[Subdural Empyema Caused by after Burr-Hole Surgery of Chronic Subdural Hematoma:A Case Report].

A 63-year old man with fever, headache, aphasia, and right hemiparesis was admitted to our hospital one month after the initial burr-hole surgery for left chronic subdural hematoma. Computed tomography(CT)revealed no regrowth of residual subdural hematoma. However, on the basis of the findings from magnetic resonance imaging(MRI)with diffusion-weighted images(DWI), an infection due to residual subdural hematoma was suspected.

Candesartan improves ischemia-induced impairment of the blood-brain barrier in vitro.

Candesartan has been reported to have a protective effect on cerebral ischemia in vivo and in human ischemic stroke. We studied the direct effects of candesartan on blood-brain barrier (BBB) function with our in vitro monolayer model generated using rat brain capillary endothelial cells (RBECs). The in vitro BBB model was subjected to normoxia or 6-h oxygen glucose deprivation (OGD)/24-h reoxygenation, with or without candesartan.

Cilostazol attenuates ischemia-reperfusion-induced blood-brain barrier dysfunction enhanced by advanced glycation endproducts via transforming growth factor-β1 signaling.

We investigated the effects of cilostazol, a selective inhibitor of phosphodiesterase 3, on blood-brain barrier (BBB) integrity against ischemia-reperfusion injury enhanced by advanced glycation endproducts (AGEs). We used in vitro BBB models with primarily cultured BBB-related cells from rats (brain capillary endothelial cells, astrocytes and pericytes), and subjected cells to either normoxia or 3-h oxygen glucose deprivation (OGD)/24-h reoxygenation with or without AGEs. Treatment of AGEs did not affect the transendothelial electrical resistance (TEER) in the BBB model under normoxia, but there was a significant decrease in TEER under 3-h OGD/24-h reoxygenation conditions with AGEs.

A Ruptured Basilar Tip Aneurysm Showing Repeated Perianeurysmal Edema after Endovascular Coil Embolization: Case Report.

The authors present an extremely rare case of a 48-year-old female who developed repeated perianeurysmal edema at 2, 9, and 16 weeks after endovascular coil embolization for the ruptured intracranial aneurysm. Interestingly, the mechanism for this edema could be different at each time point in this case; acute thrombosis formation, chemical inflammation, and aneurysm recanalization. We have to be aware of this potential complication in the long term after endovascular coil embolization for the intracranial aneurysm, especially with large size or buried into the brain parenchyma.

[Ruptured giant thrombosed aneurysm at the internal carotid artery successfully treated with endovascular internal trapping following emergent balloon occlusion test: a case report].

The authors report a case of ruptured giant thrombosed aneurysm successfully treated with endovascular internal trapping following emergent balloon occlusion test (BOT), and discuss its clinical implications regarding emergent BOT. A 41-year-old female showing massive epistaxis was referred to our institute for the treatment of a giant aneurysm. Computed tomography and digital subtraction angiography revealed a giant thrombosed aneurysm located at the petrous portion of the right internal carotid artery with an erosion of the petrous bone.

Assessment of carotid plaque stability based on the dynamic enhancement pattern in plaque components with multidetector CT angiography.

Background And Purpose: Recent studies have investigated plaque morphology to determine patients who are at high risk of carotid atherosclerosis. In this study, we investigated whether a difference in dynamic enhancement pattern in plaque components could be useful to assess plaque stability with multidetector CT angiography.

Methods: Fifty-nine lesions with moderate to severe carotid atherosclerosis in 51 patients (33 symptomatic, 18 asymptomatic) were consecutively included.

Direct arteriovenous fistula at the inferolateral trunk mimicking carotid cavernous fistula without involving the cavernous sinus: a case report.

The authors present the case of a 66-year-old female who developed progressive pulsating exophthalmos, a bruit, and conjunctival chemosis 7 months after a head injury. These symptoms, though highly suspicious of carotid cavernous fistula, were caused by an arteriovenous fistula (AVF) between the inferolateral trunk (ILT) and the ophthalmic veins. A direct AVF at the branch of the ILT without involvement of the cavernous sinus is extremely rare, but could occur in the case of acquired AVF since the ILT has some branches around venous structures outside the cavernous sinus.

Intra-arterial indocyanine green angiography in the management of spinal arteriovenous fistulae: technical case reports.

Study Design: We first present 2 cases of spinal arteriovenous fistulae (AVFs) successfully treated with the help of intra-arterial indocyanine green (ICG) angiography.

Objective: To demonstrate the efficacy of intra-arterial ICG angiography in spinal AVFs compared with the role of intravenous ICG injection and intraoperative digital subtraction angiography (DSA).

Summary Of Background Data: Intravenous ICG fluorescent angiography is an emerging intraoperative tool to recognize vascular anatomy.

[A tentorial dural arteriovenous fistula presenting progressive myelopathy: a case report].

Abstract We report a case of a dural arteriovenous fistula (DAVF) at the tentorium cerebelli, which presented progressive myelopathy. A 68-year-old man with neurological deterioration of the cervical myelopathy visited our hospital. T weighted magnetic resonance (MR) imaging showed high signal area and edema from the medulla to the upper thoracic spinal cord with flow voids on the dorsal surface of the cord.

[Preoperative analysis of platelet aggregability in carotid surgery].

To evaluate the relationship between preoperative analysis of platelet aggregability and perioperative complications, we analyzed 42 patients who underwent carotid endarterectomy or carotid artery stenting. The effect of antiplatelet drugs was tested by whole blood aggregometry. ADP (adenosine-diphosphoric acid) and collagen were used as agonists.

Restenosis after endovascular PTA/stenting for supra-aortic branches in Takayasu aortitis: report of three cases and review of the literature.

Recently, endovascular management has been reported as a feasible option for Takayasu aortitis. However, few papers have focused on restenosis in the follow-up, and therefore, it is important to predict high-risk cases for restenosis after endovascular treatment. We herein report three cases with Takayasu aortitis showing repeated restenosis after endovascular percutaneous transluminal angioplasty (PTA)/stenting and discuss its clinical implications with a review of the literature.

[A case of common femoral artery occlusion after homeostasis using device at carotid artery stenting].

The hemostatic puncture closure device Angio-Seal is a quick and easy-to-use system, allowing rapid sealing of the vascular access site after interventional procedure. The rate of complications associated with the use of this device has been reported to be low; nonetheless, certain specific complications may arise. In the present study, we describe a case of vascular occlusion that occurred because of the use of the Angio-Seal device.

Pitavastatin strengthens the barrier integrity in primary cultures of rat brain endothelial cells.

Statins have a neuroprotective effect in neurological diseases, a pleiotropic effect possibly related to blood-brain barrier (BBB) function. We investigated the effect of pitavastatin on barrier functions of an in vitro BBB model with primary cultures of rat brain capillary endothelial cells (RBEC). Pitavastatin increased the transendothelial electrical resistance (TEER), an index of barrier tightness of interendothelial tight junctions (TJs), at a concentration of 10(-8) M, and decreased the endothelial permeability for sodium fluorescein through the RBEC monolayer.

[Preoperative embolization for cranio-cervical tumors using Gelpart].

Background: Preoperative embolization of cranio-cervical tumors is commonly used to reduce intraoperative blood loss. Gelpart is a new collagen embolic agent. Because of its porous structure, it is deformable and tends not to aggregate.

[Nonfunctioning suprasellar ectopic pituitary adenoma. A case report].

A case of nonfunctioning suprasellar ectopic pituitary adenoma in a 49-year-old man is reported. The patient was refered to us with a partial visual field defect of the right eye. Neuroendocrinological examinations showed slightly higher levels of adrenocorticotrophic hormone and prolactin.

[Clinical application of ultrasonography with a burr-hole transducer during burr-hole surgery].

Ultrasound imaging has become a common method for evaluation of the central nervous system. In this report, we present our novel experience with ultrasonography monitoring conducted through a burr-hole for investigation of intracranial lesions. A portable ultrasound scanner and a small transducer with a straight, untapered head were used.

[Spontaneous cervical epidural hematoma presenting with hemiparesis following neck extension: a case report].

A 42-year-old woman suddenly developed weakness in her left extremities when stretching her neck two days after the onset of a nuchal pain. Because computed tomography (CT) of the brain did not show any apparent lesion, the patient had initially been treated as having a cerebral infarction until magnetic resonance imaging (MRI) of the cervical spine revealed a presence of a cervical epidural hematoma the next day. She was therefore transferred to our hospital, and a neurological examination showed moderate left hemiparesis, dissociated sensory loss under C6 on the right side, urinary incontinence, and left miosis and ptosis.

Massive intratumoral hemorrhage of ependymoma of the fourth ventricle.

Introduction: Ependymomas of the fourth ventricle usually show slowly progressive neurological deterioration and acute onset resulting from major intratumoral bleeding is very rare.

Case Report: A 16-month-old girl, previously in good health, showed gradual gait disturbance and appetite loss. She was transferred to our hospital because of a large enhanced tumor of the fourth ventricle with mild hydrocephalus.