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Cerebral Angiomas - Advances in Diagnosis and Therapy (Paperback)
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Cerebral Angiomas - Advances in Diagnosis and Therapy (Paperback)
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The basic principles of the management of cerebral arteriovenous
mal- formations were established during the first phase of the
neurological attack on these problems between 1930 and 1960. The
leaders were CUSHING, BAILEY and DANDY, but principally OUVECRONA,
and in Ger- many TONNIS. The experience gained showed that complete
excision of the arteriovenous angioma was the only certain cure,
and therefore was the procedure of choice. In the present second
phase important advances should be made and indeed are occurring.
New diagnostic techniques such as total angio- graphy, selective
and superselective angiography, intraoperative and fluorescein
angiography, and the EMI-scanner have been developed. The
pathophysiological aspects have been further investigated by
indirect and direct measurement of local and general cerebral blood
flow. Parallel with these developments operative technique itself
has been improved and modified by new methods. A more aggressive
attitude has been stimulated towards those angiomas, which had to
be regarded as inoperable only a few years ago. Among these many
im- provements and technical advances include microsurgical
techniques, combined stereotactic and microsurgical procedures,
artificial emboliza- tion of different kinds and the cryosurgical
management. Multiple variables such as the age of the patient, the
type, localization, and size of the angioma, its clinical picture
and the possible complica- tions, such as hemorrhage have been
analysed and are understood better. These factors influence the
indication for, and choice of, the appropriate procedure to a great
extent.
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