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country-wide. The overall incidence of trauma associated pediatric coma decreased in 2012, perhaps reflecting the success of awareness and prevention efforts. However mortality rates remain unchanged from 1997 – 2012, indicating a clear role for future efforts to better describe, characterize, and treat the underlying pathology. J Neurosurg Journal of Neurosurgery JNS 0022-3085 1933-0693 American Association of Neurological Surgeons 2015.8.JNS.AANS2015ABSTRACTS Abstract 502. Effect of Antiplatelet Therapy and Platelet Function

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, Oswestry Disability Index (ODI), and EQ-5D scores, were obtained both preand post-operatively. Results: The median survival was 7.7 months. The 30-day and 12-month mortality rates were 9% and 62%, respectively. Six weeks post-operatively, ambulatory status (p = 0.02) and bladder control (p = 0.03) were significantly improved. Overall, 67.5% of ASIA B, C, or D patients gained at least 1 grade after surgery, 25% remained stable, and 7.5% deteriorated. ODI, EQ-5D, BPI scores were significantly improved at each follow-up (p ≤ 0.01). SF-36 scores were generally higher

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Or Cohen-Inbar, Robert M. Starke, Gabriella Paisan, Hideyuki Kano, Paul P. Huang, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S. Grills, David Mathieu, Danilo Silva, Mahmoud Abbassy, Symeon Missios, John Y. K. Lee, Gene H. Barnett, Douglas Kondziolka, L. Dade Lunsford and Jason P. Sheehan

between groups when symptomatic or permanent RICs were compared (9.9% late vs 7.5% early responders, p = 0.468 for symptomatic RICs; and 2.3% vs 3%, respectively, p = 0.431 for permanent RICs). Overall mortality rates were comparable between the 2 groups (2.2% late vs 3% early responders, p = 0.886). Favorable outcome (that is, AVM nidus obliteration without post-SRS latent phase hemorrhage or permanent SRS-associated RICs) was not found to differ significantly between the 2 groups (p = 0.421). As shown in Table 2 , patients who received a higher margin dose were more

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Or Cohen-Inbar, Robert M. Starke, Hideyuki Kano, Gregory Bowden, Paul Huang, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S. Grills, David Mathieu, Danilo Silva, Mahmoud Abbassy, Symeon Missios, John Y. K. Lee, Gene H. Barnett, Douglas Kondziolka, L. Dade Lunsford and Jason P. Sheehan

fossa AVMs have a mortality rate as high as 60% for patients presenting with a nidus-related hemorrhage. 4 The management of these neurovascular lesions is complicated by the anatomical constraints of the posterior fossa and the concentration of eloquent neurological structures. The smaller and limited volume of the posterior fossa does not allow for much volume expansion (due to AVM nidus hemorrhage or edema). Clinical manifestation and neurological decompensation ensues earlier than for equal-volume supratentorial hemorrhages. 7 , 20 , 28 Unlike brainstem AVMs

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Dale Ding, Robert M. Starke, Hideyuki Kano, David Mathieu, Paul P. Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S. Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H. Barnett, L. Dade Lunsford and Jason P. Sheehan

followed for 9 years found a 13 per 100,000 annual incidence of stroke, including 8 per 100,000 and 5 per 100,000 annual incidences of ischemic and hemorrhagic stroke, respectively. 36 In 82% of the patients who suffered a hemorrhagic stroke, the cause was a vascular malformation. 36 A study including 116 children with hemorrhagic stroke found an AVM to be the cause in 31% of cases. 41 In a cohort of 34 patients with spontaneous ICH, an AVM was identified as the cause in 47%. 50 The ICH mortality rate was 25%, and 22% of survivors suffered from severe neurological

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Robert M. Starke, Dale Ding, Hideyuki Kano, David Mathieu, Paul P. Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S. Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H. Barnett, L. Dade Lunsford and Jason P. Sheehan

patients died (0.8%), resulting in a combined neurological morbidity and mortality rate of 5.3%. The rates of increased seizure frequency and de novo seizures were 6.9% (2/29 patients) and 0.3% (1/328 patients), respectively. Favorable Outcome At last follow-up, a favorable outcome (defined as AVM obliteration, no post-radiosurgery hemorrhage, and no permanently symptomatic RIC) was achieved in 211 patients (59.1%; Fig. 4 ). Table 4 details the univariate and multivariate logistic regression analyses for predictors of favorable outcome after radiosurgery. In the

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Or Cohen-Inbar, Cheng-Chia Lee, Seyed H. Mousavi, Hideyuki Kano, David Mathieu, Antonio Meola, Peter Nakaji, Norissa Honea, Matthew Johnson, Mahmoud Abbassy, Alireza M. Mohammadi, Danilo Silva, Huai-Che Yang, Inga Grills, Douglas Kondziolka, Gene H. Barnett, L. Dade Lunsford and Jason Sheehan

, the authors defined several important prognostic factors influencing mortality rates for patients with these tumors. 36 In their cohort of 563 patients, the overall median survival reported was 13 years, with 1-, 5-, 10-, and 20-year survival rates of 95%, 82%, 60%, and 23%, respectively. GTR alone was associated with a median survival of 13 years, whereas subtotal resection (STR) resulted in a median survival of 9.75 years. 36 Simpson Grade I complete resection has been reported to achieve an improved long-term control rate, and STR has been associated with a

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Dale Ding, Robert M. Starke, Hideyuki Kano, John Y. K. Lee, David Mathieu, John Pierce, Paul P. Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S. Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H. Barnett, L. Dade Lunsford and Jason P. Sheehan

commonly used system for stratifying AVMs, and its grade is derived from the nidus size, anatomical brain location, and venous drainage pattern of the AVM. 59 The SM grading system has been found to correlate with postoperative neurological morbidity and mortality rates after surgery at AVM centers with experienced personnel, and it is also correlated with outcomes after radiosurgery. 24–26 , 34 , 39 , 42 Spetzler-Martin Grade III AVMs represent the border zone between SM Grades I and II AVMs, which are typically managed with an early intervention, and SM Grades IV

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Mohana Rao Patibandla, Dale Ding, Hideyuki Kano, Zhiyuan Xu, John Y. K. Lee, David Mathieu, Jamie Whitesell, John T. Pierce, Paul P. Huang, Douglas Kondziolka, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S. Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Gene H. Barnett, L. Dade Lunsford and Jason P. Sheehan

significant in the univariate analysis (p < 0.05). Permanent neurological morbidity occurred in 27 patients (11.6%), and 12 patients died after SRS (5.2%), yielding a combined permanent morbidity and mortality rate of 16.8%. Favorable Outcome Favorable outcome (i.e., AVM obliteration, no post-SRS hemorrhage, and no permanent RIC) was achieved in 61 patients (26.2%). Table 5 details the univariate and multivariate logistic regression analyses for predictors of unfavorable outcome after SRS. Larger AVM maximum diameter (p = 0.002) and prior AVM hemorrhage (p = 0.044) were