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Locasale JW, Melman T, Song SS, Yang X, Swanson KD, Cantley LC, Asara JM, Wong ET, Adams S, Braidy N, Teo C, Guillemin G, Philippe M, Carole C, David T, Eric G, Isabelle NM, de Paula Andre M, Marylin B, Olivier C, L'Houcine O, Dominique FB, Leukel P, Seliger C, Vollmann A, Jachnik B, Bogdahn U, Hau P, Liu X, Kumar VS, McPherson CM, Chow L, Kendler A, Dasgupta B, Piya S, White E, Klein S, Jiang H, Lang F, Alfred Yung WK, Gomez-Manzano C, Fueyo J, Vartanian A, Guha A, Fenton KE, Abdelwahab M, Scheck AC, Guo D, Reinitz F, Youssef M, Hong C, Nathanson D, Akhavan D, Kuga D, Amzajerdi AN, Soto H, Zhu S, Babic I, Iwanami A, Tanaka K, Gini B, DeJesus J, Lisiero DD, Huang T, Prins R, Wen P, Robbins HI, Prados M, DeAngelis L, Mellinghoff I, Mehta M, James CD, Chakravarti A, Cloughesy T, Tontonoz P, Mischel P, Phillips J, Mukherjee J, Cowdrey C, Wiencke J, Pieper RO, Bachoo R, Marin-Valencia I, Cho S, Rakheja D, Hatanpaa K, Mashimo T, Vemireddy V, Kapur P, Good L, Sun X, Pascual J, Takahashi M, Togao O, Raisanen J, Maher EA, DeBerardinis R, Malloy C, Maher EA, Bachoo R, Marin-Valencia I, Hatanpaa K, Choi C, Mashimo T, Raisanen J, Mathews D, Pascual J, Madden C, Mickey B, Malloy C, DeBerardinis R, Mukherjee J, Zheng S, Phillips J, Cowdrey C, Ronen S, Wiencke J, Pieper RO, Park I, Jalbert LE, Ito M, Ozawa T, James CD, Phillips JJ, Vigneron DB, Pieper RO, Ronen SM, Nelson SJ. METABOLIC PATHWAYS. Neuro Oncol 2011; 13:iii69-iii72. [PMCID: PMC3199168 DOI: 10.1093/neuonc/nor153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023] Open
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Kim CY, Tate M, Chang E, Polley MY, Berger M, Mercier L, Del Maestro RF, Petrecca K, Collins DL, Doglietto F, Salehi F, Ridout R, Gentili F, Zadeh G, Shrivastava RK, Ghesani M, Sen C, Shrivastava RK, Tabaee A, Lee KD, DePowell JJ, Air E, Dwivedi AK, McPherson CM, Mishra MV, Andrews D, Evans J, Glass J, Dicker AP, Lawrence YR, Kirsch M, Juratli T, Meyer K, Schackert G, Cho JM, Kim EH, Oh MC, Chang JH, Kim SH, Lee KS, Cho JM, Kim EH, Oh MC, Chang JH, Kim SH, Lee KS, Adams H, Avendano J, Raza SM, Olivi A, Quinones-Hinojosa A, Del Maestro RF, Siu V, Seyed sadr M, Alshami J, Sabau C, Seyed sadr E, Anan M, Guiot MC, Samani A, Del Maestro P, Galameau A, Greaves K, Pouliot JF, Mangano F, Pruitt D, Hummel T. Surgical Therapies. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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McPherson CM, Bohinski RJ, Dagnew E, Warnick RE, Tew JM. Tumor resection in a shared-resource magnetic resonance operating room: experience at the University of Cincinnati. Acta Neurochir Suppl 2003; 85:39-44. [PMID: 12570136 DOI: 10.1007/978-3-7091-6043-5_6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
INTRODUCTION At the University of Cincinnati, we have developed a shared-resource magnetic resonance operating suite that facilitates performance of both neurosurgical and diagnostic procedures in a single unit. METHODS The shared-resource magnetic resonance operating suite utilizes a Hitachi AIRIS II, 0.3-T, vertical field, open MRI unit located in the MROR. This magnet can be used for both diagnostic and interventional procedures. The addition of a rotating-operating table permits neurosurgical procedures to be performed outside of the 5-G line using standard neurosurgical equipment and operating microscopes. RESULTS We review our results with the shared-resource magnetic resonance operating room including the tabulated results from 30 transsphenoidal procedures and 63 glioma procedures. In addition, 2832 diagnostic procedures have been performed in the first 4 years of use. CONCLUSION The shared-resource intraoperative MRI facility produces high-quality intraoperative imaging studies, equal to those of high-resolution magnets, and is valuable in enabling the surgeon to achieve the planned degree of resection of glioma and pituitary tumors. The ability to perform diagnostic procedures in a shared unit has been a cost-effective solution for our institution.
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Affiliation(s)
- C M McPherson
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0515, USA
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McPherson CM, Woo D, Cohen PL, Pancioli AM, Kissela BM, Carrozzella JA, Tomsick TA, Zuccarello M. Early carotid endarterectomy for critical carotid artery stenosis after thrombolysis therapy in acute ischemic stroke in the middle cerebral artery. Stroke 2001; 32:2075-80. [PMID: 11546899 DOI: 10.1161/hs0901.095679] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Tissue plasminogen activator (tPA) has been shown to be effective for acute ischemic stroke. However, if a high-grade cervical carotid stenosis remains despite tPA therapy, patients are at risk for recurrent stroke. Carotid endarterectomy (CEA) has been shown to be effective in symptomatic patients with high-grade cervical carotid stenosis in reducing the risk of stroke, but it is unknown whether CEA can be performed safely after tPA thrombolysis. We describe our experience with 5 patients who underwent early (<48 hours) CEA for residual high-grade cervical carotid stenosis after thrombolytic therapy for acute ischemic stroke in the middle cerebral artery territory. METHODS All patients had a critical (>99%) carotid artery stenosis on the symptomatic side after tPA therapy. All patients received intravenous tPA; 3 patients also received intra-aortic tPA. Three patients received intravenous heparin infusion immediately after administration of tPA. All patients showed marked improvement in their National Institutes for Health Stroke Scale scores after treatment with tPA. CEA was then performed within 45 hours (6 hours in 1 patient, 23 hours in 2, 26 hours in 1, and 45 hours in 1). RESULTS All 5 patients underwent successful CEA. There were no complications related to surgery. At discharge, 2 patients had a normal examination, and the remaining patients had mild deficits. In a long-term follow-up of 5 to 22 months, no patient had a recurrent cerebrovascular event. CONCLUSIONS Early CEA can be performed safely and successfully in patients after tPA treatment for acute ischemic stroke in appropriately selected patients.
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Affiliation(s)
- C M McPherson
- Neuroscience Institute, University of Cincinnati, Department of Neurosurgery, Cincinnati, Ohio, USA
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Eckard DA, O'Boynick PL, McPherson CM, Eckard VR, Han P, Arnold P, Batnitzky S. Coil occlusion of the parent artery for treatment of symptomatic peripheral intracranial aneurysms. AJNR Am J Neuroradiol 2000; 21:137-42. [PMID: 10669239 PMCID: PMC7976354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND AND PURPOSE Peripheral intracranial aneurysms can be difficult to treat with traditional surgical or embolization techniques that spare the parent vessel. We report the results of our use of coil occlusion of the parent vessel for the treatment of nine peripheral intracranial aneurysms. METHODS During approximately a 4-year period, nine patients (six men and three women, 27 to 68 years old; average age, 42 years) presented to our institution with peripheral intracranial aneurysms. The aneurysms were located on branches of the right posterior inferior cerebellar artery (n = 2), the right superior cerebellar artery (n = 1), the right anterior inferior cerebellar artery (n = 1), the right posterior cerebral artery (n = 3), the left middle cerebral artery (n = 1), and the left anterior cerebral artery (n = 1). Parent vessel occlusion was performed using microcoils after test injection with amobarbital (Amytal) in eight of the nine cases (one patient was comatose and could not be tested before occlusion). RESULTS Angiography immediately after the procedure showed aneurysmal occlusion in every patient. Follow-up arteriography, performed in six patients 2 to 12 months after treatment, documented continued aneurysmal occlusion in every case. Three patients exhibited mild, nondisabling neurologic deficits after coil placement; the rest had no new deficits, although one patient was severely disabled from the initial hemorrhage and one patient died of an unrelated cause. CONCLUSION Our results lend support to the use of parent vessel occlusion for peripheral aneurysms that are difficult to treat surgically or that are not amenable to intra-aneurysmal coil placement.
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Affiliation(s)
- D A Eckard
- Department of Neuroradiology, University of Kansas Medical Center, Kansas City 66160, USA
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Abstract
OBJECTIVES A technique for terminating refractory ventricular fibrillation is described. BACKGROUND Refractory ventricular fibrillation can occur in up to 0.1% of electrophysiologic studies. Animal studies have shown that rapid sequential shocks may reduce ventricular fibrillation threshold. METHODS Five patients of 2,990 consecutive patients in a 3-year period experienced refractory ventricular fibrillation during 5,450 routine electrophysiologic studies. Multiple shocks were delivered by means of a single defibrillator. Double sequential shocks were delivered externally 0.5 to 4.5 s apart by means of two defibrillators with separate pairs of electrodes. RESULTS In all patients, standard defibrillation was unsuccessful, but all were successfully resuscitated using the double sequential shocks. CONCLUSIONS This report stresses the importance of an additional defibrillator being readily available during electrophysiologic testing. This technique of rapid, double sequential external shocks may have general applicability, providing a simple and potentially lifesaving approach to refractory ventricular fibrillation.
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Affiliation(s)
- D H Hoch
- Cardiac Arrhythmia and Pacemaker Center, St. Francis Hospital, Roslyn, New York 11576
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