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1. |
Congress of Neurological Surgeons 1998 Presidential Address |
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Neurosurgery,
Volume 44,
Issue 6,
1999,
Page 1161-1165
William Friedman,
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ISSN:0148-396X
出版商:OVID
年代:1999
数据来源: OVID
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2. |
1999 Annual Meeting Congress of Neurological Surgeons |
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Neurosurgery,
Volume 44,
Issue 6,
1999,
Page 1165-1165
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ISSN:0148-396X
出版商:OVID
年代:1999
数据来源: OVID
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3. |
The Natural History of Cavernous Malformations: A Prospective Study of 68 Patients |
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Neurosurgery,
Volume 44,
Issue 6,
1999,
Page 1166-1171
John,
Moriarity Matthew,
Wetzel Richard,
Clatterbuck Sam,
Javedan Jeannie-Marie,
Sheppard Karen,
Hoenig-Rigamonti Nathan,
Crone Steven,
Breiter Roland,
Lee Daniele,
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摘要:
OBJECTIVE:Cavernous malformations are angiographically occult cerebrovascular malformations found in approximately 0.5% of the population. To help further understand the natural history of these lesions, we prospectively followed 68 patients harboring cavernous malformations.METHODS:The 68 patients in this study were all diagnosed radiographically (67 patients) or surgically (1 patient) and were entered into a patient database. Age, sex, clinical symptoms, seizure frequency, focal neurological deficits, and presence or absence of extralesional hemorrhage were all recorded at presentation. Patients were then followed prospectively to determine the rate of hemorrhage and new-onset seizures.RESULTS:The mean follow-up per patient was 5.2 years, and the total follow-up was 352.9 patient-years. There was an average of 3.4 lesions per patient. Thirteen of the patients (19%) had familial cavernous malformations. Patients with familial disease were more likely to have multiple lesions than patients with sporadic disease (85% versus 25%, respectively [P= 0.001]). Initial presentation included headache (65%), seizures (49%), and focal neurological deficit (46%). Eleven symptomatic, radiologically proven, extralesional hemorrhages occurred during the 352.9 patient-years of follow-up for an overall hemorrhage rate of 3.1% per patient-year. Female patients had a significantly higher prospective hemorrhage rate (4.2% per patient-year versus 0.9% per patient-year [P= 0.04]). A history of hemorrhage at presentation was not a risk factor for subsequent hemorrhage during follow-up. The rate of new-onset seizures was 2.4% per patient-year.CONCLUSION:The clinical presentation and prospective hemorrhage rate reported here agree well with findings of other prospective studies. This information, combined with our new-onset seizure rate, should aid clinicians caring for patients with cavernous malformations.
ISSN:0148-396X
出版商:OVID
年代:1999
数据来源: OVID
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4. |
The Natural History of Cavernous Malformations: A Prospective Study of 68 Patients |
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Neurosurgery,
Volume 44,
Issue 6,
1999,
Page 1172-1173
Issam,
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ISSN:0148-396X
出版商:OVID
年代:1999
数据来源: OVID
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5. |
Correlation of Magnetic Resonance Characteristics and Histopathological Type of Angiographically Occult Vascular Malformations |
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Neurosurgery,
Volume 44,
Issue 6,
1999,
Page 1174-1180
Marc,
Vanefsky Ming,
Cheng Steven,
Chang Alexander,
Norbash Jack,
Snipe Michael,
Marks Gary,
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摘要:
OBJECTIVE:Histological and radiological classification of vascular malformations has previously been attempted in an effort to understand their nature and predict their biological behavior. There exists a subgroup of vascular malformations that are angiographically occult and share a common magnetic resonance imaging (MRI) appearance but may differ in their behavior. We sought to determine any correlation between MRI features and final histopathological diagnosis.METHODS:We reviewed our series of 72 patients with angiographically occult vascular malformations operated on at Stanford University Medical Center between 1988 and 1993. Radiographic magnetic resonance images and histopathological specimens were retrospectively evaluated for various diagnostic features.RESULTS:Our data indicate that lesions exhibiting a ring of hemosiderin are associated with the presence of a cavernous malformation (CM) component (86% of CMs versus 33% of non-CM lesions). A lesion associated with edema, mass effect, or a single prominent blood product on MRI correlates with the presence of an arteriovenous malformation (AVM) component. Sixty-three percent of AVMs and 80% of lesions with partial AVM components showed edema, compared with 8% of CMs and 0% of venous malformations. Sixty percent of AVMs and 63% of lesions with partial AVM components showed a single prominent blood product, compared with 8% of CMs and 0% of venous malformations. Finally, 60% of AVMs exhibited mass effect, compared with 20% of CMs. Additionally, an expansile hemorrhage is suggestive of an AVM.CONCLUSION:This study is the first to demonstrate that a particular MRI appearance of an angiographically occult vascular malformation is suggestive of an AVM component. This may have important implications with regard to the behavior of the lesion and planning of future treatment.
ISSN:0148-396X
出版商:OVID
年代:1999
数据来源: OVID
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6. |
Correlation of Magnetic Resonance Characteristics and Histopathological Type of Angiographically Occult Vascular Malformations |
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Neurosurgery,
Volume 44,
Issue 6,
1999,
Page 1180-1181
Deborah,
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ISSN:0148-396X
出版商:OVID
年代:1999
数据来源: OVID
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7. |
CNS Placement Service |
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Neurosurgery,
Volume 44,
Issue 6,
1999,
Page 1181-1181
&NA;,
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ISSN:0148-396X
出版商:OVID
年代:1999
数据来源: OVID
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8. |
Boron Neutron Capture Therapy for Glioblastoma Multiforme: Interim Results from the Phase I/II Dose-Escalation Studies |
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Neurosurgery,
Volume 44,
Issue 6,
1999,
Page 1182-1192
Arjun Chanana,
Jacek Capala,
Manjeet Chadha,
Jeffrey Coderre,
Aidnag Diaz,
Eric Elowitz,
Junichi Iwai,
Darrel Joel,
Hunguan Liu,
Ruimei Ma,
Noreen Pendzick,
Nancy Peress,
Magdy Shady,
Daniel Slatkin,
George Tyson,
Lucian Wielopolski,
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摘要:
OBJECTIVE:The primary objective of these Phase I/II dose-escalation studies is to evaluate the safety of boronophenylalanine (BPA)-fructose-mediated boron neutron capture therapy (BNCT) for patients with glioblastoma multiforme (GBM). A secondary purpose is to assess the palliation of GBM by BNCT, if possible.METHODS:Thirty-eight patients with GBM have been treated. Subtotal or gross total resection of GBM was performed for 38 patients (median age, 56 yr) before BNCT. BPA-fructose (250 or 290 mg BPA/kg body weight) was infused intravenously, in 2 hours, approximately 3 to 5 weeks after surgery. Neutron irradiation was begun between 34 and 82 minutes after the end of the BPA infusion and lasted 38 to 65 minutes.RESULTS:Toxicity related to BPA-fructose was not observed. The maximal radiation dose to normal brain varied from 8.9 to 14.8 Gy-Eq. The volume-weighted average radiation dose to normal brain tissues ranged from 1.9 to 6.0 Gy-Eq. No BNCT-related Grade 3 or 4 toxicity was observed, although milder toxicities were seen. Twenty-five of 37 assessable patients are dead, all as a result of progressive GBM. No radiation-induced damage to normal brain tissue was observed in postmortem examinations of seven brains. The minimal tumor volume doses ranged from 18 to 55 Gy-Eq. The median time to tumor progression and the median survival time from diagnosis (from Kaplan-Meier curves) were 31.6 weeks and 13.0 months, respectively.CONCLUSION:The BNCT procedure used has been safe for all patients treated to date. Our limited clinical evaluation suggests that the palliation offered by a single session of BNCT is comparable to that provided by fractionated photon therapy. Additional studies with further escalation of radiation doses are in progress.
ISSN:0148-396X
出版商:OVID
年代:1999
数据来源: OVID
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9. |
Boron Neutron Capture Therapy for Glioblastoma Multiforme: Interim Results from the PhaseI/II Dose-Escalation Studies |
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Neurosurgery,
Volume 44,
Issue 6,
1999,
Page 1192-1193
Philip Gutin,
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ISSN:0148-396X
出版商:OVID
年代:1999
数据来源: OVID
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10. |
Boron Neutron Capture Therapy for Glioblastoma Multiforme: Interim Results from the Phase I/II Dose-Escalation Studies |
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Neurosurgery,
Volume 44,
Issue 6,
1999,
Page 1193-1193
Paul Kornblith,
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ISSN:0148-396X
出版商:OVID
年代:1999
数据来源: OVID
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