Angiographic Evaluation of Cranial Venous Outflow Patterns in Patients With and Without Idiopathic Intracranial Hypertension.

Background: Several collateral venous pathways exist to assist in cranial venous drainage in addition to the internal jugular veins. The important extrajugular networks (EJN) are often readily identified on diagnostic cerebral angiography. However, the angiographic pattern of venous drainage through collateral EJN has not been previously compared among patients with and without idiopathic intracranial hypertension (IIH).

Onyx extrusion through the scalp after embolization of dural arteriovenous fistula.

A man in his sixties referred with symptoms of episodic left lip numbness and left arm weakness was diagnosed with a Borden type 3 dural arteriovenous fistula (DAVF) on DSA. Successful Onyx embolization of the DAVF was performed via the distal left occipital artery using an ev3 Apollo detachable tip microcatheter. He underwent surgical obliteration for the residual DAVF 3 days later.

Onyx extrusion through the scalp after embolization of dural arteriovenous fistula.

A man in his sixties referred with symptoms of episodic left lip numbness and left arm weakness was diagnosed with a Borden type 3 dural arteriovenous fistula (DAVF) on DSA. Successful Onyx embolization of the DAVF was performed via the distal left occipital artery using an ev3 Apollo detachable tip microcatheter. He underwent surgical obliteration for the residual DAVF 3 days later.

CT perfusion-guided patient selection for endovascular recanalization in acute ischemic stroke: a multicenter study.

Background: The treatment of acute ischemic stroke is traditionally centered on time criteria, although recent evidence suggests that physiologic neuroimaging may be useful. In a multicenter study we evaluated the use of CT perfusion, regardless of time from symptom onset, in patients selected for intra-arterial treatment of ischemic stroke.

Methods: Three medical centers retrospectively assessed stroke patients with a National Institute of Health Stroke Scale of ≥ 8, regardless of time from symptom onset.

Flow failure from intracranial atherosclerotic disease: a rationale for endovascular intervention in a population with recurrent symptoms despite maximal medical therapy.

The Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS) trial, the first randomized trial to compare best medical therapies with angioplasty and stenting, was halted prematurely owing to a 30-day stroke rate of 14.7% in the angioplasty and stenting arm compared with 5.8% in the medical management arm.

Simulator based angiography education in neurosurgery: results of a pilot educational program.

Introduction: The use of simulators in medical training has been on the rise over the past decade as a means to teach procedural skills to trainees in a risk free environment. The goal of this study was to pilot a simulator based skills course for inexperienced neurosurgical residents to teach the fundamentals of cervicocerebral catheterization and angiography, with the ultimate goal of defining a universal simulator based curriculum that could be incorporated into neurosurgical resident training in the future.

Methods: Seven neurosurgery residents with no prior angiographic experience served as the pilot participants for this 2 day course.

Does rural Mississippi have access to emergency neurosurgical care?

Acute neurosurgical emergencies are a potentially devastating occurrence requiring prompt evaluation and intervention by a neurosurgeon. Current consensus for acute subdural hematoma evacuation recommends a maximum time period of four hours from injury to operation; other injuries require prompt evaluation by a neurosurgeon but do not have soundly supported recommendations. Rural hospitals, such as Field Memorial Community Hospital in Centreville, MS, transfer acutely injured neurosurgical patients to centers with neurosurgical capability after initial stabilization.