Dural arteriovenous fistulas and the role of gamma knife stereotactic radiosurgery: the Stockholm experience.
Authors: Söderman M, Dodoo E, Karlsson B
Abstract
We review the clinical and radiological outcomes of patients with dural arteriovenous fistulae (DAVFs), treated with the Gamma Knife® (GK) in Stockholm. During the period 1972-2008, 73 consecutive patients were treated. Eight were excluded due to lack of follow-up. Thus, the material comprises 65 patients harboring 67 DAVFs subjected to 75 treatments with GK stereotactic radiosurgery (SRS). Fifty-four cases were subjected to upfront GK SRS while 13 followed failed surgery or embolization. Nine patients had been retreated with GK SRS. One was recent and wa...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Stereotactic radiosurgery guidelines for the management of patients with intracranial dural arteriovenous fistulas.
Authors: Niranjan A, Lunsford LD
Abstract
Treatment options for dural arteriovenous fistulas (DAVFs) have expanded with the application of stereotactic radiosurgery (SRS). Our objective was to provide guidelines about the use of SRS in symptomatic patients with imaging-identified DAVFs of the brain. The authors reviewed evidence-based medicine and clinical experience with radiosurgery for DAVFs of the brain and developed guidelines and provided a scientific foundation for patients and physicians. Major recommendations include the definition of DAVF patients suitable for various management strategies rangin...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Series Editor's Note. Gamma knife radiosurgery.
Authors: Lunsford LD
PMID: 23258528 [PubMed - indexed for MEDLINE] (Source: Progress in Neurological Surgery)
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Cerebral concussion: a historical perspective.
Authors: Maroon JC, Mathyssek C, Bost J
Abstract
No topic in sports has gathered more attention and publicity than the diagnosis, management, and long-term effects of cerebral concussion. The relevant history of concussion starts in 1905 when President Theodore Roosevelt drew attention to the football 'death harvest'. Soon after, rules started to change to reduce the amount and severity of head injuries in football. Up until 1980, the primary focus regarding concussions was to diagnose a potentially fatal intracranial hemorrhage. While aware of long-term consequences of concussions, the perception at the t...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Biomechanics of concussion.
This report provides an overview of the biomechanics associated with mild traumatic brain injury (TBI), also known as concussion. Specifically, the role of angular acceleration in modulating concussion onset and severity is highlighted. Studies conducted and published from the 1960s to the 1980s provided initial estimates for TBI tolerance due to high rate head rotation. However, injury levels in those studies were more severe than what is considered to be concussion in the contemporary environment. Therefore, this issue deserves additional attention to provide quantitative estimates for concussive tolerance due to head ro...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
The neurophysiology of concussion.
Authors: Hovda DA
Abstract
The following report reviews our current understanding of the neurobiological response to concussion which is often referred to as mild traumatic brain injury. The historical accomplishments to reveal the brain's response to this injury are discussed along with the neurochemical and metabolic cascade that results in an energy crisis. The massive ionic flux induced by cerebral concussion is discussed as it pertains to primarily potassium and calcium. The ensuing metabolic demands placed on cells exposed to this ionic flux is discussed as it relates to an injury-induced diaschisis....
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Chronic traumatic encephalopathy.
Authors: Omalu B
Abstract
Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative syndrome, which is caused by single, episodic, or repetitive blunt force impacts to the head and transfer of acceleration-deceleration forces to the brain. CTE presents clinically as a composite syndrome of mood disorders and behavioral and cognitive impairment, with or without sensorimotor impairment. Symptoms of CTE may begin with persistent symptoms of acute traumatic brain injury (TBI) following a documented episode of brain trauma or after a latent period that may range from days to weeks to months and ...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Cumulative effects of repetitive mild traumatic brain injury.
This report provides an up-to-date review of the clinical, pathological, and pathophysiological changes associated with repetitive mTBI, and their potential for cumulative effects in certain individuals.
PMID: 24923392 [PubMed - indexed for MEDLINE] (Source: Progress in Neurological Surgery)
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Understanding concussive injuries using investigational imaging methods.
Authors: Henry LC
Abstract
Concussions have long been understood to be an invisible injury. Indeed, conventional imaging techniques [computed tomography and magnetic resonance imaging (MRI)] are largely ineffective in elucidating concussive injuries. More advanced techniques are being used experimentally to help delineate the underlying pathophysiology of concussive injuries on metabolic as well as ultrastructural levels. The current report reviews the data from several of these techniques including functional MRI, single-photon emission computed tomography, positron emission tomography, diffusion tensor i...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Neurometabolic, electrophysiological, and imaging abnormalities.
This report summarizes recent data using neurophysiological and neuroimaging techniques to better understand the acute and chronic effects of sport-related concussions.
PMID: 24923394 [PubMed - indexed for MEDLINE] (Source: Progress in Neurological Surgery)
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Detection of white matter injury in concussion using high-definition fiber tractography.
Authors: Shin SS, Pathak S, Presson N, Bird W, Wagener L, Schneider W, Okonkwo DO, Fernandez-Miranda JC
Abstract
Over the last few decades, structural imaging techniques of the human brain have undergone significant strides. High resolution provided by recent developments in magnetic resonance imaging (MRI) allows improved detection of injured regions in patients with moderate-to-severe traumatic brain injury (TBI). In addition, diffusion imaging techniques such as diffusion tensor imaging (DTI) has gained much interest recently due to its possible utility in detecting structural integrity of white matter ...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Magnetoencephalography in the diagnosis of concussion.
Authors: Lee RR, Huang M
Abstract
Magnetoencephalography (MEG) is a biomedical technique which measures the magnetic fields emitted by the brain, generated by neuronal activity. Commercial whole-head MEG units have been available for about 15 years, but currently there are only about 20 such units operating in the USA. Here, we review the basic concepts of MEG and list some of the usual clinical indications: noninvasive localization of epileptic spikes and presurgical mapping of eloquent cortex. We then discuss using MEG to diagnose mild traumatic brain injury (mTBI; concussions). Injured brain tissues in ...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Evidence-based management of sport-related concussion.
Authors: McCrea M, Guskiewicz K
Abstract
Concussion is not only one of the most common injuries encountered by athletes participating in contact and collision sports, but also among the most complex injuries to manage in a sports medicine setting. Over the past two decades, we have made great progress in advancing the basic and clinical science of concussion. These advances have had enormous clinical translational value for developing evidence-based guidelines for management of concussion in sports. Applied clinical research has clarified the defining characteristics of sport-related concussion (SRC) that ...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
In-office management of sport-related concussion.
This report will outline the essential components of a successful concussion clinic, using the UPMC Sports Concussion Program as a case example of best practice. We will share several case studies illustrating the individualized and complex nature of this injury, as well as review important rehabilitation components.
PMID: 24923398 [PubMed - indexed for MEDLINE] (Source: Progress in Neurological Surgery)
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Treating prolonged symptoms of mild traumatic brain injury: neuropharmacology.
Authors: Lercher K, Camiolo Reddy C
Abstract
The clinical presentation of concussion can vary widely as patients experience any number of symptoms including headache, dizziness, cognitive symptoms of difficulty with concentration and memory, sleep dysregulation, and mood disturbances. The variability in clinical presentation underscores the importance of thorough history-taking to clearly understand the clinical picture and to allow individualization of the treatment plan. Most postconcussive symptoms are transient in nature and respond to conservative measures, including education of the patient and their...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
