Internal Neurolysis for Trigeminal Neuralgia: A Preliminary Single-institution Experience in Japan.

Internal neurolysis (IN) is a surgical procedure in which the trigeminal fibers are separated between the pons and porus trigeminus to relieve trigeminal neuralgia (TN). Recent investigations revealed that the number of nerve bundles made by IN varies, and immediate postoperative hypesthesia exceeded 90% and pain control rate at 1 year was 77%-93.5%.

Transarterial embolization with n-butyl-2-cyanoacrylate for a ruptured aneurysm at the artery of Davidoff and Schechter.

The artery of Davidoff and Schechter (ADS) is mostly identified in pathological conditions such as dural arteriovenous fistulas and brain tumors. Herein, we report a rare case of a ruptured aneurysm of the ADS, which was one of the feeders of a falcotentorial dural arteriovenous fistula. We performed endovascular embolization of the aneurysm and parent artery using n-butyl-2-cyanoacrylate.

Surgical protocol for permanent ligation of the left anterior descending coronary artery in mice to generate a model of myocardial infarction.

Myocardial infarction (MI) is one of the most common causes of death worldwide. Animal models for MI are useful for studying the pathophysiology and developing therapies. Here, we describe a surgical protocol for permanent ligation of the left anterior descending coronary artery in mice, which mimics human acute coronary syndrome.

Semaphorin3E-PlexinD1 signaling in coronary artery and lymphatic vessel development with clinical implications in myocardial recovery.

Blood and lymphatic vessels surrounding the heart develop through orchestrated processes from cells of different origins. In particular, cells around the outflow tract which constitute a primordial transient vasculature, referred to as aortic subepicardial vessels, are crucial for the establishment of coronary artery stems and cardiac lymphatic vessels. Here, we revealed that the epicardium and pericardium-derived Semaphorin 3E (Sema3E) and its receptor, PlexinD1, play a role in the development of the coronary stem, as well as cardiac lymphatic vessels.

Paramedian thalamic infarction caused by cisternal drain placement in open clipping for aneurysmal subarachnoid hemorrhage: Two case reports.

Background: Some complications associated with cisternal drainage have been reported; however, there are few reports on direct vascular injury caused by cisternal drain. We experienced two rare cases of thalamic infarction caused by cisternal drain placement during open clipping for a ruptured anterior communicating artery (AcomA) aneurysm through an anterior interhemispheric approach.

Case Description: Two cases of ruptured AcomA aneurysm were treated by surgical clipping through an anterior interhemispheric approach, and then a cisternal drain was inserted from opticocarotid space toward prepontine cistern.

The efficacy of temporary clamping of V3 with a suboccipital far-lateral approach in microvascular decompression for Hemifacial spasm associated with the vertebral artery.

Hemifacial spasm (HFS) is often caused by compression of the vertebral artery (VA) directly or indirectly as a result of other intervening vessels, so VA-associated HFS is difficult to treat. Recently, we have achieved good surgical outcomes using a far lateral approach and temporary clamping of V3 for VA-associated HFS. Herein, we present our method with an accompanying surgical video.

Surgical removal using V3-radial artery graft-V4 bypass and occipital artery-posterior inferior cerebellar artery bypass for a giant thrombosed aneurysm of vertebral artery compressing brain stem: Case report.

Background: Giant thrombosed vertebral artery aneurysms (GTVAs) are difficult disease to treat. Here, we are reporting a case of GTVA successfully treated with excluding the pathological segment and restoring the anterograde blood flow of the parent artery, highlighting the reliable surgical procedure.

Case Description: A 55-year-old man with a left GTVA complained of right hemiparesis (manual muscle testing 4/5) represented by hand clumsiness and gait disturbance, in addition to severe left-sided dysesthesia, was referred to our hospital.

Cohesive and anisotropic vascular endothelial cell motility driving angiogenic morphogenesis.

Vascular endothelial cells (ECs) in angiogenesis exhibit inhomogeneous collective migration called "cell mixing", in which cells change their relative positions by overtaking each other. However, how such complex EC dynamics lead to the formation of highly ordered branching structures remains largely unknown. To uncover hidden laws of integration driving angiogenic morphogenesis, we analyzed EC behaviors in an in vitro angiogenic sprouting assay using mouse aortic explants in combination with mathematical modeling.

Transposition of the Culprit Artery Passing Between the Facial Nerve and Auditory Nerve in Microvascular Decompression Surgery for Hemifacial Spasm.

Background: Decompression of the culprit artery causing hemifacial spasm (HFS), which passes between the facial nerve (cranial nerve [CN] VII) and the auditory nerve (CN VIII), can be difficult, especially if the artery compresses CN VII right after passing between the 2 nerves. Perforators or small arteries branching from near the compression site to adjacent structures can hinder the decompression process because such vessels can anchor the passing condition. The effect of such perforators or small arteries on the decompression process in such cases was investigated.

Lower cranial nerve palsy after the infrafloccular approach in microvascular decompression for hemifacial spasm.

Background: The infrafloccular approach was introduced as a variation in microvascular decompression (MVD) for hemifacial spasm. However, the rate of postoperative lower cranial nerve (CN) palsy can be high. This study investigated the surgical factors in relation to the occurrence of postoperative lower CN palsy.

Safety of microvascular decompression for elderly patients with trigeminal neuralgia.

Objective: The present study compared the safety and efficacy of microvascular decompression (MVD) in groups of elderly patients and non-elderly patients with medically refractory trigeminal neuralgia (TN) and collected detailed perioperative data.

Methods: Retrospective analysis of clinical data was performed in 99 patients who underwent MVD from May 2012 to June 2015. The outcome data from 27 MVD operations for 27 patients aged 70-80 years (mean 74.

Exposure of Titanium Mesh after Cranioplasty for Microvascular Decompression Surgery: Two Case Reports.

Two cases of exposed titanium mesh occurred after implantation for cranioplasty after repeated procedures for microvascular decompression (MVD). Case 1 was a 62-year-old female who underwent MVD for left hemifacial spasm followed by repair of cerebrospinal fluid leak after the surgery, and Case 2 was a 75-year-old female who underwent MVD twice for right trigeminal neuralgia. Both patients visited our hospital again with complaints of postauricular lesion.

Microvascular decompression for hemifacial spasm: how can we protect auditory function?

Objective: The nerve function of the VIIIth nerve is at risk during microvascular decompression (MVD) for hemifacial spasm (HFS). Intraoperative monitoring of brainstem auditory evoked potentials (BAEPs) can be useful in decreasing the danger of hearing loss. This study assessed the intraoperative BAEP findings related to the surgical process to clarify the optimum maneuvers of MVD surgery to avoid hearing impairment.

Trigeminal neuralgia caused by a trigeminocerebellar artery.

This 31-year-old woman presented with typical right trigeminal neuralgia caused by a trigeminocerebellar artery, manifesting as pain uncontrollable with medical treatment. Preoperative neuroimaging studies demonstrated that the offending artery had almost encircled the right trigeminal nerve. This finding was confirmed intraoperatively, and decompression was completed.

[Extradural en bloc removal and in situ replacement of the anterior clinoid process].

Extradural removal of the anterior clinoid process (ACP) is useful and essential for approaching aneurysmal and tumor lesions in and around the cavernous sinus. A safe, rapid and less invasive technique is beneficial for this basic skull base surgery. We developed a new technique by sharply cutting the ACP together with the part of the sphenoid ridge bone followed by complete replacement.