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Bradley A. Gross, Ning Lin, Rose Du, and Arthur L. Day

C avernous malformations are clusters of dilated sinusoidal channels lined by a single layer of endothelium. 3 , 8 , 19 , 20 , 26 In contradistinction to arteriovenous malformations, these lesions do not have smooth muscle or elastin in their lining, and they are angiographically occult. Their prevalence across several reports ranges from 0.4% to 0.6% of the population. 8 , 14 , 22 , 26 , 27 Since 1991, multiple natural history reports have surfaced in the literature, with significant dissension in regard to lesion epidemiology and particularly

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Paul G. Matz, Paul A. Anderson, Langston T. Holly, Michael W. Groff, Robert F. Heary, Michael G. Kaiser, Praveen V. Mummaneni, Timothy C. Ryken, Tanvir F. Choudhri, Edward J. Vresilovic, and Daniel K. Resnick

years in 70% of cases (quality of evidence, Class III; strength of recommendation, D). It is recommended that discussion of the natural history of CSM conveys that the course of CSM is mixed, with many patients experiencing a slow, stepwise decline. Discussion should address the fact that long periods of quiescence are not uncommon and that a subgroup of patients may have interim improvement (quality of evidence, Class III; strength of recommendation, D). It is also recommended that discussion of the natural history of CSM convey that long periods of severe

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Soichi Oya, Seon-Hwan Kim, Burak Sade, and Joung H. Lee

M eningiomas are the most common benign brain tumor. 5 The recent increase in access to CT and MR imaging to evaluate minor head injury, nonspecific neurological symptoms, or paranasal sinus symptoms has led to the increased detection of small or incidental meningiomas. With increased detection of these meningiomas, clinicians including neurosurgeons, neurologists, and primary care physicians today are commonly faced with the management dilemma as to when and what treatment should be given. To solve this dilemma, we need to know the natural history of

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Aymeric Amelot, Remy van Effenterre, Michel Kalamarides, Philippe Cornu, and Anne-Laure Boch

caused by accidental damage to the oculomotor nerve or trigeminal nerve, surgical approaches to the CS have practically been abandoned. 23 Surgery is sometimes necessary and recommended only for extracavernous portions of sphenocavernous meningiomas. Radiation therapy is now the standard treatment of MCSs, but its mid- and long-term complications should not be underestimated. What complicates the choice of a treatment strategy for MCSs is an essential point: the poorly studied natural history of the disease. Indeed, it is not conceivable to randomize therapeutic

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Wajd N. Al-Holou, Samuel Terman, Craig Kilburg, Hugh J. L. Garton, Karin M. Muraszko, and Cormac O. Maher

T he prevalence and natural history of arachnoid cysts in adults are not well defined. With the increasing use of MRI and CT, there has been a corresponding increase in the number of incidentally diagnosed arachnoid cysts. 49 , 50 , 90 , 93 , 106 Prior studies of smaller groups of adults with arachnoid cysts have estimated cyst prevalence as between 0.3% and 1.7%. 8 , 27 , 49 , 50 , 90 , 93 We recently studied a large population of children undergoing brain MRI and found that the prevalence of arachnoid cysts in children was 2.6%, slightly higher than

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Wajd N. Al-Holou, Andrew Y. Yew, Zackary E. Boomsaad, Hugh J. L. Garton, Karin M. Muraszko, and Cormac O. Maher

T he prevalence and natural history of arachnoid cysts in children are not well defined. With the increased use of MR and CT imaging, there has been a corresponding increase in the number of incidentally diagnosed arachnoid cysts. 23 , 28 , 50 , 57 Prior studies focusing on adults estimate arachnoid cyst prevalence between 0.2 and 1.7%. 4 , 11 , 22 , 23 , 50 These estimates are based on smaller series of patients, almost all in the adult age range, and did not attempt to define prevalence by age. The long-term behavior of these cysts is also not well

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Wajd N. Al-Holou, Samuel W. Terman, Craig Kilburg, Hugh J. L. Garton, Karin M. Muraszko, William F. Chandler, Mohannad Ibrahim, and Cormac O. Maher

abnormalities, and Parinaud syndrome. 17 , 19 , 20 , 29 , 36 , 37 , 39 , 40 , 46 , 47 , 67 , 69 Previous studies on the prevalence of pineal cysts on intracranial imaging have reported a prevalence ranging from 1% to 4%. 3 , 15 , 22 , 33 , 35 , 40 , 51 , 59 , 61 We previously reported on the prevalence and natural history of pineal cysts in children. 3 , 4 In our current study, we evaluated a consecutive series of adult patients undergoing intracranial imaging to define the age-related prevalence of pineal cysts in this population. We then analyzed the outcome in those

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Robert D. Brown Jr., David O. Wiebers, Glenn Forbes, W. Michael O'Fallon, David G. Piepgras, W. Richard Marsh, and Robert J. Maciunas

C onsiderable controversy has surrounded the issue of whether an arteriovenous malformation (AVM) of the brain should be managed conservatively or with interventional treatment. The advent of more refined operative techniques, embolization techniques, and radiation treatments has led to greater optimism about aggressive management in recent years. However, it is not possible to assess the therapeutic benefit of any of these treatment modalities without a clear understanding of the natural history of intracranial AVM's. Relatively little is known about the

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Isaac Josh Abecassis, David S. Xu, H. Hunt Batjer, and Bernard R. Bendok

management varies substantially from patient to patient. The decision to proceed with treatment of a BAVM ultimately hinges on weighing the subsequent risk for intracranial hemorrhage with the immediate risks from intervention. Unfortunately, the natural history of BAVMs is still largely unknown. Current data are mostly limited to isolated single-center case series. Recently, ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)—a trial that randomly assigned AVM patients to either a conservative medical management group or an intervention group (any

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

Charlottesville, Virginia. 18 It is highly unlikely that these studies will ever be repeated and now, some 24 years after the first publication associated with that cooperative effort, 6 it seems appropriate to briefly summarize what has been learned about one important thrust of the work: namely, the natural history of aneurysms and arteriovenous malformations. We have summarized the findings of these reports and present conclusions, giving references to the original work, which may be examined for further details. Summary of Findings The case histories of patients