[Preoperative Embolization for Organized Hematoma of the Maxillary Sinus with Low-concentration n-butyl-2-cyanoacrylate:A Case Report].

Organized hematoma is a rare, non-neoplastic, and hemorrhage-prone condition that requires attention due to the risk of intraoperative bleeding. Preoperative embolization was performed to ensure intraoperative hemorrhage control. Here, we report a case of preoperative embolization of an organized hematoma using a low-concentration of n-butyl-2-cyanoacrylate(NBCA).

Angiogenesis in the Septum and Inner Membrane of Refractory Chronic Subdural Hematomas: Consideration of Findings after Middle Meningeal Artery Embolization with Low-concentration -butyl-2-cyanoacrylate.

The middle meningeal artery (MMA) is suggested to play an important role in the recurrence of chronic subdural hematomas (CSDHs). However, the exact mechanisms involved in the recurrence of CSDHs still remain unknown. For recurring CSDHs, MMA embolization is performed using low-concentration -butyl-2-cyanoacrylate (NBCA) at our hospital.

Impact of Right-Sided Aneurysm, Rupture Status, and Size of Aneurysm on Perforator Infarction Following Microsurgical Clipping of Posterior Communicating Artery Aneurysms with a Distal Transsylvian Approach.

Background: Posterior communicating artery (PCoA) aneurysms are among the most common aneurysms. Because blockage of the PCoA and perforators can cause adverse outcomes, occlusion of these arteries by surgical clipping should be avoided. The impact of factors on PCoA perforator infarction when using a distal transsylvian approach for PCoA aneurysms was examined.

Initially Missed or Delayed Diagnosis of Subarachnoid Hemorrhage: A Nationwide Survey of Contributing Factors and Outcomes in Japan.

Background: Subarachnoid hemorrhage (SAH) remains a significant cause of mortality in Japan. The Japan Stroke Society set out to conduct a nationwide survey to identify contributing factors and outcomes of SAH misdiagnosis.

Methods: We initially surveyed 737 training institutes and 1259 departments in Japan between April 2012 and March 2014 for the presence of misdiagnosed SAH.

Efficacy of Cone Beam Computed Tomography in Treating Cavernous Sinus Dural Arteriovenous Fistula.

Background: Exact identification of feeding arteries, shunt points, and draining veins is essential in treating cavernous sinus dural arteriovenous fistula (CS dAVF). In addition to digital subtraction angiography (DSA) and 3-dimensional rotational angiography (3DRA), high-resolution cone beam computed tomography (CBCT; especially 80-kv high-resolution cone beam computed tomography) have been performed in recent years. We evaluated the efficacy of CBCT in treating CS dAVF.

Efficacy of high-resolution cone-beam CT in the evaluation of perforators in vertebral artery dissection.

Introduction A major complication of internal coil trapping for vertebral artery dissection (VAD) is medullary infarction associated with perforator occlusion. Currently, higher spatial resolution imaging can be obtained with high-resolution cone-beam computed tomography (VASO CT), and the efficacy of perforator visualization adjacent to VAD was examined. Methods Eight patients who underwent internal coil trapping or stent-supported coil embolization underwent VASO CT to evaluate perforators around VAD.

Delayed Normalization of Electrocardiograms in Patients with Takotsubo Cardiomyopathy due to Aneurysmal Subarachnoid Hemorrhage.

Background: Takotsubo cardiomyopathy (TCM) is caused by excessive physical and mental stress, and sometimes causes potentially fatal arrhythmias such as torsades de pointes. This study characterized the features of TCM due to aneurysmal subarachnoid hemorrhage, particularly the delayed normalization of electrocardiograms compared with that of transthoracic echocardiograms.

Methods: Ten patients with TCM were selected from the 450 patients with subarachnoid hemorrhage treated in our hospital between January 2007 and November 2015.

Histopathological Findings in Brains of Patients Who Died in the Acute Stage of Poor-grade Subarachnoid Hemorrhage.

Patients with poor-grade aneurysmal subarachnoid hemorrhage (SAH) are likely to die due to irreversible acute-stage primary brain damage. However, the mechanism(s) and pathology responsible for their high mortality rate remain unclear. We report our findings on the brains of individuals who died in the acute stage of SAH.

Subarachnoid hemorrhage from dissecting aneurysm of the posterior communicating artery.

A 36-year-old woman on chronic hemodialysis presented with sudden onset of headache and deterioration of consciousness. She was sent to our hospital on day 1, with subarachnoid hemorrhage. Cerebral angiography showed pearl and string sign on the left posterior communicating artery, which was consistent with a diagnosis of hemorrhage from a dissecting aneurysm of the left posterior communicating artery.

Venous-Preserving Sylvian Dissection.

Objective: The Sylvian fissure has been dissected through the frontal side of the superficial Sylvian veins with sacrifice of the tributaries of the frontal superficial Sylvian vein, which may lead to venous infarction. In addition, disturbed venous drainage makes the brain susceptible to brain retraction. Therefore, preservation of the vein is essential in modern neurosurgery to decrease morbidity.

Efficacy of high-resolution cone-beam CT in the evaluation of carotid atheromatous plaque.

Introduction: A major disadvantage of carotid artery stenting (CAS) is the high incidence of perioperative cerebral embolism. Cerebral embolism after CAS is associated with soft plaque. Currently, higher spatial resolution imaging can be obtained with cone-beam CT (CB-CT).

Takotsubo cardiomyopathy following subarachnoid haemorrhage.

A 67-year-old woman was admitted with aneurysmal subarachnoid haemorrhage and a 12-lead ECG showed ST segment elevation. Transthoracic echocardiography confirmed akinesis of the left ventricular mid-apical segment, with an ejection fraction of 26%, features characteristic of takotsubo cardiomyopathy. Five days later, we identified thrombus in the apex of the left ventricle.

Cosmetic frontotemporal craniotomy using an osteotome: technical note.

A frontotemporal craniotomy is usually performed using a "keyhole," made at the union of the zygomatic arch and frontal bone. Consequently, skull depression may occur postoperatively, leading to temporal area deformities and poor cosmetic results. To prevent these complications, we describe our technique for frontotemporal craniotomy using an osteotome to prevent cosmetic deformities.

Middle meningeal artery aneurysm associated with meningioma.

Middle meningeal artery aneurysm associated with meningioma is extremely rare, and only two cases have previously been reported. In our case, a 72-year-old woman with convexity meningioma underwent preoperative cerebral angiography, which revealed a flow-related aneurysm on the middle meningeal artery. Embolization of the aneurysm was performed with N-butycyanoacrylate glue, and complete obliteration was confirmed under craniotomy.

Post-operative changes of cerebral circulation and metabolism in the acute stage of low-grade aneurysmal subarachnoid hemorrhage.

Objective: Pre- and post-operative cerebral circulation and metabolism were evaluated in patients with low-grade acute aneurysmal subarachnoid hemorrhage (SAH) who underwent early surgery to investigate the effects on brain dysfunction.

Methods: Positron emission tomography (PET) was performed to measure the regional cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO2), oxygen extraction fraction (OEF) and cerebral blood volume in four patients (one male and three females, mean age: 60.3 years) with low-grade SAH within 30 hours of onset.

Carotid artery resection: preoperative temporary occlusion is not always an accurate predictor of collateral blood flow.

Conclusion: The morbidity predicted by means of preoperative PET studies does not always correlate with the morbidity experienced after permanent carotid artery occlusion. A pre-resection extracranial-intracranial bypass may be necessary to reduce the risk of neurologic morbidity, in particular when carotid artery resection is planned for tumors involving the skull base.

Objectives: Carotid artery resection is generally considered the only curative treatment for patients with advanced head and neck carcinoma involving the carotid artery.

Morbidity and mortality from surgical treatment of unruptured cerebral aneurysms at Research Institute for Brain and Blood Vessels-Akita.

Objective: Although the necessity of craniotomy for an unruptured cerebral aneurysm (UCA) is controversial, surgery is warranted if surgical risks are less than the risks of natural history. In this study, we investigated the need for craniotomy for UCAs on the basis of surgical risk.

Methods: History of cerebrovascular disorders, aneurysm site and size, surgical complications, and clinical outcome were investigated in 368 patients (134 men, 234 women; ages 31-79 yr) who underwent craniotomy for treatment of UCA at our institute between 1993 and 2000.

Incidence and risk factors for the growth of unruptured cerebral aneurysms: observation using serial computerized tomography angiography.

Object: The goal of this study was to examine the growth of unruptured intracranial aneurysms with the focus on the risk factors and incidence of these lesions.

Methods: One hundred sixty-six untreated cerebral saccular aneurysms were analyzed in 140 patients. The age of the patients ranged from 29 to 82 years (mean 62.

Cooperative study of ruptured vertebrobasilar artery aneurysms in the Tohoku district in Japan.

A multicenter study investigated the clinical characteristics and overall outcome of 342 cases of ruptured vertebrobasilar artery aneurysms among 6783 ruptured intracranial berry aneurysms in 73 hospitals across the Tohoku district in Japan between 1992 and 1996. The incidence of ruptured vertebrobasilar artery aneurysms was less frequent than previously reported. The incidence was 5% among all intracranial berry aneurysms.

Extracranial-intracranial bypass for reconstruction of internal carotid artery in the management of head and neck cancer.

Extracranial-intracranial bypass surgery was performed prior to carotid resection in eight patients with head and neck carcinoma that involved the carotid artery near the skull base. Four patients underwent the standard one-stage extracranial-intracranial bypass procedure. A two-stage procedure was performed in the remaining four patients.

Anterior clinoidectomy and opening of the internal auditory canal using an ultrasonic bone curette.

Objective: During cranial base surgery, use of a high-speed drill for osteotomy has become common. We performed anterior clinoidectomy and opening of the internal auditory canal using an ultrasonic bone curette, and we report the advantages and clinical applications of this method.

Description Of Instrumentation: The ultrasonic surgical equipment comprises a power supply unit, footswitch, and handpiece (weight, 110 g; diameter, 20 mm; length, 140 mm from tip to angled section).

[Analysis using positron emission topography (PET) in hemiparetic patients with chronic subdural hematoma].

Chronic subdural hematoma (CSH) is a disease caused by minor head trauma and can be cured by surgical treatment. It remains unclear why CSH can cause neurologic dysfunction such as hemiparesis, although some reports describe the contribution of impaired cerebral blood flow (CBF) and oxygen metabolism of patients with CSH. We studied five hemiparetic patients with unilateral CSH using positron emission tomography (PET).

Diffusion-weighted magnetic resonance imaging in patients with subarachnoid hemorrhage.

Objective: To evaluate the occurrence and distribution of direct brain injury caused by acute subarachnoid hemorrhage (SAH) by the use of magnetic resonance imaging.

Methods: Computed tomography and magnetic resonance imaging, including diffusion-weighted imaging (DWI), were performed in 32 patients with SAH by use of a 1.5-T whole-body superconductive scanner equipped with an echo planar imaging system.