Surgical considerations regarding giant dilations of the perivascular spaces

2004 ◽  
Vol 100 (5) ◽  
pp. 820-824 ◽  
Author(s):  
Paul House ◽  
Karen L. Salzman ◽  
Anne G. Osborn ◽  
Joel D. MacDonald ◽  
Randy L. Jensen ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Mass Effect ◽  
Perivascular Spaces ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Content Type ◽  
Relationship Of ◽  
The Relationship ◽  
The Brain ◽  
Fine Print

Object. Dilations of brain perivascular spaces (PVSs), also known as Virchow—Robin spaces, are routinely identified on magnetic resonance imaging studies of the brain and recognized as benign normal variants. Giant dilations occur only rarely and can be easily misdiagnosed as central nervous system tumors. The relevant surgical literature was reviewed to help establish indications for surgical intervention in these typically benign lesions. Methods. Giant dilations of the PVSs in 12 patients who had undergone surgery for several different indications were identified. Both clinical and radiographic presentations of these patients were reviewed along with the surgical procedures. Conclusions. Dilations of the PVSs can become giant lesions that may necessitate surgical intervention to relieve mass effect or hydrocephalus. The relationship of these lesions to neurological symptoms such as tremor and seizures remains unclear.

Cavernous malformation of the mammillary bodies: neuropsychological implications

1995 ◽  
Vol 83 (2) ◽  
pp. 354-358 ◽  
Author(s):  
Daniel V. Loesch ◽  
Steven Gilman ◽  
Jerel Del Dotto ◽  
Mark L. Rosenblum
Keyword(s):  
Cavernous Malformation ◽  
Memory Deficits ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Content Type ◽  
Mammillary Bodies ◽  
History Of ◽  
Neuropsychological Evaluations ◽  
Relationship Of ◽  
The Relationship

✓ The authors present the first documented case of a cavernous malformation of the mammillary bodies. A 34-year-old woman presented with a 2-month history of headaches and acute memory changes. Magnetic resonance imaging studies demonstrated a retrochiasmatic interpeduncular lesion that was initially thought to be a craniopharyngioma. Operative resection confirmed the diagnosis of a cavernous malformation. This particular case is unique in its destruction of the mammillary bodies and presents further evidence of the relationship of these regions to memory. This report is also the first to document results of pre- and postoperative neuropsychological evaluations that specifically address the memory deficits created by destruction of the mammillary bodies.

Primary diffuse leptomeningeal oligodendroglioma

1995 ◽  
Vol 83 (4) ◽  
pp. 724-728 ◽  
Author(s):  
Robert Chen ◽  
David R. Macdonald ◽  
David A. Ramsay
Keyword(s):  
High Dose Chemotherapy ◽  
Postmortem Examination ◽  
High Dose ◽  
Imaging Studies ◽  
Neoplastic Cells ◽  
Content Type ◽  
Suprasellar Cistern ◽  
Brain And Spinal Cord ◽  
The Brain ◽  
Fine Print

✓ The authors describe a case of a diffuse primary leptomeningeal oligodendroglioma in a 17-year-old girl who presented with raised intracranial pressure and hydrocephalus. She underwent imaging studies and a left frontotemporal craniotomy that revealed a cystic oligodendroglioma in the suprasellar cistern and spread of neoplastic cells to the spinal leptomeninges. The tumor showed little response to maximum radiotherapy and chemotherapy, and the patient died from complications of high-dose chemotherapy 2 years after diagnosis. Postmortem examination of the brain and spinal cord revealed diffuse meningeal infiltration by neoplastic cells and no evidence of an intraparenchymal origin. Glial heterotopias were noted at several sites along the brain base, adding circumstantial support to the theory that leptomeningeal gliomas are derived from ectopic glial tissue in the subarachnoid space.

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.

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.

Thrombosis: the relationship of hemostatic mechanisms to drug therapy

1981 ◽  
Vol 54 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Stanford Wessler ◽  
Sanford N. Gitel
Keyword(s):  
Drug Therapy ◽  
Content Type ◽  
Relationship Of ◽  
The Relationship ◽  
Fine Print

✓ The mechanisms of arteriovenous and microcirculatory thrombosis and embolism are presented. Drugs affecting the hemostatic balance and their specific actions and indications are reviewed.

Meningomyelocele and progressive hydromyelia

1975 ◽  
Vol 43 (4) ◽  
pp. 457-463 ◽  
Author(s):  
Peter V. Hall ◽  
Robert L. Campbell ◽  
John E. Kalsbeck
Keyword(s):  
Clinical Improvement ◽  
Sensory Loss ◽  
Ventricular Drainage ◽  
Prominent Feature ◽  
Content Type ◽  
Relationship Of ◽  
The Relationship ◽  
Progressive Paraparesis ◽  
Fine Print

✓ Five cases of myelodysplasia with progressive paraparesis are presented. Three of the five patients developed spasticity, but dissociated sensory loss and loss of sphincter control was not a prominent feature. All were found to have compensated hydrocephalus and extensive communicating hydromyelia. The use of myelography and ventriculography in the diagnosis of hydromyelia is discussed. Ventricular drainage led to clinical improvement in two cases and radiological improvement in one. The relationship of compensated hydrocephalus, meningomyelocele, and progressive hydromyelia postnatally may support the hydrodynamic hypothesis of myelodysplasia.

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