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  • 文章类型: Journal Article
    UNASSIGNED:经静脉栓塞(TVE)已被证明是安全可行的,可作为脑动静脉畸形(AVM)的替代治疗方法。我们介绍了4例接受TVE的出血性脑AVM患者,并回顾了相关文献。
    未经评估:在2019年7月至2020年7月期间,我们中心有4名患者接受了出血性脑AVM的TVE。我们回顾性收集并分析了这些患者的临床和影像学数据以及先前发表的研究报告。
    UNASSIGNED:纳入4例出血性脑AVM患者。Nidus尺寸范围为0.79至2.56cm。Spetzler-Martin的等级从II级到III级。三名患者的AVMnidus位于大脑深处。一名患者仅接受了TVE,三名患者接受了经动脉和经静脉联合入路。数字减影血管造影(DSA)显示所有四名患者栓塞后血管畸形完全消失。3例患者出院时独立[改良Rankin量表(mRS)评分≤2]。所有4例患者在最后一次随访时都是独立的。在最后一次血管造影随访中,所有四名患者均确认了AVM闭塞。
    UNASSIGNED:经静脉栓塞可作为当代脑动静脉畸形管理的替代疗法,适当的患者选择对于获得良好的临床结果至关重要。
    UNASSIGNED: Transvenous embolization (TVE) has been proven to be safe and feasible as an alternative management of brain arteriovenous malformations (AVMs). We presented four patients with a hemorrhagic brain AVM who underwent TVE and reviewed the relevant literature.
    UNASSIGNED: Four patients underwent TVE of a hemorrhagic brain AVM in our center between July 2019 and July 2020. We retrospectively collected and analyzed the clinical and imaging data of these patients and those reported in previously published studies.
    UNASSIGNED: Four patients with a hemorrhagic brain AVM were included. Nidus sizes ranged from 0.79 to 2.56 cm. Spetzler-Martin grade ranged from grade II to grade III. The AVM nidus was located in a deep brain region in three patients. One patient underwent TVE alone and three underwent combined transarterial and transvenous approaches. Digital subtraction angiography (DSA) demonstrated complete obliteration of the vascular malformation after embolization in all four patients. Three patients were independent [modified Rankin Scale (mRS) score ≤ 2] at discharge. All four patients were independent at the last follow-up. AVM obliteration was confirmed in all four patients at the last angiographic follow-up.
    UNASSIGNED: Transvenous embolization can be used as an alternative treatment for contemporary management of brain AVMs, appropriate patient selection is essential to achieve a good clinical outcome.
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  • 文章类型: Journal Article
    OBJECTIVE: To evaluate frontal sinus complications developed after previous external craniotomies requiring frontal sinus reconstruction and their treatment with an endoscopic approach.
    METHODS: We retrospectively evaluated 22 patients who referred to Sant\'Orsola-Malpighi University Hospital and Bellaria Hospital (Bologna, Italy) between 2005 and 2017. All patients presented with frontal sinus disease after frontal craniotomy with sinus reconstruction performed to treat various pathological conditions. We reported our experience in the endoscopic management of such complications and we reviewed the current literature concerning the endoscopic treatment of these conditions.
    RESULTS: In total, 14 frontal mucoceles, 4 cases of chronic frontal sinusitis, 2 mucopyoceles and 2 fungus ball of the frontal sinus were identified. Endoscopic surgical treatment included 7 DRAF IIa, 1 DRAF IIb, 11 DRAF III and 3 DRAF IIc (modified DRAF III) approaches. The success rate of the surgical procedure was 86% (19/22 patients). Recurrence of the initial pathology occurred in three patients (14%) requiring a conversion of previous frontal sinusotomy into a DRAF III sinusotomy.
    CONCLUSIONS: Frontal sinusopathy can be a long-term complication following craniotomies and may lead to potentially severe pathological conditions, such as mucoceles and frontal sinus inflammation. Its management is still debated and requires recovery of the patency of nasal-frontal route. Our study confirms that the endoscopic endonasal approach may offer a valid solution with low morbidity avoiding re-opening of the craniotomic access. For selected cases, endoscopic approach could also be performed simultaneously to craniotomy as a combined surgery to reduce the risk of short- and long-term complications. Long-term follow-up is mandatory in patients with a history of opened and reconstructed frontal sinus and should include imaging and endoscopic outpatient evaluation.
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  • 文章类型: Case Reports
    Spontaneous regression of an arteriovenous malformation (AVM) is the phenomenon of partial or complete obliteration of the vascular anomaly without any therapeutic intervention. Complete spontaneous regression is a rare event with limited previously reported cases in the literature. We present a new case of complete spontaneous regression of a right frontal AVM and report findings from the imaging studies. Furthermore, we present the findings of a detailed literature review and discuss hypotheses regarding the pathophysiology of this rare occurrence.
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  • 文章类型: Journal Article
    目的:外侧脱位损伤是一种外伤性牙齿损伤,其中牙齿向腭/舌或唇方向移位。这种损伤在儿童中很常见,可导致牙髓管闭塞或牙髓坏死。这项系统评价的目的是收集有关未成熟牙齿外侧脱位损伤的现有数据,以评估其总体预后。
    方法:使用Medline进行了系统搜索,Pubmed,Scopus,丁香花,EMBASE和Cochrane数据库于2017年10月发布。还手工搜索了参考文献列表以鉴定其他文献。纳入前瞻性和回顾性观察性研究。共筛选了502篇文章,其中6篇被纳入研究。
    结果:牙髓管闭塞是未成熟牙齿侧脱位最常见的并发症(31.3%)。其次是牙髓坏死(17.5%),炎性再吸收(5.7%),和表面吸收(3.2%)。由于研究的异质性,未尝试进行荟萃分析.研究中报告的结果差异很大。
    结论:由于目前的研究是回顾性或前瞻性队列研究,因此很难准确评估外伤性牙齿损伤的预后。侧向脱位是一种常见的外伤性牙齿损伤,对患者来说是终身关注的问题。对于未来的研究来说,重要的是报告相同的结果,以提高有关预后和治疗干预的证据质量。不仅是侧面脱位伤,但对于所有的牙齿外伤.
    OBJECTIVE: Lateral luxation injuries are a type of traumatic dental injury in which the tooth becomes displaced in the palatal/lingual or labial direction. This injury is common among children and can result in pulp canal obliteration or pulp necrosis. The objective of this systematic review was to gather existing data on lateral luxation injuries to immature teeth to evaluate their overall prognosis.
    METHODS: A systematic search was conducted using Medline, Pubmed, Scopus, Lilacs, EMBASE and Cochrane databases in October 2017. Reference lists were also hand-searched to identify additional literature. Prospective and retrospective observational studies were included. A total of 502 articles were screened and six articles were included in the study.
    RESULTS: Pulp canal obliteration was the most frequent complication of immature teeth with lateral luxation (31.3%). This was followed by pulp necrosis (17.5%), inflammatory resorption (5.7%), and surface resorption (3.2%). Due to the heterogeneity of the studies, a meta-analysis was not attempted. There was great variation in the reported outcomes among the studies.
    CONCLUSIONS: Accurate prognosis evaluation of traumatic dental injuries is difficult due to the nature of current studies being retrospective or prospective cohort studies. Lateral luxation is a common traumatic dental injury and has life-long concerns for a patient. It is important for future studies to report on the same outcomes to increase the quality of evidence regarding prognosis and treatment interventions, not only for lateral luxation injuries, but for all traumatic dental injuries.
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  • 文章类型: Journal Article
    Stereotactic radiosurgery (SRS) is a well established, minimally invasive treatment option for patients diagnosed with cerebral arteriovenous malformations (AVM). We present the experience in linear accelerator-based SRS for cerebral AVM treated over 14 years. We prospectively followed 67 patients with 69 AVM treated with SRS from 1994 to 2008, inclusive. The mean patient age was 37 years (range 7-69) with 36 women and 31 men. The median AVM size, as defined by maximal diameter, was 2.5 cm (range 0.5-4.6 cm) and the median marginal dose was 18 Gy in one fraction. The crude angiographic obliteration rate was 55% with a 3 and 5 year actuarial rate of 39% and 65%, respectively. Median time to obliteration was 4.2 years. Higher treatment dose (p<0.0001) and smaller maximal AVM diameter (p=0.002) were associated with an increased obliteration rate. There were no deaths from treatment. Post-treatment neurological complications occurred in 10 patients (15%) including hemorrhage in two. Twelve patients (18%) required a second SRS procedure. Larger AVM diameter was associated with increased odds of requiring re-treatment (p=0.02). Radiosurgery for intracerebral AVM is a non-invasive therapeutic option with low morbidity and a reasonable likelihood of nidus obliteration. Treatment dose and AVM diameter are the main determinants of obliteration.
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