Formation of a Large Fusiform Aneurysm near a Medullary Infarction Caused by Dissection of the Posterior Inferior Cerebellar Artery.

Infarction of the posterior inferior cerebellar artery (PICA) can lead to ischemic stroke in the lateral medullary oblongata. PICA dissection can also elicit an ischemic event in this region, but its detection on radiological images is difficult because of the small diameter of the vessel. We report a case of Wallenberg syndrome due to PICA dissection in a 48-year-old man, which was difficult to diagnose on first admission.

The meningeal branches of the superior cerebellar artery: a surgical observation study.

OBJECT The tentorial branch of the posterior cerebral artery was first identified in a cadaver dissection study. However, the tentorial branch of the superior cerebellar artery (SCA) has not been clearly described in autopsy or normal anatomical studies. In this study, a dural branch of the SCA that was found during the surgical treatment of trigeminal neuralgia is described.

Successful treatment of a ruptured flow-related aneurysm in a patient with hemangioblastoma: Case report and review of literature.

Background: No cerebral aneurysms on the feeder associated with hemangioblastomas that ruptured before resection have been reported. We report a patient with a ruptured flow-related aneurysm associated with cerebellar hemangioblastoma and a tumor feeder treated simultaneously by a single procedure of embolization using N-butyl cyanoacrylate before tumor removal.

Case Description: A 36-year-old female with a cerebellar tumor was admitted to our institute.

Occlusion of the ascending pharyngeal artery during carotid artery surgery: importance and technique.

Aim: In surgeries involving clamping, opening and repairing the carotid artery such as carotid endarterectomy (CEA) and proximal anastomosis at radial artery (RA) grafting, back-bleeding, often due to insufficient occlusion of the ascending pharyngeal artery (APA), must be avoided. In 96% of cases the APA originates at the dorsal side of the external carotid artery, while in 2% each it arises at the carotid bifurcation or the internal carotid artery. We developed a method to prevent back-bleeding from the APA irrespective of its origin.

Target-controlled infusion technique with indocyanine green videoangiography for radial artery graft.

Object: To understand the relationship between the parent artery and its distal arteries, blood vessels running through the subarachnoid space need to be extensively dissected, which is time-consuming. We examined the efficacy of temporary clipping with the indocyanine green (ICG) technique (target-controlled infusion (TCI) technique), in which the parent artery is occluded using a temporary clip, and ICGV (videoangiography) is performed to clarify the relationship between the distal M4 and proximal M2.

Methods: Thirteen radial artery grafts (RAGs) for internal carotid aneurysm underwent TCI to confirm the relationship between M2 and cortical M4.

Hemothorax after the intravenous administration of tissue plasminogen activator in a patient with acute ischemic stroke and rib fractures.

A 79-year-old man experienced sudden-onset left hemiparesis and disturbance of consciousness. Diffusion-weighted magnetic resonance imaging showed an acute ischemic stroke in the territory of the right middle cerebral artery. He underwent systemic thrombolysis via the intravenous administration of tissue plasminogen activator (t-PA).

Vagus nerve neuromonitoring during carotid endarterectomy.

To determine the causes and site(s) of nerve injury and to identify potential predictors of vocal fold paralysis (VFP) after carotid endarterectomy (CEA) by application of intraoperative neuromonitoring (IONM). A total of 68 CEA patients were enrolled in this study. A 3-step IONM procedure was designed to obtain vocal fold EMG data at V1 (just after identification of the vagus nerve [VN]), V2 (just before arteriotomy), and V3 (just before wound closure).

Perioperative complications of superficial temporal artery to middle cerebral artery bypass for the treatment of complex middle cerebral artery aneurysms.

Object: Only a few studies have reported the risk of ischemic complications occurring when superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis is performed during surgery for complex MCA aneurysms.

Subjects And Methods: This is a retrospective study of 10 patients (age 52-73) with MCA aneurysms treated with revascularization surgery. The aneurysms were 10-50mm in size (mean: 21mm).

Ischemic complications after radial artery grafting and aneurysmal trapping for ruptured internal carotid artery anterior wall aneurysm.

Objective: Treatment of ruptured internal carotid artery anterior wall (ICAW) aneurysms presents a surgical challenge because limitations and difficulties are encountered with either clipping or endovascular treatment. The present study examined clinical outcomes after aneurysmal trapping followed by radial artery grafting for management of these difficult lesions.

Methods: Radial artery grafting was followed immediately by parent artery occlusion in five sides of five patients with acute ruptured ICAW aneurysm (3 men, 2 women; mean age 55.

Dissecting aneurysm of the anterior temporal artery: case report.

A 65-year-old woman presented a rare dissecting aneurysm of the anterior temporal artery (ATA) manifesting as headache. Computed tomography and magnetic resonance imaging revealed a mixed-density mass in the horizontal segment of the middle cerebral artery. Emergent angiography demonstrated aneurysmal dilatation and a thrombosed mass in the sylvian fissure.

Radial artery grafts for symptomatic cavernous carotid aneurysms in elderly patients.

Background: Radial artery grafts (RAG) have been used in the treatment of complex vascular lesions, but not for symptomatic cavernous carotid aneurysms in elderly patients.

Aim: To investigate the safety, usefulness, and perioperative complications of RAGs for symptomatic cavernous carotid aneurysms in elderly patients.

Material And Methods: Of the 74 consecutive patients, in whom RAGs were used, we retrospectively investigated the postoperative outcomes and complications in eight elderly patients aged over 70 years with symptomatic internal carotid artery aneurysms in cavernous sinus.

Cerebral artery restenosis following transluminal balloon angioplasty for vasospasm after subarachnoid hemorrhage.

Background: Although percutaneous transluminal angioplasty (PTA) is a widely used less invasive method to treat coronary artery stenosis, 10% of treated patients experience restenosis. Restenosis also occurs in approximately 5% of patients subjected to carotid artery stenting. Animal and human data suggested that restenosis is a response to injury incurred during PTA.

Dissecting posterior inferior cerebellar artery aneurysm presenting with subarachnoid hemorrhage right after anticoagulant and antiplatelet therapy against ischemic event.

Background: Dissecting aneurysms with initial ischemic manifestations may present with subsequent subarachnoid hemorrhage (SAH), and their treatment is controversial. This is a case report that illustrates the dilemma when dealing with an immediate post-SAH period dissecting posterior inferior cerebellar artery (PICA) aneurysm initially presenting with an ischemic event.

Methods: We present a 57-year-old man with a dissecting PICA aneurysm who had SAH right after anticoagulant and antiplatelet therapy for cerebral infarction.

Expression of GATA-2 in human pituitary adenomas.

Transcription factor GATA-2 contains two copies of a highly conserved zinc finger domain and plays unique roles at an early stage of hematopoietic differentiation. In the mouse pituitary gland, Pit-1-GATA-2 protein-protein interaction has been shown to lead to gene-specific actions to obtain cell-specific roles. In this study, we investigated the expression of GATA-2 and Pit-1 in human pituitary adenomas using reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemical techniques.