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Endovascular treatment for acute ischemic strokeCiccone A, Valvassori L, Nichelatti M, Sgoifo A, Ponzio M, Sterzi R, Boccardi E; SYNTHESIS Expansion InvestigatorsN Engl J Med 368:904-913, 2013

2 4.5 362t-PA t-PA 3modified Rankin score 0 1181181 t-PA 3.75t-PA 2.75p 0.0013 5530.4t-PA 6334.8 0.7195 0.44-1.14p=0.167 6 t-PA

IMSMR-RESCUE t-PA 1 t-PA 1 t-PA 5954CTMR

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Comparative effectiveness of unruptured cerebral aneurysm therapies: propensity score analysis of clipping versus coilingMcDonald JS, McDonald RJ, Fan J, Kallmes DF, Lanzino G, Cloft HJStroke 44:988-994, 2013

2006 2011 logistic propensity scorecavariate balancescore120 4,8991,3883,551Propensity scoreOdds Ratio 1.4595 0.49-4.44p=0.47Odds Ratio 4.7895 3.51-6.58p 0.0001Odds Ratio 3.4295 2.39-4.99p 0.0001Odds Ratio 2.1695 1.33-3.57p 0.0001Odds Ratio 3.3995 2.25-5.22p0.0001Odds Ratio 2.1095 1.01-4.61p=0.0320

propensity scorenational database

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Ocular Circulation and Chronic Ocular Ischemic Syndrome before and after Carotid Artery Revascularization SurgeryKawaguchi S, Iida J, Uchiyama YJournal of Ophthalmology Article ID 350475 epub 2012

ocular ischemic syndromeOIS2002 1 2012 1CEACASNASCET 50 9090 2528OIS9OphArCRAVs51OphArCRA1OphAr2565OphArVs 0.05 0.34 m/secCRAVs 0.08 0.02 m/secp 0.05OphAr 1OphArVs 0.32 0.12 m/secCRAVs 0.11 0.03 m/secp 0.05 32OphArOIS 25 5p 0.05OphArCRAVsOISp 0.05OIS 25156010 3.61560OphArCRAVsOISOphArCRAOISOIS

CAS2chronic ocular ischemic syndromeneovascular

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glaucomaneovascular glaucomaCAS

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Reperfusion therapy in unclear-onset stroke based on MRI evaluation (RESTORE): a prospective multicenter studyKang DW, Sohn SI, Hong KS, Yu KH, Hwang YH, Han MK, Lee J, Park JM, Cho AH, Kim HJ, Kim DE, Cho YJ, Koo J, Yun SC, Kwon SU, Bae HJ, Kim JSStroke 43:3278-3283, 2012

diffusion-weighted imagingDWIperfusion-weighted imagingPWIunclear-onset strokeMRI 62006 9 2009 6 6unclear-onset stroke IV rt-PAMRI 20DWI-PWI mismatchDWI 1/3 3 IV rt-PA0.9 mg/kg3 0.6 mg/kg IV rt-PA / mechanical clot disruption / angioplastystenting 36 8unclear-onset stroke 156835717 IV rt-PA9 IV rt-PANIHSS 143modified Rankin Scale 0-2 3744.6 56.0baseline NIHSSbaseline NIHSSodds ratio 2.25p=0.019unclear-onset stokeMRI

time windowmodalityDWIPWIDWICTperfusionCBFCBVMTTTmax

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DWIPWImismatchunclear-onset stroke 6unclear-onset strokeSupplemental TableDEFUSE 2unclear-onset stroke 12MRIDEFUSE 2PWIRAPIDPWIDEFUSE 2MRIDWI-PWI mismatchRCTMR RESCUEPWIclot retrieverRCT

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The Barrow Ruptured Aneurysm Trial: 3-year resultsSpetzler RF, McDougall CG, Albuquerque FC, Zabramski JM, Hills NK, Partovi S, Nakaji P, Wallace RCJ Neurosurg 2013 April 26 Epub ahead of print

the Barrow Ruptured Aneurysm TrialBRAT 3238233crossover 471 3 349 170 64

38 179 42 13 modified Rankin ScalemRS3 35.8 30OR 1.3095 CI 0.83-2.04p=0.25 339 69 2 1 3 3 5.8

BRAT1 ISAT2,3 29,559 22.42,143725 471crossoverSpetzler Zabramskisurgical arm1 1471 1 403 205 198mRS 3 69

33.7 4623.3clippingOR 1.72p=0.02050OR 2.03p=0.007Hunt & Hess grade 2OR 3.51p 0.0001403 358 180crossover 42

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109crossover 6537 245 113 2.01p=0.01 1 22.6crossover 42.2crossover ISATcrossovercrossover

References McDougall CG, Spetzler RF, Zabramski JM, et al: The Barrow Ruptured Aneurysm Trial. J

Neurosurg 116:135-144, 2012. Molyneux A, Kerr R, Stratton I, et al: International Subarachnoid Aneurysm Trial (ISAT) of

neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet 360:1267-1274, 2002.

Molyneux AJ, Kerr RS, Yu LM, et al: International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 366:809-817, 2005.

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Middle cranial fossa sphenoidal region dural arteriovenous fistulas: anatomic and treatment considerationsShi ZS, Ziegler J, Feng L, Gonzalez NR, Tateshima S, Jahan R, Martin NA, Viuela F, Duckwiler GRAJNR 34:373-380, 2013

dural arteriovenous fistuladAVFdAVFdAVFvariationdAVFdAVFdAVF 111991 2010 323dAVF retrospective review11dAVF 5 6 9 311CCF3 1156 5 41superficial middle cerebral veinSMCV 65sphenobasal sinus1laterocavernous sinusbasal vein 6 4SMCV11 4 3 17 6 18nBCAOnyx 16 23Onyx 2flow reduction11anatomical curefollow up3 7 8dAVFdAVFSMCVdVAFSMCV

dAVFdAVFFig. 1sphenoparietal sinusSPS

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SMCVdVAFSMCVSan Milln Ruzdural sinusSMCVCSdAVFSMCV sphenobasal sinussphenopetrosal sinus paracavernous sinusCVD50conventional DSA3D-CTA 3D-MRIdAVFvariation dAVFDSAdAVFdAVFdAVFdAVFdAVFdAVFsphenoparietal sinusdAVFparacavernous sinus laterocavernous sinus laterocavernous sinusCS laterocavernous sinus cavernous sinusdAVFCSdAVFpatient 5

Fig. 3 laterocavernous sinus dAVF laterocavernous sinus dAVFdAVFdAVFparacavernous sinus dAVFCSdAVFaccess root

References San Milln Ruz D, Fasel JH, Rfenacht DA, et al: The sphenoparietal sinus of breschet: does it

exist? An anatomic study. AJNR 25:112-120, 2004. Tanoue S, Kiyosue H, Okahara M, et al: Para-cavernous sinus venous structures: anatomic

variations and pathologic conditions evaluated on fat-suppressed 3D fast gradient-echo MR images. AJNR 27:1083-1089, 2006.

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Vein of Galen malformations in neonates: new management paradigms for improving outcomesBerenstein A, Fifi JT, Niimi Y, Presti S, Ortiz R, Ghatan S, Rosenn B, Sorscher M, Molofsky WNeurosurgery 70:1207-1214, 2012

vein of Galen aneurysmal malformationVGAMmedian prosencephalic vein of MarkowskiVGAMVGAM2005 2010VGAM 0.5 1/3digoxin - 5-6 10 16 7 5 9choroidal type 10 1810g 1 85 1 3 2 3-6 4.2 8 6 25 3 11 1VGAM

VGAM 10

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14.7 62.5 32.7 35.6 3 9 777.8 111VGAM 16 7 5-6digoxindigoxinNeonatal Evaluation ScoreVGAM 1 2scoreVGAMvein of Galen aneurysmal dilatation 1

References Berenstein A, Masters LT, Nelson PK, et al: Transumbilical catheterization of cerebral arteries.

Neurosurgery 41:846-850, 1997. Heuchan AM, Bhattacharyha J: Superior vena cava flow and management of neonates with

vein of Galen malformation. Arch Dis Child Fetal Neonatal Ed. 97:F344-347, 2012. Khullar D, Andeejani AM, Bulsara KR: Evolution of treatment options for vein of Galen

malformations. J Neurosurg Pediatr. 6:444-451, 2010.