New interest in fibrinogen as an ischemic risk factor.

Platelet-fibrin clot formation is a key process in acute arterial thrombosis. The relationship between thrombin-induced platelet-fibrin clot strength (P-FCS) and fibrinogen levels in patients with cardiovascular disease (CVD) and COVID-19 has not been studied. In thhe current study, the contribution of fibrinogen to P-FCS has been explored in healthy subjects (n=157), patients hospitalized with COVID-19 (n=116), and patients with CVD (n=93) using thrombelastography (TEG 6s) with citrate cartridge.

Academic accomplishments of Black neurosurgeons in the United States.

Objective: Neurosurgery has remained relatively homogeneous in terms of racial and gender diversity, trailing behind national demographics. Less than 5% of practicing neurosurgeons in the United States identify as Black/African American (AA). Research and academic productivity are highly emphasized within the field and are crucial for career advancement at academic institutions.

An overview of the utility of prasugrel hydrochloride as a treatment option for ischemic stroke.

Introduction: Prasugrel, a potent P2Y receptor inhibitor, is not currently recommended in patients with stroke due to a higher rate of recurrent stroke. Prasugrel was associated with comparable efficacy to clopidogrel in reducing the risk of ischemic stroke in a recent phase III study.

Areas Covered: The authors provide an overview of the potential role of prasugrel in the management of ischemic stroke.

Effect of online public domain representation in neurosurgical resident recruitment and decision-making.

Objective: Over the past 20 years, female representation in neurosurgical residency programs has steadily increased. Still, the number of Black women and Black neurosurgical residents overall has remained stagnant. The authors aimed to understand the factors that led to this stagnation and how online public domain representation informs current and upcoming resident recruitment and decision-making.

Scoping review on the state of racial disparities literature in the treatment of neurosurgical disease: a call for action.

Objective: Racial disparities are ubiquitous across medicine in the US. This study aims to assess the evidence of racial disparities within neurosurgery and across its subspecialties, with a specific goal of quantifying the distribution of articles devoted to either identifying, understanding, or reducing disparities.

Methods: The authors searched the MEDLINE, EMBASE, and Scopus databases by using keywords to represent the concepts of neurosurgery, patients, racial disparities, and specific study types.

Safety and efficacy of intra-arterial fibrinolytics as adjunct to mechanical thrombectomy: a systematic review and meta-analysis of observational data.

Background: Achieving the best possible reperfusion is a key determinant of clinical outcome after mechanical thrombectomy (MT). However, data on the safety and efficacy of intra-arterial (IA) fibrinolytics as an adjunct to MT with the intention to improve reperfusion are sparse.

Methods: We performed a PROSPERO-registered (CRD42020149124) systematic review and meta-analysis accessing MEDLINE, PubMed, and Embase from January 1, 2000 to January 1, 2020.

Red fox viromes in urban and rural landscapes.

The Red fox () has established large populations in Australia's urban and rural areas since its introduction following European settlement. The cryptic and highly adaptable nature of foxes allows them to invade cities and live among humans whilst remaining largely unnoticed. Urban living and access to anthropogenic food resources also influence fox ecology.

Improving medical student recruitment to neurosurgery.

Objective: Neurosurgery seeks to attract the best and brightest medical students; however, there is often a lack of early exposure to the field, among other possible barriers. The authors sought to identify successful practices that can be implemented to improve medical student recruitment to neurosurgery.

Methods: United States neurosurgery residency program directors were surveyed to determine the number of medical student rotators and medical students matching into a neurosurgery residency from their programs between 2010 and 2016.

Basilar Apex Aneurysms in the Setting of Carotid Artery Stenosis: Case Series and Angiographic Anatomic Study.

Background: Intracranial aneurysms (IAs) are life-threatening lesions known within the literature to be found incidentally during routine angiographic workup for carotid artery stenosis (CAS). As IAs are associated with vascular shear stress, it is reasonable to expect that altered flow demands within the anterior circulation, such as with CAS, increase compensatory flow demands via the Circle of Willis (COW) and may induce similar stress at the basilar apex.

Objective: We present a series of nine unruptured basilar apex aneurysms (BAA) with CAS and a comparative radiographic analysis to BAA without CAS.

Flow Photo-Nazarov Reactions of 2-Furyl Vinyl Ketones: Cyclizing a Class of Traditionally Unreactive Heteroaromatic Enones.

Nazarov reactions of 2-furyl vinyl ketones and related heteroaromatic enones, to produce furan-fused cyclopentanones using a flow photochemical approach, are described. Compounds possessing this connectivity between heterocycle and ketone (2-furyl, 2-benzofuryl, 2-thiophene-yl, and 2-benzothiophene-yl) have traditionally proven difficult or impossible to cyclize with typical Brønsted and Lewis acid mediated methods. Using mild flow photochemistry conditions and acetic acid (AcOH) or hexafluoroisopropanol (HFIP) as solvent, these compounds were found to cyclize in 45-97% yields, with typical UV exposure times of 3.

Intra-Arterial Alteplase Thrombolysis during Mechanical Thrombectomy for Acute Ischemic Stroke.

Background: Intra-arterial alteplase (IA tPA) is commonly used during mechanical thrombectomy for acute ischemic stroke in patients with large-vessel occlusion, but specific indications and applications for its use remain undefined.

Methods: We analyzed 40 patients who underwent stent-retriever mechanical thrombectomy, 28 of whom received adjunctive IA tPA. To our knowledge, this is the largest cohort with this concomitant treatment reported in the literature in the post-mechanical thrombectomy trial era.

Delayed Presentation of an Extracranial Internal Carotid Artery Pseudoaneurysm and Massive Epistaxis Secondary to a Nasal Foreign Body: Case Report and Review of the Literature.

Background: Epistaxis is a very common medical condition and can often be controlled with conservative measures. Rarely, uncontrolled and life-threatening epistaxis can occur.

Case Description: We present the case of a 58-year-old man who developed delayed, massive epistaxis caused by an extracranial left internal carotid artery pseudoaneurysm caused by an intranasal foreign object without apparent recent trauma.

VOCs Emissions from Multiple Wood Pellet Types and Concentrations in Indoor Air.

Wood pellet storage safety is an important aspect for implementing woody biomass as a renewable energy source. When wood pellets are stored indoors in large quantities (tons) in poorly ventilated spaces in buildings, such as in basements, off-gassing of volatile organic compounds (VOCs) can significantly affect indoor air quality. To determine the emission rates and potential impact of VOC emissions, a series of laboratory and field measurements were conducted using softwood, hardwood, and blended wood pellets manufactured in New York.

Balloon-Occlusion Catheter Onyx Embolization of a Spinal Dural Arteriovenous Fistula Presenting with Subarachnoid Hemorrhage in a Pediatric Patient.

Objective: Spinal dural arteriovenous fistulas (DAVFs) are insidious pathologies that, if left untreated, harbor potentially devastating consequences to the central nervous system. Spinal DAVFs are rare in the adult population and exceedingly uncommon in the pediatric population. In this report, we describe a spinal DAVF in a 3-year-old child whose initial presentation is subarachnoid hemorrhage (SAH).

Microparticle derived proteins as potential biomarkers for cerebral vasospasm post subarachnoid hemorrhage. A preliminary study.

Objective: Cerebral vasospasm (CV) and associated secondary brain injury are major contributors to death and disability after aneurysmal subarachnoid hemorrhage (aSAH). Microparticles (MP) are small vesicular micro-molecules released by red and white blood cells, platelets and endothelial cells that can change rapidly and specifically depending on the type of cellular insult. They may serve as useful tools to target a specific pool of proteins associated with the development of CV post aSAH.

Bilateral Through-and-Through Trajectory of a Low-Velocity Transcranial Penetrating Foreign Object in a Twelve-Month-Old.

A 12-month-old girl sustained a penetrating intracranial trauma of a thin aluminum rod traversing from the left frontal bone and exiting the right occipital bone. The rod entered the left anterior frontal lobe, traveled through the ventricular system, narrowly missed the right posterior cerebral artery by less than 1 mm and exited through the right cerebellum. The rod was surgically extracted, and the child remained neurologically intact.

Spontaneous regression of intracranial aneurysm following remote ruptured aneurysm treatment with pipeline stent assisted coiling.

Spontaneous aneurysm regression is a rare phenomenon. We present the interesting case of a 54-year-old woman who was admitted with a Hunt/Hess grade IV, Fisher grade III subarachnoid hemorrhage and multiple intracranial aneurysms. She was treated with coiling of the largest paraclinoid aneurysm and placement of a flow diverting pipeline embolization device that covered all internal carotid artery (ICA) aneurysms.