Abstract：
OBJECTIVE:Treatment of giant intracranial arteriovenous malformations (gAVMs) is a formidable challenge for neurosurgeons and carries significant morbidity and mortality rates for patients compared with smaller AVMs. In this study, we reviewed the treatments, angiographic results, and clinical outcomes in 64 patients with gAVMs who were treated at Henry Ford Hospital between 1980 and 2012. METHODS:The arteriovenous malformation (AVM) database at our institution was queried for patients with gAVMs (≥ 6 cm) and data regarding patient demographics, presentation, AVM angioarchitecture, and treatments were collected. Functional outcomes as well as complications were analyzed. RESULTS:Of the 64 patients, 33 (51.6%) were female and 31 (48.4%) were male, with an average age of 45.7 years (SD ± 15.5). The most common symptoms on presentation were headaches (50%), seizures (50%), and hemorrhage (41%). The mean AVM size was 6.65 cm (range, 6-9 cm). Only 6 AVMs (9.4%) were located in the posterior fossa. The most common Spetzler-Martin grade was V, seen in 64% of patients. Of the 64 patients, 42 (66%) underwent surgical excision, 10 (15.5%) declined any treatment, 8 (12.5%) were deemed inoperable and followed conservatively, 2 (3%) had stand-alone embolization, 1 (1.5%) had embolization before stereotactic radiosurgery, and 1 (1.5%) received stereotactic radiosurgery only. Complete obliteration was achieved in 90% of the surgical patients. Mortality rate was 19% in the surgical cohort compared with 22% in the observation cohort (P = 0.770). CONCLUSIONS:Treatment of gAVMs carries significant morbidity and mortality; however, good outcomes are attainable with a multimodal treatment approach in carefully selected patients.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Reinard KA,Pabaney AH,Basheer A,Phillips SB,Kole MK,Malik GMdoi
10.1016/j.wneu.2015.07.051subject
Has Abstractpub_date
2015-12-01 00:00:00pages
1765-78issue
6eissn
1878-8750issn
1878-8769pii
S1878-8750(15)00921-3journal_volume
84pub_type
杂志文章abstract：OBJECTIVE:Postoperative cerebrospinal fluid (CSF) leak in neurosurgery remains a significant source of morbidity. TissuePatchDural (TPD), a novel impermeable adhesive membrane, can be used to reinforce dural closure in cases considered at high risk to develop postoperative CSF leak. METHODS:A retrospective, single-cen...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2011.09.022
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abstract：BACKGROUND:The aim of this study was to analyze the clinical outcomes of diagnostic transforaminal epidural injection (DTEI) in selective percutaneous endoscopic lumbar discectomy for multilevel disc herniation with monoradicular symptom. METHODS:A prospective randomized clinical study was performed from November 2013...
journal_title：World neurosurgery
pub_type： 杂志文章,随机对照试验
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更新日期：2019-06-01 00:00:00
abstract：BACKGROUND:Neuroglial cysts are rare intracranial lesions that are believed to originate from the sequestration of neural tube lining during embryogenesis. They can present anywhere within the neuraxis; however, their most common location is the frontal lobe. Cerebellopontine angle (CPA) neuroglial cysts are extremely ...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.12.203
更新日期：2019-01-17 00:00:00
abstract：BACKGROUND:Major depressive disorder is a common and disabling illness and is the leading cause of disability worldwide. Despite aggressive medical, behavioral, and electroconvulsive therapies, a significant number of patients remain refractory to treatment. Deep brain stimulation (DBS) has proven efficacy in neurobeha...
journal_title：World neurosurgery
pub_type： 历史文章,杂志文章,评审
doi：10.1016/j.wneu.2012.10.068
更新日期：2013-09-01 00:00:00
abstract：BACKGROUND:Altered mental status (AMS) has been associated with inferior surgical outcomes. The factors leading to AMS after spine surgery are unknown. The aim of this study is to determine the risk factors and independent predictors of 30-day readmission for AMS in patients with spine deformity after undergoing electi...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2017.02.001
更新日期：2017-05-01 00:00:00
abstract：OBJECTIVE:Dorsal longitudinal T-myelotomy is a long-established operation to treat severe spastic paraplegia. The present study aimed to report this surgical technique and investigate the efficacy of T-myelotomy for spasticity relief. METHODS:All cases undergoing T-myelotomy for treatment of intractable spastic parapl...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.05.008
更新日期：2018-08-01 00:00:00
abstract：BACKGROUND:Parkinson disease (PD) is a major risk factor during spine surgery, and its frequency is increasing as the population ages. The study aim was to examine the influence of PD specifically on lumbar decompression surgery. METHODS:A retrospective review was performed of all patients with PD who underwent electi...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2017.09.028
更新日期：2017-12-01 00:00:00
abstract：BACKGROUND:Resection of left hemisphere (LH) tumors is often complicated by the risks of causing language dysfunction. Although neurosurgeons' concerns when operating on the presumed dominant hemisphere are well known, literature evaluating laterality as a predictive surgical parameter in glioblastoma (GB) patients is ...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.02.084
更新日期：2018-06-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.01.018
更新日期：2018-03-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章,评审
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更新日期：2019-06-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2019.06.150
更新日期：2019-10-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2019.09.125
更新日期：2020-01-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2013.01.096
更新日期：2014-02-01 00:00:00
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pub_type： 杂志文章
doi：10.1016/j.wneu.2019.03.124
更新日期：2019-06-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2020.10.050
更新日期：2021-01-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2017.06.013
更新日期：2017-09-01 00:00:00
abstract：OBJECTIVES:The pathophysiology of traumatic brain injury (TBI) largely involves the brains vascular structural integrity. We analyzed the value of an intraoperative cortical indocyanine green (ICG) angiography in patients with severe TBI and acute subdural hematoma who underwent decompressive craniectomy. METHODS:ICG-...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2017.01.054
更新日期：2017-05-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
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更新日期：2020-05-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
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更新日期：2020-05-01 00:00:00
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journal_title：World neurosurgery
pub_type：
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更新日期：2020-11-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.09.134
更新日期：2019-01-01 00:00:00
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更新日期：2020-12-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2016.01.087
更新日期：2016-06-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
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更新日期：2020-02-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
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更新日期：2018-10-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
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更新日期：2018-03-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.wneu.2016.12.132
更新日期：2017-04-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.09.132
更新日期：2019-01-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
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更新日期：2019-03-01 00:00:00
abstract：:This report portrays our pitfall in the initial diagnosis of an intracranial arterial dissection that we misinterpreted as a saccular aneurysm. Intracranial arterial dissections presenting with convexity subarachnoid hemorrhage are rare, thus being easily mistaken with mild traumatic head injuries and therefore preven...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2016.11.145
更新日期：2017-02-01 00:00:00
