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Section overview: unruptured aneurysms

H. Richard Winn

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Brain Abscess

H. Richard Winn

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Introduction

Natural history of unruptured intracranial aneurysms

H. Richard Winn

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Errors in compliance with federal rules and regulations relating to healthcare benefits programs: the University of Washington Department of Neurological Surgery experience

H. Richard Winn

✓ This article details the errors in compliance with federal rules and regulations relating to the healthcare benefits programs at the University of Washington Department of Neurological Surgery from 1996 through 2002. University faculty members, regardless of the organization to which they belong, will be identified by the federal government as the individual responsible in healthcare finance inquiries. A full understanding of all regulations and an active compliance program are necessary to avoid problems, including criminal prosecution.

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Arthur A. Ward, Jr.

An obituary

H. Richard Winn

✓ Arthur A. Ward, Jr., the former Professor and founding Chairman of the Department of Neurological Surgery at the University of Washington, died on December 23, 1997. He was a former member (1963–1973) and Chairman (1971–1973) of the Editorial Board of the Journal of Neurosurgery.

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Cerebral blood flow

Warren R. Selman and H. Richard Winn

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Brain Abscess Model

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Enlargement of an intracranial aneurysm in the eighth decade of life

Case report

Ralph G. Dacey Jr., David Pitkethly, and H. Richard Winn

✓ The management of intracranial aneurysms in elderly patients remains controversial, since the natural history of these lesions is not well understood. The authors describe the case of a 76-year-old woman with documented enlargement of an internal carotid artery aneurysm over 3 years. The management of intracranial aneurysms in elderly patients is discussed.

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The natural history of aneurysms and arteriovenous malformations

John A. Jane, Neal F. Kassell, James C. Torner, and H. Richard Winn

✓ The authors summarize the findings of previous studies relating to the natural history of aneurysms and arteriovenous malformations (AVM's). Ruptured aneurysms have their highest rate of rebleeding on Day 1, and at least 50% will rebleed during the 6 months after the first hemorrhage. Thereafter, the rate drops to at least 3% a year. This is the same rate as seen in anterior and posterior communicating artery aneurysms treated by anterior cerebral artery clipping and carotid ligation; these operations provide immediate protection but do not result in long-term diminution of the risk of rebleeding. Patients with unruptured incidental and unruptured multiple aneurysms rebleed at a rate of 1% per year, as do patients with subarachnoid hemorrhage of unknown etiology. The risk of rebleeding for AVM's is 3% a year.

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Surgery or Radiosurgery?