Effect of Intravenous Thrombolysis and Mechanical Thrombectomy on the Incidence of Acute Symptomatic Seizure and Post-Stroke Epilepsy in Patients with Acute Large-Vessel Occlusion.

Objective: Reperfusion therapy, such as intravenous tissue-plasminogen activator (IV-tPA) and mechanical thrombectomy (MT) for acute ischemic stroke, may increase the incidence of acute symptomatic seizure (ASS) and post-stroke epilepsy (PSE). This study aimed to analyze the effect and predictors of reperfusion therapy for ASS and PSE limited to large-vessel occlusions (LVOs).

Methods: This retrospective study classified 237 subjects with LVO into four groups: (1) IV-tPA + MT+ (n = 74 cases, (2) MT only (n = 82), (3) tissue-plasminogen activator (tPA) only (n = 28), and (4) IV-tPA - MT- (n = 53).

Three-dimensional vessel wall imaging with 1.5-T MRI to visualize invisible occluded cerebral artery.

Background: Endovascular thrombectomy (EVT) is performed for acute ischemic stroke (AIS) caused by large vessel occlusion; therefore, preoperative visualization of the occluded invisible vessel course reduces complications and ensures success. Three-dimensional (3D) proton density-weighted (PDW) vessel wall imaging (VWI) using variable refocusing flip angle pulse-turbo spin-echo sequences (VRFA-TSE) with 3.0-T magnetic resonance imaging (MRI) can provide this information.

Three-dimensional vessel wall MRI to characterize thrombus prior to endovascular thrombectomy for large vessel occlusion stroke.

Background And Purpose: Endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) caused by large vessel occlusion requires rapid and reliable imaging of the vessel course including the clot to reduce complications and ensure success. However, no method to acquire this information has been established.

Methods: Six consecutive patients with AIS caused by large vessel occlusion underwent EVT in our institute.

[Usefulness of Bilateral rSO Monitoring for Predicting Cerebral Hyperperfusion Syndrome after Carotid Artery Stenting].

Objective: Cerebral hyperperfusion syndrome(CHS)and cerebral hyperperfusion phenomenon(CHP)induce intracranial hemorrhage and can become critical complications after carotid artery stenting(CAS). The purpose of the present study was to predict and avoid CHS after CAS using bilateral rSO intraoperative monitoring.

Methods: We retrospectively analyzed 100 consecutive patients who underwent CAS between January 2012 and May 2014 in our institution.

The safety and efficacy of preoperative embolization of meningioma with N-butyl cyanoacrylate.

Objective: Preoperative embolization of meningioma is commonly performed; however, there is no consensus on the best embolic material to reduce intraoperative blood loss and surgery time.

Method: We retrospectively assessed the safety and efficacy of 56 cases of preoperative embolization of the middle meningeal artery with N-butyl cyanoacrylate (NBCA) in 105 cases of surgery for meningioma. We also defined a blood loss to tumor volume ratio to compensate for bias caused by tumor volume, and analyzed limited cases (the embolized group n = 52, the non-embolized group n = 21) of the convexity, the parasagittal region, the falx, and the sphenoidal ridge.

Risk factors for coil protrusion into the parent artery and associated thrombo-embolic events following unruptured cerebral aneurysm embolization.

Objective: Advances in vascular reconstruction devices and coil technologies have made coil embolization a popular and effective strategy for treatment of relatively wide-neck cerebral aneurysms. However, coil protrusion occurs occasionally, and little is known about the frequency, the risk factors and the risk of thrombo-embolic complications.

Method: We assessed the frequency and the risk factors for coil protrusion in 330 unruptured aneurysm embolization cases, and examined the occurrence of cerebral infarction by diffusion-weighted magnetic resonance imaging (DW-MRI).

Rupture of an aneurysm of the superior cerebellar artery feeding a dural arteriovenous fistula.

We experienced a very rare case of bleeding from an aneurysm of a branch of the superior cerebellar artery, which feeds a dural arteriovenous fistula (DAVF) of the posterior fossa. The aneurysm was not detected on initial angiography and 2 episodes of rebleeding resulted in deterioration of the patient's condition. Although rare, aneurysms of the pial feeding arteries should be considered as a cause of bleeding in cases of DAVF.

Risk factors and prevention of guiding catheter-induced vasospasm in neuroendovascular treatment.

Mechanically-induced vasospasm often occurs during guiding catheter insertion, occasionally preventing catheter advancement to the desired location. Delicate manipulation would be impossible without the proper positioning of guiding catheters, and vasospasm-induced cerebral hypoperfusion may cause thrombotic complications. From June 2012 to December 2013, we prospectively analyzed 150 endovascular treatment cases, excluding acute cases, for the frequency of vasospasm, risk factors, and countermeasures.

Endovascular treatment of ruptured dissecting aneurysms of the posterior inferior cerebellar artery.

Background: Dissecting aneurysms of the posterior inferior cerebellar artery (PICA) are rare, with optimal treatment strategies not well established according to the location of the aneurysm on the PICA. We present our single-center experience of endovascular treatment of ruptured dissecting aneurysms of the PICA.

Methods: Nine patients with ruptured dissecting aneurysms of the PICA were treated with endovascular embolization at our facility from August 1997 to December 2011.

Local thrombus formation at the coil-parent artery interface during endovascular coil embolization of cerebral aneurysms.

Background And Purpose: Fresh thrombus formation at the coil-parent artery interface around the neck of aneurysms is sometimes observed during coil embolization of cerebral aneurysms. We retrospectively analyzed the factors associated with local acute thrombus formation from the data of patients treated over a period of 5 years at our institute.

Methods: Between November 2004 and March 2009, 242 patients harboring 250 aneurysms were treated with endovascular coil embolization at our institute.

Embolization using endovascular technique in acute and chronic stages of traumatic ophthalmic artery aneurysm - case report - .

A 44-year-old man presented with traumatic aneurysm of the left ophthalmic artery. The first coil embolization intervention achieved relatively tight packing of the aneurysm and the parent artery. After 5 months, a second embolization procedure was required because of recurrence of the aneurysm with transition of the intraaneurysmal coil formation.

Dural arteriovenous fistula of the anterior cranial fossa with carotid artery stenosis treated by simultaneous transarterial embolization and carotid artery stenting.

A 71-year-old male presented with a rare case of dural arteriovenous fistula (AVF) of the anterior cranial fossa associated with carotid artery stenosis manifesting as a transient visual disorder. The therapeutic strategy was complicated because the collateral network to the ischemic brain from the external carotid artery was associated with the dural AVF. Transarterial embolization of the shunt was performed simultaneously with carotid artery stent placement.

Three-dimensional digital subtraction angiography for endovascular treatment of direct carotid-cavernous fistula -case report-.

A 63-year-old woman with a direct carotid-cavernous fistula (CCF), manifesting as sudden onset of severe headache and pulsatile tinnitus suffered during coronary angiography, was successfully treated with transarterial embolization based on the anatomical information obtained from volume-rendered three-dimensional digital subtraction angiography (3D DSA) images. 3D DSA is useful for understanding the configuration of such fistulas accurately and devising a therapeutic strategy for the endovascular treatment of direct CCFs.

[Percutaneous transluminal angioplasty for memory disturbance caused by stenosis of the innominate artery].

It is well known that significant narrowing of the subclavian or innominate artery may cause cerebrovascular ischemic symptoms. We report a case of a 62-year-old man who was suffering from progressive cognitive impairment and was treated by perctaneous transluminal angioplasty (PTA). The patient had undergone aorto-bifemoral bypass, left femoropopliteal bypass, and right femoral artery endoarterectomy.

[Embolic complications by ink clots removed from syringes during cerebral angiography].

Unlabelled: We noted, during cerebral angiography, that the contrast medium was contaminated with numerous small black ink clots from gradation marks on syringes. In this report, we show that ink can be removed from syringes in solid form, and that they may result in embolic complications during cerebral angiography.

Materials And Methods: To demonstrate that the ink from gradation marks on syringes can come off in a solid form and attach itself to the gloves during cerebral angiography, syringes were gripped many times (just as in an angiographic procedure) after immersion in contrast medium or 0.

[A study of intraarterial pressure changing during cerebral angiography].

Background: Elevation of cerebral blood pressure induced by injection of contrast medium has been postulated as a major cause of rerupture of cerebral aneurysms during angiography. The current study was performed to clarify whether intra-arterial pressure elevation occurs during contrast injection.

Materials And Methods: The study included six patients.

[Transarterial NBCA embolization with transvenous partial outflow obstruction for superior petrosal sinus dural arteriovenous fistula: a case report].

We encountered a case of superior petrosal sinus dural arteriovenous fistula (SPS DAVF) which was treated by a combination of a transvenous and a transarterial approach after the failure of the transvenous approach alone. A 69-year-old man presented with a complaint of progressive left bulbar conjunctival conjestion, exophthalmos, and impaired vision. Cerebral angiography revealed a left SPS DAVF fed by the left middle meningeal artery, the meningeal branches of the left internal carotid artery and the left posterior meningeal artery.

[Bilateral ptosis and upper gaze palsy with pupil sparing caused by midbrain hemorrhage].

The arrangement within the midbrain oculomotor nerve complex and crossed innervation of the superior rectus muscle are not elucidated in humans. A 65-year-old woman visited our hospital complaining of difficulty opening her eyes. Neurological examination revealed bilateral ptosis and impaired supraduction.