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'neurosurgery' posts

Treating Arteriovenous Malformations to Remove the Risk of Rupture

An arteriovenous malformation (AVM) in the brain is a relatively rare condition – occurring in less that 1 percent of the population. It can, however, be neurologically morbid in young adults ages 15 to 20, who are at the greatest risk for hemorrhage and least likely to exhibit symptoms. About 2 to 4 percent of all AVMs each year hemorrhage.

An AVM’s tangled mass of blood vessels, which forms in utero, produces multiple direct connections between arteries and veins without the normal, intervening capillaries. Symptoms often are not present until later in life or until after the AVM ruptures.

A small number of congenital syndromes, such as Sturge-Weber, Rendu-Osler-Weber, ataxia telangiectasia, and Wyburn-Mason, are associated with AVMs. Once formed, extrinsic factors, such as arterial shunting, growth factors and intracranial hemorrhage, may alter the size and shape of an AVM.

The most common types of AVMs are:

Do you know the symptoms of a brain aneurysm?

It’s easy to get caught up in day-to-day demands and ignore changes in our health. It may not be wise, however, to dismiss those changes as symptoms of a hectic life. Blurred vision, dizziness or headaches that don’t get better can signal something serious.

Anywhere from 1 to 6 percent of Americans have a brain aneurysm but don’t know it. An aneurysm is a blister-like bulge on the wall of a blood vessel. It can go unnoticed for a long time. If it’s not treated, the pressure of the blood weakens the vessel, and the aneurysm grows like a balloon filling with air. If the aneurysm bursts, it causes a stroke.

An aneurysm can put pressure on nerves or tissue in the brain, which may cause:

  • Headache or neck pain
  • Vision problems, enlarged pupil, drooping eye lid
  • Numb face
  • Severe drowsiness

If you have a brain aneurysm, your doctor may ...

Swedish to Host World’s First Live-Instagrammed, Live-Tweeted Hearing Restoration Surgery as Part of Month-Long Educational Web Series on Hearing Loss

SEATTLE, Sept. 26, 2012 - Swedish Medical Center and Douglas Backous, M.D., medical director of the Center for Hearing and Skull Base Surgery at the Swedish Neuroscience Institute, will host the world’s first live-instagrammed and live-tweeted cochlear implant (hearing restoration) surgery on Tuesday, Oct. 2 at 7 a.m. Pacific Time (PT).

Swedish Awarded Major NIH Grant for Brain Disorders Research

David Newell, M.D., co-authors cover article in Journal of Neurosurgery

David Newell, M.D., neurosurgeon and co-executive director of the Swedish Neuroscience Institute (SNI), co-authored the cover article in the September Journal of Neurosurgery on the results of a study using ultrasound for the treatment of brain hemorrhage. The study involved 33 patients with spontaneous intracerebral hemorrhage who were screened for inclusion in a SNI clinical study known as “SLEUTH” (Safety of Lysis with Ultrasound in the Treatment of Intracerebral and Intraventricular Hemorrhage). Read the abstract and full text of the article. Read background information on the study. Watch a related video on WebMD.

Swedish Releases Groundbreaking Stroke Study in Journal of Neurosurgery

Advances in thrombolysis

 Washington State has one of the high est stroke mortality rates in the nation. To improve this situation, acute intervention al therapies for stroke are being employed to restore circulation to ischemic brain tissue that surrounds areas of completed infraction, while avoiding risk of hemor rhage due to reperfusion of large areas of infracted brain tissue.

Urgent thrombolysis with intrave nous alteplase is the only therapy known to improve clinical outcomes following acute stroke. Unfortunately, alteplase has had limited usage because many patients arrive in an emergency department after the three-hour treatment window. The FDA has also approved two clot removal devices based on the ability to restore circulation. These devices are used up to eight hours after symptom onset. Several approaches to improved acute stroke care are now under way, including extension of the thrombolysis window to 4.5 hours, identification of safer thrombolytic agents and research identifying brain at risk of in farction following a stroke.

A recent European study demonstrat ed the efficacy of alteplase up to 4.5 hours after ischemic stroke in patients younger than age 80 years who have neither dia betes mellitus or prior stroke. The safety profile during this longer window for these patients appears similar to that at three hours.

Another promising advance employs a new thrombolytic agent called des moteplase.

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