scholarly journals Predictive morphological factors of rupture of arteriovenous malformations of the brain

2013 ◽  
Vol 60 (4) ◽  
pp. 77-81
Author(s):  
Sinisa Matic ◽  
Nikola Repac ◽  
Igor Nikolic ◽  
Igor Djoric ◽  
Aleksandar Janicijevic ◽  
...  

The study includes a series of 39 patients with AVM of the brain that are not subjected to any method of treatment, except for the symptomatic treatment who were hospitalized and diagnosed AVM at the Institute of Neurosurgery, Clinical Center, in the period 2005-2011. Results: The structure of the patients was measured by gender are male. Average age of the respondents was 27.4 ? 7.6 years. With the average length of the follow-up of 4.8 years, new hemorrhage occurred in 24 patients (58 episodes). Predictor (p<0.01), factors for bleeding include: arterial supply from the VB and ACA basin and multiple arterial supply. Conclusion: The analysis of our series may be proposed for following model of the natural course of AVM : After initiall haemorrhage there is annual risk of rehemorrhage of 3.33%. Bleeding events were significantly more common in medium-sized AVM (2.5 - 5 cm), localized in elocvent area of the brain with combined type of venous drainage, arterial supply from the vertebrobasilar artery, anterior cerebral artery basin or combined arterial supply.

2016 ◽  
Vol 17 (4) ◽  
pp. 434-438 ◽  
Author(s):  
Ritchell van Dams ◽  
Henry S. Park ◽  
Ahmed K. Alomari ◽  
Adele S. Ricciardi ◽  
Harini Rao ◽  
...  

This case report demonstrates that hypofractionated partial-brain radiation therapy with limited margins is a reasonable approach following gross tumor resection of Ewing sarcoma metastases to the brain. The patient presented with 2 intracranial metastases treated with gross-total resection followed by radiation therapy to 30 Gy in 5 fractions. The patient experienced symptomatic treatment-related inflammatory changes with resolution after receiving dexamethasone. He remains alive at 21 months of follow-up with no evidence of disease.


1989 ◽  
Vol 135 (3) ◽  
pp. 281-284 ◽  
Author(s):  
Wesley D. Anderson ◽  
Bettina G. Anderson ◽  
Randolph .J. Seguin

2008 ◽  
Vol 1 (2) ◽  
pp. 156-159 ◽  
Author(s):  
Sait Sirin ◽  
Serdar Kahraman ◽  
Selcuk Gocmen ◽  
Ersin Erdogan

✓The most common vascular anomaly associated with a developmental venous anomaly (DVA) is a cavernous malformation. A cerebral DVA is a rare vascular malformation of the brain when it is associated with a varix. The authors report on a 13-year-old girl who presented with 2 brief episodes of nonresponsiveness that mimicked absence seizures. The computed tomography scans, magnetic resonance images, and cerebral angiograms showed a left temporal DVA in combination with a sylvian fissure varix. To maintain normal parenchymal venous drainage, no surgical intervention was performed. Radiological and clinical follow-up was planned. This case report expands the present knowledge of the rare association of a cerebral DVA with a varix and emphasizes the need for meticulous neuroimaging to avoid unnecessary surgery.


1989 ◽  
Vol 135 (3) ◽  
pp. 285-288 ◽  
Author(s):  
Bettina G. Anderson ◽  
Wesley D. Anderson ◽  
Randolph J. Seguin

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Kretzler ◽  
C Wunderlich ◽  
M Christoph ◽  
A Langbein ◽  
S G Spitzer ◽  
...  

Abstract Background Oral anticoagulation for prophylaxis of central and peripheral embolisation is limited in its use in patients with atrial fibrillation (AF) and bleeding events. As an alternative to anticoagulation, the interventional closure of the left atrial appendage (LAAO) is available. A common clinical dilemma is the treatment of patients with potential peri-device leakage following LAA occlusion. The specific definition of the severity of the leak and the long-term clinical implications have not yet been sufficiently investigated. Methods The multi-centre ORIGINAL registry was initiated 2014. The aim of this registry is to analyze the safety and efficacy of the procedure in patients with a high risk of bleeding in everyday clinical practice and to evaluate hemorrhagic and thromboemb. events in the long term follow-up. Patients with an indication for LAA occl. were included in the registry after informed consent. The impl., follow-up and anticoagulation regimens are performed according to the standard of the participating centers. 521 patients with AF underwent an implantation of an LAA closure device between Jul. 2014 and Nov. 2018. A mean follow-up of 463 days could be reached in 386 patients. Results The periprocedural complication rate was 3.8% of which 5 patients experienced pericardial effusion (successful treatment with pericardial puncture or surgical), 2 patients had periprocedural stroke and 1 patient suffered from air embolism. In 27 patients a peri-device flow due to incomplete occlusion was detected by TEE (5.4% of the implantations). The size ranged between 1 and 8 mm (mean 2.28 mm (SD=2.11)). The eccentricity index (EI) of the LAA in these patients was 1.22 (SD 0.17), and thus the LAA rather oval, while those LAA without leakage tend to be more circular (EI 1.08 with SD=0.17). 2 of the patients with leakage (7.4%) experienced stroke or peripheral embolism, respectively. The annual risk for stroke/TIA/peripheral embolism of these patients was 5.84%, the annual risk of the patients without leakage was 2.04%. Patients with a leakage >6 mm were treated with rivaroxaban in full therapeutic dosage. One patient underwent an additional procedure. Conclusion The evaluation and management of para-device leakage after an interventional LAA occlusion represents a challenge. Currently, limited data are available on the optimal strategy. Those data indicate that residual peri-device flow into the LAA after percutaneous closure with the Watchman device represents no cause for alarm. However, our data suggest, that patients with peridevice leak might be at a higher risk of thromboembolic events. Furthermore, it could be shown, that these patients had rather oval ostium of the LAA, while those LAA without leakage tend to be more circular. This implicates the importance of advanced imaging methods, such as 3D-TEE, which are capable to precisely determine the size of the LAA and the degree of its circularity. Acknowledgement/Funding None


Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.


GeroPsych ◽  
2012 ◽  
Vol 25 (4) ◽  
pp. 235-245 ◽  
Author(s):  
Katja Franke ◽  
Christian Gaser

We recently proposed a novel method that aggregates the multidimensional aging pattern across the brain to a single value. This method proved to provide stable and reliable estimates of brain aging – even across different scanners. While investigating longitudinal changes in BrainAGE in about 400 elderly subjects, we discovered that patients with Alzheimer’s disease and subjects who had converted to AD within 3 years showed accelerated brain atrophy by +6 years at baseline. An additional increase in BrainAGE accumulated to a score of about +9 years during follow-up. Accelerated brain aging was related to prospective cognitive decline and disease severity. In conclusion, the BrainAGE framework indicates discrepancies in brain aging and could thus serve as an indicator for cognitive functioning in the future.


2019 ◽  
Vol 58 (05) ◽  
pp. 371-378
Author(s):  
Alfred O. Ankrah ◽  
Ismaheel O. Lawal ◽  
Tebatso M.G. Boshomane ◽  
Hans C. Klein ◽  
Thomas Ebenhan ◽  
...  

Abstract 18F-FDG and 68Ga-citrate PET/CT have both been shown to be useful in the management of tuberculosis (TB). We compared the abnormal PET findings of 18F-FDG- and 68Ga-citrate-PET/CT in patients with TB. Methods Patients with TB on anti-TB therapy were included. Patients had a set of PET scans consisting of both 18F-FDG and 68Ga-citrate. Abnormal lesions were identified, and the two sets of scans were compared. The scan findings were correlated to the clinical data as provided by the attending physician. Results 46 PET/CT scans were performed in 18 patients, 11 (61 %) were female, and the mean age was 35.7 ± 13.5 years. Five patients also had both studies for follow-up reasons during the use of anti-TB therapy. Thirteen patients were co-infected with HIV. 18F-FDG detected more lesions than 68Ga-citrate (261 vs. 166, p < 0.0001). 68Ga-citrate showed a better definition of intracerebral lesions due to the absence of tracer uptake in the brain. The mean SUVmax was higher for 18F-FDG compared to 68Ga-citrate (5.73 vs. 3.01, p < 0.0001). We found a significant correlation between the SUVmax of lesions that were determined by both tracers (r = 0.4968, p < 0.0001). Conclusion Preliminary data shows 18F-FDG-PET detects more abnormal lesions in TB compared to 68Ga-citrate. However, 68Ga-citrate has better lesion definition in the brain and is therefore especially useful when intracranial TB is suspected.


2020 ◽  
Vol 77 (4) ◽  
pp. 1609-1622
Author(s):  
Franziska Mathies ◽  
Catharina Lange ◽  
Anja Mäurer ◽  
Ivayla Apostolova ◽  
Susanne Klutmann ◽  
...  

Background: Positron emission tomography (PET) of the brain with 2-[F-18]-fluoro-2-deoxy-D-glucose (FDG) is widely used for the etiological diagnosis of clinically uncertain cognitive impairment (CUCI). Acute full-blown delirium can cause reversible alterations of FDG uptake that mimic neurodegenerative disease. Objective: This study tested whether delirium in remission affects the performance of FDG PET for differentiation between neurodegenerative and non-neurodegenerative etiology of CUCI. Methods: The study included 88 patients (82.0±5.7 y) with newly detected CUCI during hospitalization in a geriatric unit. Twenty-seven (31%) of the patients were diagnosed with delirium during their current hospital stay, which, however, at time of enrollment was in remission so that delirium was not considered the primary cause of the CUCI. Cases were categorized as neurodegenerative or non-neurodegenerative etiology based on visual inspection of FDG PET. The diagnosis at clinical follow-up after ≥12 months served as ground truth to evaluate the diagnostic performance of FDG PET. Results: FDG PET was categorized as neurodegenerative in 51 (58%) of the patients. Follow-up after 16±3 months was obtained in 68 (77%) of the patients. The clinical follow-up diagnosis confirmed the FDG PET-based categorization in 60 patients (88%, 4 false negative and 4 false positive cases with respect to detection of neurodegeneration). The fraction of correct PET-based categorization did not differ between patients with delirium in remission and patients without delirium (86% versus 89%, p = 0.666). Conclusion: Brain FDG PET is useful for the etiological diagnosis of CUCI in hospitalized geriatric patients, as well as in patients with delirium in remission.


2018 ◽  
Vol 3 (2) ◽  

There have been a few case reports of head injury leading to brain tumour development in the same region as the brain injury. Here we report a case where the patient suffered a severe head injury with contusion. He recovered clinically with conservative management. Follow up Computed Tomography scan of the brain a month later showed complete resolution of the lesion. He subsequently developed malignant brain tumour in the same region as the original contusion within a very short period of 15 months. Head injury patients need close follow up especially when severe. The link between severity of head injury and malignant brain tumour development needs further evaluation. Role of anti-inflammatory agents for prevention of post traumatic brain tumours needs further exploration.


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