Preoperative Predictive Factors of Short-Term Outcome in Idiopathic Normal Pressure Hydrocephalus.

Background: Surgical treatment of idiopathic normal pressure hydrocephalus (iNPH) by ventriculoperitoneal (VP) or lumboperitoneal (LP) shunting can achieve long-term recovery of activities of daily living; however, in a subset of patients, maintenance of independence lasted for <6 months. This study examined positive preoperative predictive factors of short-term outcome for shunted iNPH patients.

Methods: Over a 9-year period, consecutive patients from multiple centers diagnosed with probable iNPH underwent either VP or LP shunt surgery.

Emergency Superficial Temporal Artery-Superior Cerebellar Artery Bypass for the Refractory Vertebrobasilar Insufficiency with Partial Mastoidectomy.

Background: Although it is well-known that vertebrobasilar insufficiency (VBI) because of atherothrombosis with bilateral vertebral artery (VA) occlusion is resistant to medical treatment from the acute to subacute stages, the most appropriate treatment for progressive infarction at these stages remains unclear. Here, we described a patient with VBI who underwent emergency superficial temporal artery-superior cerebellar artery (STA-SCA) bypass under partial mastoidectomy after confirming mismatch between diffusion-weighted imaging (DWI) findings and clinical symptoms. The patient showed a good outcome with this approach.

Ultra-Early Combination Antiplatelet Therapy with Cilostazol for the Prevention of Branch Atheromatous Disease: A Multicenter Prospective Study.

Background And Purpose: The optimal use of antiplatelet therapy for intracranial branch atheromatous disease (BAD) is not known.

Methods: We conducted a prospective multicenter, single-group trial of 144 consecutive patients diagnosed with probable BAD. All patients were treated within 12 h of symptom onset to prevent clinical progression using dual antiplatelet therapy with cilostazol plus one oral antiplatelet drug (aspirin or clopidogrel).

Occipital artery-to-posterior inferior cerebellar artery anastomosis with multiple-layer dissection of suboccipital muscles under a reverse C-shaped skin incision.

Although occipital artery (OA)-to-posterior inferior cerebellar artery (PICA) anastomosis is the most familiar reconstruction for posterior cerebral circulation, the procedure is considered difficult because of the anatomical complex course of OA and the depth of the operative field at the anastomosis site. Therefore, we attempted a safe and reliable method for OA-to-PICA anastomosis under multiple-layer dissection of suboccipital muscles and a reverse C-shaped skin incision. We reviewed the clinical records of patients who underwent OA-to-PICA anastomosis in our institute, and report the outcome with special emphasis on graft patency and surgical complications.

Surgical embolectomy for middle cerebral artery occlusion after thrombolytic therapy: A report of two cases.

Background: Occlusion of the intracranial main trunk results in a poor functional outcome and a high mortality rate. Accordingly, some revascularization procedures such as intravenous administration of recombinant tissue plasminogen activator (rt-PA), endovascular surgery, or surgical embolectomy in the very acute stage have been attempted.

Case Description: We describe two patients with middle cerebral artery occlusion due to cardiogenic embolism.

[Carotid endarterectomy for high cervical internal carotid artery stenosis: study of 22 consecutive patients].

In general, carotid endarterectomy(CEA)for high cervical internal carotid artery(ICA)stenosis is considered a difficult technique. Among 132 patients who underwent CEA between May, 1996 and December, 2012 in our institute, 22 showed high cervical ICA stenosis. A wide operation field was obtained by wide range dissection of shallow anatomical structures without special techniques and the first cervical vertebra was palpable in all patients.

[Evaluation of deep infection of the surgical site after spine surgery].

Objective: Surgical site infection(SSI)is commonly seen following spinal surgery, and it can be associated with serious morbidity, mortality, and increased resource utilization. The objective of this study was to identify specific independent risk factors for SSI occurring after spinal surgery.

Methods: We performed a retrospective study of patients who had spinal surgeries performed from January 2007 to July 2012 at our hospital.

Use of bioabsorbable plates for cranial fixation.

LactoSorb fixation plates are made of a bioabsorbable polymer (82% poly-L-lactic acid and 18% polyglycolic acid), and the strength is not inferior to titanium plates. LactoSorb has been used in the fields of pediatric neurosurgery and facial plastic surgery. Cranial fixation in craniotomy is mostly performed using titanium plates and clamps, but there are issues with esthetics and artifacts on postoperative radiographic images.