BrainPath-Mediated Resection of a Ruptured Subcortical Arteriovenous Malformation

2017 ◽  
Vol 15 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Alex M Witek ◽  
Nina Z Moore ◽  
M Adeeb Sebai ◽  
Mark D Bain
Keyword(s):  
Basal Ganglia ◽  
Intracerebral Hemorrhage ◽  
Arteriovenous Malformation ◽  
Frontal Lobe ◽  
Tubular Retractor ◽  
Postoperative Imaging ◽  
Hematoma Evacuation ◽  
The Right

AbstractBACKGROUNDAlthough tubular retractor systems have gained popularity for other indications, there have been few reports of their use for arteriovenous malformation (AVM) surgery. A patient was diagnosed with a ruptured 1.2-cm subcortical AVM after presenting with intracerebral hemorrhage in the right frontal lobe and anterior basal ganglia. The characteristics of this AVM made it amenable to resection using a tubular retractor.OBJECTIVETo demonstrate the feasibility and safety of AVM resection using a tubular retractor system.METHODSResection of the ruptured 1.2-cm subcortical AVM was performed utilizing the BrainPathTM (NICO corp, Indianapolis, Indiana) tubular retractor system.RESULTSThe BrainPathTM approach provided sufficient visualization and surgical freedom to permit successful AVM resection and hematoma evacuation. Postoperative imaging demonstrated near total hematoma removal and angiographic obliteration of the AVM. There were no complications, and the patient made an excellent recovery.CONCLUSIONTubular retractors warrant consideration for accessing small, deep, ruptured AVMs. The nuances of such systems and their role in AVM surgery are discussed.

Minimally invasive endoscopic hematoma evacuation vs best medical management for spontaneous basal-ganglia intracerebral hemorrhage

2019 ◽  
Vol 11 (6) ◽  
pp. 579-583 ◽  
Author(s):  
Nitin Goyal ◽  
Georgios Tsivgoulis ◽  
Konark Malhotra ◽  
Aristeidis H Katsanos ◽  
Abhi Pandhi ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Minimally Invasive ◽  
Intracerebral Hemorrhage ◽  
Hospital Mortality ◽  
Medical Management ◽  
Intervention Group ◽  
Stroke Severity ◽  
Hematoma Evacuation ◽  
Discharge Disposition ◽  
Relative Safety

BackgroundWe conducted a case-control study to assess the relative safety and efficacy of minimally invasive endoscopic surgery (MIS) for clot evacuation in patients with basal-ganglia intracerebral hemorrhage (ICH).MethodsWe evaluated consecutive patients with acute basal-ganglia ICH at a single center over a 42-month period. Patients received either best medical management according to established guidelines (controls) or MIS (cases). The following outcomes were compared before and after propensity-score matching (PSM): in-hospital mortality; discharge National Institutes of Health Stroke Scale score; discharge disposition; and modified Rankin Scale scores at discharge and at 3 months.ResultsAmong 224 ICH patients, 19 (8.5%) underwent MIS (mean age, 50.9±10.9; 26.3% female, median ICH volume, 40 (IQR, 25–51)). The interventional cohort was younger with higher ICH volume and stroke severity compared with the medically managed cohort. After PSM, 18 MIS patients were matched to 54 medically managed individuals. The two cohorts did not differ in any of the baseline characteristics. The median ICH volume at 24 hours was lower in the intervention group (40 cm3 (IQR, 25–50) vs 15 cm3 (IQR, 5–20); P<0.001). The two cohorts did not differ in any of the pre-specified outcomes measures except for in-hospital mortality, which was lower in the interventional cohort (28% vs 56%; P=0.041).ConclusionsMinimally invasive endoscopic hematoma evacuation was associated with lower rates of in-hospital mortality in patients with spontaneous basal-ganglia ICH. These findings support a randomized controlled trial of MIS versus medical management for ICH.

Abstract TP436: Minimally Invasive Endoscopic Hematoma Evacuation vs. Best Medical Management for Spontaneous Basal Ganglia Intracerebral Hemorrhage

Stroke ◽  
2019 ◽  
Vol 50 (Suppl_1) ◽  
Author(s):  
Nitin Goyal ◽  
Georgios Tsivgoulis ◽  
Konark Malhotra ◽  
Aristeidis Katsanos ◽  
Abhi Pandhi ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Minimally Invasive ◽  
Intracerebral Hemorrhage ◽  
Medical Management ◽  
Hematoma Evacuation

scholarly journals Progressive chorea and dystonia associated with a large arteriovenous malformation

2019 ◽  
Author(s):  
Jeffrey S Raskin ◽  
Mered Parnes ◽  
Sandi Lam
Keyword(s):  
Intellectual Disability ◽  
Basal Ganglia ◽  
Arteriovenous Malformation ◽  
Movement Disorder ◽  
Progressive Movement ◽  
The Right

A 9-year-old male with intellectual disability and epilepsy presenting with a progressive movement disorder characterized by chorea and dystonia primarily affecting the left face, arm, and leg and attributed to an arteriovenous malformation centered within the right thalamus with bilateral extension into the basal ganglia, midbrain and pons is reported.

Role of the Right and Left Hemispheres in Recovery of Function during Treatment of Intention in Aphasia

2005 ◽  
Vol 17 (3) ◽  
pp. 392-406 ◽  
Author(s):  
Bruce Crosson ◽  
Anna Bacon Moore ◽  
Kaundinya Gopinath ◽  
Keith D. White ◽  
Christina E. Wierenga ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Frontal Lobe ◽  
Left Hemisphere ◽  
Language Production ◽  
Right Hemisphere ◽  
Recovery Of Function ◽  
Pre Treatment ◽  
The Right ◽  
Almost All ◽  
Production Mechanisms

Two patients with residual nonfluent aphasia after ischemic stroke received an intention treatment that was designed to shift intention and language production mechanisms from the frontal lobe of the damaged left hemisphere to the right frontal lobe. Consistent with experimental hypotheses, the first patient showed improvement on the intention treatment but not on a similar attention treatment. In addition, in keeping with experimental hypotheses, the patient showed a shift of activity to right presupplementary motor area and the right lateral frontal lobe from pre-to post-intention treatment functional magnetic resonance imaging (fMRI) of language production. In contrast, the second patient showed improvement on both the intention and attention treatments. During pre-treatment fMRI, she already showed lateralization of intention and language production mechanisms to the right hemisphere that continued into post-intention treatment imaging. From pre-to post-treatment fMRI of language production, both patients demonstrated increased activity in the posterior perisylvian cortex, although this activity was lateralized to left-hemisphere language areas in the second but not the first patient. The fact that the first patient's lesion encompassed almost all of the dominant basal ganglia and thalamus whereas the second patient's lesion spared these structures suggests that the dominant basal ganglia could play a role in spontaneous reorganization of language production functions to the right hemisphere. Implications regarding the theoretical framework for the intention treatment are discussed.

Benign astrocytoma associated with arteriovenous malformation

1971 ◽  
Vol 35 (2) ◽  
pp. 229-233 ◽  
Author(s):  
Reid R. Heffner ◽  
Robert S. Porro ◽  
Michael D. F. Deck
Keyword(s):  
Nervous System ◽  
Arteriovenous Malformation ◽  
Frontal Lobe ◽  
Vascular Malformations ◽  
Pathological Features ◽  
Primary Tumors ◽  
Content Type ◽  
Multiple Primary ◽  
The Right ◽  
Fine Print

✓ An arteriovenous malformation associated with an underlying benign astrocytoma of the right frontal lobe is reported and the radiological and pathological features discussed. Previous reports of multiple primary tumors of the nervous system are reviewed and the few cases of vascular malformations associated with gliomas noted.

scholarly journals Intracerebral Hemorrhage, Visual Hallucination and COVID-19: What Is the Connection? A Case-Related Review of the Literature on Peduncular Hallucinosis Following Intracerebral Hemorrhage

2021 ◽  
Vol 5 (2) ◽  
pp. 15
Author(s):  
Nicolas M. Nagysomkuti Mertse ◽  
Lisa Zenorini ◽  
René Müri
Keyword(s):  
Basal Ganglia ◽  
Intracerebral Hemorrhage ◽  
Visual Hallucination ◽  
Occipital Lobe ◽  
Review Of The Literature ◽  
Peduncular Hallucinosis ◽  
Intracerebral Hemorrhages ◽  
The Subject ◽  
The Right ◽  
Lesion Localization

Previous publications have discussed the occurrence of intracerebral hemorrhages, hallucinations and psychosis in COVID-19 patients. In this article, we have reviewed the literature on the subject while depicting the case of a 63-year-old female patient who suffered from an intracerebral hemorrhage in the right basal ganglia and thalamus two weeks after a COVID-19 diagnosis and who developed a visual hallucinosis shortly after. We concluded that, while there may be a correlation between COVID-19 and hallucinations according to current literature, more research is yet needed to clarify. In our case, we rather interpreted the hallucinations in the context of a peduncular hallucinosis related to the intracerebral hemorrhage. We compared our patient’s lesion localization to other 15 reported cases of peduncular hallucinations following intracerebral hemorrhages reported on Pubmed. In summary, the lesions were localized in the pons in 52.9% of the cases, 17.7% were in the thalamus and/or the basal ganglia, 17.7% in the mesencephalon and respectively 5.8% in the temporal and occipital lobe. The distribution pattern we found is consistent with the previously proposed mechanism behind peduncular hallucinations.

scholarly journals Histone Deacetylase Inhibitor Scriptaid Alleviated Neurological Dysfunction after Experimental Intracerebral Hemorrhage in Mice

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Heng Yang ◽  
Wei Ni ◽  
Hanqiang Jiang ◽  
Yu Lei ◽  
Jiabin Su ◽  
...  
Keyword(s):  
Brain Injury ◽  
White Matter ◽  
Basal Ganglia ◽  
Intracerebral Hemorrhage ◽  
Autologous Blood ◽  
White Matter Injury ◽  
Neurological Dysfunction ◽  
Vehicle Group ◽  
Hematoma Volume ◽  
The Right

Objectives. To investigate the role of Scriptaid in reducing brain injury after intracerebral hemorrhage (ICH) in mice. Methods. An ICH model was constructed by injecting autologous blood into the right basal ganglia in mice. The animals were administered 3.5 mg/kg of Scriptaid intraperitoneally after ICH. The hematoma volume and hemoglobin level were measured to examine hematoma resolution. A behavior test and brain edema and white matter injury examinations indicated brain injury after ICH. Results. Scriptaid treatment promoted hematoma resolution and reduced the hematoma volume 7 d after ICH compared with the vehicle group (P<0.05). Scriptaid treatment also alleviated the brain water content in the ipsilateral basal ganglia (P<0.05) and cortex (P<0.01) 3 d after ICH. In addition, Scriptaid improved neurological function recovery and alleviated white matter injury 35 d after ICH. Conclusions. Scriptaid can protect against brain injury after ICH and may be considered a new medical therapy method for ICH.

scholarly journals Early versus late arteriovenous malformation responders after stereotactic radiosurgery: an international multicenter study

2017 ◽  
Vol 127 (3) ◽  
pp. 503-511 ◽  
Author(s):  
Or Cohen-Inbar ◽  
Robert M. Starke ◽  
Gabriella Paisan ◽  
Hideyuki Kano ◽  
Paul P. Huang ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Arteriovenous Malformation ◽  
Stereotactic Radiosurgery ◽  
Frontal Lobe ◽  
Univariate Analysis ◽  
Venous Drainage ◽  
Institutional Review ◽  
Late Responder ◽  
Latency Interval ◽  
International Multicenter Study

OBJECTIVEThe goal of stereotactic radiosurgery (SRS) for arteriovenous malformation (AVM) is complete nidus obliteration, thereby eliminating the risk of future hemorrhage. This outcome can be observed within the first 18 months, although documentation of AVM obliteration can extend to as much as 5 years after SRS is performed. A shorter time to obliteration may impact the frequency and effect of post-SRS complications and latency hemorrhage. The authors' goal in the present study was to determine predictors of early obliteration (18 months or less) following SRS for cerebral AVM.METHODSEight centers participating in the International Gamma Knife Research Foundation (IGKRF) obtained institutional review board approval to supply de-identified patient data. From a cohort of 2231 patients, a total of 1398 patients had confirmed AVM obliteration. Patients were sorted into early responders (198 patients), defined as those with confirmed nidus obliteration at or prior to 18 months after SRS, and late responders (1200 patients), defined as those with confirmed nidus obliteration more than 18 months after SRS. The median clinical follow-up time was 63.7 months (range 7–324.7 months).RESULTSOutcome parameters including latency interval hemorrhage, mortality, and favorable outcome were not significantly different between the 2 groups. Radiologically demonstrated radiation-induced changes were noted more often in the late responder group (376 patients [31.3%] vs 39 patients [19.7%] for early responders, p = 0.005). Multivariate independent predictors of early obliteration included a margin dose > 24 Gy (p = 0.031), prior surgery (p = 0.002), no prior radiotherapy (p = 0.025), smaller AVM nidus (p = 0.002), deep venous drainage (p = 0.039), and nidus location (p < 0.0001). Basal ganglia, cerebellum, and frontal lobe nidus locations favored early obliteration (p = 0.009). The Virginia Radiosurgery AVM Scale (VRAS) score was significantly different between the 2 responder groups (p = 0.039). The VRAS score was also shown to be predictive of early obliteration on univariate analysis (p = 0.009). For early obliteration, such prognostic ability was not shown for other SRS- and AVM-related grading systems.CONCLUSIONSEarly obliteration (≤ 18 months post-SRS) was more common in patients whose AVMs were smaller, located in the frontal lobe, basal ganglia, or cerebellum, had deep venous drainage, and had received a margin dose > 24 Gy.

scholarly journals A Case Report on Hemiplegia in a Patient with an Intracerebral Hemorrhage of the Basal Ganglia of the Corona Radiata Treated with Traditional Korean and Western Medicine

2021 ◽  
Vol 42 (5) ◽  
pp. 1131-1141
Author(s):  
Da-hae Jung ◽  
Bong-hun Kil ◽  
Dong-won Kim ◽  
Hye-soo Youn ◽  
Eun-chang Lee ◽  
...  
Keyword(s):  
Case Report ◽  
Basal Ganglia ◽  
Intracerebral Hemorrhage ◽  
Western Medicine ◽  
Antihypertensive Drugs ◽  
Modified Rankin Scale ◽  
Manual Muscle Test ◽  
Psychotropic Agents ◽  
History Of ◽  
The Right

Objective: This study examined the case of a 63-year-old man with a history of hypertension and gout who had developed an intracerebral hemorrhage (ICH) of the right basal ganglia of the corona radiata.Methods: The patient was treated with herbal medicine (Boyanghwanoh-tang and powdered Oryeong-san extract), Western medicine (Anticonvulsants, antihypertensive drugs, psychotropic agents, and others), acupuncture, moxibustion, cupping, and rehabilitative therapy. Their effects were evaluated using the Manual Muscle Test (MMT), Korean version of the modified Barthel Index (K-MBI), National Institute of Health’s Stroke Scale (NIHSS), and Modified Rankin Scale (mRS).Results: After treatment, the MMT grade improved from 3/3+ to 4+/4+. Additionally, the K-MBI score improved from 62 to 77.Conclusion: The results suggest that combined traditional Korean and Western medicine can effectively treat patients with ICH.

scholarly journals Basal Ganglia Herniation into the Fourth Ventricle

1997 ◽  
Vol 24 (1) ◽  
pp. 62-63 ◽  
Author(s):  
Mensura Altumbabic ◽  
Marc R. Del Bigio ◽  
Scott Sutherland
Keyword(s):  
Basal Ganglia ◽  
Intracerebral Hemorrhage ◽  
Fourth Ventricle ◽  
Transtentorial Herniation ◽  
Intracerebral Bleeding ◽  
Rare Phenomenon ◽  
The Brain

ABSTRACT:Background:Transtentorial herniation of large cerebral fragments is a rare phenomenon.Method:Case StudyResults:Examination of the brain of a 35-year-old male showed massive intracerebral hemorrhage resulting in displacement of basal ganglia components into the fourth ventricle.Conclusions:Sufficiently rapid intracerebral bleeding can dissect fragments of cerebrum and displace them long distances across the tentorial opening.

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