Search Results

You are looking at 1 - 10 of 28 items for :

  • Refine by Access: all x
  • By Author: Tubbs, R. Shane x
Clear All
Full access

Jeffrey P. Blount, W. Jerry Oakes, R. Shane Tubbs, and Robin P. Humphreys

✓ Intracranial aneurysms are rare in children, and their origins and treatment methods tend to be different from those in these same entities in adults. These lesions tend to be congenital or to have an infectious or traumatic origin. In the current paper the authors trace the historical evolution of the diagnosis and treatment of intracranial aneurysms in children. Based on the literature, these lesions appear to occur in children in less than 3% of all series. The literature also supports the suggestion that symptoms from these aneurysms are often from mass effect and that giant aneurysms and lesions in the posterior cranial fossa are relatively more common in children than in adults. The termination of the carotid artery and the anterior cerebral artery seem to be disproportionately common sites of aneurysm formation in this cohort. Interestingly, surgical outcomes in children appear to be moderately better than in adults. Based on the literature, the claim can be made that a multidisciplinary approach to the management of such aneurysms can yield good outcomes in a very high percentage of children treated.

Restricted access

R. Shane Tubbs and W. Jerry Oakes

T he trochlear (or fourth cranial) nerve is the smallest of the cranial nerves (olfactory nerves excepted), and yet has the longest intracranial course. It arises from the dorsal midbrain, and its fibers decussate in the anterior medullary velum to end in the contralateral superior oblique muscle. 4 Because of its small caliber and its hidden location under the tentorial edge, the cisternal portion of the nerve can easily be injured during surgical procedures to treat tumors or aneurysms when the surgery involves manipulation of the tentorial edge. 9

Restricted access

Martin Mortazavi, Aman Deep, R. Shane Tubbs, and Wink S. Fisher III

D r . Kenneth Grant Jamieson ( Fig. 1 ) holds a prominent place in the history of Australian neurosurgery. Jamieson was a pioneer in the treatment of intracranial aneurysms and a neurosurgical innovator who developed new surgical techniques to operate on previously inoperable pineal region tumors. Additionally, Jamieson contributed much of his career toward the prevention of head injuries related to road trauma. F ig . 1. Photograph of Dr. Kenneth Grant Jamieson (1925–1976). Reprinted from J Clin Neurosci 11, Simpson D: Jamieson “Ladye Jayne

Full access

Paul M. Foreman, Michelle Chua, Mark R. Harrigan, Winfield S. Fisher III, Nilesh A. Vyas, Robert H. Lipsky, Beverly C. Walters, R. Shane Tubbs, Mohammadali M. Shoja, and Christoph J. Griessenauer

to systemic inflammation and subsequent DCI in patients with aSAH is not known. In this study we present a prospective cohort of patients with aSAH to evaluate the impact of nosocomial infection on the incidence of DCI. Methods A prospective cohort study was used to evaluate the effect of nosocomial infection on the incidence of DCI in patients with aSAH. All cases and controls were obtained from the Cerebral Aneurysm Renin Angiotensin System (CARAS) study, a prospective, blinded study designed to evaluate associations between the common genetic polymorphisms

Restricted access

R. Shane Tubbs, Andrew J. DeNardo, and Aaron A. Cohen-Gadol

essentially the entire right-sided anterior circulation being provided by the left ICA via the transsellar anastomosis described above. No intracranial aneurysm or other vascular abnormality was observed. The patient remains well and is being treated with medications. F ig . 1. Axial (A) and coronal (B) T2-weighted MR images and axial (C) , sagittal (D) , and coronal (E) CT angiograms demonstrating the intercavernous connection between the left and right ICAs (arrows) . The hypoplastic right ICA and A 1 segment of the anterior cerebral artery are indicated

Restricted access

R. Shane Tubbs, John C. Wellons III, Jeffrey P. Blount, and W. Jerry Oakes

10. Kosnik EJ : Use of ligamentum nuchae graft for dural closure in posterior fossa surgery. Technical note. J Neurosurg 89 : 55 – 156 , 1998 Kosnik EJ: Use of ligamentum nuchae graft for dural closure in posterior fossa surgery. Technical note. J Neurosurg 89: 55–156, 1998 11. Lang J : Suboccipital Approach (and other Approaches to Aneurysms at the Craniocervical Junction). Stuttgart : Schattauer Verlagsgesellschaft , 1992 , p 13 Lang J: Suboccipital Approach (and other Approaches to Aneurysms at

Restricted access

R. Shane Tubbs, Joshua Dixon, Marios Loukas, and Aaron A. Cohen-Gadol

-cavernous fistula, 14 , 15 carotid puncture, 8 and aneurysm formation 12 as well as paresis of the muscles of mastication (that is, the masseter, temporalis, and pterygoid muscles) with injury to the portio minor. Optic, oculomotor, and trochlear nerve injury, 15 intracerebral hemorrhage, 12 and facial vasodilatation 3 have also been reported. Complications resulting from the injury of related vasculature around the foramen ovale and extracranially along the skull base include puncture of the middle meningeal, maxillary, and internal carotid arteries and internal jugular

Restricted access

Aaron A. Cohen-Gadol, Jonathan A. Friedman, Jennifer D. Friedman, R. Shane Tubbs, James R. Munis, and Fredric B. Meyer

N eurosurgical disorders during pregnancy are rare; however, these disorders place 2 lives at risk and create special diagnostic and therapeutic challenges. Pathologies of the CNS most commonly brought to neurosurgical attention include intracranial hemorrhage due to AVMs, aneurysms, and intracranial bleeding due to eclampsia. 16 Other rapidly expanding mass lesions such as tumors, hydrocephalus, and traumatic lesions are also seen. 12 Because of the limited experience of single medical centers, little is known regarding the natural history and most

Full access

Paul M. Foreman, Michelle H. Chua, Mark R. Harrigan, Winfield S. Fisher III, R. Shane Tubbs, Mohammadali M. Shoja, and Christoph J. Griessenauer

of aSAH patients treated in the United States, we seek to externally validate the Practical Risk Chart for the prediction of DCI in patients with aSAH. Methods A prospective cohort of aSAH patients was used to externally validate the previously published Practical Risk Chart for the prediction of DCI. 5 All patients were obtained from the CARAS (Cerebral Aneurysm Renin Angiotensin System) study, a prospective, blinded study designed to evaluate associations between common genetic polymorphisms in the renin angiotensin system and occurrence and rupture of cerebral

Full access

Christoph J. Griessenauer, R. Shane Tubbs, Paul M. Foreman, Michelle H. Chua, Nilesh A. Vyas, Robert H. Lipsky, Mingkuan Lin, Ramaswamy Iyer, Rishikesh Haridas, Beverly C. Walters, Salman Chaudry, Aisana Malieva, Samantha Wilkins, Mark R. Harrigan, Winfield S. Fisher III, and Mohammadali M. Shoja

T he renin-angiotensin system (RAS) plays a crucial role in physiological vasorelaxation/vasoconstriction of the cerebral vasculature, vascular remodeling, and maintenance of arterial wall integrity. 2 , 9 , 14 Compared with the normal arterial wall, cerebral aneurysms, in particular ruptured aneurysms, express significantly less angiotensin-converting enzyme (ACE) and angiotensin II receptor Type 1 (AT1), resulting in lack of vascular remodeling and thinning of the arterial wall under hemodynamic stress. 23 Certain RAS genetic polymorphisms have been linked