Lacunar skull deformity (Lückenschädel) and intelligence in myelomeningocele

1974 ◽  
Vol 41 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Sherman Stein ◽  
Luis Schut ◽  
Patricia Borns
Keyword(s):  
Intellectual Development ◽  
Content Type ◽  
Cerebral Development ◽  
Intellectual Capacity ◽  
The Difference ◽  
Skull Deformity ◽  
Relationship Of ◽  
The Relationship ◽  
Fine Print

✓ Clinical and radiographic records of 156 children with myelomeningocele and adequate follow-up were reviewed to assess the relationship of lacunar skull deformity (Lückenschädel, or LSD) to intellectual development. LSD was present on perinatal films in 54.5% of these children. On later testing the group with LSD achieved a mean IQ of 63.8 as opposed to 95.8 found in children without LSD. The difference is very highly significant (p < 0.0005). Since the presence or absence of LSD is easily determined at birth, it can be used as an early indicator of intellectual capacity. Signs of hydrocephalus at birth were not found to be reliably associated with either LSD or eventual IQ. The significance of these findings and the relationship between LSD and defective cerebral development are discussed.

Linear accelerator radiosurgery for arteriovenous malformations: the relationship of size to outcome

1995 ◽  
Vol 82 (2) ◽  
pp. 180-189 ◽  
Author(s):  
William A. Friedman ◽  
Frank J. Bova ◽  
William M. Mendenhall
Keyword(s):  
Arteriovenous Malformations ◽  
Clinical Information ◽  
Mr Image ◽  
Content Type ◽  
Complete Obliteration ◽  
Lost To Follow Up ◽  
Relationship Of ◽  
The Relationship ◽  
Fine Print

✓ Between May, 1988 and August, 1993, 158 patients with arteriovenous malformations (AVMs) were treated radiosurgically at the University of Florida. A mean dose of 1560 cGy was directed to the periphery of the lesions, which had a mean volume of 9 cc (0.5 to 45.3 cc). One hundred thirty-nine of these individuals were treated with one isocenter. The mean follow-up interval was 33 months with clinical information available on 153 of these patients. Patients were followed until magnetic resonance (MR) studies suggested complete AVM thrombosis. An arteriogram was then performed, if possible, to verify occlusion status. If arteriography revealed any persistent nidus at 36 months posttreatment, the residual nidus was re-treated. Outcome categories of AVMs analyzed included the following possibilities: 1) angiographic cure; 2) angiographic failure; 3) re-treatment; 4) MR image suggested cure; 5) MR image suggested failure; 6) patient refused follow-up evaluation; 7) patient lost to follow-up study; or 8) patient deceased. The endpoints for success or failure of radiosurgery were as follows: angiographic occlusion (success), re-treatment (failure), and death due to AVM hemorrhage (failure). Fifty-six patients in this series reached one of the endpoints. Successful endpoints were seen in 91% of AVMs between 1 and 4 cc in volume, 100% of AVMs 4 to 10 cc in volume, and 79% of AVMs greater than 10 cc in volume. The more traditional measure of radiosurgical success, percentage of angiograms showing complete obliteration, was obtained in 81% of AVMs between 1 and 4 cc in volume, 89% of AVMs between 4 and 10 cc in volume, and 69% of AVMs greater than 10 cc in volume. A detailed analysis of the relationship of all outcome categories to size is presented.

Unruptured intracranial aneurysms and arteriovenous malformations: frequency of intracranial hemorrhage and relationship of lesions

1990 ◽  
Vol 73 (6) ◽  
pp. 859-863 ◽  
Author(s):  
Robert D. Brown ◽  
David O. Wiebers ◽  
Glenn S. Forbes
Keyword(s):  
Intracranial Hemorrhage ◽  
Arteriovenous Malformations ◽  
Low Flow ◽  
Content Type ◽  
Unruptured Intracranial Aneurysms ◽  
The Difference ◽  
Arterial Feeder ◽  
Relationship Of ◽  
The Relationship ◽  
Feeding Systems

✓ Among 91 patients with unruptured intracranial arteriovenous malformations (AVM's), 16 patients had 26 unruptured intracranial saccular aneurysms. An actuarial analysis showed the risk of intracranial hemorrhage among patients with coexisting aneurysm and AVM to be 7% per year at 5 years following diagnosis compared to 1.7% for patients with AVM alone. The difference in length of survival free of hemorrhage was significant (log-rank, p < 0.0007). Several angiographic and clinical parameters were investigated to better understand the relationship of these lesions. The aneurysms occurred in similar percentages in patients with small, medium, and large AVM's. Twenty-five aneurysms were on arteries feeding the malformation system, almost equally distributed proximally and distally. Eleven aneurysms were atypical in location, and all arose from primary or secondary branch feeders to the malformation; 24 were on enlarged feeding arteries. Eleven (16%) of the 67 patients with high-flow AVM's had associated aneurysms, compared with five (21%) of the 24 patients with low-flow AVM's. Four (16%) of 25 low-shunt malformations and 12 (18%) of 65 high-shunt malformations had associated aneurysms. All five aneurysms associated with low-shunt malformations were on a direct arterial feeder of the malformation. These data suggest that the intracranial AVM's predispose to aneurysm formation within AVM feeding systems and that the mechanism is not simply based upon the high blood flow or high arteriovenous shunt in these systems.

Acute axis fractures: a review of 229 cases

1989 ◽  
Vol 71 (5) ◽  
pp. 642-647 ◽  
Author(s):  
Mark N. Hadley ◽  
Curtis A. Dickman ◽  
Carol M. Browner ◽  
Volker K. H. Sonntag
Keyword(s):  
Treatment Guidelines ◽  
Type Ii ◽  
High Likelihood ◽  
Fracture Feature ◽  
Content Type ◽  
Nonoperative Therapy ◽  
The Difference ◽  
Cervical Spine Fractures ◽  
Fine Print

✓ Eighteen percent of acute cervical spine fractures involve the C-2 vertebra. The odontoid Type II fracture is the most common axis fracture and it is also the most difficult to treat. The degree of odontoid dislocation has been identified as the single most important fracture feature that helps separate those patients who have a high likelihood of healing with nonoperative therapy from those who are likely to fail nonoperative therapy and should be offered early surgical stabilization. The difference is statistically significant (p < 0.001, x2 = 30.20). The present series includes 229 patients with acute axis fractures. Follow-up data were available in 92% of these patients, for a median duration of 4 years 9 months. Treatment guidelines and results are offered for each subtype of axis fracture based on this experience.

A simple, inexpensive technique for accurate mass localization by computerized tomography

1980 ◽  
Vol 52 (5) ◽  
pp. 733-735 ◽  
Author(s):  
John I. Moseley ◽  
Steven L. Giannotta ◽  
Justin W. Renaudin
Keyword(s):  
Computerized Tomography ◽  
Accurate Mass ◽  
Content Type ◽  
Accurate Localization ◽  
Relationship Of ◽  
The Relationship ◽  
Inexpensive Technique ◽  
Tomography Scanning ◽  
Fine Print

✓ A simple wire template is placed on the patient's head during computerized tomography scanning, and the results of the scan are later reproduced on the scalp prior to surgery. Measurements of the distance between the wires and the relationship of the mass provide the key to accurate localization of the mass on the scalp surface.

Relationship of perfusion pressure and size to risk of hemorrhage from arteriovenous malformations

1992 ◽  
Vol 76 (6) ◽  
pp. 918-923 ◽  
Author(s):  
Robert F. Spetzler ◽  
Ronald W. Hargraves ◽  
Patrick W. McCormick ◽  
Joseph M. Zabramski ◽  
Richard A. Flom ◽  
...  
Keyword(s):  
Perfusion Pressure ◽  
Feeding Artery ◽  
Content Type ◽  
Arterial Blood ◽  
The Mean ◽  
Feeding Pressure ◽  
Risk Of Hemorrhage ◽  
Relationship Of ◽  
The Relationship ◽  
Fine Print

✓ The relationship between the size of an arteriovenous malformation (AVM) and its propensity to hemorrhage is unclear. Although nidus volume increases geometrically with respect to AVM diameter, hemorrhages are at least as common, in small AVM's compared to large AVM's. The authors prospectively evaluated 92 AVM's for nidus size, hematoma size, and arterial feeding pressure to determine if these variables influence the tendency to hemorrhage. Small AVM's (diameter ≤ 3 cm) presented with hemorrhage significantly more often (p < 0.001) than large AVM's (diameter > 6 cm), the incidence being 82% versus 21%. Intraoperative arterial pressures were recorded from the main feeding vessel(s) in 24 of the 92 patients in this series: 10 presented with hemorrhage and 14 presented with other neurological symptoms. In the AVM's that had hemorrhaged, the mean difference between mean arterial blood pressure and the feeding artery pressure was 6.5 mm Hg (range 2 to 15 mm Hg). In the AVM's that did not rupture, this difference was 40 mm Hg (range 17 to 63 mm Hg). Smaller AVM's had significantly higher feeding artery pressures (p < 0.05) than did larger AVM's, and they were associated with large hemorrhages. It is suggested that differences in arterial feeding pressure may be responsible for the observed relationship between the size of AVM's and the frequency and severity of hemorrhage.

Laboratory experience with a magnetically guided intravascular catheter system

1973 ◽  
Vol 38 (2) ◽  
pp. 145-154 ◽  
Author(s):  
Herbert L. Cares ◽  
J. Richard Hale ◽  
D. Bruce Montgomery ◽  
Howard A. Richter ◽  
William H. Sweet
Keyword(s):  
Intravascular Catheter ◽  
Selective Angiography ◽  
Content Type ◽  
Laboratory Experience ◽  
Arteriovenous Fistulas ◽  
Catheter System ◽  
Relationship Of ◽  
The Relationship ◽  
Fine Print

✓ An improved magnetically-guided intravascular catheter system in dogs is described as safe, requiring little attention, allowing the application of flow surges to aid propulsion of the tip, and providing for angiography of good quality. Current concepts of the relationship of magnetic and flow guidance are discussed. The uses of the system demonstrated include selective angiography, perfusion of isobutyl-2-cyanoacrylate into experimental arteriovenous fistulas, and perfusion of microparticulate iron suspensions into experimental aneurysms. A unique detachable macroballoon that may function as a reversible tethered embolus is reported.

Cerebral venous malformations

1990 ◽  
Vol 73 (4) ◽  
pp. 560-564 ◽  
Author(s):  
Daniele Rigamonti ◽  
Robert F. Spetzler ◽  
Marjorie Medina ◽  
Karen Rigamonti ◽  
David S. Geckle ◽  
...  
Keyword(s):  
Venous Malformation ◽  
Neurological Dysfunction ◽  
Neurological Deficits ◽  
Venous Angioma ◽  
Venous Malformations ◽  
Content Type ◽  
History Of ◽  
The Relationship ◽  
Fine Print

✓ Although cerebral venous malformations have been reported to cause epilepsy, progressive neurological deficits, and hemorrhage, their clinical significance remains controversial. In an attempt to clarify the natural history of the lesion and suggest an appropriate management strategy, the authors review their experience with 30 patients. In four patients with cerebellar venous angioma, an acute episode of ataxia was documented. The coexistence of a cavernous malformation was pathologically confirmed in the two patients who underwent surgery for bleeding presumed caused by the venous angioma. Infarction was shown in two patients and a tumor in two others. Follow-up periods ranged between 18 and 104 months, with only five patients symptomatic at the time of this report. Rebleeding had not occurred, nor had acute episodes of neurological dysfunction been documented. This clinical experience suggests that a venous malformation is frequently associated with other, more symptomatic conditions and is often erroneously identified as the source of the symptoms. Because the nature of the relationship between the venous malformation and the allied conditions remains ambiguous, it is recommended that patients harboring a “symptomatic” venous malformation undergo high-field magnetic resonance imaging to rule out underlying pathology, and that any such pathology be treated independently of the venous malformation.

Immunobiology of primary intracranial tumors

1977 ◽  
Vol 47 (6) ◽  
pp. 871-885 ◽  
Author(s):  
Ronald E. Woosley ◽  
M. Stephen Mahaley ◽  
Jane L. Mahaley ◽  
Gary M. Miller ◽  
William H. Brooks
Keyword(s):  
Effector Cell ◽  
Intracranial Tumors ◽  
Content Type ◽  
Postoperative Course ◽  
Immune Parameters ◽  
Relationship Of ◽  
The Relationship ◽  
Cytotoxic Responses ◽  
Fine Print

✓ Fifty-six in vitro microcytotoxicity assays were conducted on 30 patients with intracranial tumors at various times during their postoperative course. Significant specific cellular cytotoxic responses were found in nine of 56 assays, humoral cytotoxic responses in nine of 54 assays, and host effector cell-dependent, antibody-dependent cytotoxic responses in four of 28 assays. Variables that might influence the occurrence of cytotoxicity were studied, and the relationship of these findings to other immune parameters was discussed.

No ordinary time, no ordinary men: the relationship between Harvey Cushing and Franklin D. Roosevelt, 1928–1939

2001 ◽  
Vol 95 (2) ◽  
pp. 354-368 ◽  
Author(s):  
Richard L. Rovit ◽  
William T. Couldwell
Keyword(s):  
Personal Relationship ◽  
Content Type ◽  
Harvey Cushing ◽  
Medical Issues ◽  
Ordinary Time ◽  
The Times ◽  
Franklin Delano Roosevelt ◽  
Relationship Of ◽  
The Relationship ◽  
Fine Print

✓ The authors elucidate the strong personal relationship that developed between Dr. Harvey Cushing and Franklin Delano Roosevelt (FDR) from 1928 to 1939, as manifested in their frequent letters to each other. The relationship was initiated by the marriage of their children. Through his correspondence with FDR, Cushing was able to affect several medical issues of the period. The relationship of these two individuals is set within the historical, social, and political contexts of the times.

Relation of preoperative angiographic characteristics of the posterior communicating artery to the results of common carotid ligation

1972 ◽  
Vol 36 (5) ◽  
pp. 564-568 ◽  
Author(s):  
Kenneth Tuerk ◽  
Norman E. Chase ◽  
Irvin I. Kricheff ◽  
Joseph P. Lin ◽  
Joseph Ransohoff
Keyword(s):  
Contrast Material ◽  
Posterior Communicating Artery ◽  
Carotid Angiography ◽  
Content Type ◽  
Carotid Ligation ◽  
Before And After ◽  
Relationship Of ◽  
The Relationship ◽  
Fine Print

✓ Twenty patients with posterior communicating artery aneurysms were treated with common carotid ligation. Postligation visualization was accomplished in 16 cases by ipsilateral brachial angiography. Two other aneurysms were visualized by contralateral brachial and contralaterial carotid angiography. The size of the aneurysm was measured before and after ligation. The relationship of postoperative reduction in size to preoperative angiographic characteristics was studied. Reduction in the size of the aneurysm occurred most often when preoperative angiography showed that the sac was long and its neck narrow, and when there was stasis of contrast material in the aneurysm.

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