Angiotensin converting enzyme inhibition for arterial hypertension reduces the risk of recurrence in patients with chronic subdural hematoma possibly by an antiangiogenic mechanism.

Abstract:

OBJECTIVE:Chronic subdural hematoma (CSH) is characterized by pathological vascularization of the parietal membrane. Plasma leakage from immature vessels may be involved in hematoma enlargement and recurrence. We tested the hypothesis that the antiangiogenic side-effect of angiotensin converting enzyme (ACE)-inhibitor treatment for the control of arterial hypertension reduces the risk of recurrence in CSH. METHODS:We analyzed the data of 438 patients with CSH treated by a standard surgical procedure for hematoma evacuation in our department between 1995 and 2003. Patients with coagulopathies, malignancies, and independent neurological disorders were excluded from this study. Patient records were screened for age, sex, pre- and postoperative Markwalder score, arterial hypertension, medication with ACE-inhibitors, and recurrence of CSH. The rate of ACE-inhibitor treatment in our CSH patients was compared with an age-matched control group treated for herniated lumbar disc at the same time. The concentration of vascular endothelial growth factor was analyzed in hematoma samples and corresponding venous blood in 40 consecutive patients. RESULTS:A total of 310 patients were included in this study. The demographic data of Group A (with ACE-inhibition) and Group B (without ACE-inhibition) were comparable. In Group A, 5% (four out of 81) of the patients experienced recurrence as opposed to 18% (42 out of 229) in Group B (P = 0.00345). A negative correlation was found between the yearly rates of medication with ACE-inhibitors and recurrence (r = -0.8488; P = 0.0044). The rate of ACE-inhibitor treatment was lower in the CSH patients (25%) than in the control group (40%). The VEGF content was significantly lower in the hematoma in patients with ACE-inhibition (mean, 8891 pg/ml; range, 4300-18,300 pg/ml) than in patients without (mean, 22,565 pg/ml; range, 4200-89,650 pg/ml; P = 0.0116). CONCLUSION:Our data suggest that ACE-inhibitor treatment for the control of arterial hypertension lowers the risk of recurrence in patients undergoing operation for CSH and possibly even the development of CSH. This effect might be the result of an antiangiogenic mechanism of ACE-inhibitors.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Weigel R,Hohenstein A,Schlickum L,Weiss C,Schilling L

doi

10.1227/01.NEU.0000298907.56012.E8

subject

Has Abstract

pub_date

2007-10-01 00:00:00

pages

788-92; discussion 792-3

issue

4

eissn

0148-396X

issn

1524-4040

pii

00006123-200710000-00012

journal_volume

61

pub_type

杂志文章
  • Traumatic bilateral ophthalmic artery aneurysms: a case report.

    abstract::A case of bilateral ophthalmic artery aneurysm of traumatic origin is discussed. The patient presented with progressive loss of vision, memory deficit, and expressive aphasia. A computed tomographic scan revealed enhancing lesions near the region of the optic chiasm. The diagnosis of cerebral aneurysm was confirmed by...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198707000-00019

    authors: Hahn YS,McLone DG

    更新日期:1987-07-01 00:00:00

  • Roots of neuroanatomy, neurology, and neurosurgery as found in the Bible and Talmud.

    abstract::Historical observations and interpretations regarding the treatment of components of the nervous system can be found in the writings of the Bible and Talmud. A review of topics germane to modern neuroanatomy, neurology, and neurosurgery from these early, rich writings is presented herein. These historic writings provi...

    journal_title:Neurosurgery

    pub_type: 历史文章,杂志文章

    doi:10.1227/01.NEU.0000335082.54975.89

    authors: Tubbs RS,Loukas M,Shoja MM,Cohen-Gadol AA,Wellons JC 3rd,Oakes WJ

    更新日期:2008-07-01 00:00:00

  • Functional anatomy of the spine by Avicenna in his eleventh century treatise Al-Qanun fi al-Tibb (The Canons of Medicine).

    abstract::The history of spinal surgery is an important part of the spine-related sciences. The development of treatment strategies for spine-related disorders is acquired from the Western literature. In this article, an Eastern physician, Ibn Sina, who is known as Avicenna in the West, and his treatise, Al-Qanun fi al-Tibb (th...

    journal_title:Neurosurgery

    pub_type: 传,历史文章,杂志文章

    doi:10.1227/01.neu.0000064811.30933.7f

    authors: Naderi S,Acar F,Mertol T,Arda MN

    更新日期:2003-06-01 00:00:00

  • A new, more accurate classification of middle cerebral artery aneurysms: computed tomography angiographic study of 1,009 consecutive cases with 1,309 middle cerebral artery aneurysms.

    abstract:BACKGROUND:Classification of middle cerebral artery (MCA) aneurysms is sometimes difficult because the identification of the main MCA bifurcation, the key for accurate classification of MCA aneurysms, is inconsistent and somewhat subjective. OBJECTIVE:To use the meeting point of the M1 and M2 trunks as an objective, g...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000429842.61213.d5

    authors: Elsharkawy A,Lehečka M,Niemelä M,Billon-Grand R,Lehto H,Kivisaari R,Hernesniemi J

    更新日期:2013-07-01 00:00:00

  • Neurogenic pulmonary edema associated with ruptured intracranial aneurysm: case report.

    abstract::A case of ruptured distal anterior cerebral artery aneurysm associated with neurogenic pulmonary edema is presented. It is suggested that this association should not be accepted as a "taboo" for radical intervention followed by a proper management of ventilation with positive end-expiratory pressure to maintain the an...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198608000-00025

    authors: Yabumoto M,Kuriyama T,Iwamoto M,Kinoshita T

    更新日期:1986-08-01 00:00:00

  • Bilateral subthalamic deep brain stimulation in Parkinson disease patients with severe tremor.

    abstract:BACKGROUND:Previous studies have shown that subthalamic nucleus (STN) deep brain stimulation (DBS) improves tremor in Parkinson disease (PD). However, the patients included in those studies were unselected for tremor severity. OBJECTIVE:We specifically assessed the effect of STN DBS on tremor in selected PD patients w...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000374850.98949.D4

    authors: Kim HJ,Jeon BS,Paek SH,Lee JY,Kim HJ,Kim CK,Kim DG

    更新日期:2010-09-01 00:00:00

  • Cerebellar liponeurocytoma with an unusually aggressive clinical course: case report.

    abstract:OBJECTIVE AND IMPORTANCE:Liponeurocytomas are rare cerebellar neoplasms in adults, with benign histological features and a favorable clinical prognosis. Current clinical opinion is based on a total of less than 20 published cases and suggests that gross total resection and long-term follow-up monitoring, with possible ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000093430.61239.7e

    authors: Jenkinson MD,Bosma JJ,Du Plessis D,Ohgaki H,Kleihues P,Warnke P,Rainov NG

    更新日期:2003-12-01 00:00:00

  • Localization of stereotactic targets by microrecordings of thalamic somatosensory evoked potentials.

    abstract::To improve the localization of stereotactic targets, somatosensory evoked potentials (SEPs) were recorded from the thalamus and subthalamic area using a specially designed semimicroelectrode in 61 patients and a conventional "macroelectrode" in 17 patients. By means of the semimicroelectrode, median nerve stimulation ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199102000-00008

    authors: Shima F,Morioka T,Tobimatsu S,Kavaklis O,Kato M,Fukui M

    更新日期:1991-02-01 00:00:00

  • Moyamoya disorder in the United States.

    abstract:BACKGROUND:In Asian populations, moyamoya disease has a well-defined phenotype including a bimodal age of presentation with children typically presenting with ischemic phenomena and adults presenting with hemorrhage. Studies have provided evidence that moyamoya disease in the United States may exhibit a different pheno...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0b013e318253ab8e

    authors: Starke RM,Crowley RW,Maltenfort M,Jabbour PM,Gonzalez LF,Tjoumakaris SI,Randazzo CG,Rosenwasser RH,Dumont AS

    更新日期:2012-07-01 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...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000163599.78896.f4

    authors: Quiñones-Hinojosa A,Lawton MT

    更新日期:2005-07-01 00:00:00

  • Arteriovenous malformation in meningothelial meningioma: case report.

    abstract::An unusual association of a meningioma and an arteriovenous malformation is reported. A 68-year-old man developed left homonymous hemianopsia, left hemiparesis, and gaze palsy. Magnetic resonance imaging showed a right occipital mass lesion containing multiple signal-void areas with tubular and honeycomb appearance, s...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Sawamura Y,Janzer RC,Fankhauser H,de Tribolet N

    更新日期:1991-07-01 00:00:00

  • Prenatal diagnosis of occipital encephalocele by ultrasound scanning.

    abstract::Fetal visualization in utero can be routinely accomplished using noninvasive ultrasound techniques that do not administer ionizing radiation. Image resolution with real time sonography is sufficient to demonstrate details of possible congenital central nervous system malformations before delivery. The case reported il...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198306000-00016

    authors: Weinstein P,Weinstein L,Dotters D,Bedrick A,Anderson C

    更新日期:1983-06-01 00:00:00

  • High-dose simvastatin for aneurysmal subarachnoid hemorrhage: a multicenter, randomized, controlled, double-blind clinical trial protocol.

    abstract:BACKGROUND:Experimental evidence has indicated the benefit of simvastatin in the treatment of subarachnoid hemorrhage. However, no clinical data are available to answer whether a high-dose regimen is more effective than a normal-dose regimen, even though the biochemical actions and related neuroprotective mechanisms ar...

    journal_title:Neurosurgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1227/NEU.0b013e31828ab413

    authors: Wong GK,Liang M,Tan H,Lee MW,Po YC,Chan KY,Poon WS

    更新日期:2013-05-01 00:00:00

  • Receptor tyrosine kinase expression in astrocytic lesions: similar features in gliosis and glioma.

    abstract::The purpose of this study was to determine if the expression of receptor tyrosine kinases would distinguish astrocytosis from astrocytoma. Because the expression of this family of receptor proteins is greater in higher-grade tumors, a graded series of both reactive and neoplastic astrocytic lesions in humans was evalu...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199307000-00017

    authors: Kristt DA,Reedy E,Yarden Y

    更新日期:1993-07-01 00:00:00

  • 116 years (1889-2005) of neurosurgical practice and education at Gulhane Military Medical Academy.

    abstract::Modern medical education in the Ottoman Empire began with the founding of the School of Medicine and Surgery in 1827. This was a military school established to provide military physicians for the army. The first neurosurgical interventions at this school were initiated by Cemil Pasha in 1889. This school has gradually...

    journal_title:Neurosurgery

    pub_type: 历史文章,杂志文章

    doi:10.1227/01.NEU.0000197488.65065.C3

    authors: Timurkaynak E,Izci Y,Acar F

    更新日期:2006-03-01 00:00:00

  • Reflections on nuclear warfare.

    abstract::The author looks back on his more than 70 years of familiarity with Americans involved in warfare, noting their loyal support for our country's objectives. Drawing on the Einstein equation, his own visits to Hiroshima and Nagasaki, and current literature, he, as a physician, belatedly concurs with those who look on th...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198304000-00001

    authors: Evans JP

    更新日期:1983-04-01 00:00:00

  • Angles between A1 and A2 segments of the anterior cerebral artery visualized by three-dimensional computed tomographic angiography and association of anterior communicating artery aneurysms.

    abstract:OBJECTIVE:The angle of arteries at bifurcations, as well as the blood flow, are factors of hemodynamic stress on the apical region, where aneurysms often develop. Using images obtained with three-dimensional computed tomographic angiography, we sought to determine the angles between the A1 and A2 segments of the anteri...

    journal_title:Neurosurgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00006123-199907000-00021

    authors: Kasuya H,Shimizu T,Nakaya K,Sasahara A,Hori T,Takakura K

    更新日期:1999-07-01 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...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Wilkinson HA

    更新日期:1996-04-01 00:00:00

  • Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on Pretreatment Ophthalmology Evaluation in Patients With Suspected Nonfunctioning Pituitary Adenomas.

    abstract:BACKGROUND:Nonfunctioning pituitary adenomas (NFPAs) are the most frequent pituitary tumors. Visual symptoms from NFPAs are common and include visual field defects, loss of central vision, and motility problems resulting in diplopia. OBJECTIVE:To create evidence-based guidelines in an attempt to formulate guidance for...

    journal_title:Neurosurgery

    pub_type: 杂志文章,实务指引,评审

    doi:10.1227/NEU.0000000000001388

    authors: Newman SA,Turbin RE,Bodach ME,Tumialan LM,Oyesiku NM,Litvack Z,Zada G,Patil CG,Aghi MK

    更新日期:2016-10-01 00:00:00

  • Avoidance of carotid artery injuries in transsphenoidal surgery with the Doppler probe and micro-hook blades.

    abstract:OBJECTIVE:Internal carotid artery (ICA) injury during sellar dural opening is a potentially catastrophic complication of transsphenoidal surgery. We describe two ICA injuries that occurred early in our endonasal transsphenoidal experience. We then describe our subsequent protocol to prevent this complication in which w...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000255408.84269.A8

    authors: Dusick JR,Esposito F,Malkasian D,Kelly DF

    更新日期:2007-04-01 00:00:00

  • Stereotactic radiosurgery for tentorial dural arteriovenous fistulae draining into the vein of Galen: report of two cases.

    abstract:OBJECTIVE AND IMPORTANCE:Treatment of tentorial dural arteriovenous fistulae (DAVFs) primarily draining into the vein of Galen remains a therapeutic challenge. We present two cases of ruptured galenic DAVFs that were successfully treated with gamma knife radiosurgery. CLINICAL PRESENTATION:Patient 1, a 66-year-old wom...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200003000-00039

    authors: Shin M,Kurita H,Tago M,Kirino T

    更新日期:2000-03-01 00:00:00

  • History of the Department of Neurosurgery at Thomas Jefferson University Hospital.

    abstract::The neurosurgical tradition at Jefferson Medical College began in the 19th century with Samuel Gross. In his textbook entitled A System of Surgery, Gross revealed his knowledge of the disorders of the nervous system at a time when innovations were practically inexistent. Gross' work paved the way for William Williams ...

    journal_title:Neurosurgery

    pub_type: 历史文章,杂志文章

    doi:10.1227/01.neu.0000430299.02714.46

    authors: Chalouhi N,Osterholm J,Jabbour P,Dumont AS,Gonzalez LF,Harrop J,Sharan A,Rosenwasser R,Tjoumakaris S

    更新日期:2013-10-01 00:00:00

  • Recurrence of olfactory groove meningiomas.

    abstract:OBJECTIVE:Despite apparent gross total resection, olfactory groove meningiomas have a high rate of late recurrence (average, 23%). In this retrospective study, we confirmed that the sites of these recurrences are the cranial base and paranasal sinuses. We postulated that these recurrences stem from conservative handlin...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000079484.19821.4a

    authors: Obeid F,Al-Mefty O

    更新日期:2003-09-01 00:00:00

  • Tightness of duraplasty in rabbits: a comparative study.

    abstract:OBJECTIVE:The purpose of this study was to test, in rabbits, the tightness of seven dural substitution materials commonly used in neurosurgery, i.e., Lyodura (B. Braun Melsungen AG, Melsungen, Germany), Tutoplast dura (Tutogen Medical, Inc., Parsippany, NJ), Tutoplast fascia lata (Tutogen Medical, Inc.), autologous per...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200006000-00032

    authors: Filippi R,Derdilopoulos A,Heimann A,Krummenauer F,Perneczky A,Kempski O

    更新日期:2000-06-01 00:00:00

  • Use of local cerebral blood flow monitoring to predict brain damage after disturbance to the venous circulation: cortical vein occlusion model by photochemical dye.

    abstract::A rat model of cortical vein occlusion by the photochemical thrombotic technique was used to evaluate whether monitoring the change in the local cerebral blood flow (LCBF) could predict brain damage after cortical vein occlusion. The cortical vein occlusion was attained by using the photochemical thrombotic technique,...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199508000-00013

    authors: Nakase H,Kakizaki T,Miyamoto K,Hiramatsu K,Sakaki T

    更新日期:1995-08-01 00:00:00

  • Brain stem hemorrhage: historical perspective.

    abstract::Brain stem hemorrhage was first recorded in 1812. Its origin has been the subject of much study and experimentation. We review the studies that stress mechanical forces because dynamic axial distortion of the brain stem is a major factor in the physiology and pathology of the central nervous system. ...

    journal_title:Neurosurgery

    pub_type: 历史文章,杂志文章

    doi:10.1227/00006123-198804000-00001

    authors: Thompson RK,Salcman M

    更新日期:1988-04-01 00:00:00

  • What is the best method for reporting tumor diameter in vestibular schwannoma?

    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

    authors: Tanaka Y,Hongo K,Tada T,Kobayashi S

    更新日期:2003-09-01 00:00:00

  • The Impact of Intracranial Tumor Proximity to White Matter Tracts on Morbidity and Mortality: A Retrospective Diffusion Tensor Imaging Study.

    abstract:Background:Using diffusion tensor imaging (DTI) in neurosurgical planning allows identification of white matter tracts and has been associated with a reduction in postoperative functional deficits. Objective:This study explores the relationship between the lesion-to-tract distance (LTD) and postoperative morbidity and...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyw040

    authors: Meyer EJ,Gaggl W,Gilloon B,Swan B,Greenstein M,Voss J,Hussain N,Holdsworth RL,Nair VA,Meyerand ME,Kuo JS,Baskaya MK,Field AS,Prabhakaran V

    更新日期:2017-02-01 00:00:00

  • Lymphocytic hypophysitis with involvement of the cavernous sinus and hypothalamus.

    abstract::Two cases of lymphocytic hypophysitis are reported, in which hypothalamic involvement causing diabetes insipidus was a prominent clinical feature. In one case, a man had clinical and radiological evidence of the involvement of the cavernous sinus. This represents the second reported case of a man with lymphocytic hypo...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1097/00006123-199103000-00019

    authors: Nussbaum CE,Okawara SH,Jacobs LS

    更新日期:1991-03-01 00:00:00

  • Somatosensory evoked potential changes in neuroendovascular procedures: incidence and association with clinical outcome in 873 patients.

    abstract:BACKGROUND:Neurophysiological monitoring is routinely used during neurosurgical procedures. Use of neurophysiological monitoring has extended to neuroendovascular procedures, but evidence of its impact on clinical outcome in this arena is limited. OBJECTIVE:To report the incidence of significant intraoperative somatos...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0000000000000510

    authors: Phillips JL,Chalouhi N,Jabbour P,Starke RM,Bovenzi CD,Rosenwasser RH,Wilent WB,Romo VM,Tjoumakaris SI

    更新日期:2014-11-01 00:00:00