A literature search at Indiana University, Bloomington, Indiana
The following MEDLINE items were compiled by SilverPlatter and are presented with their generous co-operation and permission.
Record 1 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Anaesthesia for caesarean section in a patient with an intracranial arteriovenous malformation.
AUTHOR(S): Yih-PS; Cheong-KF
ADDRESS OF AUTHOR: Department of Anaesthesia, National University Hospital, Singapore.
SOURCE (BIBLIOGRAPHIC CITATION): Anaesth-Intensive-Care. 1999 Feb; 27(1): 66-8
INTERNATIONAL STANDARD SERIAL NUMBER: 0310-057X
PUBLICATION YEAR: 1999
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: AUSTRALIA
ABSTRACT: Intracranial haemorrhage from an arteriovenous malformation (AVM) during pregnancy is rare but may result in significant maternal and fetal morbidity and mortality. In the untreated patient with an AVM, the best mode of delivery remains debatable with most obstetricians preferring a caesarean section in order to avoid Valsalva manoeuvres associated with vaginal delivery. We describe the administration of epidural anaesthesia for such a parturient undergoing Caesarean section and the anaesthetic implications.
MINOR MESH HEADINGS: Adult-; Pregnancy-
MAJOR MeSH HEADINGS: *Anesthesia,-Epidural; *Anesthesia,-Obstetrical; *Cerebral-Arteriovenous-Malformations; *Cesarean-Section; *Pregnancy-Complications,-Cardiovascular
CHECKTAGS: Case-Report; Female; Human
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999159135
UPDATE CODE: 199906
SUBSET: NURSING
Record 2 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: [Quantitative sonography of peripheral arteriovenous malformations]
ORIGINAL TITLE: Quantitative Sonographie peripherer arteriovenoser Malformationen.
AUTHOR(S): Taute-BM; Podhaisky-H
ADDRESS OF AUTHOR: Klinik und Poliklinik fur Innere Medizin III, Martin-Luther-Universitat Halle-Wittenberg.
SOURCE (BIBLIOGRAPHIC CITATION): Ultraschall-Med. 1998 Dec; 19(6): 275-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0172-4614
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: GERMAN; NON-ENGLISH
COUNTRY OF PUBLICATION: GERMANY
ABSTRACT: Congenital vascular malformations occur in 1.5% of the general population. Depending on their localization and morphology, with dysfunction of local and central hemodynamics as well as tissue metabolism, congenital peripheral arteriovenous malformations (AVM) are of particular importance within the larger, heterogeneous group of diseases which comprise vascular malformations. AIM: The aim of this study was to evaluate our ability to quantity peripheral congenital AVM using sonographic, functional-hemodynamic, and morphological parameters. METHOD: Apart from obtaining a medical history and applying clinical and venous occlusion plethysmographic diagnostics, sonographic examinations of peripheral arteries and veins using cw-Doppler sonography and color-coded duplex sonography were performed on 8 patients with peripheral congenital AVM. For comparative purposes, the results of pre-intervention angiography examinations were also considered. RESULTS: For a sonographic quantification of AVM at the time of diagnosis, during assessments of diseases progress, and postinterventionally, both the resistance index of Pourcelot and measurement of the vascular blood flow velocities appeared to be particularly appropriate as functional-hemodynamic parameters. The sonomorphological parameters reflect the individual vascular pathology, which is determined by hemodynamic changes. CONCLUSION: Functional-hemodynamic and sonomorphologic parameters allow a quantification of AVM. With knowledge of the clinical picture acquired at the time, they provide the basis for deciding upon a more extensive pre-interventional invasive radiological diagnosis.
MINOR MESH HEADINGS: Adult-; Child-; English-Abstract; Hemodynamics-physiology; Middle-Age; Sensitivity-and-Specificity
MAJOR MeSH HEADINGS: *Arm-blood-supply; *Arteriovenous-Malformations-ultrasonography; *Leg-blood-supply; *Ultrasonography,-Doppler,-Color
CHECKTAGS: English-Abstract; Female; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999152917
UPDATE CODE: 199906
Record 3 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Subdural hematoma from a Type I spinal arteriovenous malformation. Case report.
AUTHOR(S): Han-PP; Theodore-N; Porter-RW; Detwiler-PW; Lawton-MT; Spetzler-RF
ADDRESS OF AUTHOR: Division of Neurological Surgery, Barrow Neurological Institute, Mercy Healthcare Arizona, Phoenix 85013-4496, USA.
SOURCE (BIBLIOGRAPHIC CITATION): J-Neurosurg. 1999 Apr; 90(4 Suppl): 255-7
INTERNATIONAL STANDARD SERIAL NUMBER: 0022-3085
PUBLICATION YEAR: 1999
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: The authors report a patient in whom a subdural hematoma developed from a Type I spinal arteriovenous malformation (AVM). The patient became symptomatic with back pain, and magnetic resonance imaging revealed a spinal subdural hematoma. Selective spinal angiography, however, failed to demonstrate a pathological process. The patient underwent exploratory laminoplasty that revealed a subdural extraarachnoid hematoma with an underlying Type I spinal AVM, which was surgically obliterated. The patient recovered completely. Subdural hematomas that affect the spine are rare. Although a negative result was obtained using selective spinal angiography, exploratory surgery should be considered for the evacuation of a subdural hematoma and possibly for the definitive treatment of a spinal AVM.
MINOR MESH HEADINGS: Adult-; Arteriovenous-Malformations-surgery; Hematoma,-Subdural-diagnosis; Hematoma,-Subdural-pathology; Hematoma,-Subdural-surgery; Magnetic-Resonance-Imaging; Spinal-Cord-surgery
MAJOR MeSH HEADINGS: *Arteriovenous-Malformations-complications; *Hematoma,-Subdural-etiology; *Spinal-Cord-blood-supply
CHECKTAGS: Case-Report; Female; Human
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999213351
UPDATE CODE: 199906
SUBSET: AIM
Record 4 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Spontaneous angiographic obliteration of cerebral arteriovenous malformations.
AUTHOR(S): Abdulrauf-SI; Malik-GM; Awad-IA
ADDRESS OF AUTHOR: Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan 48202, USA.
SOURCE (BIBLIOGRAPHIC CITATION): Neurosurgery. 1999 Feb; 44(2): 280-7; discussion 287-8
INTERNATIONAL STANDARD SERIAL NUMBER: 0148-396X
PUBLICATION YEAR: 1999
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: OBJECTIVE: The factors associated with spontaneous angiographic obliteration of cerebral arteriovenous malformations (AVMs) are not well understood. We present a review of the literature and a report of our experience with six cases (four with no previous treatment intervention and two postoperative residual malformations) that were identified as having occurred during a 20-year period and describe the clinical and lesion features associated with this rare phenomenon. We present the first detailed histological study of a spontaneously thrombosed AVM specimen, including immunohistochemical analysis of angiogenesis factor expression. METHODS: A combined experience in the management of approximately 700 AVMs during 20 years identified six cases of spontaneous angiographic obliteration of cerebral AVMs. A literature review revealed another 24 cases with angiographic documentation of the initial AVMs and follow-up data showing nonfilling of the lesions. Histological analysis of a recently excised lesion included immunostaining with monoclonal antibodies to the antigens of Factor VIII, Tie, vascular endothelial growth factor, and its receptors, Flt-1 and Flk. RESULTS: A single draining vein was a feature in each of our 6 cases and in 12 of 14 (86%) cases from the literature. Hemorrhage as the presenting symptom was identified in 5 of our 6 (83%) cases and in 17 of 24 (71%) of the literature cases. The size of the AVM was less than 6 cm in each of our 6 cases and in 22 of 24 (92%) of the literature cases. A histological examination of a thrombosed AVM surgical specimen revealed persistent patent vascular channels within the lesion. Immunohistochemical analysis with angiogenesis and endothelia-specific factors showed expression of these factors within the lumen of the thrombosed nidus vessels. CONCLUSION: We propose that the occlusion of a single draining vein may lead to total venous outflow obstruction and lesion thrombosis. Hemorrhagic presentation and small nidus may also predispose to this phenomenon. Immunohistochemical analysis of a thrombosed AVM revealed possible ongoing angiogenic changes within the AVM vessels 1 month after angiographically documented thrombosis. It is possible that neovascularization within a thrombosed AVM may lead to lesion recanalization; however, this phenomenon seems to be clinically exceedingly rare.
MINOR MESH HEADINGS: Adult-; Angiogenesis-Factor-metabolism; Cerebral-Arteriovenous-Malformations-metabolism; Cerebral-Arteriovenous-Malformations-pathology; Cerebral-Arteriovenous-Malformations-surgery; Immunohistochemistry-; Middle-Age; Remission,-Spontaneous; Tomography,-X-Ray-Computed
MAJOR MeSH HEADINGS: *Cerebral-Angiography; *Cerebral-Arteriovenous-Malformations-radiography
CHECKTAGS: Case-Report; Female; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE; REVIEW; REVIEW-OF-REPORTED-CASES
CAS REGISTRY NUMBER OR EC NUMBER: 0
NAME OF SUBSTANCE: Angiogenesis-Factor
MEDLINE ACCESSION NUMBER: 1999129661
UPDATE CODE: 199906
Record 5 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: The value of intraoperative angiography for surgical treatment of cerebral arteriovenous malformations in eloquent brain areas.
AUTHOR(S): Pietila-TA; Stendel-R; Jansons-J; Schilling-A; Koch-HC; Brock-M
ADDRESS OF AUTHOR: Department of Neurosurgery, University Medical Center Benjamin Franklin, Free University of Berlin, Germany.
SOURCE (BIBLIOGRAPHIC CITATION): Acta-Neurochir-Wien. 1998; 140(11): 1161-5
INTERNATIONAL STANDARD SERIAL NUMBER: 0001-6268
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: AUSTRIA
ABSTRACT: Intraoperative digital subtraction angiography (DSA) allows intraoperative assessment of outcome of cerebral arteriovenous malformations (AVM). This study reports on 21 patients with AVMs in eloquent areas of the brain extirpated between July 1995 to March 1998. Extirpation was always followed by intraoperative DSA. Intraoperative angiography disclosed an occult residual nidus in 4 cases (19%). Complete extirpation of the AVM was achieved in all cases. Following surgery the neurological condition improved in 15 cases (71%), remained unchanged in 5 (24%), and worsened in 1. There were no secondary postoperative haemorrhages, nor complications related to the angiography. These results indicate that intraoperative DSA should be considered in the course of surgical treatment of cerebral AVMs in eloquent areas of the brain.
MINOR MESH HEADINGS: Adolescence-; Adult-; Aged-; Cerebral-Arteriovenous-Malformations-radiography; Child-; Follow-Up-Studies; Middle-Age; Neurologic-Examination; Treatment-Outcome
MAJOR MeSH HEADINGS: *Angiography,-Digital-Subtraction; *Cerebral-Angiography; *Cerebral-Arteriovenous-Malformations-surgery; *Intraoperative-Complications-radiography; *Monitoring,-Intraoperative
CHECKTAGS: Female; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999086886
UPDATE CODE: 199906
Record 6 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Resolution of central pain after embolization of an arteriovenous malformation. Case report.
AUTHOR(S): Fukuhara-T; McKhann-GM-2nd; Santiago-P; Eskridge-JM; Loeser-JD; Winn-HR
ADDRESS OF AUTHOR: Department of Neurological Surgery, Harborview Medical Center, University of Washington, Seattle, USA.
SOURCE (BIBLIOGRAPHIC CITATION): J-Neurosurg. 1999 Mar; 90(3): 575-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0022-3085
PUBLICATION YEAR: 1999
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: The authors describe a patient with right-sided central pain resulting from a left parietal arteriovenous malformation (AVM). The AVM was treated with staged embolization and stereotactic radiosurgery, and its obliteration was documented on follow-up angiographic studies. Surprisingly, the patient noted complete resolution of her pain syndrome after embolization, which is an extremely rare result. Central pain and its proposed mechanisms are discussed.
MINOR MESH HEADINGS: Angiography,-Digital-Subtraction; Cerebral-Arteriovenous-Malformations-diagnosis; Cerebral-Arteriovenous-Malformations-surgery; Magnetic-Resonance-Imaging; Middle-Age; Radiosurgery-; Stereotaxic-Techniques
MAJOR MeSH HEADINGS: *Cerebral-Arteriovenous-Malformations-complications; *Cerebral-Arteriovenous-Malformations-therapy; *Embolization,-Therapeutic; *Pain-etiology; *Pain-physiopathology; *Parietal-Lobe-blood-supply
CHECKTAGS: Case-Report; Female; Human
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999165257
UPDATE CODE: 199906
SUBSET: AIM
Record 7 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: An angiographically occult arteriovenous malformation in the medial parietal lobe presenting as seizures of medial temporal lobe origin.
AUTHOR(S): Fujii-M; Akimura-T; Ozaki-S; Kato-S; Ito-H; Neshige-R
ADDRESS OF AUTHOR: Department of Neurosurgery, Yamaguchi University School of Medicine, Ube, Japan.
SOURCE (BIBLIOGRAPHIC CITATION): Epilepsia. 1999 Mar; 40(3): 377-81
INTERNATIONAL STANDARD SERIAL NUMBER: 0013-9580
PUBLICATION YEAR: 1999
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: We present an unusual case of a patient who was diagnosed with temporal lobe epilepsy and whose seizures were reduced markedly after excision of an angiographically occult arteriovenous malformation (AVM) located in the left medial parietal lobe. A 38-year-old man had complex partial seizures characterized by motionless staring with oroalimentary and behavioral automatisms since the age of 15 years. Magnetic resonance imaging (MRI) demonstrated a small lesion extending from the left posterior cingulate gyrus to the precuneus. There was no MRI evidence of mesial temporal sclerosis. Intracranial EEG recordings showed ictal onset from the left medial parietal lobe propagating to the medial temporal lobes. Clinical signs appeared when these discharges reached the temporal lobes. After excision of the lesion (which was histologically confirmed as an AVM), together with the marginal cortex, seizures were reduced significantly. Careful diagnostic evaluation of lesions such as the this one may reveal an epileptogenic lesion (zone) far from the region where scalp ictal discharges seem to arise. In our case, we hypothesize that false localization was due to propagation of ictal discharges from the parietal focus through the limbic system.
MINOR MESH HEADINGS: Adult-; Cerebral-Arteriovenous-Malformations-pathology; Cerebral-Arteriovenous-Malformations-radiography; Diagnosis,-Differential; Epilepsy,-Complex-Partial-diagnosis; Epilepsy,-Complex-Partial-radiography; Epilepsy,-Complex-Partial-surgery; Epilepsy,-Temporal-Lobe-radiography; Epilepsy,-Temporal-Lobe-surgery; Hippocampus-pathology; Hippocampus-radiography; Parietal-Lobe-pathology; Parietal-Lobe-radiography; Temporal-Lobe-pathology; Temporal-Lobe-radiography; Tomography,-X-Ray-Computed
MAJOR MeSH HEADINGS: *Cerebral-Arteriovenous-Malformations-diagnosis; *Electroencephalography-statistics-and-numerical-data; *Epilepsy,-Temporal-Lobe-diagnosis; *Magnetic-Resonance-Imaging; *Parietal-Lobe-physiopathology
CHECKTAGS: Case-Report; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999178608
UPDATE CODE: 199905
Record 8 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Retinal arteriovenous malformation with fluctuating vision and ischemic central retinal vein occlusion and its sequelae: 25-year follow-up of a case.
AUTHOR(S): Hardy-TG; O'Day-J
ADDRESS OF AUTHOR: Department of Neuro-Ophthalmology, Melbourne University, Royal Victorian Eye & Ear Hospital, Australia.
SOURCE (BIBLIOGRAPHIC CITATION): J-Neuroophthalmol. 1998 Dec; 18(4): 233-6
INTERNATIONAL STANDARD SERIAL NUMBER: 1070-8022
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: A patient with a retinal arteriovenous malformation (AVM) had experienced episodic visual loss with spontaneous recovery for many years, followed by permanent visual loss secondary to central retinal vein occlusion. She subsequently progressed to development of retinal neovascularization extending onto the posterior vitreous face with recurrent vitreous hemorrhage requiring vitrectomy. A brief review of the literature is presented, and the cause of the fluctuations in vision and central retinal vein occlusion are discussed.
MINOR MESH HEADINGS: Adult-; Follow-Up-Studies; Retinal-Neovascularization-pathology; Vitreous-Hemorrhage-pathology
MAJOR MeSH HEADINGS: *Arteriovenous-Malformations-complications; *Ischemia-etiology; *Retinal-Vein-Occlusion-etiology; *Retinal-Vessels-abnormalities; *Vision-Disorders-etiology
CHECKTAGS: Case-Report; Female; Human
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999073712
UPDATE CODE: 199905
Record 9 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Clinical-neuroendocrinological syndromes due to lesions of the cingulate gyrus in humans.
AUTHOR(S): Buklina-SB
ADDRESS OF AUTHOR: N. N. Burdenko Science Research Institute of Neurosurgery, Russian Academy of Medical Sciences, Moscow.
SOURCE (BIBLIOGRAPHIC CITATION): Neurosci-Behav-Physiol. 1998 Nov-Dec; 28(6): 601-7
INTERNATIONAL STANDARD SERIAL NUMBER: 0097-0549
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: Clinical and neuroendocrinological studies were performed in 41 patients with arteriovenous malformations (AVM) of the cingulate gyrus. Before surgery, the primary affliction in 38 patients consisted of memory disturbance, 5 of these having signs of Korsakov's syndrome. Autonomic and epileptic fits were not typical. Of 38 patients undergoing surgery, postoperative worsening of memory occurred in 23, but no qualitatively new disturbances appeared. Korsakov's syndrome appeared de novo after surgery in 3 patients. The extent of memory disturbances correlated with the extent of lesions to the cingulate gyrus and with the extent to which AVM affected the corpus callosum. Qualitative analysis of memory loss syndromes revealed alterations in trace selectivity in nearly all patients and failure to retain the meaning of stories, which was accompanied by lack of insight into the patients' abnormalities. The signs of these syndromes showed clear similarity with memory deficiencies in patients with frontal lesions. This suggests that not only the frontal lobes themselves, but also their connections, are involved in producing the clinical picture in humans.
MINOR MESH HEADINGS: Adolescence-; Adult-; Cerebral-Arteriovenous-Malformations-psychology; Cerebrovascular-Circulation-physiology; Child-; Endocrine-Diseases-physiopathology; Endocrine-Diseases-psychology; Gyrus-Cinguli-blood-supply; Gyrus-Cinguli-surgery; Memory-Disorders-physiopathology; Middle-Age; Nervous-System-Diseases-physiopathology; Nervous-System-Diseases-psychology; Neuropsychological-Tests; Neurosurgical-Procedures; Psychomotor-Performance; Tomography,-X-Ray-Computed
MAJOR MeSH HEADINGS: *Cerebral-Arteriovenous-Malformations-physiopathology; *Endocrine-Diseases-etiology; *Gyrus-Cinguli-abnormalities; *Nervous-System-Diseases-etiology
CHECKTAGS: Female; Human; Male
PUBLICATION TYPE: CLINICAL-TRIAL; JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999067940
UPDATE CODE: 199905
Record 10 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Successful surgical removal of a large arteriovenous malformation in a patient with hemophilia: case report.
AUTHOR(S): Nakau-H; Maruishi-M; Takiguchi-H; Shima-K
ADDRESS OF AUTHOR: Department of Neurosurgery, National Defense Medical College, Tokorozawa, Japan.
SOURCE (BIBLIOGRAPHIC CITATION): Neurosurgery. 1998 Dec; 43(6): 1459-61; discussion 1461-2
INTERNATIONAL STANDARD SERIAL NUMBER: 0148-396X
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: OBJECTIVE AND IMPORTANCE: This is the first reported case of the successful surgical removal of a large arteriovenous malformation (AVM) in a patient with hemophilia A. CLINICAL PRESENTATION: A 19-year-old male patient was admitted to our department with intracranial hemorrhage. He had previously been diagnosed with hemophilia A and a cerebral AVM. Carotid angiography revealed a large AVM in the right temporal and parietal lobes. The neurological and neuroradiological findings, especially those of single photon emission computed tomography, identified an area of devitalization around the lesion, which was thought to reduce the risk of new deficits resulting from surgical manipulation. INTERVENTION: We resected the AVM in conjunction with supplemental infusions of Factor VIII before, during, and after the operation. A slight cerebral hemorrhage on the 7th postoperative day was observed despite control with Factor VIII, but the patient was discharged without any new deficits. CONCLUSION: We evaluated and managed all problems of a patient with multiple complications and achieved a medical cure.
MINOR MESH HEADINGS: Adult-; Cerebral-Arteriovenous-Malformations-complications; Cerebral-Hemorrhage-etiology; Cerebral-Hemorrhage-prevention-and-control; Factor-VIII-therapeutic-use; Intraoperative-Care; Parietal-Lobe-blood-supply; Parietal-Lobe-surgery; Postoperative-Complications-prevention-and-control; Preoperative-Care; Temporal-Lobe-blood-supply; Temporal-Lobe-surgery; Tomography,-Emission-Computed,-Single-Photon
MAJOR MeSH HEADINGS: *Cerebral-Arteriovenous-Malformations-surgery; *Hemophilia-A-complications
CHECKTAGS: Case-Report; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE
CAS REGISTRY NUMBER OR EC NUMBER: 9001-27-8
NAME OF SUBSTANCE: Factor-VIII
MEDLINE ACCESSION NUMBER: 1999063607
UPDATE CODE: 199905
Record 11 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Hypervascular acoustic neuroma.
AUTHOR(S): LeMay-DR; Sun-JK; Fishback-D; Locke-GE; Giannotta-SL
ADDRESS OF AUTHOR: Department of Neurosurgery, MLK/Charles Drew University, USA.
SOURCE (BIBLIOGRAPHIC CITATION): Neurol-Res. 1998 Dec; 20(8): 748-50
INTERNATIONAL STANDARD SERIAL NUMBER: 0161-6412
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: ENGLAND
ABSTRACT: The authors present a patient with a large acoustic neuroma that exhibited an unusual vascular architecture. Magnetic resonance imaging demonstrated multiple flow voids in and around the mass. At surgery, intra- and extratumoral vascularity was arterialized due to luxurious shunting. Two attempts at removal produced severe engorgement and pulsatility of the surrounding brain, dramatically narrowing the operative exposure. Piecemeal resection of the tumor seemed to redistribute blood flow resulting in engorgement of the surrounding brain, analogous to perfusion breakthrough following AVM resection. Treatment strategies similar to those used for AVM resection may be indicated when encountering a hypervascular tumor.
MINOR MESH HEADINGS: Adult-; Arteriovenous-Malformations-surgery; Blood-Pressure; Cerebral-Angiography; Cerebral-Arteries; Cerebral-Veins; Cranial-Nerve-Neoplasms-diagnosis; Cranial-Nerve-Neoplasms-surgery; Facial-Nerve-blood-supply; Facial-Nerve-surgery; Magnetic-Resonance-Imaging; Neuroma,-Acoustic-diagnosis; Neuroma,-Acoustic-surgery
MAJOR MeSH HEADINGS: *Cerebellum-blood-supply; *Cranial-Nerve-Neoplasms-blood-supply; *Neovascularization,-Pathologic; *Neuroma,-Acoustic-blood-supply
CHECKTAGS: Case-Report; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999082261
UPDATE CODE: 199905
Record 12 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Proximal aneurysms in association with arteriovenous malformations: do they resolve following obliteration of the malformation with stereotactic radiosurgery?
AUTHOR(S): Hodgson-TJ; Zaman-SM; Cooper-JR; Forster-DM
ADDRESS OF AUTHOR: Department of Radiology, Royal Hallamshire Hospital, Sheffield, UK.
SOURCE (BIBLIOGRAPHIC CITATION): Br-J-Neurosurg. 1998 Oct; 12(5): 434-7
INTERNATIONAL STANDARD SERIAL NUMBER: 0268-8697
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: ENGLAND
ABSTRACT: One-hundred consecutive patients were identified who had arteriovenous malformations (AVMs) treated by stereotactic radiosurgery (STRS) which were totally obliterated as shown by follow-up angiography. Of these cases, seven had intracerebral aneurysms at initial angiography, two of which were multiple. Five patients had saccular aneurysms at commonly recognized sites on the circle of Willis or main proximal cerebral arteries, while two patients had aneurysms on distal AVM feeder arteries in atypical sites (one saccular, one fusiform). Saccular aneurysms at typical sites were found to be unchanged in size following AVM obliteration. The significance of this finding in the management of patients who present with subarachnoid haemorrhage and who have both aneurysms and AVMs is discussed.
MINOR MESH HEADINGS: Adult-; Cerebral-Aneurysm-etiology; Cerebral-Arteriovenous-Malformations-complications; Headache-etiology; Middle-Age; Seizures-etiology; Subarachnoid-Hemorrhage-etiology
MAJOR MeSH HEADINGS: *Cerebral-Aneurysm-surgery; *Cerebral-Arteriovenous-Malformations-surgery; *Radiosurgery-methods
CHECKTAGS: Female; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999169600
UPDATE CODE: 199905
Record 13 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: [The clinico-neuropsychological aspects of arteriovenous malformations of the hippocampus]
ORIGINAL TITLE: Kliniko-neiropsikhologicheskie aspekty arteriovenoznykh mal'formatsii gippokampa.
AUTHOR(S): Buklina-SB; Filatov-IuM; Eliava-ShSh
SOURCE (BIBLIOGRAPHIC CITATION): Zh-Vopr-Neirokhir-Im-N-N-Burdenko. 1998 Oct-Dec(4): 18-20; discussion 20-1
INTERNATIONAL STANDARD SERIAL NUMBER: 0042-8817
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: RUSSIAN; NON-ENGLISH
COUNTRY OF PUBLICATION: RUSSIA
ABSTRACT: A comprehensive examination was made in 39 patients with arteriovenous malformations (AVM) of hippocampus. Prior to and following surgery, all the patients underwent neuropsychological study after A. R. Luriia (1962). Mnestic disorder was found to be the most common abnormality in patients with AVM at this site. Before surgery, they were detected in 34 of 39 patients, 11 of them having severe memory disorders with the traits of the Korsakoff's syndrome. These patients were found to have mixed posthemorrhagic lesion of the hippocampus, other portions of the temporal lobe and periventricular structures. Twenty nine patients were operated on, 14 of them had progressive mnestic disorder of the modally nonspecific type irrespective the side operated on. There were no postoperative Korsakoff's syndromes. There was no progression in memory defects in patients after surgery on the brain drastically changed after hemorrhage or removal of minor malformations. Before hemorrhage, epileptic paroxysms were observed in 2 of the 39 patients only in the presence of massive AVM obligatorily involving the temporal cortex. Following surgery, there were no new epileptic paroxysms and changes in the emotional status and motivations in the patients. Thus, the hippocampal formation is involved in the primary mechanisms of fixation, retention, reproduction of a memory trace. The participation of many structures of the brain is required to form an emotional status, motivation, and clinical manifestations of epileptic activity.
MINOR MESH HEADINGS: Adolescence-; Adult-; Cerebral-Arteriovenous-Malformations-complications; Cerebral-Arteriovenous-Malformations-diagnosis; Cerebral-Arteriovenous-Malformations-surgery; Cerebral-Hemorrhage-etiology; English-Abstract; Hippocampus-surgery; Memory-Disorders-etiology; Neuropsychology-
MAJOR MeSH HEADINGS: *Cerebral-Arteriovenous-Malformations-psychology; *Hippocampus-abnormalities; *Hippocampus-blood-supply
CHECKTAGS: Comparative-Study; English-Abstract; Human
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999143431
UPDATE CODE: 199905
Record 14 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation: a meta-analysis.
AUTHOR(S): Cloft-HJ; Joseph-GJ; Dion-JE
ADDRESS OF AUTHOR: Departments of Radiology and Neurosurgery, Emory University, Atlanta, GA, USA. harry_cloft@emory.org
SOURCE (BIBLIOGRAPHIC CITATION): Stroke. 1999 Feb; 30(2): 317-20
INTERNATIONAL STANDARD SERIAL NUMBER: 0039-2499
PUBLICATION YEAR: 1999
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: BACKGROUND AND PURPOSE: A well-defined complication rate of cerebral angiography in patients with subarachnoid hemorrhage (SAH), cerebral aneurysm, and arteriovenous malformation (AVM) would be useful to physicians making decisions regarding the imaging of these patients. We sought to define a statistically significant complication rate through meta-analysis of prospective studies in the literature. METHODS: Meta-analysis of 3 published prospective studies of complications in cerebral angiography was performed to specifically define the risk of cerebral angiography in patients presenting with SAH, cerebral aneurysm, and AVM. The complication rates for cerebral angiography in patients with SAH and AVM/aneurysm without SAH were compared with the complication rates in patients who underwent cerebral angiography for transient ischemic attack (TIA)/ischemic stroke with use of the Fisher exact test. RESULTS: The combined risk of permanent and transient neurological complication was significantly lower in patients with SAH compared with patients with TIA/stroke (1.8% versus 3.7%; P=0.03). The combined risk of permanent and transient neurological complication was significantly lower in patients with aneurysm/AVM without SAH compared with patients with TIA/stroke (0.3% versus 3.7%; P=0.001). When the patients with SAH and cerebral aneurysm/AVM were combined, the overall risk of permanent and transient neurological complication was significantly lower than for the TIA/stroke patients (0.8% versus 3.0%; P=0.001), as was the risk of permanent neurological complication (0.07% versus 0.7%; P=0.004). CONCLUSIONS: The risk of permanent neurological complication associated with cerebral angiography in patients with SAH, cerebral aneurysm, and AVM is quite low (0.07%). This risk is lower than previously recognized.
MINOR MESH HEADINGS: Cerebral-Ischemia-epidemiology; Clinical-Trials; Follow-Up-Studies; Incidence-; Prospective-Studies; Recurrence-; Risk-Assessment-methods
MAJOR MeSH HEADINGS: *Arteriovenous-Malformations-radiography; *Cerebral-Aneurysm-radiography; *Cerebral-Angiography-adverse-effects; *Cerebral-Ischemia-etiology; *Subarachnoid-Hemorrhage-radiography
CHECKTAGS: Comparative-Study; Human
PUBLICATION TYPE: JOURNAL-ARTICLE; META-ANALYSIS
MEDLINE ACCESSION NUMBER: 1999132435
UPDATE CODE: 199905
Record 15 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Posterior inferior cerebellar artery aneurysms associated with posterior fossa arteriovenous malformation: report of five cases and literature review.
AUTHOR(S): Kaptain-GJ; Lanzino-G; Do-HM; Kassell-NF
ADDRESS OF AUTHOR: Department of Neurosurgery, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
SOURCE (BIBLIOGRAPHIC CITATION): Surg-Neurol. 1999 Feb; 51(2): 146-52
INTERNATIONAL STANDARD SERIAL NUMBER: 0090-3019
PUBLICATION YEAR: 1999
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: BACKGROUND: The association of posterior inferior cerebellar artery (PICA) aneurysms with posterior fossa arteriovenous malformation (AVM) is uncommon. Over the past 3 years, five patients with this condition were treated at this institution. A review of the clinical history of these and other reported cases has illuminated common threads in the presentation, treatment, and outcome of these lesions. METHODS: The findings of 27 patients (5 from our institution and 22 from the medical literature) with PICA aneurysms associated with AVMs were reviewed. RESULTS: Eighty-four percent of individuals presented with sub-arachnoid hemorrhage (SAH); 89% of these episodes resulted from aneurysm rupture documented by either intraoperative inspection or autopsy. All aneurysms were located on a feeding artery to the AVM, and 81% originated from distal portions of PICA. The majority of patients presented with Hunt & Hess grade I SAH; all patients who presented with hemorrhage were treated surgically. Surgical strategy was directed both to secure the aneurysm and to resect the AVM during the course of a single procedure. Although four individuals either died on admission or in the perioperative period, overall outcome was excellent or good in 82% of patients. CONCLUSIONS: PICA aneurysms associated with AVMs most often involve the distal segments of the artery. Patients usually present with SAH secondary to aneurysmal rupture. Surgical clipping of the aneurysm and excision of the AVM is possible in a single procedure with minimal morbidity. Overall prognosis is favorable in 80% of the cases.
MINOR MESH HEADINGS: Adult-; Aged-; Cerebral-Angiography; Middle-Age; Treatment-Outcome
MAJOR MeSH HEADINGS: *Cerebellum-blood-supply; *Cerebral-Aneurysm-complications; *Cerebral-Arteriovenous-Malformations-complications; *Cranial-Fossa,-Posterior-blood-supply
CHECKTAGS: Case-Report; Female; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE; REVIEW; REVIEW-OF-REPORTED-CASES
MEDLINE ACCESSION NUMBER: 1999151876
UPDATE CODE: 199905
Record 16 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Can the probability for obliteration after radiosurgery for arteriovenous malformations be accurately predicted?
AUTHOR(S): Karlsson-B; Lax-I; Soderman-M
ADDRESS OF AUTHOR: Department of Neurosurgery, Karolinska Hospital, Stockholm, Sweden.
SOURCE (BIBLIOGRAPHIC CITATION): Int-J-Radiat-Oncol-Biol-Phys. 1999 Jan 15; 43(2): 313-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0360-3016
PUBLICATION YEAR: 1999
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: PURPOSE: To investigate how accurate different models predict the probability for obliteration following radiosurgery for an arteriovenous malformation (AVM). METHODS AND MATERIALS: The probability for obliteration was calculated for all 838 AVMs with a known treatment outcome and treated at the Karolinska Hospital with Gamma Knife surgery 1970-1993. Four different models were used for the calculation, resulting in four different values of the probability for obliteration. The calculated prediction values were added for each model, and the total number of predicted obliteration compared to that observed in the whole patient material as well as in different subgroups. RESULTS: Three of the four models predicted the total number of obliterations accurately. In two of those three models, the accuracy of the prediction was dependent on AVM volume and treatment dose. In one model only, the prediction was accurate and independent of all investigated parameters. CONCLUSIONS: The probability for obliteration was accurately predicted by one of the models analyzed. In this model, the probability for obliteration was related to the dose to the AVM periphery only. The AVM volume had no independent impact on the probability for obliteration. There was a trend that AVMs with a central location had a better obliteration rate than predicted.
MINOR MESH HEADINGS: Adult-; Probability-
MAJOR MeSH HEADINGS: *Cerebral-Arteriovenous-Malformations-surgery; *Models,-Biological; *Radiosurgery-methods
CHECKTAGS: Female; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999153326
UPDATE CODE: 199905
Record 17 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Immediate side effects of stereotactic radiotherapy and radiosurgery.
AUTHOR(S): Werner-Wasik-M; Rudoler-S; Preston-PE; Hauck-WW; Downes-BM; Leeper-D; Andrews-D; Corn-BW; Curran-WJ Jr
ADDRESS OF AUTHOR: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA, USA.
SOURCE (BIBLIOGRAPHIC CITATION): Int-J-Radiat-Oncol-Biol-Phys. 1999 Jan 15; 43(2): 299-304
INTERNATIONAL STANDARD SERIAL NUMBER: 0360-3016
PUBLICATION YEAR: 1999
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: PURPOSE: Despite increased utilization of fractionated stereotactic radiation therapy (SRT) or stereotactic radiosurgery (SRS), the incidence and nature of immediate side effects (ISE) associated with these treatment techniques are not well defined. We report immediate side effects from a series of 78 patients. MATERIALS AND METHODS: Intracranial lesions in 78 adult patients were treated with SRT or SRS, using a dedicated linear accelerator. Those lesions included 13 gliomas, 2 ependymomas, 19 metastatic tumors, 15 meningiomas, 12 acoustic neuromas, 4 pituitary adenomas, 1 optic neuroma, 1 chondrosarcoma, and 11 arteriovenous malformations (AVM). SRT was used in 51 and SRS in 27 patients. Mean target volume was 9.0 cc. Eleven patients received prior external-beam radiation therapy within 2 months before SRT/SRS. Any side effects occurring during and up to 2 weeks after the course of radiation were defined as ISE and were graded as mild, moderate, or severe. The incidence of ISE and the significance of their association with several treatment and pretreatment variables were analyzed. RESULTS: Overall, 28 (35%) of 78 patients experienced one or more ISE. Most of the ISE (87%) were mild, and consisted of nausea (in 5), dizziness/vertigo (in 5), seizures (in 6), and new persistent headaches (in 17). Two episodes of worsening neurological deficit and 2 of orbital pain were graded as moderate. Two patients experienced severe ISE, requiring hospitalization (1 seizure and 1 worsening neurological deficit). ISE in 6 cases prompted computerized tomography of the brain, which revealed increased perilesional edema in 3 cases. The incidence of ISE by diagnosis was as follows: 46% (6 of 13) for gliomas, 50% (6 of 12) for acoustic neuromas, 36% (4 of 11) for AVM, 33% (5 of 15) for meningiomas, and 21% (4 of 19) for metastases. A higher incidence of dizziness/vertigo (4 of 12 = 33%) was seen among acoustic neuroma patients than among other patients (p< 0.01). There was no significant association of dizziness/vertigo with either a higher average and maximum brainstem dose (p = 0.74 and 0.09, respectively) or with 2-Gy equivalents of the average and maximum brainstem doses (p = 0.28 and 0.09, respectively). Higher RT dose to the margin and higher maximum RT dose were associated with a higher incidence of ISE (p = 0.05 and 0.01, respectively). However, when RT dose to the margin was converted to a 2-Gy dose-equivalent, it lost its significance as predictor of ISE (p = 0.51). Recent conventional external-beam radiation therapy, target volume, number of isocenters, collimator size, dose inhomogeneity, prescription isodose, pretreatment edema, dose of prior radiation, fraction size (2.0-7.0 Gy with SRT and 13.0-21.0 Gy with SRS), fractionation schedule, and dose to brainstem were not significantly associated with ISE. ISE occurred in 26% (8) of 31 patients taking corticosteroids prior to SRT/SRS and in 20 (42%) of 47 patients not taking them (p = 0.15). CONCLUSION: ISE occur in one third of patients treated with SRT and SRS and are usually mild or moderate and self-limited. Dizziness/vertigo are common and unique for patients with acoustic neuromas and are not associated with higher brainstem doses. We are unable to detect a relationship between ISE and higher margin or maximum RT doses. No specific conclusion can be drawn with regard to the effect of corticosteroids, used prior to SRS/SRT, on the occurrence of ISE.
MINOR MESH HEADINGS: Adult-; Aged-; Aged,-80-and-over; Middle-Age; Neuroma,-Acoustic-surgery; Pituitary-Neoplasms-surgery; Radiotherapy-Dosage
MAJOR MeSH HEADINGS: *Brain-Neoplasms-surgery; *Cerebral-Arteriovenous-Malformations-surgery; *Glioma-surgery; *Radiosurgery-adverse-effects
CHECKTAGS: Human
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999153324
UPDATE CODE: 199905
Record 18 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Association of an intracranial arteriovenous malformation and a meningioma.
AUTHOR(S): Castillo-M; Thompson-JE; Mukherji-SK
ADDRESS OF AUTHOR: Department of Radiology, University of North Carolina School of Medicine, Chapel Hill 27599-7510, USA. castillo@med.unc.edu
SOURCE (BIBLIOGRAPHIC CITATION): Neuroradiology. 1998 Sep; 40(9): 574-6
INTERNATIONAL STANDARD SERIAL NUMBER: 0028-3940
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: GERMANY
ABSTRACT: A case of a simultaneously discovered arteriovenous malformation (AVM) and a meningioma is presented. A review of the literature revealed only four similar cases, but there have been 30 reports of other intracranial tumors in association with AVM. The possible mechanisms of this rare association are discussed.
MINOR MESH HEADINGS: Cerebral-Arteries-pathology; Meningeal-Neoplasms-blood-supply; Meningioma-blood-supply; Middle-Age
MAJOR MeSH HEADINGS: *Cerebral-Arteriovenous-Malformations-diagnosis; *Image-Processing,-Computer-Assisted; *Magnetic-Resonance-Angiography; *Meningeal-Neoplasms-diagnosis; *Meningioma-diagnosis
CHECKTAGS: Case-Report; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE; REVIEW; REVIEW-OF-REPORTED-CASES
MEDLINE ACCESSION NUMBER: 1999023499
UPDATE CODE: 199904
Record 19 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Outcome from treatment for spinal arteriovenous malformation.
AUTHOR(S): Morgan-MK
ADDRESS OF AUTHOR: Department of Surgery, The University of Sydney, Royal North Shore Hospital,St Leonards, NSW, Sydney, Australia.
SOURCE (BIBLIOGRAPHIC CITATION): Neurosurg-Clin-N-Am. 1999 Jan; 10(1): 113-9
INTERNATIONAL STANDARD SERIAL NUMBER: 1042-3680
PUBLICATION YEAR: 1999
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: Our knowledge of the outcome from treatment for spinal arteriovenous malformations (AVMs) is limited to a few small, anecdotal series and is thus far from complete. Furthermore, with the recent rapid evolution of our knowledge of AVM pathology, many reported cases are difficult to place in the current classification system. In general, outcome for the four classifications of AVMs are as follows: type I respond well to surgical disconnection of the arteriovenous fistula if treatment is early; type II AVMs are currently best treated by surgery but risks of a poor outcome need to be carefully considered; type III are only rarely treatable; type IVa and IVb are likely to respond well to surgery but our knowledge is limited; and type IVc are likely to fare poorly from surgery but should have a better outcome from endovascular therapy.
MINOR MESH HEADINGS: Arteriovenous-Malformations-surgery; Dura-Mater-blood-supply; Embolization,-Therapeutic; Treatment-Outcome
MAJOR MeSH HEADINGS: *Arteriovenous-Malformations-therapy; *Spinal-Cord-blood-supply
CHECKTAGS: Human
PUBLICATION TYPE: JOURNAL-ARTICLE; REVIEW; REVIEW,-TUTORIAL
MEDLINE ACCESSION NUMBER: 1999074186
UPDATE CODE: 199904
Record 20 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Transluminal angioplasty and intra-arterial papaverine for the treatment of cerebral vasospasm after ruptured arteriovenous malformations.
AUTHOR(S): Zubkov-AY; Lewis-AI; Scalzo-D
ADDRESS OF AUTHOR: Department of Neurosurgery, University of Mississippi Medical Center, Jackson 39216-4505, USA.
SOURCE (BIBLIOGRAPHIC CITATION): Surg-Neurol. 1999 Jan; 51(1): 75-9; discussion 80
INTERNATIONAL STANDARD SERIAL NUMBER: 0090-3019
PUBLICATION YEAR: 1999
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: BACKGROUND: This is the first report on the use of intra-arterial papaverine and percutaneous transluminal angioplasty in two patients with severe, symptomatic cerebral vasospasm who suffered ruptured arteriovenous malformations (AVMs). CASE DESCRIPTIONS: The source of hemorrhage was a venous aneurysm in the first case and a pedicular aneurysm of the distal posterior inferior cerebellar artery in the second case. In both cases, the AVMs were located in the superior vermis and there was minimal subarachnoid hemorrhage. The first patient underwent removal of the AVM before the period of cerebral vasospasm and the second patient underwent removal of the AVM after the cerebral vasospasm had resolved. The outcome was excellent in the first patient and poor in the second patient. CONCLUSION: Arteriovenous malformation with ruptured aneurysms may be at high risk for cerebral vasospasm even when there is minimal subarachnoid hemorrhage. We recommend early treatment of AVMs with ruptured pedicular, intranidal, or venous aneurysms to avoid rebleeding and to allow for aggressive treatment of cerebral vasospasm. The management of cerebral vasospasm after AVM rupture is discussed.
MINOR MESH HEADINGS: Adult-; Cerebral-Angiography; Cerebral-Arteriovenous-Malformations-radiography; Cerebral-Ischemia,-Transient-drug-therapy; Cerebral-Ischemia,-Transient-physiopathology; Cerebral-Ischemia,-Transient-radiography; Cerebrovascular-Circulation-drug-effects; Combined-Modality-Therapy; Injections,-Intra-Arterial; Middle-Age; Rupture,-Spontaneous; Tomography,-X-Ray-Computed; Treatment-Outcome
MAJOR MeSH HEADINGS: *Angioplasty,-Balloon; *Cerebral-Arteriovenous-Malformations-complications; *Cerebral-Ischemia,-Transient-etiology; *Cerebral-Ischemia,-Transient-therapy; *Papaverine-administration-and-dosage; *Vasodilator-Agents-administration-and-dosage
CHECKTAGS: Female; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE
CAS REGISTRY NUMBER OR EC NUMBER: 0; 58-74-2
NAME OF SUBSTANCE: Vasodilator-Agents; Papaverine
MEDLINE ACCESSION NUMBER: 1999135598
UPDATE CODE: 199904
Record 21 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Developmental deficits in adult patients with arteriovenous malformations.
AUTHOR(S): Lazar-RM; Connaire-K; Marshall-RS; Pile-Spellman-J; Hacein-Bey-L; Solomon-RA; Sisti-MB; Young-WL; Mohr-JP
ADDRESS OF AUTHOR: Department of Neurology, Columbia-Presbyterian Medical Center, New York, NY 10032, USA.
SOURCE (BIBLIOGRAPHIC CITATION): Arch-Neurol. 1999 Jan; 56(1): 103-6
INTERNATIONAL STANDARD SERIAL NUMBER: 0003-9942
PUBLICATION YEAR: 1999
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: BACKGROUND: Cerebral arteriovenous malformations (AVMs) are congenital masses of arteries and veins that appear to undergo an unclear "maturation" for many years. Using structured interviews, we compared developmental history of adult patients with AVM with a comparison group of patients with cerebral tumor or aneurysm. OBJECTIVE: To determine whether a remote history of developmental abnormality in adult patients with AVM might be an early marker of cerebral status. DESIGN: Adult patients with AVM and a comparison group of patients with cerebral aneurysm or low-grade tumor participated in a survey. SETTING: Urban medical school-based tertiary care center. PATIENTS: Forty-four randomly selected patients with AVM from the Columbia-Presbyterian AVM Database. There were 32 comparison patients:15 randomly chosen patients from the institution's Cerebral Aneurysm Database and all 17 patients who underwent a biopsy from 1990 to 1995 with a diagnosis of low-grade tumor and who could be contacted. MAIN OUTCOME MEASURES: A brief, structured interview adapted from the Centers for Disease Control and Prevention for its 1994 study of the prevalence of learning disabilities in American children. We defined the positive occurrence of a condition as an affirmative answer to the question, " Did have (condition) during his/her school-age years?" Each patient was also asked if there had been any problems in the following skill areas: reading, writing, listening, speaking, attention, impulsivity, organization, mathematics, or drawing. The AVM size was calculated on the angiographic film by measuring its longest diameter in any dimension. RESULTS: Patients with AVM were significantly more likely to report a positive occurrence to any survey question (P<.05). Two thirds of all patients with AVM (66%) reported at least 1 skill difficulty during their school years, significantly more than the comparison group (P<.001). Neither the maximum AVM diameter nor the occurrence of hemorrhage as an adult differed between patients with AVM with and without early skill difficulty. CONCLUSIONS: Patients with AVM are more likely to report a developmental learning disorder than patients with tumor or aneurysm despite the absence of other neurologic symptoms of diseases not diagnosed for another 20 years. These data support the notion that disorders of behavioral and intellectual function are sensitive markers of early cerebral status.
MINOR MESH HEADINGS: Adult-; Brain-Neoplasms-complications; Cerebral-Aneurysm-complications; Middle-Age
MAJOR MeSH HEADINGS: *Arteriovenous-Malformations-complications; *Developmental-Disabilities-etiology
CHECKTAGS: Female; Human; Male; Support,-U.S.-Gov't,-P.H.S.
PUBLICATION TYPE: CLINICAL-TRIAL; JOURNAL-ARTICLE; RANDOMIZED-CONTROLLED-TRIAL
CONTRACT OR GRANT NUMBERS: NS27713NSNINDS
MEDLINE ACCESSION NUMBER: 1999120643
UPDATE CODE: 199904
SUBSET: AIM
Record 22 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Staged volume radiosurgery followed by microsurgical resection: a novel treatment for giant cerebral arteriovenous malformations: technical case report.
AUTHOR(S): Firlik-AD; Levy-EI; Kondziolka-D; Yonas-H
ADDRESS OF AUTHOR: Department of Neurological Surgery, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
SOURCE (BIBLIOGRAPHIC CITATION): Neurosurgery. 1998 Nov; 43(5): 1223-8
INTERNATIONAL STANDARD SERIAL NUMBER: 0148-396X
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: OBJECTIVE AND IMPORTANCE: We describe the successful treatment of symptomatic giant arteriovenous malformations (AVMs) using staged volume radiosurgery followed by microsurgical resection. CLINICAL PRESENTATION: A 57-year-old man presented with Spetzler-Martin Grade 5 AVMs, with persistent headaches and seizures. He had previously undergone eight attempts at AVM embolization and a craniotomy for attempted AVM resection; he had suffered four episodes of brain hemorrhaging but had made a good neurological recovery. INTERVENTION: Because of the persistent symptoms of the patient and his history of hemorrhaging, a treatment plan based on staged radiosurgical treatments of different portions of the AVMs (three sessions, spaced 6 mo apart), followed by delayed microsurgical removal of the much-reduced residual AVMs (3 years later), was undertaken. The patient did not suffer any additional hemorrhaging episodes, his AVMs were completely removed, and he has made a good recovery. CONCLUSION: Staged volume radiosurgery followed by microsurgical resection of the residual AVMs represents a novel treatment strategy for the management of Grade 5 AVMs that might be untreatable by any single treatment method used alone.
MINOR MESH HEADINGS: Cerebral-Angiography; Cerebral-Arteriovenous-Malformations-radiography; Cerebral-Hemorrhage-radiography; Cerebral-Hemorrhage-surgery; Combined-Modality-Therapy; Middle-Age; Postoperative-Complications-radiography; Reoperation-; Tomography,-X-Ray-Computed
MAJOR MeSH HEADINGS: *Cerebral-Arteriovenous-Malformations-surgery; *Microsurgery-; *Radiosurgery-
CHECKTAGS: Case-Report; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999017869
UPDATE CODE: 199904
Record 23 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Arteriovenous malformation of the rectum: report of a case.
AUTHOR(S): Hayakawa-H; Kusagawa-M; Takahashi-H; Okamura-K; Kosaka-A; Mizumoto-R; Katsura-K
ADDRESS OF AUTHOR: Department of Surgery, Matsusaka City Hospital, Mie, Japan.
SOURCE (BIBLIOGRAPHIC CITATION): Surg-Today. 1998; 28(11): 1182-7
INTERNATIONAL STANDARD SERIAL NUMBER: 0941-1291
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: JAPAN
ABSTRACT: We report herein the case of a 38-year-old man found to have a rectal arteriovenous malformation (AVM). The patient was admitted to our hospital for investigation of fresh anal bleeding and general malaise. Barium-enema examination showed a slightly elevated lesion in the rectum, and a selective superior rectal angiogram subsequently revealed an AVM in the peripheral region of the superior rectal artery, which was presumed to be the cause of the anal bleeding. Colonoscopic examination disclosed a submucosal tumor-like lesion in the left posterior wall of the rectum, 3cm above the anal verge. After marking the boundaries by clipping, transanal resection of the lesion was performed. Histological examination revealed an irregularly expanded arteriovenous aggregation in the submucosal layer. The patient had a favorable postoperative course, and no residual AVM was seen on a postoperative selective inferior mesenteric arteriogram. There have been no signs of recurrence in the 2 years since his operation.
MINOR MESH HEADINGS: Adult-; Arteriovenous-Malformations-diagnosis; Arteriovenous-Malformations-pathology; Arteriovenous-Malformations-radiography; Barium-Sulfate-diagnostic-use; Enema-; Magnetic-Resonance-Imaging; Rectal-Diseases-diagnosis; Rectal-Diseases-pathology; Rectal-Diseases-radiography
MAJOR MeSH HEADINGS: *Arteriovenous-Malformations-surgery; *Rectal-Diseases-surgery
CHECKTAGS: Case-Report; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE; REVIEW; REVIEW-OF-REPORTED-CASES
CAS REGISTRY NUMBER OR EC NUMBER: 7727-43-7
NAME OF SUBSTANCE: Barium-Sulfate
MEDLINE ACCESSION NUMBER: 1999066955
UPDATE CODE: 199904
Record 24 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Familial intracranial arteriovenous malformations. Case report and review of the literature.
AUTHOR(S): Amin-Hanjani-S; Robertson-R; Arginteanu-MS; Scott-RM
ADDRESS OF AUTHOR: Departments of Neurosurgery, Children's Hospital, and Massachusetts General Hospital, Boston, Mass., and Mount Sinai Hospital, New York, N.Y., USA.
SOURCE (BIBLIOGRAPHIC CITATION): Pediatr-Neurosurg. 1998 Oct; 29(4): 208-13
INTERNATIONAL STANDARD SERIAL NUMBER: 1016-2291
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: SWITZERLAND
ABSTRACT: Familial intracranial arteriovenous malformations (AVMs) are rare. We describe a father and son both presenting in childhood with cerebral AVMs. Both patients underwent successful surgical extirpation of the AVM. Familial AVMs present at a young age and tend to be multiple, as was the case in one of our patients. Imaging of asymptomatic family members may detect previously undiagnosed AVMs, and we recommend screening of the relatives of patients with a strong family history of such lesions.
MINOR MESH HEADINGS: Adolescence-; Adult-; Arteriovenous-Malformations-complications; Arteriovenous-Malformations-radiography; Cerebral-Hemorrhage-etiology; Child-; Child,-Preschool; Infant-; Middle-Age
MAJOR MeSH HEADINGS: *Arteriovenous-Malformations-genetics
CHECKTAGS: Case-Report; Female; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE; REVIEW; REVIEW-OF-REPORTED-CASES
MEDLINE ACCESSION NUMBER: 1999094847
UPDATE CODE: 199904
Record 25 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Relief of hemiballism from a basal ganglia arteriovenous malformation after radiosurgery.
AUTHOR(S): Kurita-H; Kawamoto-S; Sasaki-T; Shin-M; Ueki-K; Momose-T; Terahara-A; Kirino-T
ADDRESS OF AUTHOR: Department of Neurosurgery, Faculty of Medicine, University of Tokyo, Japan.
SOURCE (BIBLIOGRAPHIC CITATION): Neurology. 1999 Jan 1; 52(1): 188-90
INTERNATIONAL STANDARD SERIAL NUMBER: 0028-3878
PUBLICATION YEAR: 1999
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: A patient with a 3-year history of progressive hemiballism presented with an unruptured arteriovenous malformation (AVM) in the contralateral caudate nucleus and putamen. PET demonstrated a matched reduction of cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO2) in the basal ganglia and adjacent frontal lobe. The patient underwent radiosurgery for the AVM. After a period of no clinical change for 6 months, the movement disorder resolved by month 7 post-treatment. The AVM was successfully obliterated 2 years after irradiation without any significant change in the regional CBF or CMRO2.
MINOR MESH HEADINGS: Cerebral-Angiography; Middle-Age; Movement-Disorders-radionuclide-imaging; Movement-Disorders-surgery; Radiosurgery-; Tomography,-Emission-Computed; Treatment-Outcome
MAJOR MeSH HEADINGS: *Arteriovenous-Malformations-complications; *Arteriovenous-Malformations-surgery; *Basal-Ganglia-blood-supply; *Movement-Disorders-etiology
CHECKTAGS: Case-Report; Human; Male; Support,-Non-U.S.-Gov't
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999118847
UPDATE CODE: 199904
SUBSET: AIM
Record 26 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Use of a regulating flap in the treatment of a large arteriovenous malformation of the scalp.
AUTHOR(S): Dompmartin-A; Labbe-D; Barrellier-MT; Theron-J
ADDRESS OF AUTHOR: Department of Dermatology, University Hospital Caen, France.
SOURCE (BIBLIOGRAPHIC CITATION): Br-J-Plast-Surg. 1998 Oct; 51(7): 561-3
INTERNATIONAL STANDARD SERIAL NUMBER: 0007-1226
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: ENGLAND
ABSTRACT: A patient presented with a large arteriovenous malformation (AVM) of the scalp. Afferent arterial embolisation followed by repeated surgical partial excision did not prevent recurrence and haemorrhage. The malformation was controlled with a latissimus dorsi muscle free flap which was positioned on the malformation. Five years later, haemorrhages did not recur and the nidus has disappeared on the angiogram. The positioning of a well-vascularised free tissue transfer provided long-term palliation and the authors believe that this flap acted as a 'regulating flap'. As repeated surgery of these large AVMs always leads to rapid recurrences, the authors recommend treating large AVMs directly with a regulating flap when total excision is not possible.
MINOR MESH HEADINGS: Adult-; Arteriovenous-Malformations-radiography; Follow-Up-Studies; Muscle,-Skeletal-transplantation
MAJOR MeSH HEADINGS: *Arteriovenous-Malformations-surgery; *Scalp-blood-supply; *Surgical-Flaps
CHECKTAGS: Case-Report; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999123488
UPDATE CODE: 199904
Record 27 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Arteriovenous malformation presenting as a complex pelvic mass with ureteral obstruction. A case report.
AUTHOR(S): Kelly-J; Alvarez-RD; Roland-PY
ADDRESS OF AUTHOR: Department of Obstetrics and Gynecology, University of Alabama at Birmingham, USA.
SOURCE (BIBLIOGRAPHIC CITATION): J-Reprod-Med. 1998 Oct; 43(10): 916-8
INTERNATIONAL STANDARD SERIAL NUMBER: 0024-7758
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: BACKGROUND: Arteriovenous malformations (AVMs) are an abnormal communication between arterial and venous structures. Pelvic AVMs have been infrequently described in the literature and represent an uncommon cause of a palpable pelvic mass. CASE: A case of pelvic AVM with ureteral obstruction occurred. The location and radiologic appearance of the AVM suggested a complex adnexal mass. During exploration and resection of the mass, significant bleeding was encountered. The diagnosis of AVM was made only retrospectively, with histologic examination of the specimen. CONCLUSION: AVMs are an uncommon and unique cause of pelvic pathology. Preoperative diagnosis will alert the surgeon as to the technically difficult resection that may be encountered and to the massive bleeding that can be associated with their removal.
MINOR MESH HEADINGS: Adult-; Arteriovenous-Malformations-pathology; Arteriovenous-Malformations-surgery; Diagnosis,-Differential; Ureteral-Obstruction-pathology
MAJOR MeSH HEADINGS: *Arteriovenous-Malformations-diagnosis; *Pelvis-blood-supply; *Ureteral-Obstruction-etiology
CHECKTAGS: Case-Report; Female; Human
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999017060
UPDATE CODE: 199903
Record 28 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Theoretical modelling of arteriovenous malformation rupture risk: a feasibility and validation study.
AUTHOR(S): Gao-E; Young-WL; Hademenos-GJ; Massoud-TF; Sciacca-RR; Ma-Q; Joshi-S; Mast-H; Mohr-JP; Vulliemoz-S; Pile-Spellman-J
ADDRESS OF AUTHOR: Department of Electrical Engineering, Columbia University, New York, NY 10027, USA.
SOURCE (BIBLIOGRAPHIC CITATION): Med-Eng-Phys. 1998 Oct; 20(7): 489-501
INTERNATIONAL STANDARD SERIAL NUMBER: 1350-4533
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: ENGLAND
ABSTRACT: PURPOSE: To explore the feasibility of using a theoretical computational model to simulate the risk of spontaneous arteriovenous malformation (AVM) haemorrhage. METHODS: Data from 12 patients were collected from a prospective databank which documented the angioarchitecture and morphological characteristics of the AVM and the feeding mean arterial pressure (FMAP) measured during initial superselective angiography prior to any treatment. Using the data, a computational model of the cerebral circulation and the AVM was constructed for each patient (patient-specific model). Two model risk (Risk(model)) calculations (haemodynamic- and structural-weighted estimates) were performed by using the patient-specific models. In our previously developed method of haemodynamic-weighted estimate, Risk(model) was calculated with the simulated intranidal pressures related to its maximal and minimal values. In the method of structural-weighted estimate developed and described in this paper, the vessel mechanical properties and probability calculation were considered in more detail than in the haemodynamic-weighted estimate. Risk(model) was then compared to experimentally determined risk which was calculated using a statistical method for determining the relative risk of having initially presented with AVM haemorrhage, termed Risk(exp). RESULTS: The Risk(model) calculated by both haemodynamic- and structural-weighted estimates correlated with experimental risks with chi2 = 6.0 and 0.64, respectively. The risks of the structural-weighted estimate were more correlated to experimental risks. CONCLUSIONS: Using two different approaches to the calculation of AVM haemorrhage risk, we found a general agreement with independent statistical estimates of haemorrhagic risk based on patient data. Computational approaches are feasible; future work can focus on specific pathomechanistic questions. Detailed patient-specific computational models can also be developed as an adjunct to individual patient risk assessment for risk-stratification purposes.
MINOR MESH HEADINGS: Cerebral-Arteriovenous-Malformations-physiopathology; Cerebral-Hemorrhage-etiology; Cerebral-Hemorrhage-physiopathology; Feasibility-Studies; Hemodynamics-; Logistic-Models; Prognosis-; Prospective-Studies; Reproducibility-of-Results; Rupture,-Spontaneous
MAJOR MeSH HEADINGS: *Cerebral-Arteriovenous-Malformations-complications; *Models,-Cardiovascular
CHECKTAGS: Comparative-Study; Human; Support,-U.S.-Gov't,-P.H.S.
PUBLICATION TYPE: JOURNAL-ARTICLE
CONTRACT OR GRANT NUMBERS: RO1NS27713NSNINDS; RO1NS34949NSNINDS
MEDLINE ACCESSION NUMBER: 1999048865
UPDATE CODE: 199903
Record 29 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Intra-operative colour-duplex-sonography in the surgical management of cerebral AV-malformations.
AUTHOR(S): Woydt-M; Perez-J; Meixensberger-J; Krone-A; Soerensen-N; Roosen-K
ADDRESS OF AUTHOR: Department of Neurosurgery, University of Wuerzburg, Germany.
SOURCE (BIBLIOGRAPHIC CITATION): Acta-Neurochir-Wien. 1998; 140(7): 689-98
INTERNATIONAL STANDARD SERIAL NUMBER: 0001-6268
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: AUSTRIA
ABSTRACT: In this prospective study the role of intra-operative Colour-Duplex-Sonography (= CDS) during surgery of arteriovenous malformations (= AVM) is evaluated. During the last three years 20 consecutive patients with supratentorial AVMs were examined by intra-operative CDS in order to evaluate the potential of CDS to 1) localize the AVM, 2) differentiate between embolized and perfused parts, 3) identify feeding and draining vessels and 4) control the complete excision of the AVM. All AVMs were localized supratentorially, 9 were grade I and II (according to Spetzler and Martin [31]), 8 grade III and 3 grade IV. 11 were partly embolized and 8 associated with an intracerebral bleeding. In all cases the nidus was correctly localized sonographically by its typical bidirectional flow pattern in Colour-mode. CDS guided the surgeon directly to all (11 cases) deep-seated AVMs (2 to 4 cm subcortically). The smallest nidus measured 10 mm. 28 of 34 angiographically defined main feeding and 18 of 23 draining vessels were identified. 14 patients were controlled sonographically at the end of the resection regarding the completeness of excision. In 11 patients CDS was negative and was confirmed by either postoperative angiography or MRI in 10 patients. In one case residual AVM tissue was missed by CDS. Positive CDS findings in 3 cases were all confirmed by microscopic re-inspection, angiography and CCT. Our results suggest that CDS is able to localize AVMs intra-operatively with minimal instrumentation. It allows safe navigation to deep-seated malformations with high accuracy. Feeding and draining vessels can be identified and completeness of resection can be controlled.
MINOR MESH HEADINGS: Adolescence-; Adult-; Cerebral-Arteriovenous-Malformations-ultrasonography; Cerebral-Embolism-and-Thrombosis-surgery; Cerebral-Embolism-and-Thrombosis-ultrasonography; Cerebral-Hemorrhage-surgery; Cerebral-Hemorrhage-ultrasonography; Child,-Preschool; Microsurgery-; Middle-Age; Prospective-Studies; Sensitivity-and-Specificity
MAJOR MeSH HEADINGS: *Cerebral-Arteriovenous-Malformations-surgery; *Monitoring,-Intraoperative; *Ultrasonography,-Doppler,-Color; *Ultrasonography,-Doppler,-Transcranial
CHECKTAGS: Female; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1998454568
UPDATE CODE: 199903
Record 30 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Assessment of neuropsychological changes in patients with arteriovenous malformation (AVM) after radiosurgery.
AUTHOR(S): Wenz-F; Steinvorth-S; Wildermuth-S; Lohr-F; Fuss-M; Debus-J; Essig-M; Hacke-W; Wannenmacher-M
ADDRESS OF AUTHOR: Department of Clinical Radiology, University of Heidelberg, Germany.
SOURCE (BIBLIOGRAPHIC CITATION): Int-J-Radiat-Oncol-Biol-Phys. 1998 Dec 1; 42(5): 995-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0360-3016
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: PURPOSE: The purpose of this study was to investigate neuropsychological effects of radiosurgery in patients with cerebral arteriovenous malformation (AVM), with special focus on attention and memory. This report describes the study setup and presents the first results during a follow-up of up to 1 year. MATERIALS AND METHODS: Seventy-nine patients were studied before, acutely after radiosurgery, and during the regular follow-up (subacute phase: Weeks 6-12, chronic phase: Months 6-12). Radiosurgery was performed using a modified linear accelerator (minimum doses to the target volume: 15-22 Gy, median 20 Gy). Estimated whole brain dose was 0.5 to 2 Gy. Neuropsychological testing included assessment of general intelligence (Wechsler Adult Intelligence Scale), attention (modified Trail-Making Test A, Digit Symbol Test, D2 Test, Wiener Determination Machine) and memory (Rey Auditory Verbal Learning Test, Benton Visual Retention Test). During follow-up, alternate test versions were used. Neuropsychological deficits were defined as a test score of at least one standard deviation (SD) below the mean of the normal distribution. RESULTS: The pretherapeutic evaluation revealed marked deviations from the normal population; 24% had deficits in intelligence (range 23-31% in different subtests), attention (35%, 23-59%) and memory (48%, 31-61%). The overall percentage of aberrant results was reduced by 12% (memory) to 14% (attention) in the chronic phase up to 12 months after therapy. The improvement in test scores was significant (p < 0.05) in 3 of 4 subtests of attention functions. CONCLUSIONS: The acute tolerance of radiosurgery seems to be very good in these patients, showing no relevant increase in number of patients with neuropsychological deficits. Although the long-term follow-up needs to be further increased, our data indicate a tendency to slight improvement in the overall neuropsychological performance of AVM patients in the chronic phase after radiosurgery.
MINOR MESH HEADINGS: Adult-; Attention-radiation-effects; Intelligence-radiation-effects; Memory-radiation-effects; Neuropsychological-Tests; Prospective-Studies
MAJOR MeSH HEADINGS: *Cerebral-Arteriovenous-Malformations-surgery; *Radiosurgery-
CHECKTAGS: Female; Human; Male; Support,-Non-U.S.-Gov't
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999084566
UPDATE CODE: 199903
Record 31 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Early surgical treatment of intracerebral hemorrhages caused by AVM: our experience in 10 cases.
AUTHOR(S): Puzzilli-F; Mastronardi-L; Ruggeri-A; Lunardi-P
ADDRESS OF AUTHOR: University of Rome La Sapienza, Department of Neurological Sciences, Italy.
SOURCE (BIBLIOGRAPHIC CITATION): Neurosurg-Rev. 1998; 21(2-3): 87-92
INTERNATIONAL STANDARD SERIAL NUMBER: 0344-5607
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: GERMANY
ABSTRACT: Between February, 1980, and April, 1993. 10 patients with intraparenchymal hemorrhage due to the bleeding of an arteriovenous malformation (AVM) underwent emergency surgical procedures within an average time of 3 hours (min. 2-max. 7) from casualty to admission. Rapid neurological worsening and mass effect of the extensive intracerebral hemorrhage prompted early surgical treatment. Post-operative angiography was performed to confirm that the malformation had been excluded from the circulation. The aim of this study is to evaluate the role of early surgery in patients requiring emergency surgical procedures for severe neurological injury induced by extensive intracerebral hematoma produced by AVM bleeding.
MINOR MESH HEADINGS: Adolescence-; Adult-; Cerebral-Angiography; Cerebral-Arteriovenous-Malformations-radiography; Cerebral-Hemorrhage-radiography; Fatal-Outcome; Glasgow-Coma-Scale; Middle-Age; Preoperative-Care; Prognosis-; Time-Factors; Tomography,-X-Ray-Computed
MAJOR MeSH HEADINGS: *Cerebral-Arteriovenous-Malformations-complications; *Cerebral-Hemorrhage-etiology; *Cerebral-Hemorrhage-surgery
CHECKTAGS: Case-Report; Female; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999012031
UPDATE CODE: 199903
Record 32 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: [Conservative treatment of cerebral arteriovenous malformations. Follow-up study of 31 cases]
ORIGINAL TITLE: Leczenie zachowawcze naczyniakow tetniczo-zylnych mozgu. Badanie katamnestyczne 31 przypadkow.
AUTHOR(S): Majewski-T; Liebert-W; Nowak-S; Smol-S
ADDRESS OF AUTHOR: Katedry i Kliniki Neurochirurgii Akademii Medycznej w Poznaniu im.
SOURCE (BIBLIOGRAPHIC CITATION): Neurol-Neurochir-Pol. 1998 May-Jun; 32(3): 573-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0028-3843
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: POLISH; NON-ENGLISH
COUNTRY OF PUBLICATION: POLAND
ABSTRACT: The clinical course of 31 patients with conservatively treated intracranial arteriovenous malformations (AVM's) was followed-up. The average follow-up period was 8.2 years, 75% of patients were followed up for more than 5 years. The initial symptom was intracranial bleeding in 21 patients (68%), seizure in 5 (16%), neurological deficit in 2 (6.5%), headache in 2 (6.5%) and intracranial hypertension in 1 (3%). The prognosis was more favourable for patients presenting with seizures than for patients presenting with haemorrhage. Patients in the haemorrhage group had 29% incidence of haemorrhage causing 14% mortality in this group. Of the 31 patient's 20 (64.5%) had a good clinical outcome, 4 (13%) had a fair outcome and 2 (6.5%) poor, 5 patients died, with one not due to AVM. There was no correlation between pregnancy and bleeding.
MINOR MESH HEADINGS: Adolescence-; Adult-; Arteriovenous-Malformations-complications; Cerebral-Hemorrhage-etiology; Child-; Disease-Progression; Embolization,-Therapeutic-methods; English-Abstract; Follow-Up-Studies; Middle-Age; Prognosis-; Retrospective-Studies; Seizures-etiology
MAJOR MeSH HEADINGS: *Arteriovenous-Malformations-therapy
CHECKTAGS: English-Abstract; Female; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1998443633
UPDATE CODE: 199903
Record 33 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Black holes, white dwarfs and supernovas: imaging after radiosurgery.
AUTHOR(S): Lunsford-LD; Kondziolka-D; Maitz-A; Flickinger-JC
ADDRESS OF AUTHOR: Department of Neurological Surgery, University of Pittsburgh Medical Center,Pittsburgh, Pa., USA. lunsford@neuronet.pitt.edu
SOURCE (BIBLIOGRAPHIC CITATION): Stereotact-Funct-Neurosurg. 1998 Oct; 70 Suppl 1: 2-10
INTERNATIONAL STANDARD SERIAL NUMBER: 1011-6125
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: SWITZERLAND
ABSTRACT: PURPOSE: To evaluate the imaging and pathological correlates of successful or risk-related stereotactic radiosurgery (SR). Methods and Materials. The ten-year Gamma Knife experience in 2,344 patients at the University of Pittsburgh was reviewed. In addition, the results or radiosurgery primate, rat, and mouse models were analyzed. Successful results and untoward complications were evaluated. RESULTS: Dose, volume, location and histology affected the imaging changes seen after SR. Imaging changes range from central loss of contrast ('black holes'), shrinkage with diffuse contrast uptake ('white dwarfs'), or stabilization or growth arrest. Limited pathological data indicates that the prevention of cell division coupled with vascular obliteration results in tumor control, whereas a progressive endothelial proliferative and obliterative response results in arteriovenous malformation (AVM) obliteration. Perilesional imaging changes, especially in vascular malformations, may reflect flow phenomena, interstitial edema, or profound reactive astrocytosis ('supernovas'). CONCLUSION: Imaging changes correlate with both success and risks of stereotactic radiosurgery; however, pathological correlates are limited. High resolution neurodiagnostic imaging provides the best quality control available to assess the response to stereotactic radiosurgery. In the future, additional molecular probes are necessary to assess the radiobiological effects of radiosurgery.
MINOR MESH HEADINGS: Astrocytes-pathology; Brain-pathology; Brain-radiography; Brain-Diseases-diagnosis; Cerebral-Angiography; Contrast-Media; Magnetic-Resonance-Imaging; Mice-; Papio-; Postoperative-Complications-pathology; Postoperative-Period; Radiosurgery-adverse-effects; Rats-; Stereotaxic-Techniques-adverse-effects; Stereotaxic-Techniques-instrumentation; Treatment-Outcome
MAJOR MeSH HEADINGS: *Brain-surgery; *Brain-Diseases-surgery; *Radiosurgery-
CHECKTAGS: Animal; Human
PUBLICATION TYPE: JOURNAL-ARTICLE
CAS REGISTRY NUMBER OR EC NUMBER: 0
NAME OF SUBSTANCE: Contrast-Media
MEDLINE ACCESSION NUMBER: 1999000763
UPDATE CODE: 199902
Record 34 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Primary intraventricular hemorrhage in adult--an analysis of 24 cases.
AUTHOR(S): Chang-DS; Lin-CL; Howng-SL
ADDRESS OF AUTHOR: Division of Neurosurgery, Kaohsiung Medical College Hospital, Taiwan, Republic of China.
SOURCE (BIBLIOGRAPHIC CITATION): Kao-Hsiung-I-Hsueh-Ko-Hsueh-Tsa-Chih. 1998 Oct; 14(10): 633-8
INTERNATIONAL STANDARD SERIAL NUMBER: 0257-5655
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: TAIWAN
ABSTRACT: Primary intraventricular hemorrhage in adults is rare, comprising only about 3.1 % of all intracranial hemorrhage. One of the major management tasks is to find out whether the hemorrhage is secondary to underlying structural vascular abnormality, such as arteriovenous malformation (AVM) and aneurysm, so that appropriate treatment can be carried out to prevent rebleeding. We retrospectively analyzed 24 patients with computerized tomography findings of intraventricular hemorrhage in our hospital from 1991 to 1996. Cerebral angiography was performed in eighteen patients. Eight patients (57%) had positive angiographic findings (five were AVM and three were aneurysm). The angiographic yield was five of seven patients (72%) younger than 45 years of age and three of eleven (27%) older than 45 years of age. On the basis of our results, we suggest that cerebral angiography should be considered for all primary intraventricular hemorrhage patients who are younger than 45 years old.
MINOR MESH HEADINGS: Adolescence-; Adult-; Aged-; Aged,-80-and-over; Cerebral-Angiography; Middle-Age; Retrospective-Studies; Tomography,-X-Ray-Computed
MAJOR MeSH HEADINGS: *Cerebral-Hemorrhage-radiography; *Cerebral-Ventricles
CHECKTAGS: Female; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999036940
UPDATE CODE: 199902
SUBSET: DENTAL
Record 35 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Association between an aneurysm of the anterior inferior cerebral artery and an arteriovenous malformation fed by the same artery.
AUTHOR(S): Vincentelli-F; Caruso-G; Licastro-G; Rabehanta-P
ADDRESS OF AUTHOR: Division of Neurosurgery La Residence du Parc, Centre Hospitalier Prive, Marseille, France.
SOURCE (BIBLIOGRAPHIC CITATION): J-Neurosurg-Sci. 1998 Mar; 42(1): 41-5
INTERNATIONAL STANDARD SERIAL NUMBER: 0390-5616
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: ITALY
ABSTRACT: An unusual case of distal aneurysm of the anterior inferior cerebellar artery (AICA) associated with a cerebellar arteriovenous malformation in a 35 year-old woman is reported. The clinical presentation was a subarachnoid hemorrhage, that is the sudden onset of headache while she was driving her car. In the following days the patient experienced a cerebellopontine angle syndrome: unsteadiness, tinnitus and hearing loss in her left ear, along with drop episodes. All symptoms disappeared in about a week. She consulted a neurosurgeon only a month later. On the day of admission in the Neurosurgical Department of Residence du Parc Clinic her neurological status was normal. Neuroradiological investigations showed the association between the two distal AICA malformations. At surgery it was possible either to clip the aneurysm or to remove the AVM. The origin of the hemorrhage has not been clearly identified. The patient had an uneventful recovery and returned to her job three months later. The aneurysm was located on the same artery that supplied the AVM. This association is rare at the AICA level. The possible development of the aneurysm induced by increase in flow through the AVM is discussed in the light of Literature data.
MINOR MESH HEADINGS: Adult-; Cerebral-Aneurysm-radiography; Cerebral-Arteriovenous-Malformations-radiography; Cerebral-Artery-Diseases-radiography; Tomography,-X-Ray-Computed
MAJOR MeSH HEADINGS: *Cerebral-Aneurysm-complications; *Cerebral-Arteriovenous-Malformations-complications; *Cerebral-Artery-Diseases-complications
CHECKTAGS: Case-Report; Female; Human
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1998439409
UPDATE CODE: 199902
Record 36 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Surgical treatment of superficial siderosis associated with a spinal arteriovenous malformation. Case report.
AUTHOR(S): Schievink-WI; Apostolides-PJ; Spetzler-RF
ADDRESS OF AUTHOR: Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.
SOURCE (BIBLIOGRAPHIC CITATION): J-Neurosurg. 1998 Dec; 89(6): 1029-31
INTERNATIONAL STANDARD SERIAL NUMBER: 0022-3085
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: In many patients with superficial siderosis of the central nervous system (CNS) no source of bleeding can be established, despite extensive examinations. The authors report a patient with superficial siderosis and a spinal arteriovenous malformation (AVM) that was not visible on magnetic resonance (MR) imaging or myelography but was identified on angiographic studies. This 71-year-old man presented with a 2-year history of progressive gait difficulties and hearing loss. Examination showed ataxia, hearing loss, and quadriparesis. On MR imaging superficial siderosis of the brain and spinal cord as seen; however, MR imaging of the CNS, as well as cerebral angiography and myelography studies, did not reveal the source of hemorrhage. Spinal angiography revealed a small slow-flow pial AVM at the C-5 level originating from the anterior spinal artery. A C-5 corpectomy was performed and the AVM was obliterated. The patient did well and reported no further progression of his symptoms during 3 months of follow up. Spinal angiography is indicated to complete the evaluation of patients with superficial siderosis, even if results of spinal MR imaging and myelography studies are normal. Obliteration of spinal AVMs may successfully prevent the progression of superficial siderosis.
MINOR MESH HEADINGS: Aged-; Angiography-; Arteriovenous-Malformations-diagnosis; Diagnosis,-Differential; Spine-radiography
MAJOR MeSH HEADINGS: *Arteriovenous-Malformations-complications; *Arteriovenous-Malformations-surgery; *Siderosis-complications; *Siderosis-surgery; *Spine-blood-supply
CHECKTAGS: Case-Report; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE
MEDLINE ACCESSION NUMBER: 1999049578
UPDATE CODE: 199902
SUBSET: AIM
Record 37 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Control of epilepsy associated with cerebral arteriovenous malformations after radiosurgery.
AUTHOR(S): Kurita-H; Kawamoto-S; Suzuki-I; Sasaki-T; Tago-M; Terahara-A; Kirino-T
ADDRESS OF AUTHOR: Department of Neurosurgery, Faculty of Medicine, University of Tokyo, Japan.
SOURCE (BIBLIOGRAPHIC CITATION): J-Neurol-Neurosurg-Psychiatry. 1998 Nov; 65(5): 648-55
INTERNATIONAL STANDARD SERIAL NUMBER: 0022-3050
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: ENGLAND
ABSTRACT: OBJECTIVE: To investigate the effect of radiosurgery for symptomatic epilepsy associated with cerebral arteriovenous malformations (AVMs). METHODS: Thirty five patients with unruptured epileptogenic AVMs were studied with a mean follow up of 43.0 months. The duration of epilepsy before radiosurgery ranged from 2 months to 21 years (mean 2.8 years). Fifteen patients showed partial seizures; eight of these had associated secondary generalisation. The remaining 20 patients showed only generalised seizures without preceding focal seizures. RESULTS: At the final follow up examination, 28 patients remained seizure free, whereas seizures continued in seven. Variables significantly associated with continuity of seizures after radiosurgery were the number of seizures before therapy (p<0.01) and duration of epilepsy (p<0.05). According to Engel's classification, the 10 patients with intractable seizures before treatment included five with grade I, four with grade III, and one with grade IV. The frequency of seizures began to decrease several months after radiosurgery; much shorter than the time required for morphological change in the AVMs. CONCLUSIONS: Radiosurgery seems to be beneficial for seizure control in patients with unruptured epileptogenic AVM.
MINOR MESH HEADINGS: Adolescence-; Adult-; Anticonvulsants-therapeutic-use; Arteriovenous-Malformations-diagnosis; Brain-radiography; Cerebral-Angiography-methods; Epilepsy,-Generalized-drug-therapy; Follow-Up-Studies; Magnetic-Resonance-Angiography-methods; Postoperative-Period; Tomography,-X-Ray-Computed
MAJOR MeSH HEADINGS: *Arteriovenous-Malformations-complications; *Brain-surgery; *Epilepsy,-Generalized-etiology; *Epilepsy,-Generalized-surgery; *Stereotaxic-Techniques
CHECKTAGS: Female; Human; Male; Support,-Non-U.S.-Gov't
PUBLICATION TYPE: JOURNAL-ARTICLE
CAS REGISTRY NUMBER OR EC NUMBER: 0
NAME OF SUBSTANCE: Anticonvulsants
MEDLINE ACCESSION NUMBER: 1999027057
UPDATE CODE: 199902
Record 38 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: [A case of severe hypernatremia complicated with rhabdomyolysis]
AUTHOR(S): Asahara-H; Maruyama-S; Motomura-S; Tamura-K; Miyoshi-T
ADDRESS OF AUTHOR: Department of Neurology, Kyushu Rosai Hospital.
SOURCE (BIBLIOGRAPHIC CITATION): Rinsho-Shinkeigaku. 1998 Apr; 38(4): 301-4
INTERNATIONAL STANDARD SERIAL NUMBER: 0009-918X
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: JAPANESE; NON-ENGLISH
COUNTRY OF PUBLICATION: JAPAN
ABSTRACT: We report a 45-year-old male patient with severe hypernatremia followed by rhabdomyolysis and acute renal failure. He had developed hypernatremia for two years after a surgery for an intraventricular AVM involving the hypothalamic area, which was fed by the anterior cerebral artery. He was admitted to our hospital because of progressive muscle weakness. Because of loss of water intake due to impaired thirst sensation, he developed severe hypernatremia (191mEq/l) and marked rhabdomyolysis (CK 17,772 IU/l). He was treated with fluid supplement and hemodialysis for acute renal insufficiency. He had no thirst feeling. Blood studies revealed hyporeactivity to ADH in spite of marked hypernatremia and hyperosmorality. Therefore his condition was considered as adipsic hypernatremia. We concluded that rhabdomyolysis of this case was caused by severe hypernatremia. On reviewing the literature, only a few cases of rhabdomyolysis due to hypernatremia have been reported.
MINOR MESH HEADINGS: Cerebral-Arteriovenous-Malformations-surgery; English-Abstract; Hemodialysis-; Kidney-Failure,-Acute-etiology; Kidney-Failure,-Acute-therapy; Middle-Age; Postoperative-Complications
MAJOR MeSH HEADINGS: *Hypernatremia-etiology; *Rhabdomyolysis-etiology
CHECKTAGS: Case-Report; English-Abstract; Human; Male
PUBLICATION TYPE: JOURNAL-ARTICLE; REVIEW; REVIEW-OF-REPORTED-CASES
MEDLINE ACCESSION NUMBER: 1998415300
UPDATE CODE: 199902
Record 39 of 39 in MEDLINE EXPRESS (R) 1999/01-1999/06
TITLE: Image processing in stereotactic planning: volume visualization and image registration.
AUTHOR(S): Pelizzari-CA
ADDRESS OF AUTHOR: Department of Radiation and Cellular Oncology, University of Chicago, IL 60637, USA. c-pelizzari@chicago.edu
SOURCE (BIBLIOGRAPHIC CITATION): Med-Dosim. 1998 Fall; 23(3): 137-45
INTERNATIONAL STANDARD SERIAL NUMBER: 0739-0211
PUBLICATION YEAR: 1998
LANGUAGE OF ARTICLE: ENGLISH
COUNTRY OF PUBLICATION: UNITED-STATES
ABSTRACT: Radiation treatment planning (RTP), historically an image-intensive discipline and one of the first areas in which three-dimensional (3D) information from imaging was clinically applied, has become ever more critically dependent on accurate 3D identification of target and non-target organs with the advent of conformal radiation therapy, stereotactic radiotherapy, and radiosurgery. In addition to the interactive display of wire-frame or shaded surface models of anatomical objects, proposed radiation beams, and calculated dose distributions, use may also be made of direct visualization of relevant anatomy from image data. Although anatomical analysis of dose distributions is an essential component of radiation treatment design which requires geometric definition (i.e., segmentation) of all volumes of interest, geometric targeting with optimization based on 3D anatomical information is frequently performed as a separate step independent of dose calculations. For this early step in the planning process, and certainly for diagnostic purposes, visualization without explicit segmentation may be a useful additional capability. Additionally, we suggest that direct visualization of high contrast targets such as arteriovenous malformations (AVM) from computerized tomography (CT) or magnetic resonance (MR) angiography may serve as a tool for target volume delineation. Frequently, information from multiple modalities or multiple scans of the same modality is important in planning a given case. In such instances, image registration may prove useful to allow synthesis of information from multiple sources into a single consistent coordinate frame. Numerous image registration methods are available, each with characteristic strengths and weaknesses.
MINOR MESH HEADINGS: Arteriovenous-Malformations-diagnosis; Magnetic-Resonance-Angiography; Stereotaxic-Techniques; Tomography,-X-Ray-Computed
MAJOR MeSH HEADINGS: *Image-Processing,-Computer-Assisted; *Radiosurgery-; *Radiotherapy-Planning,-Computer-Assisted; *Radiotherapy,-Conformal
CHECKTAGS: Human
PUBLICATION TYPE: JOURNAL-ARTICLE; REVIEW; REVIEW,-TUTORIAL
MEDLINE ACCESSION NUMBER: 1998456605
UPDATE CODE: 199902