Clinical Outcomes of Shifting from Transfemoral-First to Transradial-First Approach in Carotid Artery Stenting: A Retrospective Two-Timeframe Comparison at a Single Center.

Carotid artery stenting (CAS) has traditionally been performed using the transfemoral approach (TFA). Recently, the transradial approach (TRA) has gained attention for its lower invasiveness and reduced complication risk. This study compares outcomes between two access strategy timeframes, TFA-first and TRA-first, to evaluate how this shift influences outcomes in a real-world setting.

Stent assisted coil embolization for a dissecting cerebral aneurysm of middle cerebral artery: A case report and the literature review.

Background: Dissecting aneurysms of the middle cerebral artery (MCA) are very rare. We herein report a case of an unruptured dissecting aneurysm of the MCA treated by stent-assisted coil embolization.

Case Description: A 65-year-old man with no history of trauma presented with a headache.

An aggressive dural arteriovenous fistula manifested by unilateral subcortical calcification and cerebral edema: A case report.

Unilateral subcortical calcifications are unique radiographic findings indicating specific focal pathologies. When the lesion is accompanied by edema, cerebral neoplasm usually leads to a differential diagnosis. This report presents a case of unilateral subcortical calcification and edema that resulted in cerebral hemorrhage and a subsequent diagnosis of an aggressive dural arteriovenous fistula.

Machine Learning to Predict Three Types of Outcomes After Traumatic Brain Injury Using Data at Admission: A Multi-Center Study for Development and Validation.

The difficulty of accurately identifying patients who would benefit from promising treatments makes it challenging to prove the efficacy of novel treatments for traumatic brain injury (TBI). Although machine learning is being increasingly applied to this task, existing binary outcome prediction models are insufficient for the effective stratification of TBI patients. The aim of this study was to develop an accurate 3-class outcome prediction model to enable appropriate patient stratification.

The impact of hormonal dynamics and serum sodium fluctuations on symptomatic vasospasm after subarachnoid hemorrhage.

Background: Symptomatic vasospasm (SVS) is a major cause of morbidity and mortality in aneurysmal subarachnoid hemorrhage (SAH), and serum sodium frequently decreases before SVS. Serum sodium changes might be regulated by sodium metabolism-related hormones. This multi-institutional prospective cohort study therefore investigated the measurement of sodium metabolism-related hormones to elucidate the pathophysiology of serum sodium changes in SAH.

[Anterior Cranial Fossa Dural Arteriovenous Fistula with Specific Drainage Route Presenting Aphasia after Head Trauma:A Case Report].

In this case report, we describe a rare case of anterior cranial fossa dural arteriovenous fistula(ACF-dAVF)that had drained into the fronto-basal vein and refluxed to the superficial middle cerebral vein(SMCV). A 45-year-old man presented with aphasia and swelling of the left eye after head trauma. MRI detected a flow void in the left frontal basal area, and digital subtraction angiography revealed ACF-dAVF, which was fed from the ophthalmic arteries on both sides and had a shunt point within the left front basal dura.

[A Case of Symptomatic Nonhemorrhagic and Nonthrombotic Cervicothoracic Epidural Varices].

We describe an extremely rare case of symptomatic nonhemorrhagic and nonthrombotic cervicothoracic epidural varices. A 45-year-old man presented with back pain and left leg weakness. MRI revealed an epidural mass at the Th1 level, on the dorsal aspect of the spinal canal on the right side.

[Pseudoaneurysm of Neck External Carotid Artery Related to Chiropractic Manipulation].

A 55-year-old man presented with progressive pain and expanding swelling in his right neck. He had no history of trauma or infectious disease. The patient had undergone chiropractic manipulations once in a month and the last manipulation was done one day before the admission to our hospital.

[Implementation of Penumbra-assisted Half-Stent Thrombectomy for Patients with Acute M2 Occlusion:Results of Initial Experiences].

The benefits of mechanical thrombectomy(MT)for acute M2 occlusion have remained unclear because of unavoidable device-related complications due to vascular morphological characteristics. We developed a Penumbra-assisted half-stent thrombectomy for achieving secure retrieval of thrombus with minimal damage to the small-caliber vessel. In total, 6 patients were treated with MT for acute M2 occlusion using this technique between November 2016 and May 2017, including 3 men and 3 women, mean age 74.

Direct Carotid Cavernous Fistula Due to Rupture of a Cavernous Carotid Aneurysm Embedded Within a Prolactinoma After Cabergoline Administration.

Background: A small number of reports have described subarachnoid hemorrhage resulting from a ruptured aneurysm embedded within a prolactinoma. To the best of our knowledge, no reports have described an embedded carotid cavernous fistula. We report a patient with carotid cavernous fistula secondary to a ruptured internal carotid artery aneurysm embedded within a prolactinoma.

[Multiple Spinal Intradural and Extradural Syphilis Granuloma Mimicking Lumbar Dumbbell Type Neurinoma:A Case Report].

Spinal intradural and extradural syphilis granuloma is extremely rare. Here, we report a patient with multiple spinal intradural and extradural syphilis granuloma mimicking dumbbell type neurinoma. The patient was a 68-year-old man, who presented with left femoral pain for a month.

Long-Term Outcomes of Carotid Endarterectomy and Carotid Artery Stenting for Carotid Artery Stenosis: Real-World Status in Japan.

Background And Purpose: We investigated long-term outcomes of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in our institute to evaluate the outcomes of real-world practice in Japan.

Methods: Between August 2006 and July 2013, 203 consecutive carotid revascularizations with either CEA or CAS were performed in our institute. The initial treatment was regarded as the starting point in the cases of the patients who received treatment by bilateral carotid artery stenosis or retreatment.

Cilostazol administration with combination enteral and parenteral nutrition therapy remarkably improves outcome after subarachnoid hemorrhage.

Objective: In order to prevent cerebral vasospasm (VS) following aneurysmal subarachnoid hemorrhage (SAH), we introduced combined enteral nutrition (EN) and parenteral nutrition (PN) with oral cilostazol administration to the postoperative patient after SAH and investigated the effect on VS.

Methods: After aneurysmal SAH, 130 postoperative patients were enrolled in this study between April 2008 and March 2012. The patients enrolled before April 2010 were treated by conventional therapy (control group).

[Allergy of calcium phosphate cement material following skull reconstruction: a case report].

The paste form of calcium phosphate cement is often used in skull reconstruction because of the biocompatibility and early handling of these cements. Although it had rarely been shown to produce a foreign body reaction, we encountered a patient who experienced an allergic reaction to calcium phosphate cements(Biopex®. A patch test was performed and a positive reaction to magnesium phosphate was obtained.

MicroRNA-183 upregulates HIF-1α by targeting isocitrate dehydrogenase 2 (IDH2) in glioma cells.

MicroRNAs (miRs) are small, non-coding RNAs that regulate gene expression and contribute to cell proliferation, differentiation and metabolism. Our previous study revealed the extensive modulation of a set of miRs in malignant glioma. In that study, miR microarray analysis demonstrated the upregulation of microRNA-183 (miR-183) in glioblastomas.

Cerebrospinal fluid interleukin-10 is a potentially useful biomarker in immunocompetent primary central nervous system lymphoma (PCNSL).

The diagnosis of primary central nervous system lymphoma (PCNSL) by radiographical examination is often difficult because of its similarity to other brain tumors. To test whether interleukin-10 (IL-10) and IL-6 can be used to distinguish PCNSL from other brain tumors that are radiographically similar, cerebrospinal fluid (CSF) levels of IL-10 and IL-6 were measured in 66 patients with intracranial tumors (PCNSLs: 26 cases; other brain tumors: 40 cases). In the patients with PCNSLs, the median CSF levels of IL-10 and IL-6 were 27 pg/mL and 5.

Syringomyelia due to thoracic spinal stenosis with ossified ligamentum flavum--case report.

A 50-year-old male presented with back pain and numbness of the lower extremities persisting for 10 years. He had played volleyball for a long period until recently. He had no history of meningitis or traumatic injury.

The novel VEGF receptor antagonist, VGA1155, reduces edema, decreases infarct and improves neurological function after stroke in rats.

Vascular endothelial growth factor (VEGF) is a major mediator of angiogenesis and also a strong vascular permeability factor. Blockade of VEGF may have a potential to treat cerebral edema after brain injury. We evaluated the effect of VGA1155 (5- [N-Methyl-N-(4-octadecyloxyphenyl)acetyl]amino-2- methylthiobenzoic acid), a novel binding antagonist of VEGF, on cerebral edema after transient focal cerebral ischemia.

Anti-VEGF receptor antagonist (VGA1155) reduces infarction in rat permanent focal brain ischemia.

Background And Purpose: Vascular endothelial growth factor (VEGF) is a major mediator of angiogenesis and a strong vascular permeability factor. VEGF is known to open the blood-brain barrier (BBB) and induce cerebral edema. Experimental studies of VEGF antagonism have shown it reduces cerebral edema after ischemia, indicating its potential for prevention of secondary brain damage.

Circadian expression of 86- and 84-kDa heat shock proteins in the mouse suprachiasmatic nucleus.

Circadian rhythm pervades in many aspects of the biological processes including basic cellular functions. Here we examined the circadian gene expression of two forms of 90 kDa heat shock proteins referred to HSP86 and HSP84 in the mouse suprachiasmatic nucleus, the circadian center. In both light-dark, and constant dark conditions, Hsp86 mRNA showed an overt circadian rhythm showing a peak at (subjective) night and a trough at (subjective) day.

Effect of VEGF receptor antagonist (VGA1155) on brain edema in the rat cold injury model.

Vascular endothelial growth factor (VEGF) is a major mediator of angiogenesis and a strong vascular permeability factor. Blockade of VEGF may have a potential to treat brain edema after brain injury. In the rat cold injury model, the VEGF receptor antagonist VGA1155 significantly reduced the brain water content and the maximum effect was obtained when given at 30 minutes after injury.

Intradural facial nerve schwannoma: diagnostic and therapeutic problems.

Objectives: To define characteristics of intradural facial schwannoma (FS) and discuss management strategies.

Method: Retrospective review of clinical charts.

Results: Six patients were diagnosed, based on surgical findings, as having intradural FS.

Multiple cavernous angiomas of the cauda equina. Case report.

An 18-year-old male presented with multiple cavernous angiomas of the cauda equina manifesting as acute onset of severe low back pain radiating into the bilateral legs. Magnetic resonance imaging revealed a 20 mm by 15 mm nonenhanced, heterogeneous intensity intradural mass at the L-1 level, which had completely obliterated the spinal canal. After laminectomy at T12-L1 and dural incision, a 20 mm dark-bluish, mulberry-like tumor was seen, displacing the cauda equina circumferentially.

Snoring associated with Ondine's curse in a patient with brainstem glioma.

Unlabelled: Ondine's curse is an uncommon type of sleep apnea syndrome characterized by failure of automatic respiration. We present an adult patient with brainstem glioma who presented with snoring and Ondine's curse as the only symptoms.

Case Report: A 52-year-old female was brought to the hospital by a fellow resident due to exceptionally loud snoring.