Search Results

You are looking at 1 - 10 of 46 items for :

  • By Author: Ding, Dale x
Clear All
Full access

Dale Ding and Kenneth C. Liu

S troke is one of the leading causes of morbidity and mortality in the US population, 3 and along with TIAs, afflicts approximately 900,000 people annually. 18 Intracranial atherosclerosis comprises 70,000–90,000 of these cases. 26 While medical therapy with aspirin has been shown to be safe and effective in treating symptomatic intracranial arterial stenosis in more than 50% of cases, 4 the rate of recurrent ischemic stroke ipsilateral to the stenotic artery is still approximately 12% at 1-year follow-up. Unfortunately, surgery has, to date, not shown

Full access

Douglas Kondziolka

identification of the AVM shunt, but the morbidity of SRS is a function of the radiation dose and the total volume targeted. Ding and colleagues provide additional evidence that embolization prior to radiosurgery is associated with reduced obliteration rates. 1 , 2 This may be due to difficulties in AVM nidus identification. Most of the data are from the pre-Onyx era, and more information is needed to see if this observation holds true today. We are now exploring the use of radiosurgery as the initial therapy followed by targeted embolization for any hemorrhagic risk

Restricted access

Robert M. Starke, Chun-Po Yen, Dale Ding and Jason P. Sheehan

patients was approved by the institutional review board. In this study, we sought to assess the outcomes of patients with AVMs who received treatment with a single session of radiosurgery. In all patients, the goal of therapy was complete AVM obliteration. Patients were excluded if they had inadequate follow-up, which was considered to be less than 2 years; however, those patients who had known complications that developed within the first 2 years after treatment were included (n = 12). These criteria resulted in the exclusion of 37 patients who had been followed up for

Full access

Gregory J. Zipfel and Roberto C. Heros

-radiosurgery embolization (27%) or surgery (11%), which qualifies about a quarter of patients in this series as receiving multimodal therapy rather than stand-alone radiosurgery; and 3) the relatively frequent use of repeat radiosurgery (16%) to address residual AVM in follow-up, which qualifies a significant portion of patients in this series as receiving repeat rather than stand-alone radiosurgery. These weaknesses notwithstanding, this is a well-conducted and rigorous study from one of the leading radiosurgical centers in the world. While none of the outcomes and predictors of

Restricted access

Dale Ding, Zhiyuan Xu, Ian T. McNeill, Chun-Po Yen and Jason P. Sheehan

.9)  visual disturbance 9 (13.8)  presyncope 7 (10.8) Tumor Characteristics Of the 90 meningiomas included for imaging analysis, 53 were parasagittal (58.9%) and 37 were parafalcine (41.1%). The median initial tumor volume was 3 cm 3 (range 0.1–15.4 cm 3 ). Preradiosurgery treatment included resection in 72 tumors (80%), embolization in 4 tumors (4.4%), and radiation therapy in 18 tumors (20%). An increase or decrease in tumor size was defined as a 15% increase or decrease in tumor volume. Tumor control was defined as decreased or unchanged tumor volume

Restricted access

Douglas Kondziolka

not yet occurred, and regional veins are less compromised? Given the problems that can be caused by such tumors, and a somewhat variable natural history, close observation is certainly warranted and early radiosurgery is reasonable depending on patient goals. For tumors between 2 and 4 cm in maximum diameter, the indications for resection compared to radiosurgery can be debated. Certainly if the goal is to improve symptoms from mass effect more rapidly, then resection is optimal. The conclusion of this report—“Radiosurgery can be used as initial and adjunct therapy

Full access

Dale Ding, Chun-Po Yen, Zhiyuan Xu, Robert M. Starke and Jason P. Sheehan

. Results Patient Population Five hundred two patients harboring SM Grade I or II AVM were eligible for analysis and consisted of 253 males (50.4%) and 249 females (49.6%) with a median age of 35.2 years. Seventy-nine patients (15.7%) were under the age of 18 years. Preradiosurgery therapies included microsurgical removal in 55 patients (11.0%) and embolization in 101 patients (20.1%). The most common presenting symptoms were hemorrhage in 235 patients (46.8%), seizure in 126 patients (25.1%), and headache in 83 patients (16.5%). The characteristics of the patient

Restricted access

Dale Ding, Chun-Po Yen, Zhiyuan Xu, Robert M. Starke and Jason P. Sheehan

. Stroke 38 : 3308 – 3309 , 2007 32 Stapf C , Mohr JP , Choi JH , Hartmann A , Mast H : Invasive treatment of unruptured brain arteriovenous malformations is experimental therapy . Curr Opin Neurol 19 : 63 – 68 , 2006 33 Steiner L , Lindquist C , Adler JR , Torner JC , Alves W , Steiner M : Clinical outcome of radiosurgery for cerebral arteriovenous malformations . J Neurosurg 77 : 1 – 8 , 1992 34 van Rooij WJ , Sluzewski M , Beute GN : Brain AVM embolization with Onyx . AJNR Am J Neuroradiol 28 : 172 – 178

Full access

Dale Ding, Chun-Po Yen, Robert M. Starke, Zhiyuan Xu and Jason P. Sheehan

, Choi JH , Hartmann A , Mast H : Invasive treatment of unruptured brain arteriovenous malformations is experimental therapy . Curr Opin Neurol 19 : 63 – 68 , 2006 49 Starke RM , Yen CP , Ding D , Sheehan JP : A practical grading scale for predicting outcome after radiosurgery for arteriovenous malformations: analysis of 1,012 treated patients. Clinical article . J Neurosurg 119 : 981 – 987 , 2013 50 Steiner L , Lindquist C , Adler JR , Torner JC , Alves W , Steiner M : Clinical outcome of radiosurgery for cerebral

Free access

Ching-Jen Chen, Pedro Norat, Dale Ding, George A. C. Mendes, Petr Tvrdik, Min S. Park and M. Yashar Kalani

closure of the nidus remains the primary goal of AVM treatment. 11 , 32 , 52 , 53 Contemporary management strategies are dictated by the angioarchitecture, location, and presentation of AVMs. 5 , 27 Currently employed treatment options include microsurgery, stereotactic radiosurgery, and endovascular embolization as standalone or combination therapies. 12 , 15 , 18 , 31 , 45 Despite unresolved controversies regarding the choice of treatment modality, obliteration of the AVM nidus with preservation of normal venous drainage remains the common theme of all interventions