Abstract:
BACKGROUND:Flow diversion is increasingly used to treat intracranial aneurysms. In previous reports, patients were pretreated with aspirin and clopidogrel before the intervention for the prevention of thromboembolic complications. OBJECTIVE:To assess the safety and efficacy of a new protocol for anticoagulation using tirofiban during flow diversion. METHODS:All patients received a 0.10-μg·kg·min maintenance infusion of tirofiban intraoperatively without a loading dose. All patients were loaded with aspirin (325 mg) and clopidogrel (600 mg) just before the procedure or intraoperatively. No patient was pretreated with aspirin or clopidogrel. Thromboembolic and hemorrhagic complications were recorded. RESULTS:A total of 46 patients were treated with this protocol. Six patients (13%) had sustained a subarachnoid hemorrhage and were treated with the Pipeline Embolization Device within 24 hours of aneurysm rupture. The mean number of devices was 1.2 ± 0.66; adjunctive coiling was performed in 3 patients (6.5%). There were 2 complications (4.3%), 1 thromboembolic (2.2%) and 1 hemorrhagic (2.2%; monocular vision loss from occlusion of the central retinal artery in 1 patient and a parenchymal hemorrhage managed conservatively in another patient). No patient developed thrombocytopenia or retroperitoneal, gastrointestinal, or genitourinary bleeding. Of 46 patients, 44 (95.7%) had a modified Rankin Scale score of 0 to 2 at their follow-up visit. CONCLUSION:A protocol of anticoagulation with tirofiban during flow diversion has an excellent safety profile. This protocol provides a reasonable alternative to pretreatment with aspirin and clopidogrel and is useful in patients with ruptured aneurysms or when the use of a stent is unexpected.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Chalouhi N,Jabbour P,Daou B,Starke RM,Shields B,Hasan DMdoi
10.1227/NEU.0000000000001071subject
Has Abstractpub_date
2016-05-01 00:00:00pages
670-4issue
5eissn
0148-396Xissn
1524-4040journal_volume
78pub_type
杂志文章相关文献
NEUROSURGERY文献大全abstract:BACKGROUND:Posttraumatic seizure (PTS) is a significant complication of traumatic brain injury (TBI). OBJECTIVE:To perform a systematic review and meta-analysis to compare levetiracetam with phenytoin for seizure prophylaxis in patients diagnosed with severe TBI. METHODS:An inclusive search of several electronic data...
journal_title:Neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1227/NEU.0000000000001445
更新日期:2016-12-01 00:00:00
abstract::We previously described an experimental model for the production of invasive and noninvasive astrocytic series tumors and a semiquantitative assessment of their invasiveness. The tumors are produced by intracerebral inoculation of simian virus 40-transformed cells from four different brain regions. Cells of cerebral c...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198709000-00015
更新日期:1987-09-01 00:00:00
abstract::Two patients with spinal dural arteriovenous malformations associated with intramedullary changes confirmed by the T2-weighted magnetic resonance imaging (MRI) scans are reported. The characteristics of the MRI findings for these 2 patients were as follows. 1) In the T2-weighted spin-echo image, intramedullary changes...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198906000-00023
更新日期:1989-06-01 00:00:00
abstract::A prototype Brown-Roberts-Welles stereotactic instrument has been used as both a diagnostic and a therapeutic surgical adjunct in cases of intracranial mass lesions. Eighty-three procedures (142 point placements) required computerized guidance stereotaxy. The unit accomplished point intracranial access with an accurac...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198303000-00005
更新日期:1983-03-01 00:00:00
abstract::A case of an intracranial hematoma in a neonate causing the release of free hemoglobin into the plasma is presented. No previous such case has been described. The relationship between hemoglobinemia and the occurrence of acute renal failure in this neonate is discussed, with comments on the possible etiological role o...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198707000-00027
更新日期:1987-07-01 00:00:00
abstract:OBJECTIVE:Neurenteric cysts (NCs) typically arise as benign ventral intradural extramedullary developmental malformations of the spine which contain heterotopic epithelium resembling the intestinal or respiratory tracts. Intracerebral NCs are extremely rare, though the frequency of symptomatic reports and incidental fi...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000361998.93841.C3
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:To determine the clinical presentation, imaging characteristics, microscopic and ultrastructural characteristics, and treatment outcomes of patients with clinically silent pituitary corticotroph adenomas. METHODS:All silent corticotroph adenomas diagnosed at the Mayo Clinic during the years 1975 through 1997...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200009000-00039
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:There are no established variables that predict the success of curative resective epilepsy surgery in children with tuberous sclerosis complex (TSC). OBJECTIVE:We performed a multicenter observational study to identify preoperative factors associated with seizure outcome in children with TSC undergoing rese...
journal_title:Neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1227/NEU.0000000000000875
更新日期:2015-10-01 00:00:00
abstract::The authors review their experience with a dorsolateral approach to the anterior rim of the foramen magnum and adjacent region. The operative technique includes exposure of the vertebral artery at C1, partial resection of the occipital condyle and lateral atlantal mass, and extradural drilling of the jugular tubercle....
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199112000-00002
更新日期:1991-12-01 00:00:00
abstract:OBJECTIVE:The superior ophthalmic vein (SOV) provides an alternative venous access for the treatment of carotid-cavernous fistulae. Its direct surgical exposure and cannulation can be difficult. This study was performed to identify anatomic landmarks to facilitate localization and exposure of the SOV. METHODS:The vasc...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000340781.34122.A2
更新日期:2009-05-01 00:00:00
abstract::A case of hemangioblastoma of the right radial nerve is presented. Hemangioblastomas are rare vascular neoplasms characteristically associated with the Von Hippel-Lindau syndrome, in which they are found in the retina, the posterior fossa, and, less often, the spinal cord. Thought of as primary central nervous system ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199501000-00028
更新日期:1995-01-01 00:00:00
abstract::One hundred eighty patients affected by cerebral arteriovenous malformations (AVMs) underwent radiosurgical treatment in our department. One hundred fifty-three patients have been treated with complete irradiation of the entire AVM nidus. In 27 patients (with large and/or three-dimensional irregular target volumes), o...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Resection of cerebellopontine angle (CPA) meningiomas may result in significant neurological morbidity. Radiosurgery offers a minimally invasive alternative to surgery. OBJECTIVE:To evaluate, in a multicenter cohort study, the outcomes of patients harboring CPA meningiomas who underwent Gamma Knife radiosur...
journal_title:Neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1227/NEU.0000000000000480
更新日期:2014-10-01 00:00:00
abstract::Respiratory problems occur commonly in association with severe head injury. Seven easily measured parameters for the diagnosis of respiratory insufficiency are outlined. Certain central and peripheral causes of insufficient ventilation are analyzed, including head trauma and drug overdose as central sources and aspira...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/00006123-197711000-00016
更新日期:1977-11-01 00:00:00
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...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199204000-00020
更新日期:1992-04-01 00:00:00
abstract::An unusual case of benign stem glioma with a 15-year survival is presented. In spite of 12 years of clinical quiescence, a focus of the tumor in the upper brain stem was found at necropsy. Morphologically, the tumor was a cystic pilocytic astrocytoma. The few previously reported similar cases in the same location were...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198204000-00015
更新日期:1982-04-01 00:00:00
abstract::Two unusual cases of constrictive arachnoiditis localized to thoracic levels after Pantopaque myelography and unrelated to any operation, trauma, or disc disease at these levels are presented. The pertinent literature is reviewed. ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1980-03-01 00:00:00
abstract:OBJECTIVE:Intracranial empyemas are the most common form of intracranial suppuration seen in our unit and, despite modern antibiotic therapy and advanced neurosurgical and imaging facilities, these pus collections remain a formidable challenge, often resulting in significant morbidity and death. We present an analysis ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199903000-00055
更新日期:1999-03-01 00:00:00
abstract::Zenker's solution is a tissue fixative containing mercuric chloride, potassium bichromate, sodium sulfate, and glacial acetic acid. In 1956, Anderson and Johnson reported its use in clinical neurosurgery. They applied the solution to the exposed dura after craniectomy. Delayed bone formation was thought to be due to t...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198001000-00006
更新日期:1980-01-01 00:00:00
abstract::There has been a renewed interest in manned spaceflight due to endeavors by private and government agencies. Publicized goals include manned trips to or colonization of Mars. These missions will likely be of long duration, exceeding existing records for human exposure to extra-terrestrial conditions. Participants will...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1093/neuros/nyy531
更新日期:2020-03-01 00:00:00
abstract::Spread of spinal cord glioblastoma multiforme to the intracranial compartment is uncommon. This report documents a case of metastatic spread of glioblastoma multiforme from the spinal cord to an intracranial arachnoid cyst. Seeding of the cyst cavity could have occurred by direct permeation of the cyst wall by the neo...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198705000-00018
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of depressed and anxious mood states in patients with cervical spondylotic myelopathy (CSM), a degenerative spine condition with symptoms of neck pain, numb clumsy hands, gait difficulties, sphincter dysfunction, and impotence. To examine the relation between mood and functional de...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000166664.19662.43
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:The incidence of reoperation for ventriculoperitoneal shunts (VPS) in adults, although lower than in pediatric patients, is not insignificant. We hypothesize that adult VPS placed for hemorrhage-related hydrocephalus have a lower incidence of reoperation than those placed for other types of hydrocephalus. ME...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000335072.32105.38
更新日期:2008-07-01 00:00:00
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...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1981-09-01 00:00:00
abstract::After a meningioma situated in the trigone of the left lateral ventricle was excised by the transcallosal approach of Kempe and Blaylock, a right-handed musician with a right hemianopsia developed alexia without agraphia. In contrast to previously reported cases of this syndrome arising from other etiologies, he was u...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-197902000-00011
更新日期:1979-02-01 00:00:00
abstract:BACKGROUND:Improved training in the socioeconomic aspects of medicine is a priority of the Accreditation Council for Graduate Medical Education and the American Board of Neurological Surgeons. There is evidence that young neurosurgeons feel ill equipped in these areas and that additional education would improve patient...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000001126
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the role of transsphenoidal selective adenomectomy alone or in combination with adjuvant therapy in treatment of recurrent Cushing's disease. METHODS:A total of 16 patients with recurrent Cushing's disease underwent reoperation, 15 via a transsphenoidal approach and one ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000215945.26764.92
更新日期:2006-06-01 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::Medical care in developing countries may be improved by various means. Advances in the medical education and training of specialists play an important role in improving health care systems. The results of the efforts of a neurosurgeon from North America who helped establish neurosurgical training in Taiwan are reporte...
journal_title:Neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.1097/00006123-200106000-00035
更新日期:2001-06-01 00:00:00
abstract::From 1985 to 1991, 13 children were diagnosed at the University of Illinois College of Medicine at Peoria, Saint Francis Medical Center, with cerebral venous thrombosis (CVT) by magnetic resonance imaging scan. Ages ranged from newborn to 5 years. Six children were premature neonates, five were term neonates and two w...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199211000-00007
更新日期:1992-11-01 00:00:00