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Introduction: Endovascular approaches to cerebral ischemia

Aaron S. Dumont and Avery J. Evans

Thetreatment of stroke has rapidly evolved over the past decade, particularly as data concerning the natural history have emerged and endovascular treatment options have matured. Therapies for acute stroke have expanded as intraarterial thrombolysis and mechanical clot retrieval have been validated. Furthermore, angioplasty and stenting of intra- and extracranial vessels have evolved with the development of new devices coupled with increasing operator experience. Endovascular therapy is now a widely accepted treatment option for cerebral ischemia in many clinical situations.

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Editorial. Contemporary treatment of ruptured intracranial aneurysms: perspectives from the Barrow Ruptured Aneurysm Trial

Peter S. Amenta, John D. Nerva, and Aaron S. Dumont

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Editorial. Follow-up of completely occluded coiled aneurysms: how long is adequate?

John D. Nerva, Peter S. Amenta, and Aaron S. Dumont

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Unruptured aneurysms

Aaron S. Dumont, Giuseppe Lanzino, and Neal F. Kassell

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Seizures and Subarachnoid Hemorrhage

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Topic Editor Aaron S. Dumont and Topic Editor John A. Jane Sr.

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Magnetic resonance angiography in the evaluation of infants with hydrocephalus: a new standard?

Aaron S. Dumont, R. Webster Crowley, and Hian K. Yeoh

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Pediatric sellar tumors: diagnostic procedures and management

Jay Jagannathan, Aaron S. Dumont, John A. Jane Jr., and Edward R. Laws Jr.

The diagnosis and management of pediatric sellar lesions is discussed in this paper. Craniopharyngiomas account for the majority of pediatric sellar masses, and pituitary adenomas are extremely uncommon during childhood. The diagnosis of sellar lesions involves a multidisciplinary effort, and detailed endocrinological, ophthalmological, and neurological testing is critical in the evaluation of a new sellar mass. The management of pituitary adenomas varies depending on the entity. For most tumors other than prolactinomas, transsphenoidal resection remains the mainstay of treatment. Less invasive methods, such as endoscopic transsphenoidal surgery and stereotactic radiosurgery, have shown promise as primary and adjuvant treatment modalities, respectively.

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Update on management of intracerebral hemorrhage

Nader Pouratian, Neal F. Kassell, and Aaron S. Dumont

Intracerebral hemorrhage (ICH) is a lingering cause of significant mortality and morbidity rates in contemporary society. Despite its established burden, considerably less investigative attention has been devoted to the study of ICH than other forms of stroke. Only a limited number of clinical studies have been performed to examine the surgical (both craniotomy and minimally invasive) and medical management of patients with ICH. No consistently efficacious strategies have been identified through such investigations. Limitations in study design and execution have universally impaired the interpretation and impact of available data. Management of ICH unfortunately remains heterogeneous across institutions, and it continues to suffer from the lack of proven medical and surgical effectiveness. Urgently needed are further prospective randomized controlled trials in which investigators consider the shortcomings of previous endeavors in the management of ICH. In the present article the authors review the current management practices of ICH, discuss the controlled trials, and highlight recent trials and future avenues of further study.

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Evolution of cerebral revascularization techniques

R. Webster Crowley, Ricky Medel, and Aaron S. Dumont

✓As a leading cause of death and disability in patients across the world, stroke is a problem that plagues both neurosurgeons and neurologists alike. Whether a result of atherosclerosis, moyamoya disease, or a complication in the treatment of a complex intracranial aneurysm, cerebrovascular occlusion can have devastating effects on patients. For nearly half a century neurosurgeons have searched for safer, more effective ways to increase the amount of blood flow to ischemic brain tissue. From the first extracranial–intracranial bypasses to the recent technological advancements seen with endovascular therapy, cerebral revascularization techniques have been constantly evolving. Over the years cerebral ischemia has gone from a condition that was previously considered surgically untreatable, to a condition with several viable options for prevention and treatment. In this paper the authors discuss the historical evolution of treatment for cerebrovascular occlusive disease.