Abstract:
OBJECTIVE:We endeavored to develop an unruptured intracranial aneurysm (UIA) treatment score (UIATS) model that includes and quantifies key factors involved in clinical decision-making in the management of UIAs and to assess agreement for this model among specialists in UIA management and research. METHODS:An international multidisciplinary (neurosurgery, neuroradiology, neurology, clinical epidemiology) group of 69 specialists was convened to develop and validate the UIATS model using a Delphi consensus. For internal (39 panel members involved in identification of relevant features) and external validation (30 independent external reviewers), 30 selected UIA cases were used to analyze agreement with UIATS management recommendations based on a 5-point Likert scale (5 indicating strong agreement). Interrater agreement (IRA) was assessed with standardized coefficients of dispersion (vr*) (vr* = 0 indicating excellent agreement and vr* = 1 indicating poor agreement). RESULTS:The UIATS accounts for 29 key factors in UIA management. Agreement with UIATS (mean Likert scores) was 4.2 (95% confidence interval [CI] 4.1-4.3) per reviewer for both reviewer cohorts; agreement per case was 4.3 (95% CI 4.1-4.4) for panel members and 4.5 (95% CI 4.3-4.6) for external reviewers (p = 0.017). Mean Likert scores were 4.2 (95% CI 4.1-4.3) for interventional reviewers (n = 56) and 4.1 (95% CI 3.9-4.4) for noninterventional reviewers (n = 12) (p = 0.290). Overall IRA (vr*) for both cohorts was 0.026 (95% CI 0.019-0.033). CONCLUSIONS:This novel UIA decision guidance study captures an excellent consensus among highly informed individuals on UIA management, irrespective of their underlying specialty. Clinicians can use the UIATS as a comprehensive mechanism for indicating how a large group of specialists might manage an individual patient with a UIA.
journal_name
Neurologyjournal_title
Neurologyauthors
Etminan N,Brown RD Jr,Beseoglu K,Juvela S,Raymond J,Morita A,Torner JC,Derdeyn CP,Raabe A,Mocco J,Korja M,Abdulazim A,Amin-Hanjani S,Al-Shahi Salman R,Barrow DL,Bederson J,Bonafe A,Dumont AS,Fiorella DJ,Gruber A,Hdoi
10.1212/WNL.0000000000001891subject
Has Abstractpub_date
2015-09-08 00:00:00pages
881-9issue
10eissn
0028-3878issn
1526-632Xpii
WNL.0000000000001891journal_volume
85pub_type
共识发展会议,杂志文章相关文献
NEUROLOGY文献大全abstract:OBJECTIVE:To determine the stage of training at which neurology residents should achieve individual elements of the Accreditation Council for Graduate Medical Education neurology Milestones and to examine the relationship between perceived importance of Milestones and the stage by which they should be achieved. METHOD...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000006361
更新日期:2018-10-16 00:00:00
abstract::The incidence of new-onset epilepsy is higher among the elderly, the most rapidly growing segment of the population, than in any other age group. New-onset seizures in elderly patients are typically cryptogenic or symptomatic partial seizures that require long-term treatment. Because seizures in the elderly are often ...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/wnl.63.10_suppl_4.s40
更新日期:2004-11-23 00:00:00
abstract:OBJECTIVE:The natural history of succinic semialdehyde dehydrogenase (SSADH) deficiency in adulthood is unknown; we elucidate the clinical manifestations of the disease later in life. METHODS:A 63-year-old man with long-standing intellectual disability was diagnosed with SSADH deficiency following hospitalization for ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000001906
更新日期:2015-09-08 00:00:00
abstract:OBJECTIVE:This study was conducted to determine the relationship of frontal lobe cortical thickness and basal ganglia volumes to measures of cognition in adults with sickle cell anemia (SCA). METHODS:Participants included 120 adults with SCA with no history of neurologic dysfunction and 33 healthy controls (HCs). Part...
journal_title:Neurology
pub_type: 杂志文章,多中心研究
doi:10.1212/WNL.0000000000000188
更新日期:2014-03-11 00:00:00
abstract::We reviewed 44 cases of ischemia and infarction of the spinal cord at two university hospitals. Three patients experienced transient ischemic attacks. Etiologies of completed strokes were diverse and included rupture and surgical repair of aortic aneurysms, aortic dissection, aortic rupture and thrombosis, global isch...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.47.2.321
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:To describe the clinical characteristics of encounters with patients misdiagnosed with multiple sclerosis (MS). METHODS:A cross-sectional Internet-based physician survey of MS specialists was performed. RESULTS:The response rate for the survey was 50.4%. Of those who responded, the majority (95%) reported h...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e318259e1b2
更新日期:2012-06-12 00:00:00
abstract:BACKGROUND:Pregnancy registries for women taking anticonvulsant drugs have been developed to determine more efficiently the fetal risks of each drug. A total of 722 drug-exposed pregnancies are needed to identify a sevenfold increase in the rate of occurrence of a specific abnormality, such as spina bifida, with a freq...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000304343.45104.d6
更新日期:2008-05-27 00:00:00
abstract::The authors report three patients with acute, chronic, and recurrent neuropathy associated with varicella zoster virus (VZV) infection but without zoster rash. CSF of all three patients contained VZV immunoglobulin G antibody, but not herpes simplex virus. In two patients, serum/CSF ratios of VZV immunoglobulin G were...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.57.2.351
更新日期:2001-07-24 00:00:00
abstract:OBJECTIVE:To determine whether groups of surrogates for patients with severe acute brain injury (SABI) with poor prognosis can be identified based on their prioritization of goals-of-care (GOC) decisional concerns, an online survey of 1,588 adults recruited via a probability-based panel representative of the US populat...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000009406
更新日期:2020-05-12 00:00:00
abstract:OBJECTIVE:To assess the impact of intracranial arterial stenosis on the progression from mild cognitive impairment (MCI) to Alzheimer disease (AD). METHODS:A total of 423 participants with MCI were included and evaluated with clinical and neuropsychological examinations annually for 4 years. The incidence of dementia ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000000185
更新日期:2014-03-11 00:00:00
abstract::We compared MRI and CT in a study of 175 patients; 87 infarcts within a week, 40 from 1 to 40 weeks, 25 a year after onset, and 23 hemorrhages, 18 within 2 weeks and 5 in 4 to 8 weeks. Fifty-nine infarcts and eight hemorrhages had sequential scanning. MRI is more sensitive than CT in the early detection of cerebral in...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.37.10.1580
更新日期:1987-10-01 00:00:00
abstract:OBJECTIVES:We aimed to determine the incidence of electrographic seizures in children in the pediatric intensive care unit who underwent EEG monitoring, risk factors for electrographic seizures, and whether electrographic seizures were associated with increased odds of mortality. METHODS:Eleven sites in North America ...
journal_title:Neurology
pub_type: 杂志文章,多中心研究
doi:10.1212/WNL.0b013e31829c5cfe
更新日期:2013-07-23 00:00:00
abstract::Tracheostomy has been employed to release the airway obstruction at the glottic level and to prevent sudden death in patients with multiple system atrophy (MSA). However, sudden death is possible even after tracheostomy. Nocturnal polysomnography showed that the apnea-hypopnea index became higher after tracheostomy, a...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000260975.74618.d7
更新日期:2007-05-08 00:00:00
abstract:OBJECTIVE:To determine the risk of seizure recurrence after a first seizure due to neurocysticercosis (NC) and to evaluate risk factors for seizure recurrence, including the influence of antihelminthic treatment. METHODS:The authors prospectively followed 77 patients with a first seizure and active or transitional NC ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000036320.69823.ea
更新日期:2002-12-10 00:00:00
abstract:BACKGROUND:The incidence of acquired demyelination of the CNS (acquired demyelinating syndromes [ADS]) in children is unknown. It is important that physicians recognize the features of ADS to facilitate care and to appreciate the future risk of multiple sclerosis (MS). OBJECTIVE:To determine the incidence, clinical fe...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000339482.84392.bd
更新日期:2009-01-20 00:00:00
abstract::Intracerebral hemorrhage (ICH) represents 8 to 15% of all strokes in the United States and 20 to 30% of all strokes in Japan and China. Although ICH represents a relatively small fraction of total strokes, it is a formidable disease, with a 30-day mortality rate two- to sixfold higher than that for ischemic stroke. Fu...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/wnl.51.3_suppl_3.s69
更新日期:1998-09-01 00:00:00
abstract::Using PET with the opioidergic ligand [11C]diprenorphine, the authors demonstrate decreased tracer binding in the pineal gland of cluster headache patients vs healthy volunteers. Opioid receptor availability in the hypothalamus and cingulate cortex depended on the duration of the headache disorder. Therefore, the path...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000204225.15947.f8
更新日期:2006-04-11 00:00:00
abstract::We studied 96 Chinese patients with TIAs using transcranial Doppler and duplex ultrasonography. We found intracranial stenosis or occlusion in 51% of cases and extracranial disease in 19% of cases. The most common intracranial lesion was stenosis of the terminal internal carotid artery or proximal middle cerebral arte...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.48.2.524
更新日期:1997-02-01 00:00:00
abstract::We report a patient with unusual MRI abnormalities that had the physical characteristics of ferromagnetic artifact. We believe that the MRI artifacts were due to microscopic embolic metal fragments, most likely from a mechanical heart valve prosthesis. Potential sources of metal emboli should be considered in patients...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.49.5.1451
更新日期:1997-11-01 00:00:00
abstract::We developed a rating scale for tic disorders that uses only objective criteria and accommodates the variety of tic manifestations. Using short videotaped recordings with the examiner out of the taping room, we measured five tic variables: number of body areas affected, frequency of motor tics and vocalizations, and s...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.37.9.1542
更新日期:1987-09-01 00:00:00
abstract::Retraction of the lower eyelid is a useful sign of disease. It is an early manifestation of weakness of the facial muscles, occurring with myopathies, myasthenia, and upper and lower motor neuron facial paresis. Rarely, lower and upper lid retraction occur without proptosis in patients with Graves disease. Lower lid r...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.29.3.386
更新日期:1979-03-01 00:00:00
abstract:OBJECTIVE:To generate a national multiple sclerosis (MS) prevalence estimate for the United States by applying a validated algorithm to multiple administrative health claims (AHC) datasets. METHODS:A validated algorithm was applied to private, military, and public AHC datasets to identify adult cases of MS between 200...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000007035
更新日期:2019-03-05 00:00:00
abstract:OBJECTIVE:To evaluate the safety, tolerability, and efficacy of glatiramer acetate (GA) 40 mg daily vs the approved 20-mg formulation in relapsing-remitting multiple sclerosis. METHODS:Eligibility criteria included clinically definite multiple sclerosis, Expanded Disability Status Scale score 0 to 5.0, no previous use...
journal_title:Neurology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1212/01.wnl.0000257109.61671.06
更新日期:2007-03-20 00:00:00
abstract::We determined the gene frequencies for the alleles of the HLA-linked complement markers C2, properdin factor B (BF), C4A (Rodgers) and C4B (Chido), and the red cell enzyme glyoxalase-I in 38 unrelated patients with senile dementia of the Alzheimer type, 42 patients with idiopathic Parkinson's disease, and 59 unaffecte...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.34.3.310
更新日期:1984-03-01 00:00:00
abstract:OBJECTIVE:To investigate clinical and economic consequences following generic substitution of one vs multiple generics of topiramate (Topamax; Ortho-McNeil Neurologics, Titusville, NJ). METHODS:Medical and pharmacy claims data of Régie de l'Assurance-Maladie du Québec from January 2006 to October 2007 were used. Patie...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e3181aa5300
更新日期:2009-06-16 00:00:00
abstract::The present study quantitatively assessed volumes of the amygdala and its subnuclei in autopsied cases of advanced Alzheimer's disease (AD) for comparison with age-matched controls. Amygdalar nuclei showed significant atrophy in AD with the exception of the paralaminar portion of the basal nucleus. The magnocellular r...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.41.3.351
更新日期:1991-03-01 00:00:00
abstract::The clinical and genetic findings are described for 16 patients from a large Italian family with a variant form of hereditary spastic paraplegia and congenital arachnoid cysts inherited as an autosomal dominant trait. A molecular study has revealed a novel missense mutation, T614I, in exon 17 of SPG4, which may play a...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000125324.32082.d9
更新日期:2004-05-25 00:00:00
abstract:OBJECTIVE:Spinal cord (SC) lesions are frequently found in multiple sclerosis (MS), but are rare in healthy aging and cerebrovascular patients. Our aim was to analyze the contribution of SC involvement in clinically isolated syndrome (CIS) in diagnosing MS according the McDonald 2010 criteria and in predicting conversi...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e31827b1a67
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To estimate rate of progression from normal cognition or mild impairment to dementia, and to identify potential risk and protective factors for incident dementia, based on age at dementia onset in a prospective study of a population-based cohort (n = 1,982) aged 65 years and older. METHODS:Following the coho...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000001113
更新日期:2015-01-06 00:00:00
abstract::Seven hours after 39 migraineurs and 37 controls consumed an amino acid drink that contained or omitted l-tryptophan (thereby reducing brain serotonin synthesis), motion sickness was provoked by the visual illusion of movement. Tryptophan depletion boosted dizziness, nausea, and the illusion of movement in controls to...
journal_title:Neurology
pub_type: 杂志文章,随机对照试验
doi:10.1212/01.wnl.0000172339.15577.a6
更新日期:2005-08-23 00:00:00