Tortuous occipital emissary vein combined with dural venous sinus stenosis in contrast-enhanced MRV for evaluation of idiopathic intracranial hypertension.

Purpose: Venous outflow impediment is increasingly recognized in idiopathic intracranial hypertension (IIH). We aim to search for the value of tortuous occipital emissary vein (OEV) in IIH by integrating measurable transverse sinus (TS) stenosis in contrast-enhanced MR venography (CE-MRV).

Methods: Twenty-one IIH patients were evaluated with CE-MRV.

Basilar artery occlusion management: An international survey of middle versus high-income countries.

Background And Purpose: Two early basilar artery occlusion (BAO) randomized controlled trials (RCTs) did not establish the superiority of endovascular thrombectomy (EVT) over medical management. Yet many providers continued to recommend EVT. The goal of the present article is to compare physicians' diagnostic and management strategies of BAO among middle-income and high-income countries (MICs and HICs, respectively).

Feasibility and Results of the Stentectomy Procedure Performed as Rescue Treatment for Acute Thrombosis of Self-Expandable Intracranial Stents: A Case Series.

Background: Self-expandable stents have been increasingly used for endovascular treatment of intracranial aneurysms. Because the usage of intracranial stents has increased overall, total numbers of complications associated with these devices have increased. Thrombosis, distortion, or incomplete opening of stents are potential complications that may result in occlusion of the parent artery.

Safety, Efficacy, and Durability of Stent Plus Balloon-Assisted Coiling for the Treatment of Wide-Necked Intracranial Bifurcation Aneurysms.

Background: Wide-necked bifurcation aneurysms remain a challenge for endovascular surgeons. Dual-stent-assisted coiling techniques have been defined to treat bifurcation aneurysms with a complex neck morphology. However, there are still concerns about the safety of dual-stenting procedures.

Flow diverter stents in the treatment of recanalized intracranial aneurysms.

Background: We assessed the safety and efficacy of flow diverter stents (FDSs) in the treatment of recanalized or residual intracranial aneurysms treated endovascularly.

Materials & Methods: Patients whose recanalized or residual aneurysms were treated with FDSs in five tertiary hospitals were reviewed retrospectively. The patients' demographic data, aneurysm characteristics, types of previous treatment, and clinical complications, or serious adverse events associated with FDSs, as well as the results of neurological and angiographic follow-up assessments, were recorded.

Long-term outcomes of wide-necked intracranial bifurcation aneurysms treated with T-stent-assisted coiling.

Objective: The endovascular treatment of complex bifurcation aneurysms possessing a neck that incorporates multiple side branches remains a surgical challenge. Double-stent-assisted coiling techniques, such as those with stents in an X and Y configuration, enable the endovascular treatment of wide-necked complex intracranial bifurcation aneurysms. However, the intraluminal struts at the intersection point in X- and Y-stents are not amenable to endothelialization, which may lead to thromboembolic complications.

Y-Stent-Assisted Coiling With Low-Profile Neuroform Atlas Stents for Endovascular Treatment of Wide-Necked Complex Intracranial Bifurcation Aneurysms.

Background: Y-stent-assisted coiling is one of the eligible techniques for the treatment of complex bifurcation aneurysms. In majority of previous literature, Y-stenting has been performed using stents that could be delivered through large profile microcatheters that are often difficult to manipulate during navigation through sharply angled side branches. Attempts to navigate with these large profile catheters might cause serious complications during Y-stenting procedure.

Crossing Y-Solitaire thrombectomy as a rescue treatment for refractory acute occlusions of the middle cerebral artery.

Background: Mechanical thrombectomy using a stent retriever has become the standard of care for acute large-vessel occlusions in the anterior circulation. Clots that are refractory to single stent retriever thrombectomy remain a challenge for neurointerventionalists.

Objective: To assess the efficacy and safety of double stent retriever (crossing Y-Solitaire) thrombectomy as a rescue treatment for acute middle cerebral artery (MCA) occlusions that are refractory to single stent retriever thrombectomy.

Anticoagulation strategy in patients with atrial fibrillation after carotid endarterectomy.

Carotid artery stenosis and atrial fibrillation are diseases of the aging patient population. Literature lacks precise anticoagulation treatment protocols for patients with atrial fibrillation following carotid endarterectomy. We present our experiences with anticoagulation strategy in this particular patient population.

Cerebral Protection with a Temporary Ascending Aorta-External Carotid Artery Bypass during Common Carotid Artery Revascularization.

Atherosclerosis is a systemic disease, and multiarterial involvement is common. Involvement of all the supra-aortic arteries may occur in the same patient making cerebral revascularization challenging. In this report, we present complete supra-aortic revascularization, that is, revascularization of the bilateral common carotid and subclavian arteries in a 51-year-old male patient with occluded brachiocephalic trunk, left subclavian artery, and proximally stenotic left common carotid artery.

Evidence for alterations of the right inferior and superior longitudinal fasciculi in patients with social anxiety disorder.

The aim of our study was to detect white matter (WM) regions being involved in the pathophysiology of SAD. We applied diffusion tensor imaging in 22 consecutive adult patients (11 women and 11 men) with SAD and 22 age and sex-matched healthy control subjects. We examined white matter (WM) alterations between the patients with social anxiety disorder (SAD) and healthy controls by a whole-brain analysis.

How to Clamp and Bypass if There Is Single Artery Supply to the Head and That Contains Severe Stenosis?

Takayasu arteritis manifests with arterial occlusions and aneurysms. Revascularization is sometimes challenging, especially when carotid arteries are affected. In this report, we present a carotid artery revascularization technique in a patient who was admitted with orthostatic and postprandial transient ischemic attacks, resulting in a diagnosis of bilaterally occluded subclavian and vertebral arteries, occluded left common carotid artery, and severely stenosed right common carotid artery.

Midterm results of T-stent-assisted coiling of wide-necked and complex intracranial bifurcation aneurysms using low-profile stents.

OBJECTIVE Coiling of wide-necked and complex bifurcation aneurysms frequently requires implantation of double stents in various configurations. T-stent-assisted coiling involves the nonoverlapping implantation of 2 stents to protect the daughter vessels of bifurcation and is followed by coiling of the aneurysm. The authors studied the feasibility, efficacy, and safety of the T-stent-assisted coiling procedure as well as the midterm angiographic/clinical outcomes of patients with wide-necked bifurcation intracranial aneurysms treated using this technique.

Clinical Course of Non-Traumatic Non-Aneurysmal Subarachnoid Hemorrhage: A Single Institution Experience over 10 Years and Review of the Contemporary Literature.

Aim: To report our experience with a relatively large series of patients with non-traumatic non-aneurysmal subarachnoid hemorrhage (NNSAH) to identify the prognosis associated with different bleeding patterns as well as a further diagnostic work-up to determine the underlying cause.

Material And Methods: Between January 2004 and December 2014, 81 patients with angiography-negative non-traumatic subarachnoid hemorrhage (SAH) were treated at our institution. Diagnosis was confirmed with a typical history of spontaneous SAH and cranial computed tomography (CT) scan or lumbar puncture (LP).

Superselective intra-arterial chemotherapy in the primary management of advanced intra-ocular retinoblastoma: first 4-year experience from a single institution in Turkey.

Purpose: To report our 4-year experience in Turkey, with advanced intra-ocular retinoblastoma managed primarily with intra-arterial chemotherapy (IAC).

Methods: From October 2011 to September 2015, 26 group D eyes of 24 treatment-naïve retinoblastoma patients managed primarily with IAC were evaluated in this prospective study.

Results: Of 76 procedures, ophthalmic artery cannulation failed in two patients with unilateral involvement.

Cerebrovascular complications of transorbital penetrating intracranial injuries.

Background: Cerebrovascular trauma secondary to transorbital intracranial penetrating injury (TIPVI) is rare. Relatively benign initial presentation may mask the underlying life-threatening vascular injury in transorbital intracranial penetrations. The aim of this study was to evaluate clinical features and endovascular treatment of TIPVI.

Rescue Retrieval of a Fully Deployed Low-Profile Intracranial Stent After Acute Occlusion.

The use of self-expandable stents for endovascular treatment of intracranial aneurysms has increased over time. Different types of stent malpositioning, such as stent migration, distortion, incomplete opening, and apposition, can occur as a complication of the stent deployment procedure. In this report, we present a successful retrieval of a low-profile stent after full deployment in a dissecting posterior-inferior cerebellar artery because of incomplete apposition and subsequent acute occlusion of the stent.

Angiographic Morphometry of Internal Carotid Artery Circulation in Turkish Children.

Aim: Knowledge of cerebrovascular morphology is integral in planning neuroendovascular interventions, especially for procedures involving placement of stents, flow diverters or stentrievers. There is insufficient data on angiographic normative values of cerebral circulation in the pediatric age group since angiograms are uncommonly performed in children except for arteriovenous malformations in which arterial dimensions are larger than normal. We aimed to measure the diameters of internal carotid circulation (ICC) arteries on digital subtraction angiograms of pediatric patients and determine the growth trends.

1H-magnetic resonance spectroscopy in obsessive-compulsive disorder: effects of 12 weeks of sertraline treatment on brain metabolites.

Several neuroimaging studies have investigated brain metabolite abnormalities in patients with obsessive-compulsive disorder (OCD) and also explored metabolic changes after OCD treatments using proton magnetic resonance spectroscopy ((1)H-MRS). The main objective of this study was to investigate the effects of a selective serotonin re-uptake inhibitor (SSRI) treatment on the neurochemical levels in patients with OCD. In the present study, levels of N-acetylaspartate (NAA), choline, and myo-Inositol were measured in terms of their ratios with creatine (Cr) using (1)H-MRS.

Proton magnetic resonance spectroscopy in obsessive-compulsive disorder: evidence for reduced neuronal integrity in the anterior cingulate.

Neuroimaging studies have suggested that dysfunction of the cortico-striatal-thalamo-cortical (CSTC) circuit is a key pathophysiologic feature of obsessive-compulsive disorder (OCD). Several studies using proton magnetic resonance spectroscopy ((1)H MRS) have found abnormal neural metabolite concentrations among OCD patients. The aim of this study was to investigate the metabolic integrity of the anterior cingulate, caudate and putamen in OCD.