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Marec von Lehe and Johannes Schramm

and tumor outcome and neurosurgical aspects . Epilepsia 44 : 822 – 830 , 2003 10 Mohamed IS , Otsubo H , Shroff M , Donner E , Drake J , Snead OC III : Magnetoencephalography and diffusion tensor imaging in gelastic seizures secondary to a cingulate gyrus lesion . Clin Neurol Neurosurg 109 : 182 – 187 , 2007 11 Nakayama N , Okumura A , Shinoda J , Nakashima T , Iwama T : Relationship between regional cerebral metabolism and consciousness disturbance in traumatic diffuse brain injury without large focal lesions: an FDG

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Marec von Lehe and Johannes Schramm

and tumor outcome and neurosurgical aspects . Epilepsia 44 : 822 – 830 , 2003 10 Mohamed IS , Otsubo H , Shroff M , Donner E , Drake J , Snead OC III : Magnetoencephalography and diffusion tensor imaging in gelastic seizures secondary to a cingulate gyrus lesion . Clin Neurol Neurosurg 109 : 182 – 187 , 2007 11 Nakayama N , Okumura A , Shinoda J , Nakashima T , Iwama T : Relationship between regional cerebral metabolism and consciousness disturbance in traumatic diffuse brain injury without large focal lesions: an FDG

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Bernhard Meyer, Horst Urbach, Carlo Schaller, and Johannes Schramm

Postoperative DS Angiography These results show that assumptions about CBF and/or cerebral metabolism derived from findings on angiographic studies can be misleading and are no more useful than a clinical guideline. A similar observation has been published recently with regard to lack of correlation between angiographic findings and metabolic data in the context of occlusive carotid artery disease. 3 The reason for this has been described earlier. First, angiographic circulation time is difficult to measure even on rapid series, and second, it reflects changes in both CBF

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considerably less insight in this regard but I continue to respect the caveat. Despite many studies by good clinician scientists, there remains considerable controversy and uncertainty regarding the perturbations of CBF, cerebral metabolism, and autoregulation in patients with AVMs and even more uncertainty regarding the pathophysiology of postresection hyperemic complications. Although more likely to occur in large AVMs with long feeding arteries from multiple cerebrovascular territories these complications rarely occur after treatment of smaller AVMs or even