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ventional radiologists; the latter is sometimes feasible even for inoperable aneurysms Otherwise, medical management as outlined above for subarachnoid hemorrhage is continued for about 6 weeks and is followed by gradual mobilization The risk of further hemorrhage is greatest within a few days of the first hemorrhage; approximately 20% of patients will have further bleeding within 2 weeks and 40% within 6 months Attempts have been made to reduce this risk pharmacologically Treatment with an antifibrinolytic agent such as aminocaproic acid during the first 14 days reduces the risk of recurrent hemorrhage but is associated with such an increase in cerebral ischemic complications that the mortality rate and the degree of disability among survivors are unchanged Thus, early operation (ie, within about 2 days of hemorrhage) is preferred for good operative candidates Calcium channel-blocking agents have helped reduce or reverse experimental vasospasm, and nimodipine has been shown to reduce, in neurologically normal patients, the incidence of ischemic deficits from arterial spasm without producing any side effects The dose of nimodipine is 60 mg every 4 hours orally for 21 days After surgical obliteration of any aneurysms, symptomatic vasospasm may also be treated by intravascular volume expansion, induced hypertension, or transluminal balloon angioplasty of involved intracranial vessels; aspirin provides no benefit With regard to unruptured aneurysms, those that are symptomatic merit prompt treatment, either surgically or by endovascular coil embolization, whereas small asymptomatic ones discovered incidentally are often monitored arteriographically and corrected surgically only if they increase in size to over 10 mm

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Doerfler A et al Endovascular treatment of cerebrovascular disease Curr Opin Neurol 2004 Aug;17(4):481 7 [PMID: 15247546] Molyneux AJ 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 2005 Sep 3 9;366(9488):809 17 [PMID: 16139655] Nieuwkamp DJ et al Subarachnoid haemorrhage in patients 75 years: clinical course, treatment and outcome J Neurol Neurosurg Psychiatry 2006 Aug;77(8):933 7 [PMID: 16638789] Pouratian N et al Endovascular management of unruptured intracranial aneurysms J Neurol Neurosurg Psychiatry 2006 May;77(5):572 8 [PMID: 16614015]

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Another feature in this example is the use of the character for continuing a line. To insert this character, press Option-Return. Input/output AppleScript excels at program automation. However, sometimes you need to use it as a general-purpose programming language. One of these cases is text-file processing. Like it or not, a simple, structured text file is one of the best ways to store data and log data during automation tasks. Here are some basic file I/O operations:

Arteriovenous malformations are congenital vascular malformations that result from a localized maldevelopment of part of the primitive vascular plexus and consist of abnormal arteriovenous communications without intervening capillaries They vary in size, ranging from massive lesions that are fed by multiple vessels and involve a large part of the brain to lesions so small that they are hard to identify at arteriography, surgery, or autopsy In approximately 10% of cases, there is an associated arterial aneurysm, while 1 2% of patients presenting with aneurysms have associated arteriovenous malformations Clinical presentation may relate to hemorrhage from the malformation or an associated aneurysm or may relate to cerebral ischemia due to diversion of blood by the anomalous arteriovenous shunt or due to venous stagnation Regional maldevelopment of the brain, compression or distortion of adjacent cerebral tissue by enlarged anomalous vessels, and progressive gliosis due to mechanical and ischemic factors may also be contributory In addition, communicating or obstructive hydrocephalus may occur and lead to symptoms

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