Cerebral Angiomas: Advances in Diagnosis and Therapy

ISBN-13: 9783540070733 / Angielski / Miękka / 1975 / 288 str.

H. W. Pia; J. R. W. Gleave; E. Grote

Opis

The basic principles of the management of cerebral arteriovenous mal- formations were established during the first phase of the neurological attack on these problems between 1930 and 1960. The leaders were CUSHING, BAILEY and DANDY, but principally OUVECRONA, and in Ger- many TONNIS. The experience gained showed that complete excision of the arteriovenous angioma was the only certain cure, and therefore was the procedure of choice. In the present second phase important advances should be made and indeed are occurring. New diagnostic techniques such as total angio- graphy, selective and superselective angiography, intraoperative and fluorescein angiography, and the EMI-scanner have been developed. The pathophysiological aspects have been further investigated by indirect and direct measurement of local and general cerebral blood flow. Parallel with these developments operative technique itself has been improved and modified by new methods. A more aggressive attitude has been stimulated towards those angiomas, which had to be regarded as inoperable only a few years ago. Among these many im- provements and technical advances include microsurgical techniques, combined stereotactic and microsurgical procedures, artificial emboliza- tion of different kinds and the cryosurgical management. Multiple variables such as the age of the patient, the type, localization, and size of the angioma, its clinical picture and the possible complica- tions, such as hemorrhage have been analysed and are understood better. These factors influence the indication for, and choice of, the appropriate procedure to a great extent.

Spis treści

The Indications and Contraindications for Treatment or Assessment.- I. Morphological Aspects.- The Morphology of Centrally-situated Angiomas.- Discussion on Chapter I.- II. Clinical Aspects.- The Epidemiology and Clinical Course of Arteriovenous Malformations.- The Influence of the Type and Localization of the Angiomaon the Clinical Syndrome.- Discussion on Chapter II.- III. Angiographical Aspects.- The Influence of Modern Angiographic Techniques.- Superselective Arteriography of the Branches of the External Carotid Artery.- Use of Intraoperative Angiography.- Extracranial and Extra-Intracranial Arteriovenous Angiomas.- Discussion on Chapter III.- IV. Pathophysiological Aspects.- The Influence of Cerebral Steal: Demonstration by Fluorescein Angiography and Focal Cerebral Blood Flow Measurement.- Investigation on Volume and Pressure Overloading of the Heart in Cerebral Angiomas.- Discussion on Chapter IV.- V. Operative Macro- and Microsurgical Treatment.- Extensive Cerebellar Arteriovenous Malformations.- Macro- and Microsurgery of Central Angiomas.- Stereotactic Treatment of Central Angiomas.- Angiomas of Cerebellum and Brain Stem.- Treatment of an Angioma of the Left Cerebral Hemisphere.- Treatment of Cranio-Cervical Angioma. Case Report.- The Acute Treatment of Cerebral Arteriovenous Angiomas Associated with Hematomas.- Discussion on Chapter V.- VI. Cryosurgical Treatment.- Freezing Arteriovenous Anomalies in the Brain.- Discussion on Chapter VI.- VII. Artificial Embolization.- Artificial Embolization of Inoperable Arteriovenous Malformations.- Experiences in the Use of Artificial Embolization as a Method of Treating Cerebral Angiomas.- The Artificial Embolization of Inoperable Angiomas.- Artificial Embolization of Inoperable Angioma with Polymerizing Substance.- Extra-Cerebral Embolization.- Treatment of Inoperable Glomus Jugulare Tumors.- Discussion on Chapter VII.- VIII. Radiotherapy.- Radiotherapy of Cerebral Angiomas. With a note on some problems in Diagnosis.- Discussion on Chapter VIII.- IX. The Natural History.- Conservative Management of Inoperable Arteriovenous Malformations.- The Conservative Treatment of Cerebral Arteriovenous Angiomas.- Summary and Conclusions.