Radiographic Predictors of Shunt Dependency in Intracranial Hemorrhage With Intraventricular Extension.

Background Intracranial hemorrhage (ICH) may be complicated by intraventricular hemorrhage (IVH) and hydrocephalus, which can require the placement of a ventriculoperitoneal shunt (VPS). ICH and IVH risk scores using radiographic and clinical characteristics have been developed but utilization for assessment of future need for VPS placement is limited. Methods This is a single-institution retrospective review for patients with primary ICH with IVH from 2018-2020.

Intraoperative localization and "snowman" muscle pledget repair for ventral dural defect in a case of spontaneous intracranial hypotension.

Background: This image report with technical notes is the first to illustrate and describe the technique used to treat spinal cerebrospinal fluid (CSF) leaks with the "snowman" muscle pledget. A 49-year-old male presented with orthostatic headaches as well as the left abducens nerve palsy. Patient's workup including findings of diffuse meningeal enhancement on magnetic resonance imaging, lumbar puncture opening pressure of 4 cm H2O, and CT myelogram demonstrating evidence of ventral spinal thoracic CSF leak.

Retraction: Effects of the COVID-19 Pandemic on Stroke Patients.

[This retracts the article DOI: 10.7759/cureus.9995.

Use of Endovascular Simulator in Training of Neurosurgery Residents - A Review and Single Institution Experience.

Simulators for surgical procedures and interventions have undergone significant technological advancement in the past decade and are becoming more commonplace in medical training. Neurosurgery residents across multiple training levels underwent performance evaluation using a neuro-interventional simulator, employing a variety of metrics for assessment. We identified seven core metrics used in the evaluation of neurosurgery residents performing simulated mechanical thrombectomies.

Spinal Arteriovenous Malformation: Case Report and Review of the Literature.

Spinal arteriovenous malformations (AVMs) are a rare form of spinal blood vessel defect that results in vessel engorgement leading to clinical signs secondary to mass effect and ischemia. We present the patient's clinical course following suspicion of spinal AVM along with a review of current classification and imaging modalities.

Contrast Extravasation Post Thrombectomy in Patients With Acute Cerebral Stroke: A Review and Recommendations for Future Studies.

Mechanical thrombectomy (MT) for cerebral revascularization in acute stroke is now considered standard of care in select patients. Patients are assessed routinely after MT with CT scanning. The phenomenon of contrast staining is well documented in the literature and is posited to be related to increased blood-brain barrier (BBB) permeability of susceptible and/or infarcting brain tissue allowing angiographic contrast to be visualized outside the normal cerebral vasculature.

Effects of the COVID-19 Pandemic on Stroke Patients.

Introduction The severe acute respiratory syndrome coronavirus 2 (SARS2-CoV-2) induced pandemic (COVID-19 pandemic) has affected healthcare in all aspects, including stroke care. We sought to investigate this effect with analysis of our hospital's stroke treatment protocols as well as stroke volume on state, regional, and national levels. Methods This was a retrospective review of prospectively collected data from our stroke registry to assess the impact of the SARS2-CoV-2 induced pandemic on the volume of stroke patients presenting to our facility.

A Novel Method for Practicing Fascial Closure with Suture.

Closure of the fascial layer can be challenging to learn for junior level residents. Wound dehiscence involving the fascial layer can lead to complicated clinical courses for patients, including readmission to the hospital, wound vacuum placement, antibiotic regimens, and re-operation. Typical suturing techniques taught in medical school focus more on basic techniques of suture placement such as interrupted or running techniques.

Differential Expression of Vascular Endothelial Growth Factor-A Isoforms Between Intracranial Atherosclerosis and Moyamoya Disease.

Background: Vascular endothelial growth factor-A (VEGF-A) has been identified as a combination of 2 alternative splice variants: proangiogenic VEGF-Aa and antiangiogenic VEGF-Ab. Intracranial atherosclerotic disease (ICAD) and moyamoya disease (MMD) are 2 main types of intracranial arterial steno-occlusive disorders with distinct capacities for collateral formation. Recent studies indicate that VEGF-A regulates collateral growth in ischemia.

Effect of insurance and racial disparities on outcomes in traumatic brain injury.

Introduction: We evaluated outcome and resource utilization disparities between commercially insured, Medicaid, and Medicare patients. We further analyzed racial disparities in a subset cohort.

Methods: We reviewed the MarketScan database (2000-2009) for adult traumatic brain injury (TBI) patients.

How can a chemical element elicit complex immunopathology? Lessons from mercury-induced autoimmunity.

Although most autoimmune diseases develop without a manifest cause, epidemiological studies indicate that external factors play an important role in triggering or aggravating autoimmune processes in genetically predisposed individuals. Nevertheless, most autoimmune disease-promoting environmental agents are unknown because their relationships to immune function are not understood. Thus, the study of animal models of chemically-induced autoimmunity should shed light on the pathways involved and allow us to identify these agents.

Interindividual variability and parent of origin DNA methylation differences at specific human Alu elements.

We investigated the CpG methylation of 19 specific members of Alu sub-families in human DNA isolated from whole blood, using an assay based on methylation-sensitive restriction endonuclease digestion of genomic DNA and 'hot-stop' polymerase chain reaction. We found significant interindividual variability in the level of methylation for specific Alu elements among the members of 48 three-generation families. Surprisingly, some of the elements also displayed quantitative parent of origin methylation differences; i.