Journal of neurosurgery
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Journal of neurosurgery · Dec 2000
Primary intracerebral and aneurysmal subarachnoid hemorrhage in Izumo City, Japan. Part II: management and surgical outcome.
The purpose of this study was to assess the overall management and surgical outcome of primary intracerebral hemorrhage (ICH) and aneurysmal subarachnoid hemorrhage (SAH) among the 85,000 residents of Izumo City, Japan. ⋯ The overall survival rates for patients with ICH or SAH in Izumo were more favorable than those in previously published epidemiological studies. However, despite improved surgical results, the overall management of ICH and SAH still produced an unsatisfactory outcome, mainly because of primary brain damage.
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Journal of neurosurgery · Dec 2000
Case ReportsDe novo formation and rupture of an azygos pericallosal artery aneurysm. Case report.
An azygos pericallosal artery (APCA) aneurysm is a rare anomaly that is closely associated with saccular aneurysms. This is the earliest report to document de novo formation and rupture of an aneurysm at the bifurcation of an unpaired pericallosal trunk. ⋯ De novo formation of aneurysms after SAH rarely occurs and certain risk factors like multiple and familial aneurysms, arterial hypertension, or smoking have been postulated. Late follow-up examination with angiography to detect de novo aneurysms should be considered in patients with this vascular anomaly after SAH.
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Journal of neurosurgery · Dec 2000
Fluorescence-guided resection of glioblastoma multiforme by using 5-aminolevulinic acid-induced porphyrins: a prospective study in 52 consecutive patients.
It has been established that 5-aminolevulinic acid (5-ALA) induces the accumulation of fluorescent porphyrins in glioblastoma multiforme (GBM), a phenomenon potentially exploitable to guide tumor resection. In this study the authors analyze the influence of fluorescence-guided resection on postoperative magnetic resonance (MR) imaging and survival in a series of patients who underwent surgery in the authors' department. ⋯ The observations in this study indicate the usefulness of 5-ALA-induced tumor fluorescence for guiding tumor resection. The completeness of resection, as determined intraoperatively from residual tissue fluorescence, was related to postoperative MR imaging findings and to survival in patients suffering from GBM.
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Journal of neurosurgery · Dec 2000
Analysis of the causes of treatment failure in gamma knife radiosurgery for intracranial arteriovenous malformations.
The authors sought to analyze causes for treatment failure following gamma knife radiosurgery (GKS) for intracranial arteriovenous malformations (AVMs), in cases in which the nidus could still be observed on angiography 3 years postsurgery. ⋯ The causes of failed GKS for treatment of AVMs seen on 3-year follow-up angiograms include inadequate nidus definition, large nidus volume, suboptimal radiation dose, recanalization/reexpansion, and radioresistance associated with an intranidal fistula.
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Journal of neurosurgery · Dec 2000
Case ReportsCerebral circulation and metabolism in the acute stage of subarachnoid hemorrhage.
The mechanism of reduction of cerebral circulation and metabolism in patients in the acute stage of aneurysmal subarachnoid hemorrhage (SAH) has not yet been fully clarified. The goal of this study was to elucidate this mechanism further. ⋯ The initial reduction in CBF due to elevated ICP, followed by reduction in CMRO, at the time of aneurysm rupture may play a role in the disturbance of CBF and cerebral metabolism in the acute stage of aneurysmal SAH.