OBJECT: Between 1989 and 2002 the authors treated 416 cases of angiographically confirmed arteriovenous malformations (AVMs) of the brain. METHODS: Three hundred fifty-five patients underwent resection of an AVM; 2% died and 12% experienced a permanent morbidity (1.7% experienced a deterioration of modified Rankin Scale [mRS] score of 3-5). Patient ...

PURPOSE: Retrospective analysis of 117 patients treated between 1996 and 2000 with low-dose radiotherapy (RT) for painful heel spurs. PATIENTS AND METHODS: 71 women and 46 men were irradiated on 136 painful heel spurs in one (n = 104) or two radiation series (n = 13). The painful spurs were ...

PURPOSE: To evaluate the efficacy of embolotherapy in patients with bleeding traumatic uterine arteriovenous malformations (AVMs). MATERIALS AND METHODS: A retrospective review of all patients who underwent pelvic arterial embolization at our institution between July 1992 and September 2002 was performed. Fifteen patients were diagnosed with a uterine vascular malformation ...

OBJECTIVE: To evaluate the clinical results achievable using current techniques of gamma knife stereotactic radiosurgery to treat sporadic unilateral acoustic neuromas. METHODS: A retrospective review of 234 consecutive patients treated for unilateral acoustic neuromas between 1996 and 1999, with a mean (SD) follow up of 35 (16) months. Tumour control ...

OBJECTIVE: To investigate whether data obtained by transcranial Doppler (TCD) have prognostic value in patients with intracerebral hemorrhage (ICH). METHODS: A prospective study of patients with an acute (<12 hours from onset of symptoms) spontaneous supratentorial ICH was conducted. Mortality was assessed at 30-day follow-up. TCD parameters were obtained from ...

BACKGROUND: We undertook this study to characterize those patients who required reoperations for Chiari malformation and to determine whether modifications in surgical technique at the initial procedure might have obviated the need for repeat surgery. METHODS: We reviewed the hospital records, imaging studies, operative reports, and follow-up data of those ...

OBJECTIVE: The goal of this study was to determine the rate of radiological resolution of histopathologically proven tuberculomas treated with antituberculous therapy (ATT). The effects of the size of the tuberculomas, the number of tuberculomas, and the addition of corticosteroid therapy on the rate of resolution of the tuberculomas were ...

OBJECT: In this study the authors evaluate the efficacy of and complications associated with dedicated linear accelerator (LINAC) radiosurgery for trigeminal neuralgia (TN). METHODS: Between August 1995 and February 2001, 60 patients whose median age was 66.1 years (range 45-88 years) were treated with dedicated LINAC radiosurgery for TN. Forty-one ...

OBJECTIVE: The management of major hemorrhage complicating mediastinoscopy is not well described. We reviewed our experience to determine the frequency, optimal management strategy, and outcome of these injuries. METHODS: A retrospective review of all mediastinoscopies performed at a single institution during a 12-year period (January 1990-January 2002) was performed. Major ...

BACKGROUND: Fluoroscopic guidance is frequently utilized in interventional pain management. The major purpose of fluoroscopy is correct needle placement to ensure target specificity and accurate delivery of the injectate. Radiation exposure may be associated with risks to physician, patient and personnel. While there have been many studies evaluating the risk ...

OBJECT: The use of radiosurgery for the treatment of cerebral arteriovenous malformations (AVMs) and other lesions demands an accurate understanding of the risk of radiation-related complications. Some commonly used formulas for predicting risk are based on extrapolation from small numbers of animal experiments, pilot human treatment series, and theoretical radiobiological ...

OBJECTIVE: To elucidate the advances of diagnosis and surgical treatment of the cavernous sinus hemangiomas (CSHs). METHODS: The data from 20 patients with the CSHs surgically treated by authors from 1996 through 2000 was analyzed retrospectively, and a review of relevant literature was conducted. RESULTS: These 20 cases accounted for ...

OBJECTIVE: To determine the usefulness of endovascular embolization for treatment of dural arteriovenous fistulae of the superior petrosal sinus. METHODS: We performed a retrospective review of 18 patients treated during a 16-year period. Transarterial and/or transvenous embolizations were performed as a preoperative adjunct or definitive therapy. Clinical follow-up status was ...

We reviewed 63 patients with primary intracerebral haemorrhage (PICH) in basal ganglia treated by computed tomography (CT)-guided stereotactic aspiration to evaluate the impact of surgical timing and degree of haematoma volume reduction on neurological outcome evaluated with Glasgow Outcome Score (GOS). In 19 patients operation was performed within 24h from ...

OBJECTIVE: Radiosurgery is commonly performed for patients with small to medium-sized arteriovenous malformations (AVMs). However, few articles present overall outcomes after one or more radiosurgical procedures, and few data are available for periods longer than 5 years after AVM radiosurgery. METHODS: Between 1990 and 1997, 144 patients underwent AVM radiosurgery ...

OBJECTIVE: To sum up the causes of recurrence of chronic subdural hematoma (CSDH) from failure of trepanation and drainage and explore its prevention and treatment. METHODS: From October 1988 to June 2002 a total of 358 patients with CSDH were treated with trepanation and drainage in our hospital. Among them ...

OBJECT: In many new clinical trials of patients with malignant gliomas surgical intervention is incorporated as an integral part of tumor-directed interstitial therapies such as gene therapy, biodegradable wafer placement, and immunotherapy. Assessment of toxicity is a major component of evaluating these novel therapeutic interventions, but this must be done ...

BACKGROUND: The Gildenberg-Laitinen Adapter Device for X-Ray (GLAD-X/LS) frame is a positioning device that allows the use of the same fiducial points as the Brown-Robert-Wells (BRW) system. Thus it permits treatment planning to be accomplished by the Radionics X-knife Radiosurgery Program. We investigated the commissioning and clinical benefits of the ...

This study evaluated the clinical outcomes following venous ligation for the treatment of dural arteriovenous fistulas (DAVF) with leptomeningeal or cortical venous drainage. The authors conducted a single-centre, retrospective study of 15 patients with DAVF treated consecutively between 1990 and 2000. There were eight female patients of mean age 60 ...

A number of clinical studies have reported poor clinical outcomes for patients treated with barbiturate therapy in acute neurological and neurosurgical emergencies. Barbiturate therapy, as currently practised with thiopentone and pentobarbitone at least, is also associated with a prolonged post-infusion period of clinical unresponsiveness. Hence, the popularity of barbiturate therapy ...

The aim of this study was to compare nonsurgical versus stereotactic aspiration of intracerebral hematomas in relation to clinical aspects, computed tomographic imaging features of the brain, laboratory parameters and specific risk factors that may influence the outcome in southeast Asian Malay patients. Fifty-five of the patients with intracerebral hemorrhage ...

OBJECTIVE: To ascertain the efficacy of stereotactic radiosurgery (gamma knife) for the control of glomus jugulare tumours. METHOD: Between March 1994 and December 1997 we treated eight patients of glomus jugulare tumour with radiosurgery. These patients have been followed for more than four years (range 52 to 97 months). The ...

BACKGROUND AND PURPOSE: The aim of this study was to test the hypothesis that patterns of cerebrovascular reactivity (CVR) in the vicinity of cerebral arteriovenous malformations (AVMs) before and after resection are not specific for this disease. METHODS: With a microspectrophotometer, cortical oxygen saturation (So2) was measured under steady-state conditions ...

OBJECTIVE: Hypertensive putaminal hematoma (HPH) is a devastating type of stroke that mostly results in death or severe neurologic deficit. There seems to be no general agreement on the selection of treatment modality for individual patients. In this study a comparison has been made between conservative treatment and the results ...

This study was conducted to evaluate the clinical profile and outcome in late hemorrhagic disease of the newborn (HDN) with particular reference to intracranial hemorrhage. Infants (n = 42) presenting with late HDN from January 1998 to December 2001 were studied. Majority (76%) were in the age group of 1-3 ...

OBJECTIVE: This study was undertaken to determine which factors were statistically predictive of radiological and clinical outcomes in the radiosurgical treatment of arteriovenous malformations (AVMs). METHODS: The computerized dosimetric and clinical data for 269 patients were reviewed. The AVM nidus was hand-contoured on successive enhanced computed tomographic slices through the ...

BACKGROUND: This study was undertaken to determine the natural history of untreated skull base meningiomas. Although there are reports on the natural history of meningiomas, most series contain only a few cases of meningiomas involving the skull base. Natural history information is important when recommending treatment and evaluating results. METHODS: ...

OBJECT: The goal of this study was to evaluate the outcomes of patients who underwent repeated radiosurgery to treat a residual intracranial arteriovenous malformation (AVM) after an initial radiosurgical treatment failure. METHODS: The authors reviewed the cases of 52 patients who underwent repeated radiosurgery for residual AVM at the University ...

BACKGROUND: Although gamma knife radiosurgery (GKRS) has been shown to be safe and effective for the treatment of trigeminal neuralgia (TN), there are few studies that report the results of a second GKRS. METHOD: Between May 22, 1998 and April 1, 2003, we treated 335 primary TN patients with GKRS. ...

OBJECT: In this study the authors quantified a subgroup of patients with Spetzler-Martin Grades IV and V arteriovenous malformations (AVMs) recommended for complete, partial, or no treatment, and calculated the retrospective hemorrhage rate for these lesions. METHODS: Between July 1997 and May 2000, 73 consecutive patients with Grades IV and ...

One of the most common complications of craniopharyngioma treatment is recurrence. The outcomes of treatment for recurrent tumors with different modalities were evaluated. Of the 61 patients treated initially, 24 had recurrence during follow-up period (1-29 years, mean 11 years). Twenty-two patients underwent a total of 35 additional operations for ...

OBJECTIVES: Since introduction of stereotactic aspiration and fibrinolysis into the treatment of deep-seated intracerebral hematomas by Hondo and Matsumoto 1984 this method has become widely used, and satisfactory morphological results are achieved. Nevertheless, whether the outcome is improved has not yet been investigated. MATERIAL AND METHOD: 17 patients with spontaneous ...

Clinical experiences from 15 meningeomas located on the free edge of the tentorium are reported. Unexpected findings and complications found in five patients are presented in detail: Despite successful removal without postoperative morbidity after a presigmoid approach the preoperative loss of function of the ophthalmic nerve may cause increasing keratitis, ...

BACKGROUND: Intracerebral hemorrhage (ICH) causes higher morbidity and mortality than other forms of stroke and has no proven effective treatment. Hematoma volume is a powerful predictor of outcome after ICH. SUMMARY OF REVIEW: Historically, ICH bleeding was considered to be a monophasic event that stopped quickly as a result of ...

BACKGROUND: The authors present a retrospective clinical analysis of meningeal hemangiopericytomas. The long-term outcome and biologic behavior, including local recurrence and extraneural distant metastasis, are elucidated. METHOD: Clinical records and radiologic findings of 31 cases with meningeal hemangiopericytoma treated at Seoul National University Hospital and Asian Medical Center between 1982 ...

PURPOSE: The purpose of this study was to search for an optimal radiation dose in the treatment of patients with uveal melanoma using 125I episcleral plaque radiotherapy (EPRT) and episcleral hyperthermia (HT). METHODS AND MATERIALS: From 1991-1998, 35 patients with uveal melanoma were enrolled in a phase II prospective randomized ...

PURPOSE: To evaluate the long-term cognitive function of patients with cerebral arteriovenous malformations (AVMs) after radiosurgery. METHODS AND MATERIALS: The data of 95 AVM patients were prospectively assessed up to 3 years after radiosurgery. Of these patients, 39 had a follow-up of at least 2 years. Radiosurgery was performed using ...

Multivariate and single variable analyses were employed to investigate the recovery mode of aphasia in right-handed patients with putaminal hemorrhage on the left side. Speech disturbance was evaluated using the standard language test for aphasia (SLTA) at intervals of 1, 3 and 6 months after the ictus. Recovery was assessed ...

BACKGROUND AND PURPOSE: By undertaking long-term follow-up of a functionally isolated population study group, we sought to achieve a true picture of intrinsic brain arteriovenous malformation (BAVM). We sought to assess the validity of earlier population-based series and to determine the effects of newer treatment methods on the overall morbidity ...

OBJECTIVES: The authors report the results of gamma knife (GK) radiosurgery on a clinical series of selected patients with basal ganglia arteriovenous malformations (BGAVMs) in the brain. Clinical, epidemiological, anatomical and functional characteristics of BGAVMs and of supratentorial cortical AVMs are comparatively analyzed, and their influence on radiosurgical outcome is ...

OBJECT: The purpose of this paper is to report a unique complication of gamma knife radiosurgery (GKS) for trigeminal neuralgia (TN). The nature of this complication and its related factors are discussed. METHODS: Forty-one medically refractory patients with TN were treated with GKS. All patients received 80 Gy to the ...

OBJECT: The authors report on the follow-up studies in patients treated at the Karolinska Hospital to evaluate the efficacy of gamma knife radiosurgery (GKS) for pilocytic astrocytoma. METHODS: Twelve male and seven female patients were treated (mean age 10.6 years [range 2-60 years]). Sixteen of these patients were children in ...

PURPOSE: To investigate outcome and toxicity after fractionated stereotactic radiation therapy (FSRT) in patients with craniopharyngiomas. METHODS AND MATERIALS: Twenty-six patients with craniopharyngiomas were treated with FSRT between May 1989 and February 2001. Median age was 33.5 years (range: 5-57 years). Nine patients received FSRT after surgery as primary treatment, ...

The results of treating primary subglottic carcinoma (PSC) with radiation or surgery are disappointing, and recurrent disease is common. The purpose of this study was twofold: first, to present our experience of treating two multifocal patients with PSC and second, to report our treatment results using two different clinical treatment ...

BACKGROUND AND PURPOSE: Little is known about the relationship between perihematomal edema in spontaneous intracerebral hemorrhage (ICH) and outcome. The purpose of this study was to determine whether absolute or relative edema volume (edema volume divided by hematoma volume) predicts mortality or functional outcome in patients with hyperacute spontaneous ICH. ...

To determine efficacy, safety, and requirements for adjunctive embolization or surgery in the treatment of symptomatic arteriovenous malformations (AVMs) with superabsorbent polymer microsphere (SAP-MS) particles. SAP-MS particles (sodium acrylate and vinyl alcohol copolymer) are nonbiodegradable spheres with a precisely calibrated diameter. SAP-MS particles swell by absorbing fluids and become soft ...

OBJECTIVE: To describe a frameless stereotactic technique used to resect cerebral arteriovenous malformations (AVMs) and to determine whether frameless stereotaxy during AVM resection could decrease operative times, minimize intraoperative blood losses, reduce postoperative complications, and improve surgical outcomes. METHODS: Data for 44 consecutive patients with surgically resected cerebral AVMs were ...

OBJECT: To obtain information essential to the decision to perform radiosurgery for arteriovenous malformations (AVMs) in children and adolescents, the authors retrospectively analyzed their experience with gamma knife surgery for AVMs in 100 patients ranging in age from 4 to 19 years. METHODS: Follow-up periods ranged from 6 to 124 ...

OBJECTIVE: To elucidate the role of venous drainage in cerebral arteriovenous malformation (AVM) surgery, with respect to the development of postoperative hyperperfusion injury. METHODS: For 52 patients with supratentorial AVMs, cortical capillary oxygenation (SaO(2)) was assessed intraoperatively, before and after resection, in the vicinity of the AVMs, by using a ...

BACKGROUND: The management of cerebral arteriovenous malformations needs effective treatments. So far, no study has shown that partial targeted embolization treatment (PTET) reduces the risk of intracranial hemorrhage with respect to the natural history of the malformation. METHODS: The pre-treatment and post-treatment-initialization hemorrhage incidences of neuro-interventional patients were compared. Two ...