Factors Related to Frailty Associated with Clinical Deterioration After Meningioma Surgery in the Elderly.

Background: Older patients are increasingly presenting for surgery with intracranial meningioma because of progress with diagnostic imaging and longer life expectancy. However, older patients have many problems, such as comorbidities and reduced physiological capacity reflected in the frailty index. This study examines the factors affecting clinical deterioration after surgery in older patients, particularly factors associated with frailty.

[A Case of Cervical Spinal Dural Arteriovenous Fistula with Extradural Drainage Presenting with Subarachnoid Hemorrhage due to a Ruptured Anterior Spinal Artery Aneurysm].

We report a rare case of a cervical spinal dural arteriovenous fistula(AVF)at the C2 level presenting with subarachnoid hemorrhage(SAH)due to a ruptured anterior spinal artery aneurysm. A 61-year-old man presented with sudden onset headache. Initial computed tomography revealed SAH around the brainstem.

[A case of cavernous angioma at the convexity in the dura mater: characteristics of images in the literature].

We describe a rare case of cavernous angioma in the dura mater and discuss published MRI findings on similar cases. The patient was a 78-year-old woman who was referred to Shimane Prefectural Central Hospital with complaints of headaches. We were subsequently able to identify a tumor at the convexity in the dura mater.

Treatment of ruptured vertebral artery dissecting aneurysms. A short report.

We evaluated the outcomes of endovascular or surgical treatment of ruptured vertebral artery dissecting aneurysms (VADAs), and investigated the relations between treatment complications and the development and location of the posterior inferior cerebellar artery (PICA). We treated 14 patients (12 men, two women; mean age, 56.2 years) with ruptured VADAs between March 1999 and June 2012 at our hospital.

Extracranial internal carotid artery pseudoaneurysm associated with neurofibromatosis type 1 treated with endovascular stenting and coil embolization.

An internal carotid artery (ICA) pseudoaneurysm associated with neurofibromatosis type 1 (NF-1) is rare. We report the first case of unruptured extracranial pseudoaneurysm of the ICA in a patient with NF-1 successfully treated with endovascular stenting and coil embolization.A 66-year-old woman diagnosed with NF-1 had sudden left neck pain and massive swelling 3 years earlier.

[A case of tumor progression after gamma knife radiosurgery for brain metastasis of thyroid papillary carcinoma in deep subcortical white matter].

We report a case of a brain metastasis of thyroid papillary carcinoma. A 67-year-old man had undergone a radical operation for thyroid papillary carcinoma 6 years before. He had no neurological deficit, but CT showed an enhanced lesion in the left frontal lobe.

Probable blood-brain barrier disruption after carotid artery stenting.

A 74-year-old man presented with prolonged reversible neurological deficits caused by internal carotid artery stenosis. He underwent carotid artery stenting (CAS) and developed persistent neurological deficits shortly following the intervention. Delayed gadolinium enhancement of the cerebrospinal fluid space on fluid-attenuated inversion recovery images indicated probable blood-brain barrier (BBB) disruption.

Post-mortem pathological examination of two patients after intraaneurysmal embolization using guglielmi detachable coils.

We report the histological findings in two patients treated using Guglielmi detachable coils with almost complete occlusion of the aneurysms.Autopsies of these patients were performed one week and one year after GDC embolization respectively. In one aneurysm that was obtained at autopsy one week after embolization, the histological findings revealed coils and an unorganized thrombus-filled aneurysm sac; an incomplete cell-lining on the luminal side of fibrin thrombi in the region of the neck of the aneurysm was recognized.

[Experience of cerebral angiography using gadolinium for renal insufficiency].

Angiography by means of iodinated contrast material, before endovascular or surgical treatment, may result in serious complications in patients with renal insufficiency or previous anaphylactoid reaction to iodine. Alternative techniques, such as magnetic resonance angiography or carbon dioxide angiography, have their own limitations. We report effectiveness and safety of cerebral angiography using gadolinium for a patient with right vertebral artery and basilar artery occlusion and renal insufficiency.

Severe ocular and orbital toxicity after intracarotid injection of carboplatin for recurrent glioblastomas.

Background: Glioblastoma is a malignant tumor that occurs in the cerebrum during adulthood. With current treatment regimens including combined surgery, radiation and chemotherapy, the average life expectancy of the patients is limited to approximately 1 year. Therefore, patients with glioblastoma sometimes have intracarotid injection of carcinostatics added to the treatment regimen.

Intracranial meningeal melanocytoma.

A 59-year-old man presented with a rare intracranial meningeal melanocytoma in the left cerebellopontine angle. The patient underwent partial surgical excision and radiosurgery for successful control of the tumor. Meningeal melanocytoma is an essentially benign melanotic tumor, derived from the melanocytes of the leptomeninges, and may occur anywhere in the cranial and spinal meninges.

Stent-assisted angioplasty for intracranial atherosclerosis.

We report on two patients with intracranial atherosclerosis of the carotid artery or vertebral artery treated with stent-assisted angioplasty. Both patients have severe intracranial atherosclerosis (>70%) with refractory symptoms despite optimal medical treatment. In both patients, a coronary balloon-expandable stent was successfully placed using a protective balloon technique without procedural complications.

[A case with diffuse vasospasm after perimesencephalic nonaneurysmal subarachnoid hemorrhage].

Perimesencephalic nonaneurysmal subarachnoid hemorrhage(PNSH), defined as bleeding in the cisterns around the midbrain with a negative four-vessel angiographic study, is uniformly associated with an excellent outcome without associated rebleeding or symptomatic vasospasm. Angiographic vasospasm is uncommon in patients with this disease, and if vasospasm is present, severe and diffuse angiographical vasospasm is rare. We report a case with PNSH who developed severe and diffuse angiographic vasospasm.

[A case of juvenile pilocytic astrocytoma with unusual neuroimaging features].

We present a case of cerebellar juvenile pilocytic astrocytoma(JPA) with unusual neuroimaging features. The patient was a 14-year-old male who suffered from chronic headaches for a couple of weeks. Plain craniogram showed a decalcification and bulging of the occipital bone.

Brain metastasis of Merkel cell carcinoma. Case report and review of the literature.

Merkel cell carcinoma (MCC) is a rare primary cutaneous neuroendocrine tumor that is locally aggressive and has potential for metastatic spread. However, brain metastases are rare, and therapy for such tumors has never reported. The authors present a 48-year-old woman with MCC of the left elbow and a right cerebellar metastasis.

[A case of Rathke's cleft cyst in association with anterior communicating artery aneurysm presenting a rare visual field defect].

We report a case of Rathke's cleft cyst associated with anterior communicating artery aneurysm. The patient was 60-year-old woman who developed visual disturbance two months before admission to our hospital. Visual acuity on the right was 0.