Microsurgical Management of Internal Carotid Artery Bifurcation Aneurysm After Failure of Endovascular Coiling and Flow Diversion: 2-Dimensional Operative Video.

We describe the case of a 51-year-old woman who underwent craniotomy and surgical clipping of a large internal carotid bifurcation aneurysm that was refractory to treatment with 2 rounds of endovascular coiling and internal carotid artery (ICA) to middle cerebral artery pipeline placement. The patient initially presented in 2004 with a 3-week history of sudden-onset headache with associated nausea. Computed tomography and lumbar puncture on presentation in 2004 were negative for subarachnoid hemorrhage.

A Transcriptomic Comparative Study of Cranial Vasculature.

In genetic studies of cerebrovascular diseases, the optimal vessels to use as controls remain unclear. Our goal is to compare the transcriptomic profiles among 3 different types of control vessels: superficial temporal artery (STA), middle cerebral arteries (MCA), and arteries from the circle of Willis obtained from autopsies (AU). We examined the transcriptomic profiles of STA, MCA, and AU using RNAseq.

Somatic Variants in SVIL in Cerebral Aneurysms.

Background And Objectives: While somatic mutations have been well-studied in cancer, their roles in other complex traits are much less understood. Our goal is to identify somatic variants that may contribute to the formation of saccular cerebral aneurysms.

Methods: We performed whole-exome sequencing on aneurysm tissues and paired peripheral blood.

Orbital reconstruction for tumor-associated proptosis: quantitative analysis of postoperative orbital volume and final eye position.

Objective: Surgical resection of sphenoid wing tumors and intraorbital pathology carries the dual goal of appropriately treating the target pathology as well as correcting proptosis. Residual proptosis following surgery can lead to cosmetic and functional disability. The authors sought to quantitatively assess the effect of orbital volume before and after reconstruction to determine the optimal strategy to achieve proptosis correction.

Microsurgical treatment of recurrent coiled aneurysms.

The number of endovascularly-treated aneurysms has steadily increased over the past two decades. A small but significant number of recurrent or partially recanalized aneurysms have been identified. If repeat endovascular therapies are not feasible due to anatomical or technical considerations, surgical clipping may be considered.

Superficial temporal artery dissection: a technical note.

Background: Dissection of the superficial temporal artery (STA) is often required in preparation for a bypass procedure. Traditionally, dissection of the STA involves a direct cutdown on the artery after marking the course of the artery on the skin with the help of a Doppler ultrasound probe.

Objective: We describe a method that takes advantage of the position of the STA superficial to the temporal fascia.

Obliteration of a metameric spinal arteriovenous malformation (Cobb syndrome) using combined endovascular embolization and surgical excision.

Cobb syndrome represents the concurrent findings of a metameric spinal vascular malformation and a cutaneous vascular malformation within several dermatomes of each other. This rare entity engenders many difficult decisions with respect to appropriate therapeutic management. Historically, surgical excision carried a high morbidity, and conservative management without intervention was preferred.

Incidence and predictors of intracranial hemorrhage after minor head trauma in patients taking anticoagulant and antiplatelet medication.

Background: The yield of head computed tomography (CT) for patients who suffered head trauma with a presenting Glasgow Coma Scale (GCS) score of 15 has been reported to be low, even in patients who are anticoagulated or on antiplatelet therapy. We undertook this study to (1) determine the frequency of intracranial hemorrhage in anticoagulated patients and patients on antiplatelet therapy and its impact on clinical management, (2) identify predictors of positive imaging findings, and (3) assess potential differences between anticoagulation and antiplatelet therapy.

Methods: We conducted a retrospective review of the trauma registry at our institution, a Level II trauma center.

Postoperative resolution of abnormal blood vessels related to a nerve root hemangioblastoma.

To our knowledge, there are currently no published reports that describe the postoperative evolution of abnormal blood vessels associated with spinal nerve root hemangioblastomas. We present a patient with a hemangioblastoma that was completely resected. Follow-up imaging revealed complete resolution of the abnormal blood vessels.

Lumbar microdiscectomy and microendoscopic discectomy.

Lumbar microdiscectomy, which relies on the operating microscope for visualization, was first described in the late 1970s. This operation is considered the gold standard procedure for patients who require surgery for symptomatic lumbar disc herniation causing radiculopathy that has not improved with conservative measures. A new approach to the management of symptomatic lumbar disc herniation, microendoscopic discectomy, was introduced in 1997.