ABSTRACT
OBJECTIVES: In this article, we describe our experience in surgical management of dural arteriovenous fistulae (dAVF). MATERIALS AND METHODS: From August 2001 to February 2006 a total of six patients, were admitted at our hospital, 2 women and 4 men with ages between 40 and 68 years. RESULTS: Four of the six cases were entered through the service of Emergency Service by neurological deficit (in two cases) or decrease in the level of consciousness (in two patients); the remaining two patients were referred by lengthy headache and alterations on neuroimaging studies suggestive of dAVF. All of them showed dAVF in different locations which were treated successfully with surgery after angiographic studies. CONCLUSION: Although multiple therapeutic options are available, surgery is the treatment of choice in dAVF which shows aggressive clinical course, especially intracranial hemorrhage.
Subject(s)
Central Nervous System Vascular Malformations/surgery , Neurosurgical Procedures/methods , Adult , Aged , Aneurysm, Ruptured/etiology , Aneurysm, Ruptured/surgery , Central Nervous System Vascular Malformations/complications , Central Nervous System Vascular Malformations/diagnostic imaging , Cerebral Angiography , Cerebral Hemorrhage/etiology , Cerebral Hemorrhage/surgery , Emergencies , Female , Headache/etiology , Humans , Intracranial Aneurysm/etiology , Intracranial Aneurysm/surgery , Male , Middle Aged , Retrospective Studies , Sinus Thrombosis, Intracranial/etiology , Sinus Thrombosis, Intracranial/surgery , Tomography, X-Ray Computed , Treatment Outcome , Unconsciousness/etiologyABSTRACT
Objetivos. En este artículo describimos la experiencia quirúrgica de nuestro centro en el manejo quirúrgico de las malformaciones arteriovenosas duralesintracraneales (MAVd´s).Material y métodos. Presentamos una serie de seis casos, dos mujeres y cuatro hombres, con edades comprendidas entre 40 y 68 años, en el periodo que transcurre entre los años 2001 y 2006, en el Hospital Clínico San Carlos de Madrid. Resultados. Cuatro de los seis casos fueron ingresados a través del servicio de Urgencias por clínica deficitaria (en dos casos) o disminución del nivel de conciencia (en dos pacientes); los dos restantes fueron remitidos desde consultas externas por cefalea de larga evolución y alteraciones en el estudio de neuroimagen sugerentes de FAVd o MAVd. En todos ellos el tratamiento quirúrgico fue definitivo. Conclusiones. A pesar las múltiples opciones terapéuticas, la cirugía es de elección en MAVd que presenta especial tendencia a comportarse de forma agresiva; fundamentalmente con riesgo de hemorragia intracraneal
Objetives. In this article, we describe our experience in surgical management of dural arteriovenous fistulae (dAVF).Materials and methods. From Agust 2001 to Febrery2006 a total of six patients, were admitted at our hospital, with ages between 40 and 68 years. Results. Four of the six cases were entered through the service of Emergency Service by neurological defecit (in two cases) or decrease in the level of consciousness(in two patients); the remaining two patients were refered by lengthy headache and alterations on neuroimagen studies suggestive of dAVF. All of them showed dAVF in different locations which were treated successfully with surgery of the unique mortality of treatment after angiographical studies. Conclusion. Although multiple therapeutic option sare avaible, surgery is in dAVF which shows aggressive clinical course, especially intracranial hemorrhage
Subject(s)
Humans , Male , Female , Infant , Adult , Middle Aged , Aged , Central Nervous System Vascular Malformations/surgery , Central Nervous System Vascular Malformations/complications , Neurosurgical Procedures/methods , Retrospective Studies , Sinus Thrombosis, Intracranial/etiology , Cerebral Angiography , Cerebral Hemorrhage/etiology , Emergencies , Headache/etiology , Tomography, X-Ray Computed , Treatment Outcome , Unconsciousness/etiology , Intracranial Aneurysm/etiology , Aneurysm, Ruptured/etiologyABSTRACT
INTRODUCTION: Intraoperative brain mapping is used during neurosurgery in functional cortex to facilitate the extent of cortical resection and to identify nonfunctional tissue to remove subcortical lesions. OBJECTIVE: To describe the intraoperative brain mapping protocol that has been utilized in the Hospital Clínico San Carlos of Madrid, Spain. Detailed somatotopic motor, sensitive and language localization is possible using direct cortical electric stimulation in the awake patient. CONCLUSIONS: Intraoperative brain mapping is a surgical adjunct used during lesionectomy in functional cortex. In addition to preserving functions, the other essential goal is to achieve a radical removal while attempting to minimize the associated morbidity.
