A Case of Subdural Hygroma due to a Ruptured Arachnoid Cyst in the Middle Cranial Fossa That Improved after Long-term Subdural Drainage: A Case Report and Review of the Literature.

Arachnoid cysts have the potential to rupture, leading to the development of a subdural hygroma following minor trauma. Although surgery may be considered in cases of increased intracranial pressure (ICP) or regional neurological symptoms, the optimal approach remains unclear. We report a case of subdural hygroma due to a ruptured arachnoid cyst (SHrAC) with elevated ICP successfully treated with long-term subdural drainage for over 1 month.

Thrombolysis for Acute Wake-Up and Unclear-Onset Strokes with Alteplase at 0.6 mg/kg in Clinical Practice: THAWS2 Study.

Introduction: The aim of this study was to determine the safety and efficacy of intravenous (IV) alteplase at 0.6 mg/kg for patients with acute wake-up or unclear-onset strokes in clinical practice.

Methods: This multicenter observational study enrolled acute ischemic stroke patients with last-known-well time >4.

Interhemispheric Asymmetry of Network Connecting Between Frontal and Temporoparietal Cortices: A Corticocortical-Evoked Potential Study.

Background: The connection between the ventrolateral frontal and temporoparietal cortices has an important role in language function on the language-dominant side and spatial awareness on the nondominant side. However, the laterality of these pathways remains controversial. We investigated the laterality of this connection using corticocortical-evoked potentials (CCEPs).

Arterial Spin Labeling Method as a Supplemental Predictor to Distinguish Between High- and Low-Grade Gliomas.

Background: Preoperative evaluation of malignancy in gliomas is important for surgical planning, particularly to determine whether a 1,3-bis-2-chloroethyl-1-nitrosourea wafer should be placed into the tumor cavity. In some cases, the intraoperative pathologic diagnosis of World Health Organization grade differs from the final diagnosis. Supplemental methods in addition to the routine contrast tomography or magnetic resonance imaging sequences may provide a more accurate preoperative diagnosis.

Digital Polymerase Chain Reaction Quantification of SERPINA1 Predicts Prognosis in High-Grade Glioma.

Background: SERPINA1 plays an anti-inflammatory role in protecting tissues from proteolytic mechanisms. SERPINA1 is positive in gliomas by immunohistochemical analysis; however, the role of SERPINA1, including the relationship with prognosis, has been uncertain. In recent years, digital polymerase chain reaction (PCR) has provided ultra-sensitive assessment of messenger RNA expression from formalin-fixed paraffin-embedded (FFPE) tissues.

Electrophysiological influence of temporal occlusion of the parent artery during aneurysm surgery.

Intraoperative monitoring of the motor evoked potential (MEP) during cerebral aneurysm surgery has been widely used to confirm surgical safety. In this study, we retrospectively analyzed the influence of the MEP amplitude resulting from temporal occlusion of the parent artery, and appropriate judgement in the surgery was discussed. Ten patients underwent temporal occlusion of the parent artery during aneurysm surgery, and five of these patients showed a decrease in the MEP amplitude following temporal arterial occlusion.

[Bone Flap Resorption after Cranioplasty in Pediatric Patients:Report of 2 Cases].

Aseptic bone flap resorption, a rare complication after cranioplasty following decompressive craniectomy, is more likely to develop in children. We experienced two cases of aseptic bone flap resorption and identified potential pathophysiological mechanisms through histological findings. In the first case, an 11-year-old girl underwent decompressive craniectomy due to brain swelling with contusion.

Co-expression of tissue factor and IL-6 in immature endothelial cells of cerebral cavernous malformations.

Cerebral cavernous malformations (CCMs) are congenital abnormal clusters of capillaries that are prone to leaking and thought to result from a disorder of endothelial cells. The underlying pathology of CCM is not fully understood. We analyzed the expression of tissue factor (TF) and interleukin-6 (IL-6) in CCMs to determine the association of TF and IL-6 with clinical and pathological findings.

Interleukin-13 receptor alpha 2 as a marker of poorer prognosis in high-grade astrocytomas.

Background: Interleukin-13 receptor alpha 2 (IL13Rα2) is considered a prognostic marker for gliomas according to the World Health Organization (WHO) grade. However, the expression levels of the marker vary from case to case, even within the same grade. We investigated whether IL13Rα2 could serve as a predictor of poorer prognosis in gliomas.

Assessment of Hemodynamic Compromise Using Computed Tomography Perfusion in Combination with I-IMP Single-Photon Emission Computed Tomography without Acetazolamide Challenge Test.

Objectives: The acetazolamide challenge test in conjunction with I-IMP single-photon emission computed tomography (SPECT) is a known method of assessing cerebrovascular reserve capacity. In this study, we investigated whether CT perfusion in combination with resting state I-IMP SPECT could be used instead of the acetazolamide challenge test to evaluate hemodynamic compromise in patients with atherosclerotic occlusive disease.

Methods: Twenty consecutive patients with unilateral internal carotid artery or middle cerebral artery steno-occlusive disease were enrolled.

Biological relevance of tissue factor and IL-6 in arteriovenous malformations.

Arteriovenous malformations (AVMs) are congenital abnormal vessels that shunt blood directly from the arterial to the venous system without a capillary bed. The underlying pathology of AVMs is not fully understood. The objective of the study was to determine the association between the expression patterns of tissue factor (TF) and interleukin-6 (IL-6) in AVMs with clinical and pathological findings.

Assessment of the cortical artery using computed tomography angiography for bypass surgery in moyamoya disease.

Computed tomography angiography (CTA) is often used to assess the vascular status in moyamoya disease. The purpose of the study is to identify the characteristics of cortical arteries (M4) of moyamoya disease on CTA; the clinical significance of which is also discussed. A total of 38 hemispheric sides of 27 patients with moyamoya disease were included in this study.

Neuromodulatory Role of Revascularization Surgery in Moyamoya Disease.

Background: To evaluate the effectiveness of bypass surgery for moyamoya disease, electrocorticography was first evaluated.

Methods: A total of 13 hemispheres in 9 patients with moyamoya disease were included in this study. To record the spectral power of electrocorticography continuously during the bypass procedure, a 4 × 5 subdural electrode grid was placed on the middle frontal gyrus.

ACTC1 as an invasion and prognosis marker in glioma.

OBJECTIVE Glioma is a major class of brain tumors, and glioblastoma (GBM) is the most aggressive and malignant type. The nature of tumor invasion makes surgical removal difficult, which results in remote recurrence. The present study focused on glioma invasion and investigated the expression of actin, alpha cardiac muscle 1 (ACTC1), which is 1 of 6 actin families implicated in cell motility.

Training for Skull Base Surgery with a Colored Temporal Bone Model Created by Three-Dimensional Printing Technology.

Objective: A 3-dimensional temporal bone model for skull base surgical training was reconstructed via the use of a selective laser sintering technique, which is one of the 3-dimensional printing technologies.

Methods: The temporal bone model was created in 2 pieces to remove powder material in the mastoid air cells and to place dye into the semicircular canal and the Fallopian canal.

Results: The powder material was minimal, and the decisive structures were identified in color.

Reversibility of White Matter Hyperintensity by Revascularization Surgery in Moyamoya Disease.

Background: White matter lesions (WMLs) indicate progressive cerebral small vessel disease and are frequently observed in aging people and stroke patients. The purpose of this study was to evaluate WMLs and the influence of revascularization surgery for WMLs in patients with moyamoya disease.

Methods: A total of 42 hemispheres in 21 patients with moyamoya disease were included in this analysis.

The influence of depth of anesthesia on motor evoked potential response during awake craniotomy.

OBJECTIVE Motor evoked potentials (MEPs) are a critical indicator for monitoring motor function during neurological surgery. In this study, the influence of depth of anesthesia on MEP response was assessed. METHODS Twenty-eight patients with brain tumors who underwent awake craniotomy were included in this study.

Cortical and subcortical vascular hypointensity on T2* weighted imaging in moyamoya disease.

Objectives: Decreased cortical and subcortical vascular signals in gradient echo T2* weighted imaging have been reported in acute stroke due to major artery occlusion. The purpose of this study was to evaluate this cortical and subcortical vascular hypointensity (CSVH) in patients with moyamoya disease.

Methods: Subjects were 20 consecutive patients with moyamoya disease.

Intraoperative Mapping and Monitoring for Rootlets of the Lower Cranial Nerves Related to Vocal Cord Movement.

Background: Damage to the motor division of the lower cranial nerves that run into the jugular foramen leads to hoarseness, dysphagia, and the risk of aspiration pneumonia; therefore, its functional preservation during surgical procedures is important. Intraoperative mapping and monitoring of the motor rootlets at the cerebellomedullary cistern using endotracheal tube electrodes is a safe and effective procedure to prevent its injury.

Objective: To study the location of the somatic and autonomic motor fibers of the lower cranial nerves related to vocal cord movement.

Vascular remodeling of the circle of Willis in moyamoya disease.

Objectives: A positive (outward) remodelling pattern in patients with typical atherosclerotic disease was recognised using magnetic resonance imaging (MRI). In this report, the outer diameter of the circle of Willis was evaluated in patients with moyamoya disease, and its remodelling pattern was verified.

Methods: A total of 18 consecutive patients with moyamoya disease were included in this analysis.

IgG4-related disease initially presented as an orbital mass lesion mimicking optic nerve sheath meningioma.

We report a case of an optic nerve mass lesion associated with IgG4-related disease. A 39-year-old man presented with right blurred vision and proptosis 8 years before admission. Magnetic resonance imaging showed a mass lesion in the center of the right orbit, which was diagnosed as optic nerve sheath meningioma by neuroradiologists and neurosurgeons.