CSF leak after acoustic neuroma surgery.
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Drug Combinations↗
Biomedical subjects
S Nutik
Publications and source records attributed to S Nutik.
Management of dural arteriovenous malformations of the anterior cranial fossa.
Eight patients with dural arteriovenous malformations (AVM's) of the anterior cranial fossa are presented, and the pertinent literature is reviewed. Unlike cases of dural AVM's in other locations, sudden massive intracerebral hemorrhage was the most frequent reason for presentation. Other symptoms included tinnitus, retro-orbital headache, and a generalized seizure. The malformations were supplied consistently by the anterior ethmoidal artery, usually in combination with other less prominent feeding vessels. The lesion's venous drainage was through the superior sagittal sinus via a cortical vein; in addition, in two cases a subfrontal vein drained the AVM. A venous aneurysm was encountered near the site of anastomosis with the dural feeder in most cases, and was found in all patients who presented with hemorrhage. The AVM was obliterated surgically in six patients, with favorable results achieved in five. One patient died postoperatively from a pulmonary complication. Because of their anatomy and proclivity for hemorrhage, these vascular malformations represent a unique group of dural AVM's. Surgical management of anterior fossa dural AVM's carries low morbidity, and is indicated when the lesions have caused hemorrhage or when there is an associated venous aneurysm.
Adult↗
Northern California Oncology Group protocol 6G91: response to treatment with radiation therapy and seven-drug chemotherapy in patients with glioblastoma multiforme.
The Northern California Oncology Group (NCOG) conducted a nonrandomized phase II study to evaluate the benefit of a seven-drug chemotherapy protocol (NCOG 6G91) in patients with glioblastoma multiforme (GM). Time to tumor progression was the primary end point of the study. The treatment consisted of 5-FU and lomustine administered after surgery and before radiation therapy, hydroxyurea and misonidazole during radiation therapy, and procarbazine and vincristine alternated with carmustine and 5-FU after radiation therapy. Ninety patients entered the study; data from the 64 patients with GM who completed radiation therapy and at least started the postradiation chemotherapy regimen and returned for follow-up examination are analyzed in this report. The median time to tumor progression in the 64 adequately treated patients was 42 weeks; the 25th percentile value was 60 weeks. A Cox multivariate analysis showed that age and extent of surgical resection were important prognostic variables in patients with GM. The results of this treatment regimen were similar to those of a previous NCOG protocol (6G61), which consisted of hydroxyurea during radiation therapy followed by chemotherapy with carmustine or a combination of lomustine, procarbazine, and vincristine.
Adult↗
Phase III comparison of BCNU and the combination of procarbazine, CCNU, and vincristine administered after radiotherapy with hydroxyurea for malignant gliomas.
The authors report the results of a randomized study conducted to evaluate the relative benefit of treatment with 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) or the combination of procarbazine, 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea, and vincristine (PCV) administered after radiation therapy with hydroxyurea to 76 evaluable patients with glioblastoma multiforme and 72 patients with other anaplastic gliomas. The primary end-point of the study was time to tumor progression. For better-risk patients with Karnofsky performance scores of 70 to 100, results suggest that PCV was of greater benefit than BCNU (p = 0.15 for glioblastoma multiforme; p = 0.13 for other anaplastic gliomas). Median times to tumor progression were 31 and 32 weeks for patients with glioblastoma multiforme; 25th percentile times to progression were 70 and 40 weeks for patients treated with PCV and BCNU, respectively. For patients with other anaplastic gliomas treated with PCV and BCNU, median times to progression were 123 and 77 weeks, respectively. Multivariate analysis showed that the prognostic variables of age and Karnofsky scores were important for patients with glioblastoma multiforme and other anaplastic gliomas, and that the extent of surgical resection was important for those with other anaplastic gliomas.
Adult↗
Carotid paraclinoid aneurysms with intradural origin and intracavernous location.
Five cases of a congenital berry aneurysm of the internal carotid artery with origin partially intradural and fundus mainly intracavernous are presented. Angiography does not allow a precise definition of the amount of aneurysm that is intradural, a fact of importance when planning treatment of these cases. However, the angiographic features are characteristics of the type and suggest that these aneurysms be grouped together as a separate entity.
Aged↗
Ceruminous tumor of the jugular foramen.
Intrapetrous ceruminomas are rate tumors; only four cases have been reported in the literature. These had characteristics of cerebellopontine angle tumors. Our case had the characteristics of a tumor of the jugular foramen.
Adenoma↗
Carotid-anterior cerebral artery anastomosis. Case report.
The angiographic and anatomical features of an anomalous communication between the intradural internal carotid artery and the anterior cerebral artery are described. Essential features of the anastomosis include an origin at, or close to, the origin of the ophthalmic artery, a course ventral to the ipsilateral optic nerve and anterior to the optic chiasm, and a termination near the anterior communicating artery. Although rare, the condition should be considered as an entity. The incidence of associated berry aneurysm and other congenital vascular anomalies is high.
Adult↗
[Effects of intrathoracic pressure on cerebral circulation in the monkey as a function of body posture, sitting or standing].
Sixty-four measurements of CBF were performed in 8 monkeys in supine and in sitting position under various conditions of ventilation. The position of the body does not normally influence the response of brain circulation to CO2. The response is not different from normal with high insufflation pressure in supine position and the capacities to autoregulation seem to be maintained. In vertical position however there are no longer any significant relations between CBF and PaCO2, and the loss of autoregulation seems to occur earlier and to be more marked. Correlation of these findings to neuroradiologic data indicates that the cerebral venous drainage through the meningospinal plexus is enhanced in vertical position and that during intrathoracic hyperpressure the cerebral venous blood is retained in the jugular vein and meningospinal plexus, thus decreasing the cerebral venous pressure increase and maintaining a perfusion of brain tissue compatible with the survival of the animal.
Animals↗
Angiographic demonstration of the cervical vertebral venous plexus in man.
Opacification of the cervical vertebral venous plexus was achieved by injecting contrast material into the upper part of the internal jugular vein while the lower portion of this vein was compressed externally with a tourniquet. The injection was easily performed via a percutaneous catheter which was advanced upwards into the jugular vein. Demonstration of the cervical plexus is made easier with the patients sitting up. Both sides of the plexus may be shown with a single injection if both jugular veins are injected simultaneously through bilateral catheters joined with a Y connector.
Animals↗
PCNU treatment for recurrent malignant gliomas.
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Adult↗