A proposed grading system for arteriovenous malformations

1986 ◽  
Vol 65 (4) ◽  
pp. 476-483 ◽  
Author(s):  
Robert F. Spetzler ◽  
Neil A. Martin
Keyword(s):  
Venous Drainage ◽  
Neurological Complications ◽  
Management Decision ◽  
Grading System ◽  
Content Type ◽  
Treatment Techniques ◽  
Clinical Series ◽  
Management Decision Making ◽  
Eloquent Cortex ◽  
Fine Print

✓ An important factor in making a recommendation for treatment of a patient with arteriovenous malformation (AVM) is to estimate the risk of surgery for that patient. A simple, broadly applicable grading system that is designed to predict the risk of morbidity and mortality attending the operative treatment of specific AVM's is proposed. The lesion is graded on the basis of size, pattern of venous drainage, and neurological eloquence of adjacent brain. All AVM's fall into one of six grades. Grade I malformations are small, superficial, and located in non-eloquent cortex; Grade V lesions are large, deep, and situated in neurologically critical areas; and Grade VI lesions are essentially inoperable AVM's. Retrospective application of this grading scheme to a series of surgically excised AVM's has demonstrated its correlation with the incidence of postoperative neurological complications. The application of a standardized grading scheme will enable a comparison of results between various clinical series and between different treatment techniques, and will assist in the process of management decision-making.

A proposed grading system for arteriovenous malformations

2008 ◽  
Vol 108 (1) ◽  
pp. 186-193 ◽  
Author(s):  
Robert F. Spetzler ◽  
Neil A. Martin
Keyword(s):  
Venous Drainage ◽  
Neurological Complications ◽  
Management Decision ◽  
Grading System ◽  
Treatment Techniques ◽  
Critical Areas ◽  
Clinical Series ◽  
Management Decision Making ◽  
Eloquent Cortex ◽  
Adjacent Brain

✓ An important factor in making a recommendation for treatment of a patient with arteriovenous malformation (AVM) is to estimate the risk of surgery for that patient. A simple, broadly applicable grading system that is designed to predict the risk of morbidity and mortality attending the operative treatment of specific AVM's is proposed. The lesion is graded on the basis of size, pattern of venous drainage, and neurological eloquence of adjacent brain. All AVM's fall into one of six grades. Grade I malformations are small, superficial, and located in non-eloquent cortex; Grade V lesions are large, deep, and situated in neurologically critical areas; and Grade VI lesions are essentially inoperable AVM's. Retrospective application of this grading scheme to a series of surgically excised AVM's has demonstrated its correlation with the incidence of postoperative neurological complications. The application of a standardized grading scheme will enable a comparison of results between various clinical series and between different treatment techniques, and will assist in the process of management decision-making.

Delayed neurological deterioration following resection of arteriovenous malformations of the brain

1999 ◽  
Vol 90 (4) ◽  
pp. 695-701 ◽  
Author(s):  
Michael K. Morgan ◽  
Lali H. S. Sekhon ◽  
Simon Finfer ◽  
Verity Grinnell
Keyword(s):  
Arteriovenous Malformations ◽  
Cerebral Arteries ◽  
Venous Drainage ◽  
Neurological Deficits ◽  
Grading System ◽  
Content Type ◽  
Drainage Networks ◽  
Middle Cerebral Arteries ◽  
The Brain ◽  
Fine Print

Object. The aim of this study was to analyze delayed neurological deficits following surgical resection of arteriovenous malformations (AVMs).Methods. The authors report on a consecutive series of 200 patients with angiographically proven AVMs of the brain that were surgically resected between January 1989 and June 1998. The 30-day mortality rate for patients in this series was 1%, with one death caused by AVM resection and one death attributed to basilar artery aneurysm repair following successful AVM resection. The Spetzler—Martin grading system correlated well with the difficulty of surgery. No permanent incidence of morbidity resulted from resection of Grade I or II AVMs; the percentage of patients with a significant neurological deficit due to resection was 7.8% for those with Grade III lesions and 33.3% for those with Grade IV or V AVMs. However, this grading system did not accurately predict the development of delayed neurological deficits.Ten patients (5%) developed delayed neurological deficits after recovering from anesthesia and surgery. The delayed deficit was due to hemorrhage in four of the 10 patients and all four had undergone resection of AVMs measuring at least 4 cm in diameter. An increase in blood pressure during the first 8 postoperative days precipitated hemorrhage in these patients. Edema arising as a consequence of propagated venous thrombosis (two patients) was associated with extensive venous drainage networks rather than large AVM niduses. Both hemorrhagic and edematous complications can be included under the umbrella term of “arterial-capillary-venous hypertensive syndrome” to describe the common underlying pathogenesis accurately. An additional four patients developed a delayed deficit as a result of vasospasm. Vasospasm occurred when resection had involved extensive dissection of proximal anterior and middle cerebral arteries; in such cases the incidence of vasospasm was 27%.Conclusions. On the basis of their analysis of these complications, the authors recommend strict blood pressure control for patients with lesions measuring 4 cm or more in diameter (particularly those with a deep arterial supply). Thromboprophylaxis with aspirin and heparin is prescribed for patients with extensive venous drainage networks, and prophylactic nimodipine therapy and angiographic surveillance for vasospasm are suggested for patients in whom extensive dissection of proximal anterior or middle cerebral arteries has been necessary.

Theory of value co-creation: a systematic literature review

2014 ◽  
Vol 24 (6) ◽  
pp. 643-683 ◽  
Author(s):  
Marco Galvagno ◽  
Daniele Dalli
Keyword(s):  
Management Decision ◽  
Content Type ◽  
The Past ◽  
Theoretical Perspectives ◽  
Emerging Trends ◽  
Building Management ◽  
Innovation And Technology ◽  
Management Decision Making ◽  
Theory Of Value ◽  
Science Innovation

Purpose – The purpose of this paper is to summarize and classify extant research and to better understand the past, present, and future state of the theory of value co-creation. Its main objectives are: to identify the different theoretical perspectives and research streams that characterize and define the co-creation literature, and to highlight the connections between them; to look for emerging trends and gaps in the literature by comparing the most recent papers with those representing the field's core. Design/methodology/approach – The paper relies on bibliometric data: co-citation techniques were employed to select, analyze, and interpret citation patterns within the co-creation literature. Findings – The paper identified two main clusters, as well as specific research streams and common themes, representing scholarly journals’ publications on co-creation over the past years. These research streams and themes apply three different theoretical perspectives: service science, innovation and technology management, and marketing and consumer research. Data from the most recent publications has been used to verify if and how the original streams and themes are reflected in the contemporary debate. Research limitations/implications – Inevitably, the findings of the analysis have limitations related to the research design, the databases, and the applied bibliometric methods. Practical implications – From a practical perspective, the research impacts on theory building, management decision making, and teaching. Originality/value – This study depicts the remarkable development of the literature on co-creation and shows the latent structure underlying its different research streams. To the best knowledge, this study is the first to determine co-citation frequencies from both the SSCI and Scopus databases.

scholarly journals Manager perceptions of big data reliability in hotel revenue management decision making

2019 ◽  
Vol 36 (1) ◽  
pp. 25-39 ◽  
Author(s):  
David Egan ◽  
Natalie Claire Haynes
Keyword(s):  
Decision Making ◽  
Big Data ◽  
Revenue Management ◽  
Management Decision ◽  
Local Market ◽  
Data Systems ◽  
Local Data ◽  
Content Type ◽  
User Input ◽  
Management Decision Making

PurposeThe purpose of this paper is to investigate the perceptions that managers have of the value and reliability of using big data to make hotel revenue management and pricing decisions.Design/methodology/approachA three-stage iterative thematic analysis technique based on the approaches of Braun and Clarke (2006) and Nowell et al. (2017) and using different research instruments to collect and analyse qualitative data at each stage was used to develop an explanatory framework.FindingsWhilst big data-driven automated revenue systems are technically capable of making pricing and inventory decisions without user input, the findings here show that the reality is that managers still interact with every stage of the revenue and pricing process from data collection to the implementation of price changes. They believe that their personal insights are as valid as big data in increasing the reliability of the decision-making process. This is driven primarily by a lack of trust on the behalf of managers in the ability of the big data systems to understand and interpret local market and customer dynamics.Practical implicationsThe less a manager believes in the ability of those systems to interpret these data, the more they perceive gut instinct to increase the reliability of their decision making and the less they conduct an analysis of the statistical data provided by the systems. This provides a clear message that there appears to be a need for automated revenue systems to be flexible enough for managers to import the local data, information and knowledge that they believe leads to revenue growth.Originality/valueThere is currently little research explicitly investigating the role of big data in decision making within hotel revenue management and certainly even less focussing on decision making at property level and the perceptions of managers of the value of big data in increasing the reliability of revenue and pricing decision making.

The natural history of intracranial venous angiomas

1991 ◽  
Vol 75 (5) ◽  
pp. 715-722 ◽  
Author(s):  
Timothy B. Garner ◽  
O. Del Curling ◽  
David L. Kelly ◽  
D. Wayne Laster
Keyword(s):  
Natural History ◽  
Imaging Techniques ◽  
Venous Drainage ◽  
Vascular Lesion ◽  
Neurological Dysfunction ◽  
Content Type ◽  
History Of ◽  
Clinical Records ◽  
Venous Angiomas ◽  
Fine Print

✓ Cerebral venous angiomas are congenital anomalies of the intracranial venous drainage. Many believe that they are associated with a high risk of hemorrhage and neurological dysfunction, but newer neurodiagnostic imaging techniques are showing not only that they are more common than previously known but also that many have no associated symptoms. In this retrospective study, the natural history of venous angiomas was examined in 100 patients (48 males and 52 females) with radiographically identifiable lesions treated over a 14-year period. Information on the natural history of the lesion was obtained from clinical records and follow-up data. Imaging studies included angiography, computerized tomography, and magnetic resonance imaging. Angioma locations were classified as frontal (42 cases), parietal (24 cases), occipital (4 cases), temporal (2 cases), basal or ventricular (11 cases), cerebellar (14 cases), or brain stem (3 cases); 47 lesions were on the left side. Headache as a presenting symptom was common (36 patients) and often led to other radiographic studies, but this appeared to be related to the vascular lesion in only four patients. Other possibly related complications were hemorrhage in one patient, seizures in five, and transient focal deficits in eight. Fifteen patients had no neurological signs or symptoms. The mean patient age at last contact was 45.3 years (range 3 to 94 years). All patients have been managed without surgery. It is concluded that significant complications secondary to venous angiomas are infrequent and that surgical resection of these lesions and of surrounding brain is rarely indicated.

scholarly journals Big data and dynamic capabilities: a bibliometric analysis and systematic literature review

2019 ◽  
Vol 57 (8) ◽  
pp. 2052-2068 ◽  
Author(s):  
Riccardo Rialti ◽  
Giacomo Marzi ◽  
Cristiano Ciappei ◽  
Donatella Busso
Keyword(s):  
Big Data ◽  
Literature Review ◽  
Bibliometric Analysis ◽  
Systematic Literature Review ◽  
Dynamic Capabilities ◽  
Process Management ◽  
Big Data Analytics ◽  
Management Decision ◽  
Content Type ◽  
Management Decision Making

Purpose Recently, several manuscripts about the effects of big data on organizations used dynamic capabilities as their main theoretical approach. However, these manuscripts still lack systematization. Consequently, the purpose of this paper is to systematize the literature on big data and dynamic capabilities. Design/methodology/approach A bibliometric analysis was performed on 170 manuscripts extracted from the Clarivate Analytics Web of Science Core Collection database. The bibliometric analysis was integrated with a literature review. Findings The bibliometric analysis revealed four clusters of papers on big data and dynamic capabilities: big data and supply chain management, knowledge management, decision making, business process management and big data analytics. The systematic literature review helped to clarify each clusters’ content. Originality/value To the authors’ best knowledge, minimal attention has been paid to systematizing the literature on big data and dynamic capabilities.

Acute meningeal reaction following Pantopaque myelography

1971 ◽  
Vol 34 (3) ◽  
pp. 396-404 ◽  
Author(s):  
William E. Mayher ◽  
Ernest F. Daniel ◽  
Marshall B. Allen
Keyword(s):  
Hypersensitivity Reaction ◽  
Contrast Material ◽  
Neurological Complications ◽  
Content Type ◽  
Incomplete Removal ◽  
Fine Print

✓ Severe neurological complications including one death followed Pantopaque myelography in three cases in a series of 6000 myelograms over a 10-year period. In each of the three cases there was incomplete removal of the contrast material at the end of the procedure. The literature is reviewed and similar cases cited. The possibility that the acute meningeal reaction may be due to a hypersensitivity reaction is discussed.

Percutaneous radiofrequency denervation of spinal facets

1975 ◽  
Vol 43 (4) ◽  
pp. 448-451 ◽  
Author(s):  
C. Norman Shealy
Keyword(s):  
Neurological Complications ◽  
Content Type ◽  
Radiofrequency Denervation ◽  
Fine Print

✓ A technique for radiofrequency localization and coagulation of articular nerves supplying the spinal facets is described and results are reported from a series of 207 patients followed 6 to 21 months (mean 13 months). Relief of pain was achieved in 79% of previously unoperated patients, in 41% of those with laminectomy but no fusion, and in 27% of those with an earlier fusion. No neurological complications were encountered.

Loyalty card adoption in SME retailers: the impact upon marketing management

2015 ◽  
Vol 49 (3/4) ◽  
pp. 467-490 ◽  
Author(s):  
Karise Hutchinson ◽  
Lisa Victoria Donnell ◽  
Audrey Gilmore ◽  
Andrea Reid
Keyword(s):  
Decision Making ◽  
Current Knowledge ◽  
Marketing Management ◽  
Management Decision ◽  
Adoption Process ◽  
Longitudinal Case Study ◽  
Content Type ◽  
Management Decision Making ◽  
The Impact ◽  
Loyalty Card

Purpose – The purpose of this paper is to understand how small to medium-sized enterprise (SME) retailers adopt and implement a loyalty card programme as a marketing management decision-making tool. Design/methodology/approach – A qualitative and longitudinal case study research design is adopted. Data were collected from multiple sources, incorporating semi-structured interviews and analysis of company documents and observation within a retail SME. Findings – The findings presented focus on the loyalty card adoption process to reflect both the organisational issues and impact upon marketing management decision-making. Research limitations/implications – This research is restricted to one region within the UK, investigating loyalty card adoption within a specific industry sector. Practical implications – SME retailers operate in an industry environment whereby there is a competitive demand for loyalty card programmes. SME retailers need to carefully consider how to match the firm’s characteristics with customer relationship management (CRM) operational requirements as highlighted in this case. Originality/value – The evidence presented extends current knowledge of retail loyalty card programmes beyond the context of large organisations to encompass SMEs. The study also illustrates the value of a structured, formal CRM system to help SME retailers compete in a complex, competitive and omni-channel marketplace, adding new insights into the retail literature.

A sacral dural arteriovenous fistula presenting with an intermittent myelopathy aggravated by menstruation

1991 ◽  
Vol 75 (6) ◽  
pp. 947-949 ◽  
Author(s):  
Dong-Ik Kim ◽  
In-Sup Choi ◽  
Alex Berenstein
Keyword(s):  
Arteriovenous Fistula ◽  
Clinical Manifestation ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Spinal Dural Arteriovenous Fistula ◽  
Content Type ◽  
Repeat Angiography ◽  
Fine Print

✓ The case is reported of a woman with a spinal dural arteriovenous fistula whose intermittent myelopathy became aggravated with menstruation. Her symptoms recurred in spite of successful acrylic embolization of the lateral sacral arteriovenous fistula. Repeat angiography showed venous drainage from the uterus toward the medullary vein. Total abdominal hysterectomy cured her symptoms. The pathophysiological basis for this peculiar clinical manifestation and its management are discussed.

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