Christopher D Roark

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Ischemic strokes in childhood are rare. Thrombolytic therapy with intravenous (IV) tissue plasminogen activator (tPA) has been the main intervention for the management of pediatric stroke patients, but safety data are lacking and efficacy has been questioned. Recently, successful endovascular treatments for acute ischemic stroke in children have been(More)
OBJECTIVE Diathermy is contraindicated in patients with implanted deep brain stimulation (DBS) electrodes. As the clinical applications for diathermy and the number of patients with DBS implants continue to grow, the opportunity for diathermy-induced complications in the population with DBS electrodes increases. We report a case of reversible neurological(More)
PURPOSE To evaluate the capabilities of MR-guided "prospective stereotaxy" methods for accessing brain structures for biopsy or electrode implantation. MATERIALS AND METHODS MR-guided biopsy and deep brain stimulator (DBS) electrode implantations were performed with a trajectory guide and real-time MR guidance. Imaging methods were used to plan the(More)
BACKGROUND The frequency and associations of spontaneous hyperventilation in subarachnoid hemorrhage (SAH) are unknown. Because hyperventilation decreases cerebral blood flow, it may exacerbate delayed cerebral ischemia (DCI) and worsen neurological outcome. METHODS This is a retrospective analysis of data from a prospectively collected cohort of SAH(More)
BACKGROUND Hemiballismus is a rare presentation of symptomatic carotid stenosis that is underreported in the neurosurgical literature. It is characterized by severe large-amplitude movements that are classically caused by lesions of the subthalamic nucleus. Given the arterial border zone position of the subthalamic nucleus between the anterior and posterior(More)
BACKGROUND Stereotactic radiosurgery (SRS) is a treatment option for cerebral arteriovenous malformations (AVMs) to prevent intracranial hemorrhage. The decision to proceed with SRS is usually based on calculated nidal volume. Physicians commonly use the ABC/2 formula, based on digital subtraction angiography (DSA), when counseling patients for SRS. (More)
BACKGROUND Some patients undergoing dural sinus stenting for idiopathic intracranial hypertension (IIH) develop clinical and hemodynamic failure (recurrence of the pressure gradient) owing to stent-adjacent stenosis. OBJECTIVE To characterize factors associated with hemodynamic failure, and to describe outcomes of patients after repeat stenting. (More)
OBJECTIVE Flow-diverting devices have been used for the treatment of complex intracranial vascular pathology with success, but the role of these devices in treating iatrogenic intracranial vascular injuries has yet to be clearly defined. Here, the authors report their bi-institutional experience with the use of the Pipeline embolization device (PED) for the(More)
OBJECTIVE The characteristics, diagnosis, and preferred management strategies for distal posterior inferior cerebellar artery (PICA) aneurysms associated with cerebellar arteriovenous malformation (AVMs) are poorly understood. We present a case series with attention to aneurysm angioarchitecture, diagnostic imaging, treatment approaches, and a thorough(More)
Aneurysm rebleeding following initial endovascular management is uncommon, and the factors associated with its occurrence are poorly defined. We retrospectively analyzed a consecutive series of patients presenting with aneurysmal subarachnoid hemorrhage who underwent endovascular management to determine factors associated with rebleeding. Rebleeding(More)