Four French sheath-based transradial cerebral angiographies in the elderly: A single neurointerventionalist's experience.

Background: Catheter angiography via transradial access (TRA) is better at reducing access site complications and morbidity than via transfemoral access (TFA). The rate of periprocedural complications increases in elderly populations and using a smaller sheath can help reduce access site complications. The aim of this study was to assess the feasibility and safety of 4 F sheath-based TRA cerebral angiography in elderly patients (≥65 years) and compare it to TFA cerebral angiography.

Radiotherapy for brain metastasis and long-term survival.

Patients with brain metastases (BM) can benefit from radiotherapy (RT), although the long-term benefits of RT remain unclear. We searched a Korean national health insurance claims database and identified 135,740 patients with newly diagnosed BM during 2002-2017. Propensity score matching (PSM) was used to evaluate survival according to RT modality, which included whole-brain radiotherapy (WBRT) and/or stereotactic radiosurgery (SRS).

Does work time limit for resident physician affect short-term treatment outcome and hospital length of stay in patients with spontaneous intracerebral hemorrhage?: a two-year experience at a single training hospital in South Korea.

Objective: To compare short-term treatment outcomes at hospital discharge and hospital length of stay (LOS) in patients with spontaneous intracerebral hemorrhage (sICH) before and after introduction of resident physician work time limit (WTL).

Methods: We retrospectively reviewed consecutive patients treated for sICH at our institution between 2016 and 2019. Then we dichotomized these patients into two groups, pre-WTL and post-WTL.

Risk factors of postoperative remote intracerebral hemorrhage after craniotomy for ruptured cerebral aneurysms.

Objective: We aimed to identify the relation between perioperative cerebrospinal fluid (CSF) drain through lumbar drainage (LD) and development of postoperative (POP) remote intracerebral hemorrhage (rICH) in craniotomy to treat ruptured intracranial aneurysms.

Methods: We retrospectively reviewed consecutive patients who underwent craniotomy for ruptured cerebral aneurysms at the authors' institution between 1998 and 2004. We subsequently compared the incidence and characteristics of POP rICH between the patients who had a perioperative LD and those who did not.

Practical Dose Parameter Values for the Prediction of the Adverse Effect of Neurointerventional Radiation: Relationship Between the Dose Parameters and Temporary Alopecia After Intracranial Coil Embolization.

Objective: To present values for the dose parameters predictive of alopecia as an adverse effect induced by neuroembolization using a biplane fluoroscopy.

Methods: This study included a total of 151 patients (52 men, mean age of 55.1 ± 12.

Idiopathic Pseudoaneurysm of External Carotid Artery with Delayed Facial Palsy After Covered Stenting.

Background: Idiopathic pseudoaneurysms of the external carotid artery (ECA) between the internal maxillary artery and the facial artery are rare. Endovascular covered stenting is an alternative method for surgically challenging cases; however, movable and flexible vessels may prevent the maintenance of the stent.

Case Description: A 26-year-old woman presented with sudden swelling and pain of the left chin due to a pseudoaneurysm of the proximal ECA trunk.

Gradual expansion of stent retriever in mechanical thrombectomy for curved middle cerebral artery: structural findings of the stent for predictable recanalization results.

Background: Trevo Provue stent retriever with visible struts under fluoroscopy may be useful in identifying the optimal position and expansion of the stent during the procedure. This study aimed to demonstrate and analyze changes in the segmental diameter of a radio-opaque stent retriever after deployment according to recanalization results, and its relationship with the angle of the occluded segment of the middle cerebral artery (MCA).

Methods: Forty-one patients who underwent mechanical thrombectomy using a Trevo stent retriever were divided into two groups according to Thrombolysis in Cerebral Infarction (TICI) score (TICI 0-2a and TICI 2b/3).

Trifunctional Fluorogenic Probes for Fluorescence Imaging and Isolation of Glycosidases in Cells.

For both fluorescence imaging and isolation of glycosidases in cells, we prepared novel activity-based, trifunctional fluorogenic probes that consist of (1) a sugar moiety as a glycosidase substrate, (2) a fluoromethylated coumarin for fluorescent labeling, and (3) an alkyne tag for click reaction to enable isolation of the labeled enzyme. One probe, β-GlcNAc-CM-F, was employed to fluorescently detect endogenous O-GlcNAcase in cells and to isolate the labeled enzyme by affinity chromatography.

Carbohydrate Analogue Microarrays for Identification of Lectin-Selective Ligands.

Fifty-five mono- and disaccharide analogues were prepared and used for the construction of microarrays to uncover lectin-selective ligands. The microarray study showed that two disaccharide analogues, 28' and 44', selectively bind to Solanum tuberosum lectin (STL) and wheat germ agglutinin (WGA), respectively. Cell studies indicated that 28' and 44' selectively block the binding of STL and WGA to mammalian cells, unlike the natural ligand LacNAc, which suppresses binding of both STL and WGA to cells.

Lumbosacral Subdural Hematoma and Concomitant Acute Lower Extremity Monoparesis After Intracranial Aneurysmal Subarachnoid Hemorrhage.

Background: Spinal subdural hematoma (SDH) secondary to intracranial aneurysmal subarachnoid hemorrhage (SAH) occurs rarely and can cause neurologic deficits.

Case Description: A 52-year-old man was diagnosed with SAH caused by rupture of an anterior communicating artery aneurysm. The aneurysm was treated by coil embolization on the day of admission.

Modified Supraorbital Keyhole Approach to Anterior Circulation Aneurysms.

Objective: To select a surgical approach for aneurysm clipping by comparing 2 approaches.

Materials And Methods: 204 patients diagnosed with subarachnoid hemorrhage treated by the same neurosurgeon at a single institution from November 2011 to October 2013, 109 underwent surgical clipping. Among these, 40 patients with Hunt and Hess or Fisher grades 2 or lower were selected.

Nitinol clip distal migration and resultant popliteo-tibial artery occlusion complicating access closure by the StarClose SE vascular closure system.

Lower extremity ischemia following deployment of a vascular closure device for access site closure after a transfemoral endovascular procedure rarely occurs. A 68-year-old woman diagnosed with subarachnoid hemorrhage due to a ruptured anterior communicating aneurysm was treated by endovascular coil embolization. The StarClose SE device was deployed for right femoral arteriotomy closure.

Nitinol clip distal migration and resultant popliteo-tibial artery occlusion complicating access closure by the StarClose SE vascular closure system.

Lower extremity ischemia following deployment of a vascular closure device for access site closure after a transfemoral endovascular procedure rarely occurs. A 68-year-old woman diagnosed with subarachnoid hemorrhage due to a ruptured anterior communicating aneurysm was treated by endovascular coil embolization. The StarClose SE device was deployed for right femoral arteriotomy closure.

Necessity of Surgical Site Closed Suction Drain for Pterional Craniotomy.

Objective: The aim of this study was to assess the benefit of using a prophylactic surgical site closed suction drain in pterional craniotomy.

Materials And Methods: A retrospective review was conducted on 607 consecutive patients who underwent a pterional craniotomy for treatment of intracranial anterior circulation aneurysms over a 5-year period. Between January 2000 and December 2004, 607 patients were divided into two groups, those who had a prophylactic suction drain during closure of the surgical site (drain group, DG) and those who did not (non-drain group, NDG).

Velocity measurement of microvessels using phase-contrast magnetic resonance angiography at 7 Tesla MRI.

Purpose: The purpose of this study was to measure the velocity and direction of blood flow in microvessels, such as lenticulostriate arteries (LSAs), using PC MRA.

Methods: Eleven healthy subjects were scanned with 7 Tesla (T) MRI. Three velocity encoding (VENC) values of 15, 50, and 100 cm/s were tested for detecting the flow velocity in LSAs.

Fires and Burns Occurring in an Electrocautery after Skin Preparation with Alcohol during a Neurosurgery.

While there are reports regarding burns occurring to patients during the surgery, there are little reports concerning the incidents of the burns related to neurosurgical operations. Moreover, in Korea, even surveys and statistics on the incidents of burns in operating rooms are not known. This report explores burns occurring to a patient in an electrocautery scenario after disinfecting the surgical site with alcohol during the preparation of a neurosurgical operation in an operating room where there is much exposure to oxygen.

Resorption of Autogenous Bone Graft in Cranioplasty: Resorption and Reintegration Failure.

Objective: Re-implantation of autologous skull bone has been known to be difficult because of its propensity for resorption. Moreover, the structural characteristics of the area of the defect cannot tolerate physiologic loading, which is an important factor for graft healing. This paper describes our experiences and results with cranioplasty following decompressive craniectomy using autologous bone flaps.

Association between the daily temperature range and occurrence of spontaneous intracerebral hemorrhage.

Objective: We have observed, anecdotally, that the incidence of primary spontaneous intracerebral hemorrhage (sICH), as well as spontaneous subarachnoid hemorrhage, varies in accordance with seasonality and meteorological conditions. This retrospective single-hospital-based study aimed to determine the seasonality of sICH and the associations, if any, between the occurrence of sICH and meteorological parameters in Incheon city, which is a northwestern area of South Korea.

Methods: Electronic hospital data on 708 consecutive patients admitted with primary sICH from January 2008 to December 2010 was reviewed.

Solitary ruptured aneurysm of the spinal artery of adamkiewicz with subarachnoid hemorrhage.

Spinal subarachnoid hemorrhage (SAH) due to solitary spinal aneurysm is extremely rare. A 45-year-old female patient visited the emergency department with severe headache and back pain. Imaging studies showed cerebral SAH in parietal lobe and spinal SAH in thoracolumbar level.

Impact of admission month on outcomes in spontaneous subarachnoid hemorrhage: evidence against the march effect.

Objective: We attempted to identify the presence of a so called 'March effect (or phenomenon)' (which had long been known as a 'July effect' in western countries), a transient increase in adverse outcomes during an unskilled period for new interns and residents in a teaching hospital, among a cohort of patients with spontaneous subarachnoid hemorrhage (sSAH).

Methods: A total of 455 consecutive patients with sSAH from our department database from 2008 to 2010 were enrolled retrospectively and the admission month, patient demographics and clinical characteristics, treatment modalities and discharge outcomes were analyzed. Multivariate regression analysis was used to determine whether unfavorable discharge and in-hospital mortality showed a significant increase during the unskilled months for new interns and residents (from March to May) in a pattern suggestive of a "March effect".

The Comparative Study of Microsurgical Cerebral Aneurysm Clip Implants; Titanium Clip vs. Stainless Steel Clip.

Objective: To perform a comparative study between two groups of populations, titanium (T) group versus stainless steel (S) group, who were clipped with titanium and stainless steel materials, respectively, the incidence of regrowth from the original aneurysms, the clip slippage, and post-clipping seizure attack were analyzed. The patients were followed more than 5 years after microsurgical cerebral aneurysms clipping.

Methods: Data from 1986 through 2008 were extensively reviewed on a consecutive series of 3,770 patients who referred for ruptured/unruptured cerebral aneurysms.

Microvascular imaging of asymptomatic MCA steno-occlusive patients using ultra-high-field 7T MRI.

It is common that physicians are faced with patients who have severe steno-occlusion of intracranial arteries in the absence of clinical symptoms. This study is to determine whether a 7T magnetic resonance angiogram (MRA) could provide the improved depiction of microvessels of asymptomatic patients with steno-occlusive middle cerebral artery (MCA) and possible clues for diagnosis of their clinical symptoms. All the patients who were identified as severe MCA steno-occlusions underwent a 7T MRA study.

Three dimensional model-based analysis of the lenticulostriate arteries and identification of the vessels correlated to the infarct area: preliminary results.

Background: Small vessel diseases have been studied noninvasively with magnetic resonance imaging. Direct observation or visualization of the connected microvessel to the infarct, however, was not possible due to the limited resolution. Hence, one could not determine whether vessel occlusion or abnormal narrowing is the cause of an infarct.

Lenticulostriate arteries in chronic stroke patients visualised by 7 T magnetic resonance angiography.

Background: Noninvasive magnetic resonance angiography using ultra-high-field magnetic resonance imaging has recently provided us with the potential to image cerebral microvascular structures such as the lenticulostriate arteries. However, most studies using ultra-high-field magnetic resonance angiography have been limited to the visualisation of microvessels in healthy subjects, and the direct comparison of patients with microvascular disease has not been reported.

Aim: The aim of this study was to investigate the lenticulostriate arteries of patients with lacunar strokes of the basal ganglia and surrounding areas using 7 T magnetic resonance angiography.

Non-invasive visualization of basilar artery perforators with 7T MR angiography.

Purpose: To visualize the perforating arteries originating from basilar artery (BA) by using ultra-high resolution 7T MR angiography (MRA) and optimizing MR parameters as well as radio frequency (RF) coils, which may provide important information for neurosurgery and understanding diseases of the pons, but was unable to clearly visualize with conventional MRA techniques.

Materials And Methods: Seven healthy volunteers (five males and two females, age [mean +/- SD] = 28.71 +/- 7.