Solid brain metastasis mimicking intracerebral hematoma on imaging.

A 79-year-old woman with a history of resection of the ascending colon cancer presented with conscious disturbance, dysarthria, nausea, and dizziness. Computed tomography (CT) revealed striking high-density lesions in the left cerebellum and left frontal lobe with slight perifocal edema. These lesions were suspected the coexistence of spontaneous cerebellar hemorrhage and frontal lobe metastasis, or multiple brain metastases with massive hematoma.

Mutism due to a massive hematoma after rebleeding of an aneurysmal subarachnoid hemorrhage in the territory of the distal anterior cerebral artery.

Background: The mutism caused by hematoma after subarachnoid hemorrhage (SAH) is extremely rare, and the details of its clinical course have not been clarified.

Case Description: A 75-year-old woman who presented with transient loss of consciousness and a subsequent severe headache was transferred to our hospital. She was diagnosed with the World Federation of Neurosurgical Societies Grade II SAH due to the rupture of an aneurysm at the A2-3 junction in the left anterior cerebral artery (ACA).

Prehospital triage for endovascular clot removal in acute stroke patients.

Aim: To establish prehospital triage in accordance with the new guidelines for endovascular therapy, we retrospectively analyzed the monitoring data of the city-wide transportation system using the Maria Prehospital Stroke Scale (MPSS), a novel prehospital stroke scale for emergency medical technicians (EMTs) to predict the likelihood of thrombolytic therapy after transportation.

Methods: Kawasaki City, Japan, has six comprehensive stroke centers (CSCs) and six primary stroke centers (PSCs). In CSCs, endovascular therapy can be carried out 24 h a day, 7 days a week, but not in PSCs.

Quality assurance monitoring of a citywide transportation protocol improves clinical indicators of intravenous tissue plasminogen activator therapy: a community-based, longitudinal study.

Background: Stroke-bypass transportation to the stroke center by paramedics is important to maximize the efficiency of intravenous tissue plasminogen activator (iv-tPA) therapy. To improve access to stroke thrombolysis, a citywide protocol was launched on January 2007 in Kawasaki City (population 1.4 million) using the Maria Prehospital Stroke Scale (MPSS), and quality assurance monitoring has been performed every 6 months.

[Three-dimensional DSA imaging and 3-dimensional measurement of cross section for internal carotid artery stenosis].

We have performed rotational DSA for internal carotid artetry (ICA) stenosis and examined cross sectional imaging of the stenosis. Then, we compared the area stenosis rate (ASR) with stenosis rate by NASCET method and with results of duplex carotid ultrasonography. Of consecutive 451 patients who underwent digital subtraction angiography, 28 patients with ICA stenosis were selected for this study.