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Andrew B. Harris, Floreana Kebaish, Lee H. Riley III, Khaled M. Kebaish and Richard L. Skolasky

lacked preoperative PAM scores, were excluded, and an additional 381 patients, who lacked complete 1-year follow-up data, were also excluded. Measurement of Patient Activation The Patient Activation Measure (PAM) is a questionnaire composed of 13 questions designed to determine how “engaged and active” patients are in their own healthcare. The questionnaire was developed initially by Hibbard and colleagues in 2004, 12 and it assesses the degree to which patients believe that taking an active role is important, have the confidence and knowledge to take action, have the

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Thomas J. Sorenson, Waleed Brinjikji, Kelly D. Flemming and Giuseppe Lanzino

W ith the widespread utilization of noninvasive imaging studies, incidental vascular lesions are discovered and diagnosed with increasing frequency. In the past few years, a newly described vascular pathology has been characterized by the sole presence of coiled, sometimes ectatic, arterial loops without any arteriovenous shunting. These lesions have been termed “pure arterial malformations” (PAMs). 4 , 5 Presently, the genesis and clinical significance of PAMs are unresolved. One of the initial hypotheses was that these lesions could represent asymptomatic

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Vinayak Narayan, Amey R. Savardekar, Devi Prasad Patra, Nasser Mohammed, Jai D. Thakur, Muhammad Riaz and Anil Nanda

that the obliteration of petrosal vein during surgery for petrous apex meningioma (PAM) did not have any major influence on postoperative outcome. 10 In their series of 55 patients with PAM, the vein of Dandy was sacrificed in 27 (49%) patients and the postoperative complication of hearing loss was noted in 3 (11%) patients; however, a similar deficit was also noted in 11% of the cohort in which veins were preserved. Pathmanaban et al. published their experience of 184 patients with coagulation and division of the SPV during MVDs. 24 The overall rate of venous

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Yukitomo Ishi, Shigeru Yamaguchi, Akihiro Iguchi, Yuko Cho, Junjiro Ohshima, Kanako C. Hatanaka, Emi Takakuwa, Hiroyuki Kobayashi, Shunsuke Terasaka and Kiyohiro Houkin

–5), VP-16 (100 mg/m 2 /day on Days 1–5), actinomycin D (0.015 mg/kg/day on Days 1–5), and vincristine (1.5 mg/m 2 /day on Days 8–15); 1 course of chemotherapy with VP-16 (100 mg/m 2 /day on Days 1–5), CPA (1200 mg/m 2 /day on Day 2), pirarubicin (60 mg/m 2 /day on Day 3), and CDDP (20 mg/m 2 /day on Days 1–5); and focal radiation of 22.8 Gy and craniospinal radiation of 25.2 Gy. Fourteen days after the last of the chemotherapy, peripheral blood stem cells were extracted. Subsequently, we performed HDC with VP-16 (200 mg/m 2 /day on Day −8 to Day −4) and melphalan (L-PAM

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Lee A. Tan, Michael Chen and Lorenzo F. Muñoz

differentiating intracerebral hemorrhage from iodinated contrast material staining . Radiology 257 : 205 – 211 , 2010 2 Phan CM , Yoo AJ , Hirsch JA , Nogueira RG , Gupta R : Differentiation of hemorrhage from iodinated contrast in different intracranial compartments using dual-energy head CT . AJNR Am J Neuroradiol 33 : 1088 – 1094 , 2012 3 Postma AA , Das M , Stadler AAR , Wildberger JE : Dualenergy CT: what the neuroradiologist should know . Curr Radiol Rep 3 : 16 , 2015 4 Tijssen MPM , Hofman PAM , Stadler AAR , van Zwam

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Pui Man Rosalind Lai and Nirav J. Patel

TO THE EDITOR: We read with great interest the article by Brinjikji and colleagues 1 ( Brinjikji W, Cloft HJ, Flemming KD, et al: Pure arterial malformations. J Neurosurg 129:91–99, July 2018 ). The authors presented a consecutive series of 12 patients meeting criteria for a pure arterial malformation (PAM). First described in 2013 by McLaughlin et al., 2 these malformations have been defined as vascular lesions with dilated, overlapping, and tortuous arteries, with no venous component or arteriovenous shunting . Pure arterial malformations are thought to

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.3171/jns.1996.85.3.0452 Long-term effects of continuous intrathecal opioid treatment in chronic pain of nonmalignant etiology Matthias Winkelmüller Wolfhard Winkelmüller September 1996 85 3 458 467 10.3171/jns.1996.85.3.0458 Activation of the complement cascade and increase of clusterin in the brain following a cortical contusion in the adult rat Bo-Michael Bellander Hans von Holst Pam Fredman Mikael Svensson September 1996 85 3 468 475 10.3171/jns.1996.85.3.0468 Blood-brain barrier breach following cortical contusion in

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. Kim Iman Feiz-Erfan Jonathan S. Hott Pam Goslar Joseph M. Zabramski Robert F. Spetzler February 2004 100 2 225 229 10.3171/jns.2004.100.2.0225 Comparison of routine and selective use of intraoperative angiography during aneurysm surgery: a prospective assessment Jeffrey D. Klopfenstein Robert F. Spetzler Louis J. Kim Iman Feiz-Erfan Patrick P. Han Joseph M. Zabramski Randall W. Porter Felipe C. Albuquerque Cameron G. McDougall David J. Fiorella February 2004 100 2

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Juan J. López-Lozano, Gonzalo Bravo, Begoña Brera, Isabel Millán, Jose Dargallo, Javier Salmeán, Jose Uría, Jose Insausti and Clínica Puerta de Hierro Neural Transplantation Group

implantations in Grade IV and V parkinsonian patients (selected on the basis of common clinical criteria and followed under the same clinical protocols) in whom the surgical technique and the implantation site were the constants and the donor tissue was the determinative variable. Using open surgery to implant perfused adrenal medulla (PAM) or fetal ventral mesencephalon (FVM) or to coimplant adrenal medulla and peripheral nerve in the caudate nucleus, we have achieved varying degrees of clinical improvement. 38–41 The purpose of this report is to describe the clinical

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Robert A. Beatty

. Acknowledgment The author thanks Pam Olsen, medical artist at the University of Illinois, for her assistance. References 1. Benini A : A modified technique for the construction of a lumbo-peritoneal shunt. Preliminary report and technical note. Acta Neurochir 28 : 189 – 192 , 1973 Benini A: A modified technique for the construction of a lumbo-peritoneal shunt. Preliminary report and technical note. Acta Neurochir 28: 189–192, 1973 2. Dakters JG , Yashon D , Croft TJ , et al : Cerebrospinal fluid