Verfügbarkeit: Surgical neuroangiography

Surgical neuroangiography: 2,2 Clinical and endovascular treatment aspects in adults : cerebral arteriovenous shunts ; spinal arteriovenous shunts ; spinal vascular tumors ; technical aspects of endovascular neurosurgery ; 155 tables

Gespeichert in:

Bibliographische Detailangaben
Hauptverfasser:	Lasjaunias, Pierre L. 1948- (VerfasserIn), Berenstein, Alex 1947- (VerfasserIn)
Format:	Buch
Sprache:	English
Veröffentlicht:	Berlin [u.a.] Springer 2004
Ausgabe:	2. ed.
Online-Zugang:	Inhaltsverzeichnis
Beschreibung:	XXIV S., S. 566 - 1269 Ill.
ISBN:	3540416684

Internformat

MARC


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245	1	0	\|a Surgical neuroangiography \|n 2,2 \|p Clinical and endovascular treatment aspects in adults : cerebral arteriovenous shunts ; spinal arteriovenous shunts ; spinal vascular tumors ; technical aspects of endovascular neurosurgery ; 155 tables \|c P. Lasjaunias ; A. Berenstein ; K. G. ter Brugge
250			\|a 2. ed.
264		1	\|a Berlin [u.a.] \|b Springer \|c 2004
300			\|a XXIV S., S. 566 - 1269 \|b Ill.
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700	1		\|a Berenstein, Alex \|d 1947- \|e Verfasser \|0 (DE-588)111120713 \|4 aut
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Datensatz im Suchindex

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adam_text	CONTENTS OF VOLUMES 2.1 AND 2.2 1 OCCLUSIVE VASCULAR DISEASE . . . . . . . . . . . . . . . 1 1.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 2 1.2 ARTERIAL OCCLUSIVE DISEASE . . . . . . . . . . . . . . . . . 3 1.2.1 CEREBROVASCULAR PHYSIOLOGY . . . . . . . . . . . . . . . . 3 1.2.1.1 THE BLOODBRAIN BARRIER . . . . . . . . . . . . . . . . . . 3 1.2.1.2 CEREBRAL BLOOD FLOW . . . . . . . . . . . . . . . . . . . . 4 1.2.1.3 CEREBRAL AUTOREGULATION . . . . . . . . . . . . . . . . . . 5 1.2.1.4 CEREBRAL BLOOD VOLUME . . . . . . . . . . . . . . . . . . . 7 1.2.1.5 BLOOD VISCOSITY . . . . . . . . . . . . . . . . . . . . . . . 8 1.2.1.6 METABOLISM IN CEREBRAL BLOOD FLOW . . . . . . . . . . . . 8 1.2.1.7 CARBON DIOXIDE REACTIVITY . . . . . . . . . . . . . . . . . 9 1.2.1.8 OXYGEN REACTIVITY . . . . . . . . . . . . . . . . . . . . . . 9 1.2.1.9 NITROUS OXIDE IN CEREBRAL CIRCULATION . . . . . . . . . . . 9 1.2.1.10 OTHER FACTORS . . . . . . . . . . . . . . . . . . . . . . . . 10 1.2.2 ARTERIAL ISCHEMIC STROKE . . . . . . . . . . . . . . . . . . 14 1.2.2.1 DEFINITION . . . . . . . . . . . . . . . . . . . . . . . . . . 14 1.2.2.2 NEURONAL METABOLISM AND CEREBRAL ISCHEMIA . . . . . . 17 1.2.2.3 SELECTIVE NEURONAL VULNERABILITY . . . . . . . . . . . . . . 18 1.2.2.4 HEMODYNAMIC EFFECTS OF ISCHEMIA . . . . . . . . . . . . 21 1.2.2.5 NITROUS OXIDE AND CEREBRAL ISCHEMIA . . . . . . . . . . . 21 1.2.2.6 WINDOW OF OPPORTUNITY . . . . . . . . . . . . . . . . . . 22 1.2.2.7 NEUTROPHIL . . . . . . . . . . . . . . . . . . . . . . . . . . 23 1.2.3 ATHEROSCLEROSIS . . . . . . . . . . . . . . . . . . . . . . . 23 1.2.3.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 23 1.2.3.2 EPIDEMIOLOGY . . . . . . . . . . . . . . . . . . . . . . . . 23 1.2.3.3 PATHOGENESIS . . . . . . . . . . . . . . . . . . . . . . . . . 24 1.2.3.4 MECHANISMS OF ATHEROGENESIS . . . . . . . . . . . . . . . 24 1.2.3.5 FATTY STREAK . . . . . . . . . . . . . . . . . . . . . . . . . 27 1.2.3.6 FIBROUS PLAQUE . . . . . . . . . . . . . . . . . . . . . . . . 28 1.2.3.7 UNSTABLE FIBROUS PLAQUES . . . . . . . . . . . . . . . . . . 28 1.2.3.8 COMPLICATED PLAQUE . . . . . . . . . . . . . . . . . . . . . 28 1.2.3.9 CAROTID ATHEROSCLEROSIS . . . . . . . . . . . . . . . . . . . 29 1.2.3.10 CONCLUSION . . . . . . . . . . . . . . . . . . . . . . . . . . 29 1.2.3.11 NEUROIMAGING OF ISCHEMIC STROKE . . . . . . . . . . . . . 30 1.2.4 ISCHEMIC STROKE TREATMENT . . . . . . . . . . . . . . . . . 31 1.2.4.1 MEDICAL TREATMENT OF ACUTE STROKE . . . . . . . . . . . . 31 1.2.4.2 THROMBOLYTIC THERAPY: INTRODUCTION . . . . . . . . . . . 32 1.2.4.3 THROMBOLYTICS (IV) . . . . . . . . . . . . . . . . . . . . . 32 1.2.4.4 RECOMBINED TISSUE PLASMINOGEN ACTIVATOR . . . . . . . . 32 1.2.4.5 STREPTOKINASE . . . . . . . . . . . . . . . . . . . . . . . . 33 1.2.4.6 ANTIPLATELETS . . . . . . . . . . . . . . . . . . . . . . . . . 34 1.2.4.7 COUMADIN VERSUS ASPIRIN . . . . . . . . . . . . . . . . . 39 1.2.4.8 NEUROPROTECTIVE AGENTS . . . . . . . . . . . . . . . . . . . 39 1.2.4.9 PHARMACOLOGICAL PROPERTIES OF NEUROPROTECTIVE DRUGS . 40 1.2.4.10 BINDING PROPERTIES . . . . . . . . . . . . . . . . . . . . . 41 1.2.4.11 ANGIOGRAPHIC EVALUATION . . . . . . . . . . . . . . . . . . 41 1.2.4.12 MIDDLE CEREBRAL ARTERY STROKE: NATURAL HISTORY . . . . . 44 1.2.4.13 LOCAL INTRA-ARTERIAL THROMBOLYSIS IN THE ANTERIOR CIRCULATION . . . . . . . . . . . . . . . . . 45 1.2.4.14 INTERNAL CAROTID ARTERY OCCLUSION . . . . . . . . . . . . . 52 1.2.4.15 CAROTID DISSECTION . . . . . . . . . . . . . . . . . . . . . 57 1.2.4.16 CENTRAL RETINAL ARTERY OCCLUSION . . . . . . . . . . . . . 67 1.2.4.17 INTERNAL CAROTID ARTERY STENOSIS ABOVE THE CAROTID BULB 68 1.2.4.18 GENERAL ORGANIZATION OF A STROKE EMERGENCY TEAM . . . 70 1.2.4.19 EVOLVING TREATMENT STRATEGIES . . . . . . . . . . . . . . . 72 1.2.5 EXTRACRANIAL CAROTID ARTERY STENOSIS . . . . . . . . . . . 73 1.2.5.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 73 1.2.5.2 NATURAL HISTORY . . . . . . . . . . . . . . . . . . . . . . . 73 1.2.5.3 CAROTID BRUIT . . . . . . . . . . . . . . . . . . . . . . . . . 75 1.2.5.4 IMAGING . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 1.2.5.5 TREATMENT . . . . . . . . . . . . . . . . . . . . . . . . . . 84 1.2.5.6 SYMPTOMATIC CAROTID STENOSIS . . . . . . . . . . . . . . . 86 1.2.5.7 ASYMPTOMATIC CAROTID STENOSIS . . . . . . . . . . . . . . 86 1.2.5.8 RESTENOSIS AFTER CAROTID ENDARTERECTOMY . . . . . . . . . 89 1.2.6 CAROTID ANGIOPLASTY AND STENTING . . . . . . . . . . . . . 90 1.2.6.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 90 1.2.6.2 TECHNIQUES OF CAROTID ANGIOPLASTY AND STENTING . . . . . 93 1.2.6.3 INTIMAL HYPERPLASIA AND RESTENOSIS . . . . . . . . . . . . 93 1.2.6.4 FOLLOW-UP MONITORING . . . . . . . . . . . . . . . . . . . 98 1.2.7 POSTERIOR CIRCULATION STROKE (STROKE PREVENTION) . . . . . 98 1.2.7.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 98 1.2.7.2 CLINICAL PRESENTATION . . . . . . . . . . . . . . . . . . . . 98 1.2.7.3 PRETHERAPEUTIC EVALUATION IN CEREBRAL VASCULAR INSUFFICIENCY . . . . . . . . . . . . . 99 1.2.7.4 MANAGEMENT OF POSTERIOR CIRCULATION INSUFFICIENCY . . . 104 1.2.7.5 BASILAR THROMBOSIS . . . . . . . . . . . . . . . . . . . . . 110 1.2.7.6 TAKAYASUS ARTERITIS . . . . . . . . . . . . . . . . . . . . . 115 1.2.8 CEREBRAL ANGIOPLASTY . . . . . . . . . . . . . . . . . . . . 116 1.2.8.1 VASOSPASM . . . . . . . . . . . . . . . . . . . . . . . . . . 117 1.3 VENOUS OCCLUSIVE DISEASE . . . . . . . . . . . . . . . . . . 135 1.3.1 ETIOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 1.3.2 INCIDENCE . . . . . . . . . . . . . . . . . . . . . . . . . . . 136 1.3.3 CLINICAL PRESENTATION AND NATURAL HISTORY . . . . . . . . 137 1.3.4 IMAGING . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 1.3.5 TREATMENT . . . . . . . . . . . . . . . . . . . . . . . . . . 143 APPENDIX . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 VIII CONTENTS OF VOLUMES 2.1 AND 2.2 2 DURAL AND BONY TUMORS . . . . . . . . . . . . . . . . . 153 2.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 154 2.2 MENINGIOMAS . . . . . . . . . . . . . . . . . . . . . . . . 154 2.2.1 EPIDEMIOLOGY . . . . . . . . . . . . . . . . . . . . . . . . 154 2.2.1.1 ORIGIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 2.2.1.2 INCIDENCE . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 2.2.1.3 ASSOCIATION OF MENINGIOMAS WITH OTHER TUMORS . . . . 155 2.2.1.4 SEX HORMONE RECEPTORS IN MENINGIOMAS . . . . . . . . . 156 2.2.1.5 CHROMOSOMAL PATTERNS IN MENINGIOMAS . . . . . . . . . 156 2.2.1.6 MENINGIOMAS IN CHILDREN . . . . . . . . . . . . . . . . . 156 2.2.1.7 FAMILIAL OCCURRENCE . . . . . . . . . . . . . . . . . . . . . 157 2.2.1.8 MENINGIOMA INCIDENCE, PREVALENCE, AND MORTALITY . . . . 157 2.2.1.9 ETIOLOGY OF HUMAN MENINGIOMAS . . . . . . . . . . . . . 157 2.2.1.10 ONCOGENIC VIRUSES . . . . . . . . . . . . . . . . . . . . . 158 2.2.2 PATHOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . 161 2.2.2.1 GROWTH AND SPREAD . . . . . . . . . . . . . . . . . . . . . 162 2.2.2.2 MALIGNANT MENINGIOMA . . . . . . . . . . . . . . . . . . . 162 2.2.2.3 ANGIOBLASTIC MENINGIOMA AND/OR HEMANGIOPERICYTOMA 165 2.2.2.4 MENINGIOANGIOMATOSIS . . . . . . . . . . . . . . . . . . . 166 2.2.2.5 MENINGEAL MENINGIOMATOSIS . . . . . . . . . . . . . . . . 166 2.2.3 CLINICAL PRESENTATION . . . . . . . . . . . . . . . . . . . . 166 2.2.3.1 SITES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169 2.2.3.2 EPIDURAL MENINGIOMAS . . . . . . . . . . . . . . . . . . . 177 2.2.3.3 MENINGIOMAS OF THE ORBIT . . . . . . . . . . . . . . . . . 177 2.2.3.4 MENINGIOMAS INVOLVING THE CAVERNOUS SINUS . . . . . . . 178 2.2.3.5 MENINGIOMAS IN OTHER UNUSUAL SITES . . . . . . . . . . . 179 2.2.3.6 INTRACRANIAL VASCULAR INVOLVEMENT . . . . . . . . . . . . . 179 2.2.3.7 PERITUMORAL EDEMA IN MENINGIOMAS . . . . . . . . . . . 181 2.2.4 PRETHERAPEUTIC EVALUATION . . . . . . . . . . . . . . . . . 181 2.2.4.1 CT SCANNING IN MENINGIOMAS . . . . . . . . . . . . . . . 181 2.2.4.2 MRI SCANNING . . . . . . . . . . . . . . . . . . . . . . . . 182 2.2.4.3 ANGIOGRAPHIC INVESTIGATION . . . . . . . . . . . . . . . . 184 2.2.4.4 DIFFERENTIAL DIAGNOSIS . . . . . . . . . . . . . . . . . . . . 187 2.2.5 THERAPEUTIC STRATEGY AND CLINICAL OBJECTIVES . . . . . . . 187 2.2.6 TECHNICAL ASPECTS OF EMBOLIZATION . . . . . . . . . . . . 189 2.2.7 SPECIAL CONSIDERATIONS IN MENINGIOMA EMBOLIZATION . . 192 2.2.7.1 EXTRACRANIAL TUMOR EXTENSION . . . . . . . . . . . . . . . 192 2.2.7.2 RECURRENT MENINGIOMAS . . . . . . . . . . . . . . . . . . 192 2.2.7.3 INTERNAL CAROTID SUPPLY TO RECURRENT OR MALIGNANT MENINGIOMAS AFTER RADIATION THERAPY HAS FAILED . . . . 194 2.2.7.4 PIAL SUPPLY . . . . . . . . . . . . . . . . . . . . . . . . . . 194 2.2.7.5 PRE- AND POSTEMBOLIZATION MEDICAL MANAGEMENT . . . . 194 2.2.7.6 TIME OF OPERATION . . . . . . . . . . . . . . . . . . . . . . 196 2.2.7.7 COMPLICATIONS OF EMBOLIZATION . . . . . . . . . . . . . . 196 2.3 OTHER BONY AND DURAL TUMORS . . . . . . . . . . . . . . . 198 2.3.1 CEREBRAL TUMORS . . . . . . . . . . . . . . . . . . . . . . . 198 2.3.2 NEURINOMAS . . . . . . . . . . . . . . . . . . . . . . . . . 199 2.3.3 ESTHESIONEUROBLASTOMAS . . . . . . . . . . . . . . . . . . 199 CONTENTS OF VOLUMES 2.1 AND 2.2 IX 3 NASOPHARYNGEAL TUMORS . . . . . . . . . . . . . . . . 201 3.1 JUVENILE ANGIOFIBROMAS . . . . . . . . . . . . . . . . . . 201 3.1.1 MACROSCOPIC PATHOLOGY . . . . . . . . . . . . . . . . . . . 201 3.1.2 MICROSCOPIC PATHOLOGY . . . . . . . . . . . . . . . . . . . 204 3.1.3 EPIDEMIOLOGY . . . . . . . . . . . . . . . . . . . . . . . . 205 3.1.4 PATHOPHYSIOLOGY . . . . . . . . . . . . . . . . . . . . . . . 206 3.1.4.1 JUVENILE ANGIOFIBROMAS AND SEX HORMONES . . . . . . . 206 3.1.4.2 PHYSIOLOGY AND THE NASAL MUCOSA . . . . . . . . . . . . . 206 3.1.4.3 HORMONES AND THE VASCULAR SYSTEM . . . . . . . . . . . . 207 3.1.4.4 GLOBAL HYPOTHESIS FOR THE DEVELOPMENT OF JUVENILE ANGIOFIBROMAS . . . . . . . . . . . . . . . . . 207 3.1.5 CLINICAL FINDINGS . . . . . . . . . . . . . . . . . . . . . . 210 3.1.6 NATURAL HISTORY . . . . . . . . . . . . . . . . . . . . . . . 211 3.1.7 PRETHERAPEUTIC EVALUATION . . . . . . . . . . . . . . . . . 211 3.1.7.1 COMPUTED TOMOGRAPHY . . . . . . . . . . . . . . . . . . . 211 3.1.7.2 MAGNETIC RESONANCE IMAGING . . . . . . . . . . . . . . . 211 3.1.7.3 ANGIOGRAPHY . . . . . . . . . . . . . . . . . . . . . . . . . 211 3.1.8 THERAPEUTIC GOALS . . . . . . . . . . . . . . . . . . . . . . 214 3.1.8.1 RADIATION THERAPY . . . . . . . . . . . . . . . . . . . . . 221 3.1.9 TECHNICAL ASPECTS OF EMBOLIZATION . . . . . . . . . . . . 221 3.1.10 TUMOR RECURRENCE . . . . . . . . . . . . . . . . . . . . . 223 3.2 OTHER NASOPHARYNGEAL TUMORS . . . . . . . . . . . . . . 224 3.3 CONCLUSION . . . . . . . . . . . . . . . . . . . . . . . . . . 226 4 PARAGANGLIOMAS . . . . . . . . . . . . . . . . . . . . . . 227 4.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 227 4.2 EMBRYOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . 228 4.3 EPIDEMIOLOGY . . . . . . . . . . . . . . . . . . . . . . . . 230 4.4 PATHOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . 232 4.4.1 VASCULAR ARCHITECTURE . . . . . . . . . . . . . . . . . . . . 233 4.5 NATURAL HISTORY . . . . . . . . . . . . . . . . . . . . . . . 235 4.6 CLINICAL ASPECTS . . . . . . . . . . . . . . . . . . . . . . . 236 4.6.1 TYMPANIC PARAGANGLIOMAS . . . . . . . . . . . . . . . . . 236 4.6.2 JUGULAR PARAGANGLIOMAS . . . . . . . . . . . . . . . . . . 238 4.6.3 CERVICAL PARAGANGLIOMAS . . . . . . . . . . . . . . . . . . 238 4.6.4 PARAGANGLIOMAS IN OTHER LOCATIONS . . . . . . . . . . . . 244 4.6.5 SECRETORY PARAGANGLIOMAS . . . . . . . . . . . . . . . . . 245 4.6.6 ASSOCIATED LESIONS . . . . . . . . . . . . . . . . . . . . . 246 4.7 DIFFERENTIAL DIAGNOSIS . . . . . . . . . . . . . . . . . . . 246 4.8 PRETHERAPEUTIC EVALUATION . . . . . . . . . . . . . . . . . 250 4.8.1 ANGIOGRAPHIC PROTOCOL . . . . . . . . . . . . . . . . . . . 252 4.8.2 TEMPORAL PARAGANGLIOMAS: SPECIFIC FEATURES . . . . . . . 252 4.8.3 CERVICAL PARAGANGLIOMAS: SPECIFIC FEATURES . . . . . . . . 257 4.9 THERAPEUTIC STRATEGIES . . . . . . . . . . . . . . . . . . . 260 4.10 TECHNICAL ASPECTS OF EMBOLIZATION . . . . . . . . . . . . 261 4.11 COMPLICATIONS OF EMBOLIZATION OF PARAGANGLIOMAS . . . 264 X CONTENTS OF VOLUMES 2.1 AND 2.2 5 OTHER HEAD AND NECK TUMORS . . . . . . . . . . . . . 265 5.1 THYROLARYNGEAL TUMORS . . . . . . . . . . . . . . . . . . 265 5.2 CRANIOFACIAL TUMORS . . . . . . . . . . . . . . . . . . . . 270 6 TRAUMATIC ARTERIOVENOUS FISTULAE . . . . . . . . . . 277 6.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 277 6.2 TRAUMATIC CAROTID CAVERNOUS FISTULAE . . . . . . . . . . 279 6.2.1 ETIOLOGY AND EPIDEMIOLOGY . . . . . . . . . . . . . . . . . 279 6.2.2 CLINICAL ASPECTS OF TRAUMATIC CAROTID CAVERNOUS FISTULAE 285 6.2.2.1 OPHTHALMOLOGICAL SYMPTOMS . . . . . . . . . . . . . . . 293 6.2.2.2 CORNEAL ULCERATIONS AND/OR INFECTIONS AND SECONDARY GLAUCOMA . . . . . . . . . . . . . . . . . . 293 6.2.2.3 DIPLOPIA . . . . . . . . . . . . . . . . . . . . . . . . . . . 298 6.2.2.4 CRANIAL NERVE INVOLVEMENT IN TRAUMATIC CAROTID CAVERNOUS FISTULAE . . . . . . . . . 298 6.2.2.5 BRUIT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300 6.2.2.6 ARTERIAL STEAL . . . . . . . . . . . . . . . . . . . . . . . . . 300 6.2.2.7 HEMISPHERIC ARTERIAL INSUFFICIENCY . . . . . . . . . . . . 300 6.2.2.8 ASSOCIATED TRAUMATIC LESIONS . . . . . . . . . . . . . . . 302 6.2.3 PRETHERAPEUTIC EVALUATION . . . . . . . . . . . . . . . . . 306 6.2.3.1 LOCATION OF THE FISTULA . . . . . . . . . . . . . . . . . . . 308 6.2.3.2 VENOUS DRAINAGE OF THE FISTULA . . . . . . . . . . . . . . . 314 6.2.4 THERAPEUTIC OBJECTIVES AND STRATEGY . . . . . . . . . . . 321 6.2.4.1 EMBOLIZATION . . . . . . . . . . . . . . . . . . . . . . . . 321 6.2.4.2 EMERGENCY TREATMENT . . . . . . . . . . . . . . . . . . . 322 6.2.4.3 SURGICAL APPROACH TO CAROTID CAVERNOUS FISTULAE . . . . 324 6.2.4.4 CONSERVATIVE TREATMENT OF TRAUMATIC CAROTID CAVERNOUS FISTULAE . . . . . . . . . 325 6.2.5 TECHNICAL ASPECTS OF EMBOLIZATION . . . . . . . . . . . . 325 6.2.5.1 BALLOON SELECTION . . . . . . . . . . . . . . . . . . . . . . 325 6.2.5.2 MANUAL COMPRESSION . . . . . . . . . . . . . . . . . . . . 332 6.2.5.3 THE USE OF NBCA IN THE MANAGEMENT OF CAROTID CAVERNOUS FISTULAE . . . . . . . . . . . . . . . 332 6.2.6 POSTEMBOLIZATION CARE . . . . . . . . . . . . . . . . . . . 333 6.3 OTHER TRAUMATIC ARTERIOVENOUS FISTULAE . . . . . . . . . 334 6.3.1 EXTRACAVERNOUS ARTERIOVENOUS FISTULAE . . . . . . . . . . 334 6.3.2 VERTEBRAL ARTERIOVENOUS FISTULAE . . . . . . . . . . . . . 338 6.3.3 COMMON CAROTID FISTULAE . . . . . . . . . . . . . . . . . 342 6.3.4 EXTERNAL CAROTID FISTULAE . . . . . . . . . . . . . . . . . . 342 6.3.5 MALIGNANT FISTULAE . . . . . . . . . . . . . . . . . . . . . 354 6.3.6 OTHER EPISTAXIS . . . . . . . . . . . . . . . . . . . . . . . 354 6.3.6.1 COAGULOPATHY . . . . . . . . . . . . . . . . . . . . . . . . 357 6.3.6.2 SPONTANEOUS EPISTAXIS . . . . . . . . . . . . . . . . . . . 357 6.3.6.3 TUMORAL EPISTAXIS . . . . . . . . . . . . . . . . . . . . . . 357 6.3.6.4 BIOPSY . . . . . . . . . . . . . . . . . . . . . . . . . . . . 359 6.3.6.5 TRAUMATIC EPISTAXIS . . . . . . . . . . . . . . . . . . . . . 362 CONTENTS OF VOLUMES 2.1 AND 2.2 XI 7 ANEURYSMAL VASCULOPATHIES . . . . . . . . . . . . . . 365 7.1 FROM ANEURYSM TO ANEURYSMAL VASCULOPATHIES . . . . . 366 7.1.1 GENERAL PERSPECTIVES . . . . . . . . . . . . . . . . . . . . 366 7.1.1.1 MEDICAL CHALLENGE . . . . . . . . . . . . . . . . . . . . . . 367 7.1.1.2 DECISION-MAKING CHALLENGE IN PATIENTS WITH UNRUPTURED ANEURYSMS . . . . . . . . . . . . . . . . 370 7.1.1.3 ETHICAL CHALLENGE . . . . . . . . . . . . . . . . . . . . . . 370 7.1.1.4 ACADEMIC AND NOSOLOGICAL CHALLENGES . . . . . . . . . . 371 7.1.2 PHYSIOPATHOGENESIS AND RISKS . . . . . . . . . . . . . . . 371 7.1.2.1 CLASSIFICATION . . . . . . . . . . . . . . . . . . . . . . . . 374 7.1.3 SEGMENTAL VULNERABILITY . . . . . . . . . . . . . . . . . . 375 7.1.3.1 EMBRYOLOGICAL ORIGIN . . . . . . . . . . . . . . . . . . . . 377 7.1.3.2 AGE OF ANEURYSMS . . . . . . . . . . . . . . . . . . . . . . 380 7.2 EXTRADURAL ANEURYSMS . . . . . . . . . . . . . . . . . . . 382 7.2.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 382 7.2.2 EXTRADURAL INTERNAL CAROTID ARTERY ANEURYSMS . . . . . 382 7.2.2.1 CERVICAL INTERNAL CAROTID ANEURYSMS . . . . . . . . . . . 384 7.2.2.2 ACUTE SPONTANEOUS DISSECTION OF THE CAROTID ARTERY . . 394 7.2.2.3 PETROUS INTERNAL CAROTID ARTERY ANEURYSMS . . . . . . . 399 7.2.2.4 ANEURYSMS OF THE CAVERNOUS SEGMENT OF THE INTERNAL CAROTID ARTERY . . . . . . . . . . . . . . . 401 7.2.2.5 CERVICAL FIBROMUSCULAR DYSPLASIA . . . . . . . . . . . . . 415 7.2.3 INTERNAL CAROTID ARTERY OCCLUSION IN EXTRADURAL INTERNAL CAROTID ARTERY ANEURYSMS . . . . 417 7.2.3.1 TOLERANCE TO CAROTID OCCLUSION . . . . . . . . . . . . . . 418 7.2.3.2 POSTEMBOLIZATION CARE . . . . . . . . . . . . . . . . . . . 420 7.2.4 EXTRADURAL VERTEBRAL ANEURYSMS . . . . . . . . . . . . . . 420 7.2.5 ANEURYSMS OF THE EXTERNAL CAROTID ARTERY . . . . . . . . 425 7.3 INTRADURAL ANEURYSMS . . . . . . . . . . . . . . . . . . . 431 7.3.1 SACCULAR ARTERIAL ANEURYSMS AND ASSOCIATED DISEASES . . 431 7.3.1.1 POLYCYSTIC KIDNEY DISEASE . . . . . . . . . . . . . . . . . 431 7.3.1.2 EHLERSDANLOS SYNDROME . . . . . . . . . . . . . . . . . . 434 7.3.1.3 NEUROFIBROMATOSIS TYPE 1 . . . . . . . . . . . . . . . . . 435 7.3.1.4 BOURNEVILLE DISEASE . . . . . . . . . . . . . . . . . . . . . 436 7.3.1.5 FIBROMUSCULAR DYSPLASIA . . . . . . . . . . . . . . . . . . 438 7.3.2 SACCULAR ARTERIAL ANEURYSMS WITHOUT DIAGNOSED ASSOCIATED DISEASES . . . . . . . . . 438 7.3.2.1 NONSYNDROMIC FAMILIAL ARTERIAL ANEURYSMS . . . . . . . 438 7.3.2.2 MULTIPLE SACCULAR ARTERIAL ANEURYSMS . . . . . . . . . . . 440 7.3.2.3 ARTERIAL ANATOMY, SINGLE, MIRROR, AND TWIN SACCULAR ARTERIAL ANEURYSMS . . . . . . . . . . 442 7.4 INTRADURAL ARTERY DISSECTIONS . . . . . . . . . . . . . . . 454 7.5 INTRADURAL GIANT SACCULAR AND NONSACCULAR ARTERIAL ANEURYSMS . . . . . . . . . . . 478 7.5.1 GENERAL REMARKS . . . . . . . . . . . . . . . . . . . . . . 478 7.5.2 GIANT INTRACRANIAL ANEURYSMS WITH THROMBOSIS . . . . . 486 7.5.3 NONSACCULAR GIANT ARTERIAL ANEURYSMS . . . . . . . . . . 497 7.5.3.1 MEGADOLICHO ARTERIES AND SERPENTINE ARTERIAL ANEURYSMS 498 XII CONTENTS OF VOLUMES 2.1 AND 2.2 7.5.4 MULTIPLE GIANT ARTERIAL ANEURYSMS AND MIRROR GIANT ARTERIAL ANEURYSMS . . . . . . . . . . . 500 7.6 INFECTIOUS, IMMUNE, AND INFLAMMATORY INTRADURAL ANEURYSMS . . . . . . . . 502 7.6.1 INFECTIOUS ARTERIAL ANEURYSMS . . . . . . . . . . . . . . . 502 7.6.2 INTRADURAL FUSIFORM ANEURYSMS IN PATIENTS WITH IMMUNE DEFICIENCIES . . . . . . . . . . . . . . . . . 509 7.6.3 INFLAMMATORY DISEASES AND ARTERIAL ANEURYSMS . . . . . 513 7.7 FLOW-RELATED ARTERIAL ANEURYSMS AND OTHER ANEURYSMAL VASCULOPATHIES . . . . . . . . . . 514 7.7.1 INTRADURAL TRAUMATIC ARTERIAL ANEURYSMS . . . . . . . . 518 7.7.2 ARTERIAL ANEURYSMS ASSOCIATED WITH PROLIFERATIVE DISEASES 523 7.7.3 ARTERIAL ANEURYSMS WITH CONGENITAL HEART DISORDERS AND COARCTATION OF THE AORTA . . . . . . . . . . . . . . . . 524 7.8 THERAPEUTIC MANAGEMENT . . . . . . . . . . . . . . . . . 527 7.8.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 527 7.8.2 METHOD . . . . . . . . . . . . . . . . . . . . . . . . . . . . 532 7.8.3 RESULTS OF THE ENDOVASCULAR APPROACH . . . . . . . . . . 538 7.8.4 MANAGEMENT OF MULTIPLE ARTERIAL ANEURYSMS . . . . . . 549 7.8.5 MANAGEMENT OF GIANT ARTERIAL ANEURYSMS . . . . . . . . 560 8 DURAL ARTERIOVENOUS SHUNTS . . . . . . . . . . . . . . 565 8.1 HISTORICAL REVIEW . . . . . . . . . . . . . . . . . . . . . . 566 8.2 PATHOPHYSIOLOGY . . . . . . . . . . . . . . . . . . . . . . 570 8.3 THE OSTEODURALVENOUS COMPLEX . . . . . . . . . . . . . 571 8.3.1 DURAL VENOUS PLEXUS . . . . . . . . . . . . . . . . . . . . 572 8.3.2 TRANSDURAL VEINS . . . . . . . . . . . . . . . . . . . . . . . 573 8.4 CLASSIFICATION . . . . . . . . . . . . . . . . . . . . . . . . 575 8.5 CLINICAL PRESENTATION OF DURAL ARTERIOVENOUS SHUNTS . . 579 8.5.1 CRANIAL NERVE SYMPTOMS . . . . . . . . . . . . . . . . . . 580 8.5.2 TINNITUS AND OBJECTIVE BRUITS . . . . . . . . . . . . . . . 581 8.5.3 FOCAL NEUROLOGICAL DEFICITS . . . . . . . . . . . . . . . . . 582 8.5.4 GLOBAL NEUROLOGICAL DEFICITS . . . . . . . . . . . . . . . . 585 8.5.5 INTRACRANIAL HEMORRHAGE . . . . . . . . . . . . . . . . . . 587 8.5.6 HORMONAL INFLUENCES . . . . . . . . . . . . . . . . . . . . 587 8.5.7 ASSOCIATED CONDITIONS AND MULTIPLICITY . . . . . . . . . . 590 8.6 NATURAL HISTORY . . . . . . . . . . . . . . . . . . . . . . . 594 8.7 PROGRESSION OF SYMPTOMS . . . . . . . . . . . . . . . . . 596 8.8 PRETHERAPEUTIC EVALUATION . . . . . . . . . . . . . . . . . 598 8.9 THERAPEUTIC ASPECTS . . . . . . . . . . . . . . . . . . . . 598 8.9.1 INDICATIONS AND STRATEGY . . . . . . . . . . . . . . . . . . 598 8.9.2 TOPOGRAPHIC CONSIDERATIONS . . . . . . . . . . . . . . . . 602 8.9.3 TECHNICAL ASPECTS . . . . . . . . . . . . . . . . . . . . . . 605 8.9.4 TIMING OF EMBOLIZATION . . . . . . . . . . . . . . . . . . 605 8.9.5 RESULTS OF EMBOLIZATION . . . . . . . . . . . . . . . . . . . 606 CONTENTS OF VOLUMES 2.1 AND 2.2 XIII 8.9.6 COMPLICATIONS OF EMBOLIZATION . . . . . . . . . . . . . . 606 8.9.7 SURGERY . . . . . . . . . . . . . . . . . . . . . . . . . . . . 607 9 CEREBRAL VASCULAR MALFORMATIONS: INCIDENCE, CLASSIFICATION, ANGIOARCHITECTURE, AND SYMPTOMATOLOGY OF BRAIN ARTERIOVENOUS AND VENOUS MALFORMATIONS . . . . . . . . . . . . . . . 609 9.1 INCIDENCE OF CEREBRAL VASCULAR MALFORMATIONS . . . . . 609 9.2 PRINCIPLES OF CLASSIFICATION . . . . . . . . . . . . . . . . . 612 9.3 CLASSIFICATION OF CEREBRAL VASCULAR MALFORMATIONS . . . 614 9.3.1 BRAIN ARTERIOVENOUS SHUNTS . . . . . . . . . . . . . . . . 615 9.3.1.1 GENERAL APPEARANCE OF ARTERIOVENOUS SHUNTS . . . . . . 615 9.3.1.2 MULTIPLE BRAIN ARTERIOVENOUS MALFORMATIONS . . . . . . 618 9.3.1.3 TOPOGRAPHIC ANALYSIS OF BRAIN ARTERIOVENOUS MALFORMATIONS . . . . . . . . . . 625 9.3.1.4 ANGIOARCHITECTURE OF BRAIN ARTERIOVENOUS MALFORMATIONS 631 9.3.1.5 CLINICALANGIOARCHITECTURAL CORRELATION IN BRAIN ARTERIOVENOUS MALFORMATIONS . . . . . . . . . . 677 9.3.2 VENOUS VARIATIONS, MALFORMATIONS, AND MIXED LESIONS . . 684 9.3.2.1 DEVELOPMENTAL VENOUS ANOMALIES . . . . . . . . . . . . . 685 9.3.2.2 CAVERNOUS HEMANGIOMAS . . . . . . . . . . . . . . . . . 686 9.3.2.3 CEREBRAL CAVERNOUS MALFORMATIONS . . . . . . . . . . . . 687 9.3.2.4 OCCULT AND CRYPTIC MALFORMATIONS . . . . . . . . . . . . 690 9.3.2.5 STURGEWEBER SYNDROME . . . . . . . . . . . . . . . . . . 691 10 GOALS AND OBJECTIVES IN THE MANAGEMENT OF BRAIN ARTERIOVENOUS MALFORMATIONS . . . . . . . 695 10.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 695 10.2 INDICATIONS FOR TREATMENT OF BRAIN ARTERIOVENOUS MALFORMATIONS . . . . . . . . . . 696 10.2.1 AGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 700 10.2.2 SEX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 701 10.2.3 LIFESTYLE AND OCCUPATION . . . . . . . . . . . . . . . . . . 701 10.2.4 PRESENTING SYMPTOMS . . . . . . . . . . . . . . . . . . . . 703 10.2.4.1 HEMORRHAGE . . . . . . . . . . . . . . . . . . . . . . . . . 703 10.2.4.2 SEIZURES . . . . . . . . . . . . . . . . . . . . . . . . . . . 704 10.2.4.3 HEADACHES . . . . . . . . . . . . . . . . . . . . . . . . . . 704 10.2.4.4 NEUROLOGICAL DEFICITS . . . . . . . . . . . . . . . . . . . . 708 10.2.5 LOCATION, SIZE, AND DEEP VENOUS DRAINAGE . . . . . . . . 708 10.2.6 BRAIN ARTERIOVENOUS MALFORMATIONS AND ARTERIAL ANEURYSMS . . . . . . . . . . . . . . . . . . 708 10.3 THERAPEUTIC MANAGEMENT STRATEGY . . . . . . . . . . . . 715 10.4 EMBOLIZATION . . . . . . . . . . . . . . . . . . . . . . . . 716 10.4.1 PARTIAL (TARGETED) EMBOLIZATION . . . . . . . . . . . . . . 716 10.4.2 PARTIAL (PALLIATIVE) EMBOLIZATION . . . . . . . . . . . . . . 720 XIV CONTENTS OF VOLUMES 2.1 AND 2.2 10.4.3 CURATIVE EMBOLIZATION . . . . . . . . . . . . . . . . . . . 720 10.4.4 PREOPERATIVE EMBOLIZATION . . . . . . . . . . . . . . . . . 728 10.4.5 INTRAOPERATIVE EMBOLIZATION THERAPY . . . . . . . . . . . 729 10.4.6 EMBOLIZATION PRIOR TO RADIOSURGERY . . . . . . . . . . . . 729 10.4.6.1 SIZE REDUCTION . . . . . . . . . . . . . . . . . . . . . . . . 729 10.4.6.2 TARGETED EMBOLIZATION PRIOR TO STEREOTACTIC RADIOSURGERY 731 10.4.7 STAGING OF EMBOLIZATION . . . . . . . . . . . . . . . . . . 732 10.4.8 EMERGENCY EMBOLIZATION . . . . . . . . . . . . . . . . . . 732 10.4.9 CONTRAINDICATIONS FOR ENDOVASCULAR TREATMENT . . . . . 732 10.4.10 EMBOLIZATION RESULTS . . . . . . . . . . . . . . . . . . . . 734 11 SPINAL ARTERIOVENOUS MALFORMATIONS . . . . . . . . 737 11.1 PARACHORDAL ARTERIOVENOUS FISTULAE (EXTRACRANIAL, VERTEBRO-VERTEBRAL, PARASPINAL, EXTRADURAL, AND EXTRASPINAL ARTERIOVENOUS FISTULAE) . . . . . . . . . 738 11.1.1 GENERAL REMARKS . . . . . . . . . . . . . . . . . . . . . . 738 11.1.2 CRANIAL (BRANCHIAL) ARTERIOVENOUS SHUNTS . . . . . . . . 740 11.1.2.1 MAXILLARY ARTERY-TO-VEIN ARTERIOVENOUS FISTULAE (STAPEDIAL) 743 11.1.2.2 ASCENDING PHARYNGEAL-INTERNAL JUGULAR ARTERIOVENOUS FISTULAE (HYPOGLOSSAL) . . . . . . . . . . . . . . . . . . . 743 11.1.3 VERTEBRO-VERTEBRAL ARTERIOVENOUS FISTULAE (PROATLANTAL AND INTERSEGMENTAL) . . . . . . . . . . . . . 743 11.1.3.1 VERTEBRO-VERTEBRAL ARTERIOVENOUS FISTULAE . . . . . . . . 743 11.1.3.2 CLINICAL FINDINGS . . . . . . . . . . . . . . . . . . . . . . 751 11.1.4 PARASPINAL ARTERIOVENOUS FISTULAE . . . . . . . . . . . . . 752 11.2 SPINAL CORD VASCULAR LESIONS . . . . . . . . . . . . . . . 758 11.3 SPINAL CORD ARTERIOVENOUS MALFORMATIONS . . . . . . . . 760 11.3.1 CLASSIFICATION OF SPINAL CORD ARTERIOVENOUS MALFORMATIONS . . . . . . . . . . . . . . . . . . . . . . . . 767 11.3.2 ANGIOARCHITECTURE . . . . . . . . . . . . . . . . . . . . . . 775 11.3.2.1 ARTERIAL FEATURES . . . . . . . . . . . . . . . . . . . . . . . 775 11.3.2.2 DIRECT ARTERIOVENOUS FISTULAE . . . . . . . . . . . . . . . 784 11.3.2.3 HIGH-FLOW ANGIOPATHY . . . . . . . . . . . . . . . . . . . 786 11.3.2.4 ARTERIAL ANEURYSMS IN SPINAL CORD ARTERIOVENOUS MALFORMATIONS . . . . . . 786 11.3.2.5 DURAL SUPPLY . . . . . . . . . . . . . . . . . . . . . . . . . 794 11.3.2.6 NIDUS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 794 11.3.2.7 VEINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 802 11.3.3 PRETHERAPEUTIC EVALUATION . . . . . . . . . . . . . . . . . 808 11.3.3.1 CLINICAL ASSESSMENT . . . . . . . . . . . . . . . . . . . . . 808 11.3.3.2 NONINVASIVE IMAGING MODALITIES . . . . . . . . . . . . . . 808 11.3.3.3 ANGIOGRAPHY . . . . . . . . . . . . . . . . . . . . . . . . . 809 11.4 SPINAL CORD HEMODYNAMICS . . . . . . . . . . . . . . . . 810 11.4.1 PARTICULAR FORMS OF SPINAL CORD ARTERIOVENOUS MALFORMATIONS . . . . . . 811 11.4.1.1 SPINAL CORD INTRADURAL ARTERIOVENOUS FISTULAE . . . . . . 811 11.4.1.2 SPINAL ARTERIOVENOUS METAMERIC SYNDROMES . . . . . . . 813 CONTENTS OF VOLUMES 2.1 AND 2.2 XV 11.4.1.3 ASSOCIATED CEREBRAL AND SPINAL ARTERIOVENOUS MALFORMATIONS . . . . . . . . . 822 11.4.2 CLINICAL ASPECTS . . . . . . . . . . . . . . . . . . . . . . . 825 11.4.2.1 NATURAL HISTORY AND CLINICAL PRESENTATION . . . . . . . . 825 11.4.2.2 PROGNOSIS . . . . . . . . . . . . . . . . . . . . . . . . . . 830 11.4.2.3 AGGRAVATING FACTORS . . . . . . . . . . . . . . . . . . . . . 831 11.5 TREATMENT OF VASCULAR LESIONS . . . . . . . . . . . . . . . 833 11.5.1 INDICATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . 833 11.5.2 RESULTS OF SPINAL CORD ARTERIOVENOUS MALFORMATION EMBOLIZATION . . . . . . . . . . . . . . . . 839 11.5.3 COMPLICATIONS OF EMBOLIZATION . . . . . . . . . . . . . . 840 11.5.4 SURGERY IN THE TREATMENT OF SPINAL CORD ARTERIOVENOUS MALFORMATIONS . . . . . . 842 11.5.5 RADIOTHERAPY OF SPINAL CORD ARTERIOVENOUS MALFORMATIONS . . . . . . 843 11.5.6 MEDICAL THERAPY . . . . . . . . . . . . . . . . . . . . . . . 843 12 SPINAL DURAL ARTERIOVENOUS FISTULAE . . . . . . . . . 849 12.1 PATHOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . 850 12.1.1 MACROSCOPIC APPEARANCE . . . . . . . . . . . . . . . . . . 851 12.1.2 MICROSCOPIC APPEARANCE . . . . . . . . . . . . . . . . . . 853 12.1.3 PATHOLOGICAL CHANGES IN THE SPINAL CORD . . . . . . . . . 854 12.2 PATHOPHYSIOLOGY . . . . . . . . . . . . . . . . . . . . . . 854 12.3 CLINICAL PRESENTATION OF SPINAL DURAL ARTERIOVENOUS FISTULAE . . . . . . . . . . 858 12.4 IMAGING OF SPINAL DURAL ARTERIOVENOUS FISTULAE . . . . . 859 12.5 TREATMENT OF SPINAL DURAL ARTERIOVENOUS FISTULAE . . . 867 12.5.1 INDICATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . 867 12.5.2 EMBOLIZATION OF SPINAL DURAL ARTERIOVENOUS FISTULAE: TECHNIQUES . . . . . . . . . . . . . . . . . . . . . . . . . . 867 12.5.3 RESULTS OF SPINAL DURAL ARTERIOVENOUS FISTULA EMBOLIZATION 869 12.5.4 SURGERY FOR SPINAL DURAL ARTERIOVENOUS FISTULAE . . . . . 871 12.5.5 POSTOPERATIVE FOLLOW-UP . . . . . . . . . . . . . . . . . . 872 13 TUMORS OF THE SPINAL COLUMN AND SPINAL CORD . . 873 13.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 874 13.2 SPINAL ANGIOGRAPHY . . . . . . . . . . . . . . . . . . . . 874 13.3 ANGIOGRAPHIC PROTOCOL . . . . . . . . . . . . . . . . . . . 875 13.4 EMBOLIZATION . . . . . . . . . . . . . . . . . . . . . . . . 876 13.4.1 CERVICAL TUMORS . . . . . . . . . . . . . . . . . . . . . . . 877 13.4.2 THORACIC, LUMBAR, AND SACRAL TUMORS . . . . . . . . . . . 877 13.4.3 CHEMOEMBOLIZATION . . . . . . . . . . . . . . . . . . . . 877 13.4.4 INTRALESIONAL EMBOLIZATION . . . . . . . . . . . . . . . . . 880 13.5 BENIGN TUMORS . . . . . . . . . . . . . . . . . . . . . . . 883 13.5.1 VERTEBRAL HEMANGIOMAS . . . . . . . . . . . . . . . . . . 883 13.5.1.1 ASSOCIATED LESIONS . . . . . . . . . . . . . . . . . . . . . 888 XVI CONTENTS OF VOLUMES 2.1 AND 2.2 13.5.1.2 PRETHERAPEUTIC EVALUATION . . . . . . . . . . . . . . . . . 888 13.5.1.3 TREATMENT . . . . . . . . . . . . . . . . . . . . . . . . . . 889 13.5.1.4 EMBOLIZATION . . . . . . . . . . . . . . . . . . . . . . . . 889 13.5.2 ANEURYSMAL BONE CYSTS . . . . . . . . . . . . . . . . . . . 890 13.5.2.1 CLINICAL PRESENTATION . . . . . . . . . . . . . . . . . . . . 890 13.5.2.2 PRETHERAPEUTIC EVALUATION . . . . . . . . . . . . . . . . . 891 13.5.2.3 ANGIOGRAPHY . . . . . . . . . . . . . . . . . . . . . . . . . 891 13.5.2.4 DIFFERENTIAL DIAGNOSIS . . . . . . . . . . . . . . . . . . . . 891 13.5.2.5 PATHOGENESIS . . . . . . . . . . . . . . . . . . . . . . . . . 892 13.5.3 OTHER BENIGN VASCULAR TUMORS . . . . . . . . . . . . . . 893 13.5.4 GIANT CELL TUMORS . . . . . . . . . . . . . . . . . . . . . . 893 13.5.4.1 PATHOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . 893 13.5.4.2 CLINICAL PRESENTATION . . . . . . . . . . . . . . . . . . . . 893 13.5.4.3 RADIOGRAPHIC FINDINGS . . . . . . . . . . . . . . . . . . . 893 13.5.4.4 EMBOLIZATION . . . . . . . . . . . . . . . . . . . . . . . . 895 13.6 MALIGNANT TUMORS . . . . . . . . . . . . . . . . . . . . . 895 13.6.1 PRETHERAPEUTIC EVALUATION . . . . . . . . . . . . . . . . . 897 13.6.2 EMBOLIZATION . . . . . . . . . . . . . . . . . . . . . . . . 897 13.7 SPINAL CORD TUMORS . . . . . . . . . . . . . . . . . . . . . 898 13.7.1 HEMANGIOBLASTOMAS . . . . . . . . . . . . . . . . . . . . 898 13.7.1.1 HISTOPATHOLOGY . . . . . . . . . . . . . . . . . . . . . . . 898 13.7.1.2 VON HIPPEL-LINDAU DISEASE . . . . . . . . . . . . . . . . . 900 13.7.2 PRETHERAPEUTIC EVALUATION OF HEMANGIOBLASTOMAS . . . . 904 13.7.2.1 COMPUTERIZED TOMOGRAPHY . . . . . . . . . . . . . . . . 904 13.7.2.2 MAGNETIC RESONANCE IMAGING . . . . . . . . . . . . . . . 904 13.7.2.3 ANGIOGRAPHY . . . . . . . . . . . . . . . . . . . . . . . . . 905 13.7.3 FEEDING ARTERIES . . . . . . . . . . . . . . . . . . . . . . . 906 13.7.4 DRAINING VEINS . . . . . . . . . . . . . . . . . . . . . . . . 906 13.7.5 TREATMENT AND EMBOLIZATION . . . . . . . . . . . . . . . . 906 13.8 OTHER INTRADURAL VASCULAR TUMORS AND SPINAL HEMORRHAGE 909 14 TECHNICAL ASPECTS OF SURGICAL NEUROANGIOGRAPHY . . 913 14.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 915 14.2 PATIENT PREPARATION . . . . . . . . . . . . . . . . . . . . 917 14.2.1 ANGIOGRAPHIC EQUIPMENT . . . . . . . . . . . . . . . . . . 917 14.2.2 PREOPERATIVE MEDICATIONS . . . . . . . . . . . . . . . . . . 917 14.2.2.1 CORTICOSTEROIDS . . . . . . . . . . . . . . . . . . . . . . . 918 14.2.2.2 ANTICONVULSANTS . . . . . . . . . . . . . . . . . . . . . . . 918 14.2.2.3 ANTIPLATELETS . . . . . . . . . . . . . . . . . . . . . . . . . 919 14.3 ANESTHESIA . . . . . . . . . . . . . . . . . . . . . . . . . . 919 14.3.1 GENERAL ANESTHESIA . . . . . . . . . . . . . . . . . . . . . 919 14.3.2 NEUROLEPTIC ANALGESIA . . . . . . . . . . . . . . . . . . . . 920 14.3.3 TRACHEOSTOMY . . . . . . . . . . . . . . . . . . . . . . . . 920 14.3.4 LOCAL ANESTHESIA . . . . . . . . . . . . . . . . . . . . . . . 920 14.3.5 INPUT AND OUTPUT MONITORING . . . . . . . . . . . . . . . 921 14.3.6 ARTERIAL LINE AND VENOUS LINE . . . . . . . . . . . . . . . 921 14.3.7 HEPARINIZATION . . . . . . . . . . . . . . . . . . . . . . . 923 CONTENTS OF VOLUMES 2.1 AND 2.2 XVII 14.3.8 ACTIVATED COAGULATION TIME MONITORING . . . . . . . . . 924 14.3.9 FUNCTIONAL EVALUATION . . . . . . . . . . . . . . . . . . . . 925 14.3.9.1 SOMATOSENSORY- AND MOTOR-EVOKED POTENTIALS . . . . . . 925 14.3.9.2 FACIAL NERVE MONITORING . . . . . . . . . . . . . . . . . . 925 14.3.10 PHARMACOLOGICAL TESTING . . . . . . . . . . . . . . . . . . 926 14.3.10.1 AMOBARBITAL . . . . . . . . . . . . . . . . . . . . . . . . . 926 14.3.10.2 XYLOCAINE . . . . . . . . . . . . . . . . . . . . . . . . . . . 929 14.3.10.3 MUCOCUTANEOUS TERRITORIES . . . . . . . . . . . . . . . . . 929 14.4 ARTERIOTOMY SITES . . . . . . . . . . . . . . . . . . . . . . 929 14.4.1 INTRODUCER SHEATH . . . . . . . . . . . . . . . . . . . . . . 930 14.4.2 CLOSURE DEVICES . . . . . . . . . . . . . . . . . . . . . . . 932 14.4.2.1 HEMOSTASIS OF THE ARTERIOTOMY SITE CLOSURE . . . . . . . 932 14.4.2.2 INTERNAL CLOSURE DEVICES . . . . . . . . . . . . . . . . . . 932 14.5 CATHETERS AND DELIVERY SYSTEMS . . . . . . . . . . . . . . 933 14.5.1 GUIDING CATHETERS . . . . . . . . . . . . . . . . . . . . . . 933 14.5.2 MICROCATHETERS . . . . . . . . . . . . . . . . . . . . . . . . 934 14.5.3 BALLOON CATHETERS . . . . . . . . . . . . . . . . . . . . . . 942 14.5.3.1 TOLERANCE TESTING AND FLOW CONTROL . . . . . . . . . . . . 942 14.5.3.2 DETACHABLE BALLOONS . . . . . . . . . . . . . . . . . . . . 955 14.5.3.3 ANGIOPLASTY BALLOON CATHETERS . . . . . . . . . . . . . . . 958 14.5.3.4 BALLOON-MOUNTED STENTS . . . . . . . . . . . . . . . . . . 962 14.5.3.5 STENT DELIVERY CATHETERS . . . . . . . . . . . . . . . . . . 962 14.6 GUIDEWIRES . . . . . . . . . . . . . . . . . . . . . . . . . 965 14.6.1 MICROGUIDEWIRES . . . . . . . . . . . . . . . . . . . . . . 965 14.7 EMBOLIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . 969 14.7.1 PARTICULATE AGENTS . . . . . . . . . . . . . . . . . . . . . . 969 14.7.1.1 ABSORBABLE MATERIALS . . . . . . . . . . . . . . . . . . . . 970 14.7.1.2 NONABSORBABLE PARTICULATE MATERIALS . . . . . . . . . . . 974 14.7.1.3 FLOW-DIRECTED PARTICLE EMBOLIZATION . . . . . . . . . . . 980 14.7.1.4 GENERAL PRINCIPLES IN ANEURYSM TREATMENT . . . . . . . . 1020 14.7.1.5 GENERAL PRINCIPLES OF COIL TREATMENT OF ANEURYSMS . . . 1030 14.7.2 NONABSORBABLE LIQUID AGENTS . . . . . . . . . . . . . . . 1059 14.7.2.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 1059 14.7.2.2 ACRYLATES . . . . . . . . . . . . . . . . . . . . . . . . . . . 1059 14.7.2.3 SCLEROTHERAPY . . . . . . . . . . . . . . . . . . . . . . . . 1074 14.7.2.4 ETHYLENE-VINYL ALCOHOL COPOLYMER . . . . . . . . . . . . 1083 14.7.3 EVOH IN BRAIN ARTERIOVENOUS MALFORMATION TREATMENT 1089 14.8 OPACIFYING AGENTS . . . . . . . . . . . . . . . . . . . . . . 1092 14.8.1 TANTALUM POWDER . . . . . . . . . . . . . . . . . . . . . . 1092 14.8.2 IOPHENDYLATE (PANTOPAQUE) . . . . . . . . . . . . . . . . . 1093 14.8.3 IODIZED OIL . . . . . . . . . . . . . . . . . . . . . . . . . . 1093 14.8.4 ETHIODOL . . . . . . . . . . . . . . . . . . . . . . . . . . . 1093 14.9 CHEMOTHERAPY . . . . . . . . . . . . . . . . . . . . . . . . 1093 14.9.1 INTRA-ARTERIAL INFUSIONS . . . . . . . . . . . . . . . . . . . 1093 14.9.2 TIME-RELEASED MICROCAPSULES (CHEMOEMBOLIZATION) . . 1094 14.10 MISCELLANEOUS . . . . . . . . . . . . . . . . . . . . . . . . 1094 14.10.1 SYRINGES . . . . . . . . . . . . . . . . . . . . . . . . . . . 1094 XVIII CONTENTS OF VOLUMES 2.1 AND 2.2 14.10.2 STOPCOCKS AND Y-ADAPTERS . . . . . . . . . . . . . . . . . 1095 14.10.3 TRAY CONTAINERS . . . . . . . . . . . . . . . . . . . . . . . 1095 14.10.4 FLUSHING SOLUTIONS . . . . . . . . . . . . . . . . . . . . . . 1095 14.10.5 CORTICOSTEROIDS . . . . . . . . . . . . . . . . . . . . . . . 1096 14.10.6 NORMAL PHYSIOLOGY OF THE EXTERNAL CAROTID ARTERIES . . . 1096 14.11 FLOW CONTROL . . . . . . . . . . . . . . . . . . . . . . . . . 1097 14.11.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 1097 14.11.2 FLOW CONTROL IN THE CRANIOFACIAL AREA . . . . . . . . . . . 1097 14.11.2.1 PROTECTION OF AN ENDANGERED ANASTOMOSIS . . . . . . . . 1101 14.11.2.2 INTRALESIONAL FLOW CONTROL . . . . . . . . . . . . . . . . . 1101 14.11.2.3 OCCLUSIVE BALLOON FLOW REVERSAL . . . . . . . . . . . . . . 1102 14.11.2.4 FUNCTIONAL REARRANGEMENT OF THE SUPPLY TO A TERRITORY . 1104 14.11.2.5 SURGICAL FLOW CONTROL . . . . . . . . . . . . . . . . . . . . 1104 14.11.3 FLOW CONTROL IN THE MENINGEAL ARCADE AND DURAL SURFACES 1104 14.11.4 FLOW CONTROL IN THE CEREBRAL CIRCULATION . . . . . . . . . 1104 14.11.4.1 DISTAL CATHETERIZATION . . . . . . . . . . . . . . . . . . . . 1106 14.11.4.2 FLOW REVERSAL . . . . . . . . . . . . . . . . . . . . . . . . 1108 14.11.4.3 FLOW ARREST . . . . . . . . . . . . . . . . . . . . . . . . . . 1111 14.11.4.4 SYSTEMIC HYPOTENSION . . . . . . . . . . . . . . . . . . . 1111 14.11.4.5 CATHETER WITHDRAWAL . . . . . . . . . . . . . . . . . . . . 1111 14.11.5 SPINE AND SPINAL CORD . . . . . . . . . . . . . . . . . . . 1113 14.11.5.1 TECHNICAL ASPECTS OF ENDOVASCULAR TREATMENT IN THE SPINE AND SPINAL CORD . . . . . . . . . . . . . . . . . . . . . . . 1113 14.12 POSTEMBOLIZATION CARE . . . . . . . . . . . . . . . . . . . 1128 14.12.1 HEAD AND NECK . . . . . . . . . . . . . . . . . . . . . . . 1128 14.12.2 CEREBRAL ARTERIOVENOUS MALFORMATIONS . . . . . . . . . . 1128 14.12.3 INTRADURAL ANEURYSMS . . . . . . . . . . . . . . . . . . . 1128 14.12.4 SPINAL ARTERIOVENOUS MALFORMATIONS . . . . . . . . . . . 1129 14.13 COMPLICATIONS OF EMBOLIZATION . . . . . . . . . . . . . . 1129 14.13.1 COMPLICATIONS OF HEAD AND NECK EMBOLIZATION . . . . . 1129 14.13.1.1 NEUROLOGICAL DEFICIT . . . . . . . . . . . . . . . . . . . . . 1129 14.13.1.2 CRANIAL NERVE DEFICIT . . . . . . . . . . . . . . . . . . . . 1129 14.13.1.3 POSTOPERATIVE SWELLING . . . . . . . . . . . . . . . . . . . 1130 14.13.1.4 SKIN NECROSIS . . . . . . . . . . . . . . . . . . . . . . . . 1130 14.13.2 COMPLICATIONS OF CEREBRAL EMBOLIZATION . . . . . . . . . 1130 14.13.2.1 MEDICAL THERAPY FOR ACUTE ISCHEMIC STROKE . . . . . . . 1130 14.13.2.2 RECANALIZATION . . . . . . . . . . . . . . . . . . . . . . . . 1131 14.13.2.3 MICROCIRCULATION AGENTS . . . . . . . . . . . . . . . . . . 1132 14.13.2.4 ANTIPLATELETS . . . . . . . . . . . . . . . . . . . . . . . . . 1132 14.13.2.5 ANTICOAGULATION . . . . . . . . . . . . . . . . . . . . . . . 1132 14.13.2.6 BIORHEOLOGICAL FACTORS . . . . . . . . . . . . . . . . . . . 1133 14.13.2.7 ANTIEDEMA AND PHARMACOLOGICAL PROTECTION AGENTS . . . 1134 14.13.2.8 ADDITIONAL MEASURES . . . . . . . . . . . . . . . . . . . . 1135 14.13.3 HEMORRHAGE . . . . . . . . . . . . . . . . . . . . . . . . . 1135 14.13.3.1 GENERALITIES . . . . . . . . . . . . . . . . . . . . . . . . . 1135 14.13.3.2 BRAIN ARTERIOVENOUS MALFORMATION RUPTURE . . . . . . . 1137 14.13.3.3 ANEURYSM RUPTURE . . . . . . . . . . . . . . . . . . . . . 1141 14.13.3.4 ARTERIAL STENOSIS . . . . . . . . . . . . . . . . . . . . . . . 1143 14.13.3.5 VASOSPASM . . . . . . . . . . . . . . . . . . . . . . . . . . 1146 CONTENTS OF VOLUMES 2.1 AND 2.2 XIX 14.14 FOLLOW-UP . . . . . . . . . . . . . . . . . . . . . . . . . . 1146 14.15 COMBINED ENDOVASCULAR TREATMENTS . . . . . . . . . . . 1146 14.15.1 COMBINED ENDOVASCULAR TREATMENT IN ANEURYSM THERAPY . . . . . . . . . . . . . . . . . . . . 1147 14.15.2 COMBINED ENDOVASCULAR TREATMENT IN BRAIN ARTERIOVENOUS MALFORMATION THERAPY . . . . . . 1147 14.15.3 COMBINED ENDOVASCULAR TREATMENT IN OCCLUSIVE AND HEMORRHAGIC VASCULAR DISEASE . . . . . . . . . . . . 1147 14.16 TECHNIQUES OF CAROTID ANGIOPLASTY AND STENTING . . . . . 1152 14.16.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . 1152 14.16.2 HEMODYNAMIC DISTURBANCES DURING STENTING . . . . . . 1152 14.16.3 PREMEDICATION . . . . . . . . . . . . . . . . . . . . . . . . 1153 14.16.4 VASOACTIVE MEDICATIONS . . . . . . . . . . . . . . . . . . . 1154 14.16.5 INTERVENTION . . . . . . . . . . . . . . . . . . . . . . . . . 1154 14.16.6 PREDILATATION ANGIOPLASTY . . . . . . . . . . . . . . . . . . 1164 14.16.7 STENT SELECTION . . . . . . . . . . . . . . . . . . . . . . . . 1164 14.16.7.1 SELF-EXPANDABLE STENTS . . . . . . . . . . . . . . . . . . . 1169 14.16.7.2 NITINOL . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1169 14.16.7.3 BALLOON-EXPANDABLE STENTS . . . . . . . . . . . . . . . . . 1171 14.16.7.4 LOW-PROFILE BALLOON-EXPANDABLE STENTS . . . . . . . . . . 1171 14.16.7.5 GFX II . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1171 14.16.8 POSTDILATATION ANGIOPLASTY . . . . . . . . . . . . . . . . . 1173 14.16.8.1 DISTAL CEREBRAL PROTECTION . . . . . . . . . . . . . . . . . 1173 14.16.9 MECHANICAL REVASCULARIZATION OF TOTALLY OCCLUDED BRACHIOCEPHALIC VESSELS . . . . . . . 1176 14.16.10 COMPLICATIONS OF MECHANICAL REVASCULARIZATION . . . . . 1178 14.16.11 STENT RETRIEVAL . . . . . . . . . . . . . . . . . . . . . . . . 1179 REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1183 SUBJECT INDEX FOR VOLUMES 2.1 AND 2.2 . . . . . . . . . . . . . . 1259 MANUFACTURERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1271 XX CONTENTS OF VOLUMES 2.1 AND 2.2
any_adam_object	1
author	Lasjaunias, Pierre L. 1948- Berenstein, Alex 1947-
author_GND	(DE-588)111120705 (DE-588)111120713
author_facet	Lasjaunias, Pierre L. 1948- Berenstein, Alex 1947-
author_role	aut aut
author_sort	Lasjaunias, Pierre L. 1948-
author_variant	p l l pl pll a b ab
building	Verbundindex
bvnumber	BV017895965
ctrlnum	(OCoLC)634024995 (DE-599)BVBBV017895965
edition	2. ed.
format	Book
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institution	BVB
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spelling	Lasjaunias, Pierre L. 1948- Verfasser (DE-588)111120705 aut Surgical neuroangiography 2,2 Clinical and endovascular treatment aspects in adults : cerebral arteriovenous shunts ; spinal arteriovenous shunts ; spinal vascular tumors ; technical aspects of endovascular neurosurgery ; 155 tables P. Lasjaunias ; A. Berenstein ; K. G. ter Brugge 2. ed. Berlin [u.a.] Springer 2004 XXIV S., S. 566 - 1269 Ill. txt rdacontent n rdamedia nc rdacarrier Berenstein, Alex 1947- Verfasser (DE-588)111120713 aut Brugge, Karel G. ter Sonstige oth (DE-604)BV017978238 2,2 SWB Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=010733818&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis
spellingShingle	Lasjaunias, Pierre L. 1948- Berenstein, Alex 1947- Surgical neuroangiography
title	Surgical neuroangiography
title_auth	Surgical neuroangiography
title_exact_search	Surgical neuroangiography
title_full	Surgical neuroangiography 2,2 Clinical and endovascular treatment aspects in adults : cerebral arteriovenous shunts ; spinal arteriovenous shunts ; spinal vascular tumors ; technical aspects of endovascular neurosurgery ; 155 tables P. Lasjaunias ; A. Berenstein ; K. G. ter Brugge
title_fullStr	Surgical neuroangiography 2,2 Clinical and endovascular treatment aspects in adults : cerebral arteriovenous shunts ; spinal arteriovenous shunts ; spinal vascular tumors ; technical aspects of endovascular neurosurgery ; 155 tables P. Lasjaunias ; A. Berenstein ; K. G. ter Brugge
title_full_unstemmed	Surgical neuroangiography 2,2 Clinical and endovascular treatment aspects in adults : cerebral arteriovenous shunts ; spinal arteriovenous shunts ; spinal vascular tumors ; technical aspects of endovascular neurosurgery ; 155 tables P. Lasjaunias ; A. Berenstein ; K. G. ter Brugge
title_short	Surgical neuroangiography
title_sort	surgical neuroangiography clinical and endovascular treatment aspects in adults cerebral arteriovenous shunts spinal arteriovenous shunts spinal vascular tumors technical aspects of endovascular neurosurgery 155 tables
url	http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=010733818&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA
volume_link	(DE-604)BV017978238
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