Spontaneous disappearance of vein of galen malformation and posterior fossa venous pouch.

Cerebrovascular anomalies remain an issue of controversy regarding diagnosis, classification, and treatment. We report the first case of total and asymptomatic regression and disappearance of a vein of Galen malformation associated with a posterior fossa venous pouch. Different aspects of the vein of Galen are discussed together with emphasis on the underlying mechanisms of spontaneous thrombosis and regression.

Hemodynamic evaluation of basilar and vertebral artery angioplasty.

Objective: The postangioplasty evaluation of a stenotic vessel is often conducted by studying serial angiograms to determine the anatomic reduction in stenosis. In flow-limiting stenosis, the hemodynamic change that accompanies these anatomic changes is of great importance in evaluating the success of the angioplasty. The purpose of this article is to demonstrate the usefulness of phase contrast magnetic resonance angiography (PCMRA) in evaluating the hemodynamic changes that occur after angioplasty of the basilar and vertebral arteries.

Follow-up angiography of intracranial aneurysms treated with endovascular placement of Guglielmi detachable coils.

Objective: The success of endovascular treatment of intracranial aneurysms with Guglielmi detachable coils (GDCs) is dependent on the long-term exclusion of the aneurysm from the circulation. We reviewed our experience with the long-term angiographic follow-up monitoring of aneurysms that had been treated with GDCs.

Methods: All patients whose aneurysms had been treated with GDCs between January 1995 and August 1999 and who subsequently underwent follow-up angiography at 6 months or more were included in this study.

Contemporary management of subarachnoid hemorrhage and vasospasm: the UIC experience.

Background: Cerebral vasospasm is a well-known and serious complication of aneurysmal subarachnoid hemorrhage. The means of monitoring and treatment of vasospasm have been widely studied. Each neurosurgical center develops a protocol based on their experience, availability of equipment and personnel, and cost, so as to keep morbidity and mortality rates as low as possible for their patients with vasospasm.

Guglielmi detachable coiling for intracranial aneurysms: the story so far.

Spontaneous rupture of cerebral aneurysms typically results in subarachnoid hemorrhage. The primary goal of treatment of cerebral aneurysms is to prevent future rupture. Surgical clipping had been the mainstay of treatment of both ruptured and unruptured cerebral aneurysms.

Surgery following endovascular coiling of intracranial aneurysms.

Background: Surgery for intracranial aneurysms that have been treated by endovascular coiling is a new challenge for neurosurgeons and the need for it will undoubtedly continue to increase. The indications for, timing, and technique of surgery in our experience are described.

Methods: We have reviewed our experience with 11 patients who underwent surgery following endovascular coiling with Guglielmi detachable coils (GDCs) of an aneurysm.

Endovascular treatment of paraclinoid aneurysms.

Background: Paraclinoid aneurysms include those that are distal to the cavernous segment of the internal carotid artery and proximal to the posterior communicating artery. The purpose of this study was to review our experience with the endovascular treatment of this group of aneurysms, which are difficult to treat surgically.

Methods: Between June 1994 and April 1999, 66 patients (56 female, 10 male) with a mean age of 50.

Intracranial percutaneous transluminal angioplasty for arteriosclerotic stenosis.

Background: Patients with intracranial arteriosclerotic disease have significant morbidity and mortality rates, and some are unresponsive to medical treatment and have unacceptable surgical risks. Percutaneous transluminal angioplasty of the intracranial vessels is a possible alternative to surgery.

Objectives: To present our experience with percutaneous transluminal angioplasty and to summarize our data.

The remodeling technique of balloon-assisted Guglielmi detachable coil placement in wide-necked aneurysms: experience at the University of Illinois at Chicago.

Object: Reports in the literature have offered discussions of the feasibility, efficacy, and safety of balloon-assisted Guglielmi detachable coil (GDC) placement in wide-necked intracranial aneurysms, which was first described by Jacques Moret as the "remodeling technique." In this article the authors summarize their results in a subset of aneurysms treated with GDCs using the remodeling technique.

Methods: This report contains a retrospective analysis of 72 patients with 75 aneurysms who underwent 79 endovascular procedures performed using the remodeling technique.

Arteriovenous malformation of the forehead, anterior scalp, and nasal dorsum.

Management of complex and relentless large arteriovenous malformations with long term control and acceptable aesthetic results can be accomplished. This outcome requires selective intra-arterial embolization, judicious surgical resection, composite reconstruction with free tissue transfer, other ancillary procedures, or both, and careful serial follow-up examinations to rule out recurrent or persistent disease.

What percentage of surgically clipped intracranial aneurysms have residual necks?

Objective: To determine the angiographically proven rate and persistence of occlusion of intracranial aneurysms after surgical clipping as reported in the literature. This should establish a basis for comparing surgery with new endovascular methods of treatment.

Methods: We reviewed the literature published during the period from 1979 through 1999, dividing the articles into two groups.

Role of magnetic resonance imaging and diagnostic and interventional angiography in vascular and neoplastic diseases of the skull base associated with vestibulocochlear symptoms.

There are many vascular and neoplastic diseases as well as normal variants that produce the vestibulocochlear symptoms of pulsatile tinnitus, hearing loss, dizziness, and ataxia. Magnetic resonance imaging may be diagnostic, and magnetic resonance angiography/magnetic resonance venography have added to the ability of magnetic resonance to image vascular abnormalities. The extent of neoplasms is accurately assessed and complication of vascular lesions are clearly seen.

Techniques of coiling cerebral aneurysms.

Background: More than 200 aneurysms have been coiled at the UIC Medical Center within the last 5 years. We describe in detail the technical factors that increase the chance of complete occlusion of a cerebral aneurysm with coils. Aneurysms selected for coiling have good geometry or are in a location that is difficult to reach surgically.

Carotid-Cavernous Fistula Associated with Ehlers-Danlos Syndrome Type IV. A Case Report and Review of Literature.

A case of traumatic, direct, carotid cavernous fistula (CCF) associated with Ehlers - Danlos syndrome (EDS) Type IV is reported along with a review of the literature. Excluding the present case, three similar cases associated with EDSTypeJV have already been reported by Gerard M. Debrun et Al(l).

Direct cervical internal carotid access for GDC treatment of an ophthalmic origin carotid aneurysm.

The use of detachable coils in the treatment of intracranial aneurysms continues to evolve since its introduction in 1991 [1-5]. Although not well described in the literature, technical considerations in gaining and maintaining access to intracranial aneurysms play a pivotal role in any successful endovascular treatment. Tortuosity and looping of the cervical internal carotid artery (ICA) is one problem occasionally encountered.

Management of pericentral arteriovenous malformations.

Pericentral arteriovenous malformations (AVMs) have more often been deemed inoperable lesions because of their complexity, owing to their critical locations and dismal outcome. This study discusses the management of this group of patients with a variety of treatments which includes surgery, nidus embolization, and radiosurgery. Out of 89 patients treated for AVMs in our institute over a period of 30 months (1992 through May 1995), we present a case series of 34 patients who had AVMs located in the pericentral region.

Aneurysm geometry: an important criterion in selecting patients for Guglielmi detachable coiling.

The study was aimed determine the criteria for treating cerebral aneurysms, ruptured and unruptured, suitable for endovascular Guglielmi detachable coiling (GDC) with least morbidity and mortality. We will discuss the importance of knowledge of the geometry of cerebral aneurysm and its impact on the results of coiling. We have treated 324 patients with cerebral aneurysms at the University of Illinois Hospital from May 1, 1994 to June 1997.

Evaluation and endovascular treatment of juxtaorbital vascular anomalies.

The evaluation of juxtaorbital anomalies with routine imaging, including CT and MR imaging, usually is insufficient for endovascular therapy planning. Cerebral angiography remains crucial to define detail necessary for endovascular therapy. This article provides an overview of the authors' approach and the endovascular therapies available to treat these lesions.

Selection of cerebral aneurysms for treatment using Guglielmi detachable coils: the preliminary University of Illinois at Chicago experience.

Objective: We present our initial experience with Guglielmi detachable coils (GDCs). The aim of this study was to determine the criteria for aneurysms, ruptured or unruptured, that are suitable for this technique. The importance of aneurysm geometry and its impact on the final results are discussed.