervical spine surgery associated with the development of pseudomeningoceles. Two cases of SCH have been reported after an...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.01.078
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:Evaluation of lumbar canal dimensions in a Chicago population born in 2 different decades. METHODS:This is a retrospective chart review analyzing computed tomography reconstruction from patients born between 1940 and 1949 (older group) and 1970 and 1979 (younger group). The cross-sectional area (CSA) and ant...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.11.039
更新日期:2020-11-16 00:00:00
abstract:BACKGROUND:Adenoidectomy is one of the most common procedures in the field of pediatric otolaryngology. Postoperative bleeding is one of the most frequent complications (0.4%). In turn, cerebrospinal fluid fistula is a very uncommon but critical complication in this type of surgery. METHODS:We report the case of a 3-y...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2016.07.053
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Endoscopic surgery for lumbar stenosis is gaining acceptance because of the minimal muscle damage, short recovery times, reduced blood loss, and good clinical results. We report a novel technique of decompressing contralateral traversing and exiting nerve roots through a single interlaminar window, avoiding ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.05.111
更新日期:2018-09-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2013.06.021
更新日期:2013-11-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.10.010
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:High-mobility group box 1 (HMGB1) was shown to be a major extracellular mediator involved in relayed neuro-inflammation in animals after subarachnoid hemorrhage (SAH). It is of interest to examine the effect of rhinacanthin-C (RCT-C, C25H30O5) on pro-inflammatory cytokines/HMGB1 in an SAH-related early brain ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.08.071
更新日期:2016-02-01 00:00:00