The Experts below are selected from a list of 21 Experts worldwide ranked by ideXlab platform

Roberto Delfini - One of the best experts on this subject based on the ideXlab platform.

  • surgical treatment of pial Cerebellar arteriovenous fistulas with aneurysm of the main feeding artery
    Surgical Neurology, 2006
    Co-Authors: Emiliano Passacantilli, Angelo Pichierri, Giulio Guidetti, Antonio Santoro, Roberto Delfini
    Abstract:

    Abstract Background Intracranial pial arteriovenous fistulas (pAVFs) are rare vascular lesions only recently considered distinct from arteriovenous malformations. Conservative management was associated with a high mortality rate. The abnormality of the lesion arises from its high-flow nature. The authors present a case of a Cerebellar pAVF associated with aneurysms of the main feeding artery that was surgically treated. Case Description A 54-year-old woman was referred to us after an attack of severe headache and vomiting. Computerized tomography scan visualized a hematoma of the fourth ventricle. Digital subtraction angiography (DSA) revealed a Cerebellar pAVF mainly fed by the right posteroinferior Cerebellar artery (PICA) and with drainage into one of the superior Cerebellar Veins. The PICA presented a saccular aneurysm on its fourth segment and a fusiform dilatation on its third segment. The patient underwent surgical operation via a midline suboccipital craniotomy. The fusiform dilatation was wrapped and the saccular aneurysm was clipped. The most fistulous connections were closed. The draining vein at the level of torcular herophili was closed by application of a clip. Control DSA demonstrated exclusion of both the aneurysms and the fistula from the circulation. At 1-year follow-up, the patient was neurologically intact. Conclusions The association of a Cerebellar pAVF and an aneurysm is rare. Surgical treatment of multiple-channel arteriovenous fistulas by closure of venous varix should guarantee the exclusion from the circulation and avoid recruitment of new arterial connections and recurrence. Attention must be paid to normal venous channels draining into the varix.

  • Surgical treatment of pial Cerebellar arteriovenous fistulas with aneurysm of the main feeder artery
    'Elsevier BV', 2006
    Co-Authors: Passacantilli E, Pichierri A, Guidetti G, Santoro A, Roberto Delfini
    Abstract:

    BACKGROUND: Intracranial pial arteriovenous fistulas (pAVFs) are rare vascular lesions only recently considered distinct from arteriovenous malformations. Conservative management was associated with a high mortality rate. The abnormality of the lesion arises from its high-flow nature. The authors present a case of a Cerebellar pAVF associated with aneurysms of the main feeding artery that was surgically treated. CASE DESCRIPTION: A 54-year-old woman was referred to us after an attack of severe headache and vomiting. Computerized tomography scan visualized a hematoma of the fourth ventricle. Digital subtraction angiography (DSA) revealed a Cerebellar pAVF mainly fed by the right posteroinferior Cerebellar artery (PICA) and with drainage into one of the superior Cerebellar Veins. The PICA presented a saccular aneurysm on its fourth segment and a fusiform dilatation on its third segment. The patient underwent surgical operation via a midline suboccipital craniotomy. The fusiform dilatation was wrapped and the saccular aneurysm was clipped. The most fistulous connections were closed. The draining vein at the level of torcular herophili was closed by application of a clip. Control DSA demonstrated exclusion of both the aneurysms and the fistula from the circulation. At 1-year follow-up, the patient was neurologically intact. CONCLUSIONS: The association of a Cerebellar pAVF and an aneurysm is rare. Surgical treatment of multiple-channel arteriovenous fistulas by closure of venous varix should guarantee the exclusion from the circulation and avoid recruitment of new arterial connections and recurrence. Attention must be paid to normal venous channels draining into the varix

John M Tew - One of the best experts on this subject based on the ideXlab platform.

  • management of tentorial dural arteriovenous malformations transarterial embolization combined with stereotactic radiation or surgery
    Journal of Neurosurgery, 1994
    Co-Authors: Adam I Lewis, Thomas A Tomsick, John M Tew
    Abstract:

    The clinical, anatomical, and radiological features of nine cases of tentorial dural arteriovenous malformations (AVM's) are presented, and 45 reported cases are reviewed. Unlike dural AVM's of the transverse sigmoid and cavernous sinuses that usually have a benign natural history, dural AVM's of the tentorium typically present with hemorrhage or progressive neurological deficit. In this series, patients ranged in age from 52 to 72 years and included five men and four women. These patients presented with subarachnoid hemorrhage, parenchymal hemorrhage, brainstem dysfunction, Cerebellar signs, and obstructive hydrocephalus. Malformations were fed principally by the meningohypophyseal trunk, branches of the middle meningeal artery, and the occipital artery. Venous drainage was uniform through the cortical Veins (predominantly the mesencephalic, petrosal, and Cerebellar Veins). Eight of the nine patients had an associated venous aneurysm(s); two had more than one venous aneurysm, and two patients had a vein of Galen aneurysm associated with the tentorial dural AVM. Eight of nine patients improved after treatment, including four patients with complete obliteration of the dural AVM. Based on our experience, we have developed a treatment protocol for tentorial dural AVM's that uses transarterial embolization followed by direct microsurgery or stereotactic radiation. These therapies, applied in a staged manner, have proven safe and relatively effective for the treatment of dural AVM's.

Adam I Lewis - One of the best experts on this subject based on the ideXlab platform.

  • management of tentorial dural arteriovenous malformations transarterial embolization combined with stereotactic radiation or surgery
    Journal of Neurosurgery, 1994
    Co-Authors: Adam I Lewis, Thomas A Tomsick, John M Tew
    Abstract:

    The clinical, anatomical, and radiological features of nine cases of tentorial dural arteriovenous malformations (AVM's) are presented, and 45 reported cases are reviewed. Unlike dural AVM's of the transverse sigmoid and cavernous sinuses that usually have a benign natural history, dural AVM's of the tentorium typically present with hemorrhage or progressive neurological deficit. In this series, patients ranged in age from 52 to 72 years and included five men and four women. These patients presented with subarachnoid hemorrhage, parenchymal hemorrhage, brainstem dysfunction, Cerebellar signs, and obstructive hydrocephalus. Malformations were fed principally by the meningohypophyseal trunk, branches of the middle meningeal artery, and the occipital artery. Venous drainage was uniform through the cortical Veins (predominantly the mesencephalic, petrosal, and Cerebellar Veins). Eight of the nine patients had an associated venous aneurysm(s); two had more than one venous aneurysm, and two patients had a vein of Galen aneurysm associated with the tentorial dural AVM. Eight of nine patients improved after treatment, including four patients with complete obliteration of the dural AVM. Based on our experience, we have developed a treatment protocol for tentorial dural AVM's that uses transarterial embolization followed by direct microsurgery or stereotactic radiation. These therapies, applied in a staged manner, have proven safe and relatively effective for the treatment of dural AVM's.

Passacantilli E - One of the best experts on this subject based on the ideXlab platform.

  • Surgical treatment of pial Cerebellar arteriovenous fistulas with aneurysm of the main feeder artery
    'Elsevier BV', 2006
    Co-Authors: Passacantilli E, Pichierri A, Guidetti G, Santoro A, Roberto Delfini
    Abstract:

    BACKGROUND: Intracranial pial arteriovenous fistulas (pAVFs) are rare vascular lesions only recently considered distinct from arteriovenous malformations. Conservative management was associated with a high mortality rate. The abnormality of the lesion arises from its high-flow nature. The authors present a case of a Cerebellar pAVF associated with aneurysms of the main feeding artery that was surgically treated. CASE DESCRIPTION: A 54-year-old woman was referred to us after an attack of severe headache and vomiting. Computerized tomography scan visualized a hematoma of the fourth ventricle. Digital subtraction angiography (DSA) revealed a Cerebellar pAVF mainly fed by the right posteroinferior Cerebellar artery (PICA) and with drainage into one of the superior Cerebellar Veins. The PICA presented a saccular aneurysm on its fourth segment and a fusiform dilatation on its third segment. The patient underwent surgical operation via a midline suboccipital craniotomy. The fusiform dilatation was wrapped and the saccular aneurysm was clipped. The most fistulous connections were closed. The draining vein at the level of torcular herophili was closed by application of a clip. Control DSA demonstrated exclusion of both the aneurysms and the fistula from the circulation. At 1-year follow-up, the patient was neurologically intact. CONCLUSIONS: The association of a Cerebellar pAVF and an aneurysm is rare. Surgical treatment of multiple-channel arteriovenous fistulas by closure of venous varix should guarantee the exclusion from the circulation and avoid recruitment of new arterial connections and recurrence. Attention must be paid to normal venous channels draining into the varix

Emiliano Passacantilli - One of the best experts on this subject based on the ideXlab platform.

  • surgical treatment of pial Cerebellar arteriovenous fistulas with aneurysm of the main feeding artery
    Surgical Neurology, 2006
    Co-Authors: Emiliano Passacantilli, Angelo Pichierri, Giulio Guidetti, Antonio Santoro, Roberto Delfini
    Abstract:

    Abstract Background Intracranial pial arteriovenous fistulas (pAVFs) are rare vascular lesions only recently considered distinct from arteriovenous malformations. Conservative management was associated with a high mortality rate. The abnormality of the lesion arises from its high-flow nature. The authors present a case of a Cerebellar pAVF associated with aneurysms of the main feeding artery that was surgically treated. Case Description A 54-year-old woman was referred to us after an attack of severe headache and vomiting. Computerized tomography scan visualized a hematoma of the fourth ventricle. Digital subtraction angiography (DSA) revealed a Cerebellar pAVF mainly fed by the right posteroinferior Cerebellar artery (PICA) and with drainage into one of the superior Cerebellar Veins. The PICA presented a saccular aneurysm on its fourth segment and a fusiform dilatation on its third segment. The patient underwent surgical operation via a midline suboccipital craniotomy. The fusiform dilatation was wrapped and the saccular aneurysm was clipped. The most fistulous connections were closed. The draining vein at the level of torcular herophili was closed by application of a clip. Control DSA demonstrated exclusion of both the aneurysms and the fistula from the circulation. At 1-year follow-up, the patient was neurologically intact. Conclusions The association of a Cerebellar pAVF and an aneurysm is rare. Surgical treatment of multiple-channel arteriovenous fistulas by closure of venous varix should guarantee the exclusion from the circulation and avoid recruitment of new arterial connections and recurrence. Attention must be paid to normal venous channels draining into the varix.