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Results of volume-staged fractionated Gamma Knife radiosurgery for large complex arteriovenous malformations: obliteration rates and clinical outcomes of an evolving treatment paradigm

Alberto Franzin, Pietro Panni, Giorgio Spatola, Antonella del Vecchio, Alberto L. Gallotti, Carmen R. Gigliotti, Andrea Cavalli, Carmine A. Donofrio, and Pietro Mortini

) Grades III to V were independent risk factors for poor outcome after embolization. 17 Theoretically, volume-staged radiosurgery could have the benefit of administering a high margin dose to the AVM nidus while maintaining a safe risk-profile. A few series report promising results using volume-staged radiosurgery for large cerebral AVMs. 2 , 3 , 6 , 11 , 13 , 23 , 26 , 27 We think volume-staged radiosurgery should be considered the first line of treatment for these formidable cerebral vascular malformations, and here we report the results of our experience with such a

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Cerebrospinal Fluid Volume

Neurosurgical Forum: Letters to the Editor To the Editor Takamitsu Fujimaki , M.D., Ph.D. Kiyoshi Takagi , M.D., Ph.D. Teikyo University Kazuya Nagata , M.D., Ph.D. NTT East Kanto Hospital Tokyo, Japan 1144 1146 Abstract Object. The purpose of this study was to establish a standard curve to demonstrate normal age-related changes in the proportion of intracranial cerebrospinal fluid (CSF) in intracranial volume (ICV) during each decade of life. Methods. Using volumetric

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Dynamic nature of cavernous malformations: a prospective magnetic resonance imaging study with volumetric analysis

Richard E. Clatterbuck, John L. Moriarity, Ilhan Elmaci, Roland R. Lee, Steven N. Breiter, and Daniele Rigamonti

. Over the course of 352.9 patient years, 114 lesions were identified and analyzed by location, volume, and MR imaging signal characteristics. In 71 lesions at least one follow-up image was available for similar analysis. On the basis of these serial data, we have calculated the rate of volume change in CMs and have described the progression of typical signal characteristics in these lesions over time. The natural history of our patient population has been reported elsewhere. 13 Clinical Material and Methods Patient Population The patient population consisted of 68

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Intracranial volume change in childhood

Spiros Sgouros, J. Henry Goldin, Anthony D. Hockley, Michael J. C. Wake, and Kalyan Natarajan

W hile attempting to investigate changes in intracranial volume in children with craniosynostosis, it became apparent that there was no normal reference range of changes in intracranial volume throughout childhood that could be used for a comparative study. Few studies have been published in which the development of intracranial volume in childhood has been investigated in healthy individuals. 3, 14, 18, 21, 25, 28 In all of these, volume was calculated from two-dimensional (2D) parameters derived from landmarks observed on plain skull radiographs. Following

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Ventricular volume following third ventriculostomy

Theodore H. Schwartz, Brian Ho, Charles J. Prestigiacomo, Jeffrey N. Bruce, Neil A. Feldstein, and Robert R. Goodman

, 29 This technique has demonstrated that ICP may remain elevated immediately after third ventriculostomy and begins to decrease between 4 to 8 days postoperatively. In an earlier retrospective study, 30 we showed that careful measuring of ventricular diameter on standard CT scans will show a consistent decrease in both third and lateral ventricular size if performed later than 1 month after successful surgery (that is, in patients with clinical improvement). We hypothesized that, because volume changes in proportion to the cube of the radius, measurements of

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Ventricular volume change in childhood

Chris Xenos, Spyros Sgouros, and Kalyan Natarajan

M any different methods have been reported for measuring the volume of the ventricular system in humans. Traditional volumetric methods required the production of casts of the ventricular system. 3, 18 The use of autopsy material led to artifacts directly attributable to the postmortem brain swelling or shrinkage due to fixation, and had the potential to compromise volume accuracy and reliability. 1, 8, 15, 25, 32 Before the advent of modern neuroimaging, pneumoencephalography was used for various described linear measurements. The classic Evans ratio 9

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Combined metopic and sagittal craniosynostosis: is it worse than sagittal synostosis alone?

Jordan S. Terner, Roberto Travieso, Su-shin Lee, Antonio J. Forte, Anup Patel, and John A. Persing

superimposed deformational plagiocephaly. D and E: Frontal (D) and lateral (E) views of a patient with combined sagittal and metopic craniosynostosis showing a deceivingly less severe–appearing deformity. In the normal pediatric skull, ICV, BTV, and CSF volume continually increase through early childhood. Yet, this increase is most rapid during the first 2.5 years of life, allowing the brain to reach more than 80% of its adult size in this period. Untreated craniosynostosis may lead to an inhibition of brain growth and in some cases an increase in intracranial

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Intracranial volume change in craniosynostosis

Spiros Sgouros, Anthony D. Hockley, J. Henry Goldin, Michael J. C. Wake, and Kalyan Natarajan

until the patient reaches 12 months of age. 21, 46 This wide variation implies that there is no clearly defined view of the relationship between the brain and skull vault growth in patients with craniosynostosis. The dynamics of intracranial volume change in patients with craniosynostosis have not been addressed systematically thus far. A significant problem implicated previously has been the lack of an accurate, reproducible, and simple way of measuring the capacity of the intracranial cavity. For the same reason, no adequate reference information exists on normal

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Normative human brain volume growth

Mallory Peterson, Benjamin C. Warf, and Steven J. Schiff

with neurocognitive development. 17 Although such efforts point to the potential value of tracking brain volume in the management of childhood hydrocephalus, as of yet there are no existing clinical brain growth charts suitable for the management of such cases. In this study, we seek to create such growth curves. Since this is an area of active research, we propose to create such charts at this stage to facilitate clinical research trials. Our expectation is that if brain volumes are validated as useful in managing hydrocephalus in clinical trials, brain growth

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The pressure-volume function of brain elasticity

Physiological considerations and clinical applications

Frederick H. Sklar and Ilya Elashvili

T he significance of the intracranial pressure-volume relationship has been a topic of extensive clinical and laboratory investigation. The elasticity of brain, meninges, and blood vessels determines the immediate pressure response to a rapid alteration of intracranial volume. 4, 14, 26, 27 It has been suggested that quantitative consideration of the pressure-volume relationship has important clinical and therapeutic applications. 21, 24, 28 This paper reviews the relationship of intracranial pressure as a function of volume. The pressure-volume function is