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Surgical Neuroangiography: Vol. 2: Clinical and Endovascular Treatment Aspects in Adults PDF

1320 Pages·2004·69.41 MB·English
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Preview Surgical Neuroangiography: Vol. 2: Clinical and Endovascular Treatment Aspects in Adults

Surgical Neuroangiography 2.1 Springer Berlin Heidelberg New York Hong Kong London Milan Paris Tokyo The complete three-volume set consists of Volume 1 Clinical Vascular Anatomy and Variations Volume 2 Clinical and Endovascular Treatment Aspects in Adults Volume 3 Clinical and Interventional Aspects in Children A. Berenstein Surgical P. Lasjaunias K.G. ter Brugge Neuroangiography 2.1 Clinical and Endovascular Treatment Aspects in Adults • Cerebral Ischemia • Vascular Tumors of the Head and Neck • Traumatic Arteriovenous Fistulae • Aneurysms Second Edition with 734 Figures in 2926 Separate Illustrations, Some in Color and 155 Tables Springer Alejandro Berenstein, M. D. Professor of Radiology and Neurosurgery Albert Einstein School of Medicine, NY Director of the Hyman-Newman Institute of Neurology and Neurosurgery, and of The Center for Endovascular Surgery Beth Israel Medical Center New York 170 East End Avenue at 87th Street, New York, NY 10128, USA Pierre Lasjaunias M. D., Ph. D. Professeur des Universites en Anatomie Chef de Service de Neuroradiologie Diagnostique et Therapeutique Centre Hospitalier Universitaire de Bicetre 78, rue du General Leclerc, 94275 Le Kremlin Bicetre, France Karel G. ter Brugge, M. D. Professor of Radiology and Neurosurgery Head, Division of Neuroradiology University of Toronto / University Health Network Department of Medical Imaging, Toronto Western Hospital, FP3-21O 399 Bathurst Street, Toronto, ON M5T 2S8, Canada The second volume of the second edition of Surgical Neuroangiography combines the previous volumes 2, 4 and 5 in a two part volume. ISBN 3-540-41668-4 Springer-Verlag Berlin Heidelberg New York Cataloging-in-Publication Data applied for Bibliographic information published by Die Deutsche Bibliothek Die Deutsche Bibliothek lists this publication in the Deutsche Nationalbibliografie; detailed bibliographic data is available in the Internet at <http://dnb.ddb.de>. This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other ways, and storage in data banks. Duplication of this publication or parts thereof is only permitted under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under the German Copyright Law. Springer-Verlag is a part of Springer Science+ Business Media springeronline.com © Springer-Verlag Berlin Heidelberg 1987/1992,2004 The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about the application of operative techniques and medications contained in this book. In every individual case the user must check such information by consulting the relevant literature. Cover design: E. Kirchner, Heidelberg, Germany Typesetting: Fotosatz-Service Kohler GmbH, Wiirzburg, Germany Printed on acid-free paper 2113150/ih 5 4 3 210 Preface Anatomy is a language and mastery of this language is in our opinion essential for physicians involved in the management of patients with vas cular diseases of the central nervous system, head and neck, and spine and spinal cord. Understanding the clinicopathological aspects of vascular disease, its natural history, and the various therapeutic options is manda tory for optimal patient management. Functional endovascular therapeutic strategies continue to expand and those that are currently available are discussed within the realm of the authors' combined experience. Our approach goes beyond today's tech nological advances and involves a new understanding of how vascular pathology is expressed, its impact on the structure of the vascular sys tems, and the possible repair mechanisms of the vascular system in vari ous environments. The latest techniques that improve such therapeutic goals are illustrated in the individual chapters on the diseases and high lighted in the chapter on techniques. The important field of occlusive vascular disease and our ability to re open stenotic or even occluded vessels are revolutionizing Endovascular Neurosurgery. An in-depth study of occlusive vascular disease is a major addition to this second edition of Surgical Neuroangiography (Vol. 2). Functional anatomical strategies and protocols are illustrated with the lat est technological devices. As the rapid technological evolution continues, our approach and understanding will help guide us to the safest and most effective revascularization strategy. Our new concepts with respect to aneurysms as a group of diseases of different etiologies and pathophysiologies alter the therapeutic indica tions for their management and therefore the role of specific treatment techniques. Our experience in the management of patients with vascular disorders now extends over many decades and forms the basis for an approach to cerebral and dural vascular malformations that is both at the leading edge and well balanced. Management decisions based on a thorough under standing of these vascular pathologies, their natural history, as well as the risks associated with their treatment have been outlined in the text. This work is a reflection of the authors' ongoing commitment to balancing the exciting technological advances of the tools that have become available with thorough knowledge of vascular anatomy and an exhaustive under standing of vascular pathologies. It is this unique approach that facilitates ongoing progress in the safe management of patients with vascular disor ders affecting the brain, the spine, and the head and neck. December 2003 A. Berenstein, P. Lasjaunias, K.G. ter Brugge Contents of Volumes 2.1 and 2.2 1 Occlusive Vascular Disease 1 1.1 Introduction . . . . . . . . . 2 1.2 Arterial Occlusive Disease . 3 1.2.1 Cerebrovascular Physiology ........ . 3 1.2.1.1 The Blood-Brain Barrier 3 1.2.1.2 Cerebral Blood Flow 4 1.2.1.3 Cerebral Autoregulation 5 1.2.1.4 Cerebral Blood Volume . 7 1.2.1.5 Blood Viscosity ..... . . . . . . . . 8 1.2.1.6 Metabolism in Cerebral Blood Flow . . . . . . 8 1.2.1.7 Carbon Dioxide Reactivity .......... . 9 1.2.1.8 Oxygen Reactivity .............. . 9 1.2.1.9 Nitrous Oxide in Cerebral Circulation ... . 9 1.2.1.1 0 Other Factors ......... ...... . 10 1.2.2 Arterial Ischemic Stroke .......... . 14 1.2.2.1 Definition ................... . 14 1.2.2.2 Neuronal Metabolism and Cerebral Ischemia 17 1.2.2.3 Selective Neuronal Vulnerability . . . . . . . 18 1.2.2.4 Hemodynamic Effects of Ischemia ..... 21 1.2.2.5 Nitrous Oxide and Cerebral Ischemia . . . . 21 1.2.2.6 Window of Opportunity ......... . 22 1.2.2.7 Neutrophil ................ . 23 1.2.3 Atherosclerosis ............. . 23 1.2.3.1 Introduction . . . . . . . . . . . . . . . . 23 1.2.3.2 Epidemiology ............. . 23 1.2.3.3 Pathogenesis . . . . . . . . . . 24 1.2.3.4 Mechanisms of Atherogenesis 24 1.2.3.5 Fatty Streak ...... . 27 1.2.3.6 Fibrous Plaque . . . . . . 28 1.2.3.7 Unstable Fibrous Plaques 28 1.2.3.8 Complicated Plaque . . . 28 1.2.3.9 Carotid Atherosclerosis . . . . . . 29 1.2.3.10 Conclusion . . . . . . . . . . . . . 29 1.2.3.11 Neuroimaging of Ischemic Stroke 30 1.2.4 Ischemic Stroke Treatment . . . . 31 1.2.4.1 Medical Treatment of Acute Stroke ........... . 31 1.2.4.2 Thrombolytic Therapy: Introduction .......... . 32 1.2.4.3 Thrombolytics (IV) . . . . . . . . . . . . . . . . . . . . . 32 1.2.4.4 Recombined Tissue Plasminogen Activator . . . . . . . . 32 VIII Contents of Volumes 2.1 and 2.2 1.2.4.5 Streptokinase ..... . 33 1.2.4.6 Antiplatelets . . . . . . . 34 1.2.4.7 Coumadin Versus Aspirin 39 1.2.4.8 Neuroprotective Agents .. 39 1.2.4.9 Pharmacological Properties of Neuroprotective Drugs 40 1.2.4.10 Binding Properties ............... . 41 1.2.4.11 Angiographic Evaluation . . . . . . . . . . . . . 41 1.2.4.12 Middle Cerebral Artery Stroke: Natural History 44 1.2.4.13 Local Intra-arterial Thrombolysis in the Anterior Circulation . . . . 45 1.2.4.14 Internal Carotid Artery Occlusion 52 1.2.4.15 Carotid Dissection ....... . 57 1.2.4.16 Central Retinal Artery Occlusion 67 1.2.4.17 Internal Carotid Artery Stenosis Above the Carotid Bulb 68 1.2.4.18 General Organization of a Stroke Emergency Team 70 1.2.4.19 Evolving Treatment Strategies .... 72 1.2.5 Extracranial Carotid Artery Stenosis 73 1.2.5.1 Introduction . . 73 1.2.5.2 Natural History 73 1.2.5.3 Carotid Bruit 75 1.2.5.4 Imaging 75 1.2.5.5 Treatment . 84 1.2.5.6 Symptomatic Carotid Stenosis 86 1.2.5.7 Asymptomatic Carotid Stenosis 86 1.2.5.8 Restenosis After Carotid Endarterectomy 89 1.2.6 Carotid Angioplasty and Stenting .... 90 1.2.6.1 Introduction . . . . . . . . . . . . . . . . 90 1.2.6.2 Techniques of Carotid Angioplasty and Stenting 93 1.2.6.3 Intimal Hyperplasia and Restenosis . . . . . . . 93 1.2.6.4 Follow-up Monitoring ............. . 98 1.2.7 Posterior Circulation Stroke (Stroke Prevention) 98 1.2.7.1 Introduction . . . . . . . . 98 1.2.7.2 Clinical Presentation ...... . 98 1.2.7.3 Pretherapeutic Evaluation in Cerebral Vascular Insufficiency 99 1.2.7.4 Management of Posterior Circulation Insufficiency 104 1.2.7.5 Basilar Thrombosis . 110 1.2.7.6 Takayasu's Arteritis . 115 1.2.8 Cerebral Angioplasty 116 1.2.8.1 Vasospasm ..... . 117 1.3 Venous Occlusive Disease 135 1.3.1 Etiology ........ . 135 1.3.2 Incidence ........ . 136 1.3.3 Clinical Presentation and Natural History 137 1.3.4 Imaging 138 1.3.5 Treatment 143 Appendix. 147 Contents of Volumes 2.1 and 2.2 IX 2 Dural and Bony Tumors 153 2.1 Introduction . 154 2.2 Meningiomas 154 2.2.1 Epidemiology 154 2.2.1.1 Origin 154 2.2.1.2 Incidence ... 154 2.2.1.3 Association of Meningiomas with Other Tumors 155 2.2.1.4 Sex Hormone Receptors in Meningiomas 156 2.2.1.5 Chromosomal Patterns in Meningiomas 156 2.2.1.6 Meningiomas in Children ....... . 156 2.2.1.7 Familial Occurrence . . . . . . . . . . . . 157 2.2.1.8 Meningioma Incidence, Prevalence, and Mortality 157 2.2.1.9 Etiology of Human Meningiomas 157 2.2.1.10 Oncogenic Viruses 158 2.2.2 Pathology ..... 161 2.2.2.1 Growth and Spread 162 2.2.2.2 Malignant Meningioma 162 2.2.2.3 Angioblastic Meningioma and/or Hemangiopericytoma 165 2.2.2.4 Meningioangiomatosis ... 166 2.2.2.5 Meningeal Meningiomatosis 166 2.2.3 Clinical Presentation . 166 2.2.3.1 Sites ............ . 169 2.2.3.2 Epidural Meningiomas .. 177 2.2.3.3 Meningiomas of the Orbit 177 2.2.3.4 Meningiomas Involving the Cavernous Sinus 178 2.2.3.5 Meningiomas in Other Unusual Sites 179 2.2.3.6 Intracranial Vascular Involvement . . 179 2.2.3.7 Peri tumoral Edema in Meningiomas 181 2.2.4 Pretherapeutic Evaluation .. 181 2.2.4.1 CT Scanning in Meningiomas 181 2.2.4.2 MRI Scanning ....... . 182 2.2.4.3 Angiographic Investigation 184 2.2.4.4 Differential Diagnosis . . . . 187 2.2.5 Therapeutic Strategy and Clinical Objectives 187 2.2.6 Technical Aspects of Embolization ..... 189 2.2.7 Special Considerations in Meningioma Embolization 192 2.2.7.1 Extracranial Tumor Extension . . . . . . . . . . . . 192 2.2.7.2 Recurrent Meningiomas .............. . 192 2.2.7.3 Internal Carotid Supply to Recurrent or Malignant Meningiomas After Radiation Therapy Has Failed 194 2.2.7.4 Pial Supply . . . . . . . . . . . . . . . . . . . . . . 194 2.2.7.5 Pre- and Postembolization Medical Management 194 2.2.7.6 Time of Operation . . . . . . . . 196 2.2.7.7 Complications of Embolization 196 2.3 Other Bony and Dural Tumors 198 2.3.1 Cerebral Tumors . . . . . 198 2.3.2 Neurinomas ...... . 199 2.3.3 Esthesioneuroblastomas 199 X Contents of Volumes 2.1 and 2.2 3 Nasopharyngeal Tumors 201 3.1 Juvenile Angiofibromas 201 3.1.1 Macroscopic Pathology 201 3.1.2 Microscopic Pathology 204 3.1.3 Epidemiology ........................ 205 3.1.4 Pathophysiology . . . . . . . . . . . . . . . . . . . . . .. 206 3.1.4.1 Juvenile Angiofibromas and Sex Hormones 206 3.1.4.2 Physiology and the Nasal Mucosa ... 206 3.1.4.3 Hormones and the Vascular System . . . . . 207 3.1.4.4 Global Hypothesis for the Development of Juvenile Angiofibromas 207 3.1.5 Clinical Findings ..... 210 3.1.6 Natural History ...... 211 3.1.7 Pretherapeutic Evaluation 211 3.1.7.1 Computed Tomography. . . . . .. .......... 211 3.1.7.2 Magnetic Resonance Imaging ............... 211 3.1.7.3 Angiography . . . . . . . . . . . . . . . . . . . . . . . .. 211 3.1.8 Therapeutic Goals . . . . . . . . . . . . . . . . . . . . .. 214 3.1.8.1 Radiation Therapy ................ 221 3.1.9 Technical Aspects of Embolization ....... 221 3.1.10 Tumor Recurrence ....... 223 3.2 Other Nasopharyngeal Tumors 224 3.3 Conclusion . . . . . . . . . . . . 226 4 Paragangliomas 227 4.1 Introduction . . . 227 4.2 Embryology ... 228 4.3 Epidemiology .... 230 4.4 Pathology ...... 232 4.4.1 Vascular Architecture 233 4.5 Natural History ... 235 4.6 Clinical Aspects ...... 236 4.6.1 Tympanic Paragangliomas 236 4.6.2 Jugular Paragangliomas 238 4.6.3 Cervical Paragangliomas 238 4.6.4 Paragangliomas in Other Locations ..... . . . . . .. 244 4.6.5 Secretory Paragangliomas 245 4.6.6 Associated Lesions 246 4.7 Differential Diagnosis 246 4.8 Pretherapeutic Evaluation ............. 250 4.8.1 Angiographic Protocol ............... 252 4.8.2 Temporal Paragangliomas: Specific Features ... 252 4.8.3 Cervical Paragangliomas: Specific Features 257 4.9 Therapeutic Strategies ............... 260 4.10 Technical Aspects of Embolization ........ 261 4.11 Complications of Embolization of Paragangliomas 264 Contents of Volumes 2.1 and 2.2 XI 5 Other Head and Neck Tumors 265 5.1 Thyrolaryngeal Tumors 265 5.2 Craniofacial Tumors 270 6 Traumatic Arteriovenous Fistulae 277 6.1 Introduction . . . . . . . . . . . . . . 277 6.2 Traumatic Carotid Cavernous Fistulae 279 6.2.1 Etiology and Epidemiology . . . . . . . 279 6.2.2 Clinical Aspects of Traumatic Carotid Cavernous Fistulae 285 6.2.2.1 Ophthalmological Symptoms ............... 293 6.2.2.2 Corneal Ulcerations and/or Infections and Secondary Glaucoma . 293 6.2.2.3 Diplopia ................. 298 6.2.2.4 Cranial Nerve Involvement in Traumatic Carotid Cavernous Fistulae 298 6.2.2.5 Bruit ................. 300 6.2.2.6 Arterial Steal . . . . . . . . . . . . . 300 6.2.2.7 Hemispheric Arterial Insufficiency 300 6.2.2.8 Associated Traumatic Lesions 302 6.2.3 Pretherapeutic Evaluation .. 306 6.2.3.1 Location of the Fistula 308 6.2.3.2 Venous Drainage of the Fistula 314 6.2.4 Therapeutic Objectives and Strategy 321 6.2.4.1 Embolization ............. 321 6.2.4.2 Emergency Treatment ........ 322 6.2.4.3 Surgical Approach to Carotid Cavernous Fistulae 324 6.2.4.4 Conservative Treatment of Traumatic Carotid Cavernous Fistulae 325 6.2.5 Technical Aspects of Embolization 325 6.2.5.1 Balloon Selection ........... 325 6.2.5.2 Manual Compression . . . . . . . . . 332 6.2.5.3 The Use of NBCA in the Management of Carotid Cavernous Fistulae .... 332 6.2.6 Postembolization Care ........ 333 6.3 Other Traumatic Arteriovenous Fistulae 334 6.3.1 Extracavernous Arteriovenous Fistulae 334 6.3.2 Vertebral Arteriovenous Fistulae 338 6.3.3 Common Carotid Fistulae 342 6.3.4 External Carotid Fistulae 342 6.3.5 Malignant Fistulae 354 6.3.6 Other Epistaxis 354 6.3.6.1 Coagulopathy ... 357 6.3.6.2 Spontaneous Epistaxis 357 6.3.6.3 Tumoral Epistaxis . 357 6.3.6.4 Biopsy ....... 359 6.3.6.5 Traumatic Epistaxis 362

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From the reviews:"The presentation of the book is admirable with most chapters beginning with discussion of basic pathophysiology and continuing with clinical aspects and practical advice. … The authors are careful not to present simply the latest technological advances, but to underpin the book w
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Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.