Real Stiffness and Vividness Reproduction of Anatomic Structures Into the 3-Dimensional Printed Models Contributes to Improved Simulation and Training in Skull Base Surgery.

Background: Despite the advancement of 3-dimensional (3D) printing technology with medical application, its neurosurgical utility value has been limited to understanding the anatomy of bones, lesions, and their surroundings in the neurosurgical field.

Objective: To develop a 3D printed model simulating the surgical technique applied in skull base surgery (SBS), especially to reproduce visually the surgical field together with the mechanical properties of tissues as perceived by the surgeon through procedures performance on a model.

Methods: The Young modulus representing the degree of stiffness was measured for the tissues of anesthetized animals and printing materials.

Management strategy for bilateral complex vertebral artery aneurysms.

Bilateral complex vertebral artery aneurysms (BCoVAAns) have no established strategy of management. We retrospectively reviewed five consecutive patients with unruptured BCoVAAns between January 2006 and December 2012. Considering surgical risks of lower cranial nerve (LCN) injuries and eventual growth of an opposite side lesion after unilateral vertebral artery (VA) occlusion, we proposed a strategy of combined open and interventional treatment using revascularization.

Use of external lumbar cerebrospinal fluid drainage and lumboperitoneal shunts with Strata NSC valves in idiopathic normal pressure hydrocephalus: a single-center experience.

Objective: In Japan, idiopathic normal pressure hydrocephalus (iNPH) currently is treated mainly with lumboperitoneal (LP) shunts. Our aim was to evaluate whether LP shunting via the use of Medtronic Strata NSC programmable valves was as effective as ventriculoperitoneal shunting in the treatment of patients with iNPH from the perspectives of safety and symptomatic improvement rate.

Methods: The clinical records of 51 iNPH patients (mean age, 75 years; males, 29), who underwent placement of Medtronic Strata NSC LP shunt systems were reviewed retrospectively as a cohort.

A new support system using a mobile device (smartphone) for diagnostic image display and treatment of stroke.

Background And Purpose: With the increasing demand for rapid diagnosis and treatment of stroke, the telemedicine role of coordinating timely the efforts of the stroke team became important. We developed a system for rapidly exchanging diagnostic images and clinical and management information.

Methods: A system was created on the basis of communicating patient data and images between hospital systems and participating staff members in and out of the hospital through their standard, currently used handheld communication devices.

Leucine-rich α-2-glycoprotein is a marker for idiopathic normal pressure hydrocephalus.

Objective: Cerebrospinal fluid (CSF) shunting can improve symptoms of elderly patients' idiopathic normal pressure hydrocephalus (iNPH). However, adjunctive means for confirming the diagnosis remain unavailable. We have previously reported the specific increase of leucine-rich alpha-2-glycoprotein (LRG) in iNPH CSF, and the present study investigates its potential clinical applications.

Role of aneurysm projection in "A2" fork orientation for determining the side of surgical approach.

Purpose: To determine factors that help decide the side of approach for anterior communicating artery (AComA) aneurysms, based on a prospective study.

Methods: Between January 2004 and January 2006, 93 cases with AComA aneurysms were treated through pterional approach. They were classified as Type I, II (IIa, IIb), III and IV, based on the various projections and size of aneurysm.

Dorsal column stimulation in persistent vegetative state.

Objectives.  The problem of treating patients in a vegetative state remains grossly unresolved, and spinal cord stimulation (SCS) had seemed promising in some studies, suggesting, to us, further study. Materials and Methods.

Usefulness of a simplified management scheme for paraclinoid aneurysms based on a modified classification.

Background: Our objective was to set up a management-oriented classification for paraclinoid aneurysms, and then design and apply a simplified management scheme according to each group defined by this classification.

Methods: Paraclinoid aneurysms were classified as group I (supraophthalmic artery), group II (ophthalmic artery) and group III (infraophthalmic artery) aneurysms intradurally. Between January 2005 and December 2006, 86 cases with 89 paraclinoid aneurysms were treated.

Management of complex, surgically intractable intracranial aneurysms: the option for intentional reconstruction of aneurysm neck followed by endovascular coiling.

Background: A limited series of patients with aneurysm were reviewed retrospectively to analyze strategies for integrating microsurgical and endovascular techniques in the management of complex, surgically intractable aneurysms.

Methods: Four patients were managed in Fujita Health University with a multimodality approach: intentional reconstruction of the aneurysm neck followed by endovascular coiling.

Results: A total of 5 aneurysms were treated, of which 3 were large or giant in size, and 3 were fusiform or multilobulated.