Endovascular treatment for secondary basilar occlusion caused by spontaneous thrombus migration from the vertebral artery: Two case reports.

Thrombus migration is a well-known clinical condition that occurs before mechanical thrombectomy and after intravenous thrombolysis in patients with anterior circulation strokes. Although thrombus migration from the vertebral artery (VA) can result in life-threatening basilar artery (BA) occlusion, its occurrence in the posterior circulation has rarely been discussed. Two patients with secondary BA occlusion caused by spontaneous thrombus migration from the VA are presented.

Coil embolization of recurrent ruptured vertebral artery dissection through a marathon microcatheter: A case report.

A 56-year-old healthy woman presented with subarachnoid hemorrhage caused by ruptured vertebral artery dissecting aneurysm and was treated with internal trapping of the affected site including the aneurysm. She suffered rebleeding due to recanalization of the aneurysm 5 days after the first treatment. Because of the close proximity of the coil mass to the posterior inferior cerebellar artery (PICA) origin at first treatment, additional coil embolization by tight packing of the coil mass was planned.

Correlation Between Low-Density Hematoma at 1-Week Post-Middle Meningeal Artery Embolization and Rapid Resolution of Chronic Subdural Hematoma.

Background: Temporal changes in the volume of chronic subdural hematoma (CSDH) following middle meningeal artery (MMA) embolization vary. We aimed to determine whether CSDH density on computed tomography is related to hematoma resolution following particle MMA embolization.

Methods: Patients who underwent MMA embolization for CSDH were enrolled.

[A case of irreversible metronidazole encephalopathy during liver abscess treatment].

Metronidazole (MNZ) is a widely used drug for protozoan and anaerobic infections. The continuous use of MNZ causes various neurological symptoms, such as cerebellar ataxia, visual disturbance, vestibulocochlear symptoms, gait disturbance, dysarthria, and epileptic seizures of unknown cause, named MNZ-induced encephalopathy (MIE), in rare cases. MIE is a reversible disease that often improves within a few days of MNZ discontinuation, but irreversible neurological symptoms rarely remain.

Spontaneous middle meningeal arteriovenous fistula without cortical venous reflux presenting with acute subdural hematoma: illustrative case.

Background: Dural arteriovenous fistula (AVF) without cortical venous reflux (CVR) has a relatively benign course. Here, the authors describe a patient presenting with subdural hematoma due to a middle meningeal AVF without CVR.

Observations: A 17-year-old male was admitted to the emergency department with acute headache without an episode of head trauma.

[A case of multiple duodenal gastrointestinal stromal tumors associated with neurofibromatosis type 1].

Gastrointestinal stromal tumors (GISTs) associated with von Recklinghausen's disease (neurofibromatosis type 1 [NF1]) have different pathogenesis and characteristics from common GISTs. Furthermore, no treatment strategy for this type of GIST has been established. This study presents the case of a 76-year-old man previously diagnosed with NF1 who was later diagnosed with GISTs.

Mesentero-axial gastric volvulus treated with laparoscopic gastropexy: a case report.

Background: Mesentero-axial gastric volvulus (MAGV) is an uncommon subtype of gastric volvulus (GV). However, reports of such cases in adult patients are very rare. We present an unusual case of idiopathic MAGV in an old woman.

Endovascular embolization and needle aspiration of a life-threatening cervical hematoma due to a neurofibromatosis type 1-associated arteriovenous fistula: illustrative case.

Background: In cases of neurofibromatosis in which the bleeding source is considered strongly related to a neurofibroma, an open surgical approach could risk uncontrollable bleeding from the vascular wall infiltration by neurofibroma. The case of a neurofibromatosis type 1 (NF1)-associated arteriovenous fistula presenting with a life-threatening cervical hematoma that was successfully treated with alternative treatment is described.

Observations: A 68-year-old woman diagnosed with NF1 presented with sudden onset of a spontaneous right cervical mass.

Utility of manual venous compression during transvenous Onyx injection for a scalp arteriovenous fistula: illustrative case.

Background: When performing transvenous liquid embolization for scalp arteriovenous fistulas, multiple networks of venous drainage could limit effective retrograde penetration of embolic agents into feeding arteries, resulting in incomplete obliteration. A salvage technique to achieve effective Onyx penetration with manual venous compression during transvenous embolization is demonstrated.

Observations: A 43-year-old man presented with a progressively enlarging mass on his left temporal scalp that was first noticed approximately 20 years earlier.

Small Sphenoid Ridge as a Factor Associated with Laterally Deviated Proximal Sylvian Fissure in Patients Undergoing Pterional Craniotomy.

Background: During the pterional-transsylvian approach, we sometimes encounter the proximal Sylvian fissure (SF) deviating laterally beyond the fold of the sphenoidal ridge (SR) and experience difficulty dissecting the SF due to the deep and oblique dissection plane. In the present study, we explored the association between the height of the SR and lateral deviation of the SF during the pterional-transsylvian approach.

Methods: The association between the height of the SR on axial computed tomography and the presence of a laterally deviated SF was evaluated by reviewing patients who had undergone pterional craniotomy.

Balloon-hooking technique for stabilizing a guiding catheter in tortuous supra-aortic vessel: A case report.

When performing endovascular interventions for supra-aortic vessels, the tortuous vascular anatomy observed in patients with atherosclerotic lesions often limits the ability to maintain a stable guiding catheter position. Here, we report a case of right vertebral artery (VA) stenosis treated with transfemoral stenting and discuss the utility of balloon-hooking technique using partially inflated balloon for stabilizing the balloon guiding catheter (BCG) in the supra-aortic vessel. A 74-year-old man who underwent right carotid artery stenting, coronary artery bypass grafting, and bilateral iliac artery stenting was admitted to our emergency department because of dizziness related to head movement.

Long-term outcomes, including the survival rate and period to death, in patients over 80 years old after ruptured cerebral aneurysm clipping.

Objective: This study aimed to identify the long-term outcomes, including the survival rate, period to death, causes of death, and predictors of poor outcomes, in patients aged over 80 years who underwent surgical clipping for a ruptured anterior circulation aneurysm.

Materials And Methods: In this retrospective observational study, the medical records of patients from April 1, 1994, to June 30, 2019, were evaluated. All patients underwent surgical clipping within 72 h of subarachnoid hemorrhage (SAH) onset.

Transfemoral subclavian artery stenting through a shaped guiding catheter without pull-through technique: A case report.

Transfemoral subclavian artery stenting can be challenging unless the placement of the guiding catheter is secured. Herein, we present a patient with subclavian artery stenosis treated with endovascular stenting using a shaped guiding catheter. A 79-year-old woman was admitted to our department because of a cold sensation and numbness of her left arm.

Cerebral protection during retrograde brachiocephalic artery stenting using a single filter and increased subclavian steal phenomenon: illustrative case.

Background: Cerebral protection during brachiocephalic artery (BCA) stenting is important. However, the maneuver is sometimes challenging because both the internal carotid artery (ICA) and vertebral artery (VA) should be protected. Herein, the authors present an alternative cerebral protection technique involving filter protection for the ICA and hemodynamic protection for the VA during retrograde BCA stenting.

Endovascular intervention for bilateral paramedian thalamic stroke due to occlusion of the unilateral P1 segment of the posterior cerebral artery: illustrative cases.

Background: Occlusion of the unilateral P1 segment can result in bilateral paramedian thalamic infarction in patients with anatomical variants of the bilateral paramedian thalamic artery arising from a single P1 segment. Despite the life-threatening presentation of bilateral paramedian thalamic stroke, timely diagnosis is often challenging.

Observations: The authors herein describe 3 patients treated with endovascular intervention for occlusion of the unilateral P1 segment wherein the bilateral paramedian thalamic arteries arose.

Drag-out technique using a large balloon fixed with an aspiration catheter for retrieving residual thrombus on the wall of the superior sagittal sinus: illustrative case.

Background: The authors report a patient with sagittal sinus thrombosis that was resistant to reported endovascular treatments but successfully recanalized by dragging out the thrombus using a large balloon fixed with an aspiration catheter.

Observations: A 57-year-old man presented with the persistent headache and a simple partial seizure. Diagnostic study with computed tomography and angiography demonstrated the superior sagittal sinus (SSS) thrombosis.

Intracranial aneurysm rupture within three days after receiving mRNA anti-COVID-19 vaccination: Three case reports.

Background: Although neurological adverse events have been reported after receiving coronavirus disease 2019 (COVID-19) vaccines, associations between COVID-19 vaccination and aneurysmal subarachnoid hemorrhage (SAH) have rarely been discussed. We report here the incidence and details of three patients who presented with intracranial aneurysm rupture shortly after receiving messenger ribonucleic acid (mRNA) COVID-19 vaccines.

Case Description: We retrospectively reviewed the medical records of individuals who received a first and/ or second dose of mRNA COVID-19 vaccine between March 6, 2021, and June 14, 2021, in a rural district in Japan, and identified the occurrences of aneurysmal SAH within 3 days after mRNA vaccination.

Intracranial hemorrhage associated with direct oral anticoagulant after clipping for an unruptured cerebral aneurysm: A report of two cases.

Background: Two cases of patients who developed intracranial hemorrhage associated with direct oral anticoagulant (DOAC) use after clipping of an unruptured cerebral aneurysm (uAN) are presented. These cases will help neurosurgeons assess the risks of patients with atrial fibrillation or deep venous thrombosis receiving DOACs who require craniotomy.

Case Description: Case 1 was a 65-year-old man on apixaban 10 mg/day who underwent clipping for a left middle cerebral artery uAN.

Successful Leptomeningeal Enhancement in a Patient with Tandem Occlusion of a Carotid and Middle Cerebral Artery Following Carotid Artery Stenting for Contralateral Carotid Artery Stenosis.

Objective: Although the presence of leptomeningeal anastomosis is known as a predictor of favorable outcome in patients with acute large vessel occlusion, the efficacy of enhancing leptomeningeal collateral flow has rarely been demonstrated.

Case Presentation: A 73-year-old man previously diagnosed with asymptomatic bilateral carotid stenosis was admitted to our emergency department 2 hours after the onset of fluctuating symptoms, including aphasia, left conjugate deviation, and right hemiparesis. CT demonstrated no hemorrhagic lesion.

Feasibility and safety of partial resection of the anterior insular cortex for microsurgical treatment of middle cerebral artery aneurysms located in the limen recess: patient series.

Background: When performing clip ligation of superior projecting aneurysms of the proximal (M1) segment of the middle cerebral artery (MCA), meticulous sylvian fissure dissection alone may be inadequate for safe clip application, especially in cases in which the aneurysm is buried in the limen recess, since the limen insulae may be positioned lateral to the aneurysm. In the present patient series, the authors present their surgical technique for clip ligation of aneurysms located in the limen recess, with partial resection of the limen insulae.

Observations: A retrospective analysis of patients who had undergone clip ligation of MCA aneurysms located at the limen recess at a single institute was performed.

A case of paroxysmal homonymous hemianopsia: Uncommon presentation of nonconvulsive status epilepticus.

Paroxysmal homonymous hemianopsia (HH) is uncommon presentation of epilepsy. We demonstrate a rare case of paroxysmal HH that was diagnosed by magnetic resonance (MR) arterial spin-labeling (ASL). A 82-year-old woman presented with abrupt onset of isolated visual field abnormality without convulsive epilepsy at 16 days after a traumatic head injury.

A patient with colitis-associated cancer who developed clinically manifest Crohn's disease only after surgery.

Background: Patients with prolonged inflammatory bowel disease have a greater risk of colorectal cancer, known as colitis-associated cancer. Here we describe an unusual case of colitis-associated cancer.

Case Presentation: The subject is a 41-year-old male who has not presented digestive symptoms and has an appreciable medical history.

Spontaneous rectus sheath hematoma associated with warfarin administration: a case report.

Rectus sheath hematoma (RSH) can result from bleeding into the rectus abdominis muscle or a direct muscular tear; nontraumatic spontaneous RSH is a rare condition. Here, we report a case of spontaneous RSH associated with warfarin administration for the treatment of chronic thromboembolic pulmonary hypertension (CTEPH). An 87-year-old woman was referred to our hospital because of abdominal pain, nausea, and vomiting for 3 days.

Efficacy and safety of therapeutic endoscopic retrograde cholangiopancreatography in patients with native papillae with a performance status score of 3 or 4: A single-center retrospective study.

This study aimed to assess the efficacy and safety of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in patients with an Eastern Cooperative Oncology Group performance status (ECOG-PS) score of 3 or 4. We reviewed the data of 287 patients with native papillae who underwent therapeutic ERCP for biliary disease at our hospital between October 2016 and October 2018. The patients were divided into two groups; those with an ECOG-PS score of 3 or 4 (group A; n=78) and those with an ECOG-PS score of 0-2 (group B; n=209).

Gastric gastrointestinal stromal tumor with predominant cystic formation diagnosed by endoscopic ultrasound-fine needle aspiration.

A 69-year-old woman who had no symptoms was found to have an intraperitoneal tumor on abdominal ultrasonography in a medical checkup. Thereafter, she was referred to our hospital for a further detailed examination. Contrast-enhanced computed tomography revealed a thin-walled cystic tumor with a diameter of 8 cm and with a hypervascular solid masses in the cystic wall, along with intraperitoneal multiple nodules.