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The main aim of this study is to define the clinical criteria which must be considered in order to come to an adequate decision whether a patient with intracranial arteriovenous malformation (AVM) should be operated upon or treated conservatively. A special method was used to reduce the effects of selection. This method made it possible to evaluate the therapeutic efficacy of conservative treatment versus surgery. The method implies that patients with equal combinations of variables (risk profiles) were compared in the two treatment lines. The variables building up the risk-profile pattern were chosen by analysing the decision process, as it was originally practiced by the surgeon who selected and treated the patients of this study. The risk profiles thus described relevant characteristics of the patient and his malformation. The variables were assigned numerical values accord ing to their prognostic value. Summation of the variables making up the risk profile then gives each risk profile a certain value. A low value symbolizes a bad prognosis and a high value a good prognosis in both treatment groups. There were many risk profiles with the same value in both groups and a comparison could be made over a large part of the risk-profile scale. This comparison showed that surgical treatment of A VM can always be justified, although the indications for surgery are less strong in patients with low risk profile values.
This book reviews the natural course of arteriovenous malformation (AVM) disease and the active treatment modalities. These are compared with surgical and neuropsychological results achieved at the Military University Hospital, Prague, Czech Republic. Based on these comparisons, treatment recommendation for AVM is articulated. Furthermore, the long-term efficacy of different treatment is discussed. This book is written by an international group of European authors, and is aimed at neurovascular surgeons and neurosurgical residents.
Vascular malformations of the brain and spine pose many management challenges. This text provides a comprehensive, state-of-the-art review of the natural history, treatment options, and outcomes of patients with these conditions. Despite their relative rarity, these lesions are responsible for devastating injury to individuals and can cause an enduring physical, psychological, and economic burden on patients and families. Many new therapeutic options are now available with the advent of novel surgical, endovascular, and radiosurgical techniques. The basic sciences have fuelled development of small molecule and biologic therapies targeting the molecular basis of disease. Authored by international experts in the fields of neurosurgery, neurology, radiology, and radiation oncology, this book provides state-of-the-art treatment plans and discussions of ideal therapy. This text is aimed at practitioners in the fields of neurology, neurosurgery, neuroradiology, radiation oncology, rehabilitation medicine and allied fields who care for patients with brain and spinal vascular malformations.
This volume provides an overview of new concepts in neurovascular interventions based on clinical and scientific knowledge of cerebrovascular disorders. It especially focuses on subarachnoid hemorrhage and cerebrovascular malformations, e.g. aneurysms, arterio-venous malformations, and cavernomas. A separate part addresses cerebral revascularization for both complex aneurysms and ischemia. All contributions were written by recognized experts and cover original papers presented at the 7th European Japanese Stroke Surgery Conference, held in Verona, Italy in June 2014. The authors present new trends and strategies for managing emerging problems, as well as in-depth discussions on controversial issues in the field.
Focusing on both the patient's perspective and the neurosurgeon's concerns, Intracranial Arteriovenous Malformations: Essentials for Patients and Practitioners, edited by leading experts Drs. Philip E. Stieg, Alexander A. Khalessi, and Michael L. J. Apuzzo, starts with an up-to-date approach to the matter of doctor-patient communication and moves on to the highly technical details of AVM treatment options. The first section covers communication with patients (who may well want to read it themselves); the second section is directed to neurosurgeons and other specialists caring for patients with intracranial AVMs, including those in emergency medicine, obstetrics, anesthesia, and intensive care. It offers a highly sophisticated but readable approach to the contemporary treatment of these challenging lesions. - Provides expert guidance on diagnosis, histopathology, natural history, anatomy, imaging, and treatment options and their risks and benefits—all with the goal of helping patients make informed decisions about the optimal management choices for their own individual cases. - Facilitates articulate, data-driven discussion and regarding the clinical diagnosis and surgical procedures involved in treating AVMs. - Addresses specific, difficult issues that arise during the treatment of AVMs, offering real-world advice to neurosurgeons and other care providers. - Includes key pearls in every chapter, as well as stunning anatomical illustrations throughout.
This book describes neurosurgical cases following the format of the clinical handover. Each case has a one line summary and differential diagnosis, appropriate interpretation of illustrated radiological studies, further ancillary tests, and management options. When appropriate, scoring/scaling systems and detailed anatomy are described, as well as basic surgical techniques and approaches. The information provided is evidence-based, referring to the relevant publications. Neurosurgery: A Case-Based Approach is aimed at junior neurosurgical trainees, both when studying for their exams and enhancing their ability to handover to colleagues.
Since its introduction 52 years ago, Leksell radiosurgery has become a widely applied technique for the management of a diverse group of vascular, neoplastic, and functional disorders. This publication presents an update on state-of-the-art radiosurgery technology, including outcomes, by the pioneers in the field. Experts have contributed chapters on various topics. They provide a history of the development of Leksell Gamma Knife and its evolution from frame-based to the inclusion of mask-based radiosurgery in the latest Gamma Knife model. For beginners, there is valuable information related to imaging, quality assurance, patient care, anesthesia, and regulatory requirements. Advance users will appreciate the summary of the long-term outcome of important indications. Additional chapters on cavernous malformation, orbital, uveal, and ocular disorders clarify the role of radiosurgery. This book is a concise overview for physicians interested in radiosurgery. It will be of great value to neurosurgeons, radiation oncologists, and medical physicists concerned with learning about the indications of radiosurgery.
The massive convergence of information about cavernous malformations has been synthesized in this volume by experts in the field of pathology, neuroradiology and neurosurgery. Cavernous Malformations represents state-of-the-art knowledge about this lesion and the spectrum of opinion about its nature, clinical behavior and management strategies. Highlights of Cavernous Malformations: Definition and pathologic features Epidemiology Diagnostic imaging Epilepsy Hemorrhage Conservative management Surgical intervention Microsurgical treatments Spinal cavernous malformations Pediatrics Radiotherapy (Distributed by Thieme for the American Association of Neurological Surgeons)