Monitoring of filter patency during carotid artery stenting using near-infrared spectroscopy with high time-resolution.

We aimed to evaluate the usefulness of a newly developed, near-infrared spectroscopy (NIRS) device for monitoring hemodynamic changes during carotid artery stenting (CAS), as a means to detect filter obstruction due to distal embolism. We evaluated 16 patients with internal carotid artery (ICA) stenosis during the CAS procedure, using a NIRS system that can monitor not only changes in oxygenation of hemoglobin (Hb), but also the fluctuation of oxyhemoglobin (oxy-Hb) synchronized with heartbeat. The NIRS system detected a marked decrease of oxy-Hb and an increase of deoxyhemoglobin (deoxy-Hb) during ICA occlusion in patients without anterior cross circulation (ACC).

Endovascular treatment for ruptured vertebral artery dissecting aneurysms at the acute stage.

Objective: Ruptured vertebral artery dissecting aneurysms (VADA) should be treated promptly because of the high risk of rebleeding. However, it is difficult to treat dissecting aneurysm during the acute stage using microsurgery because of high intracranial pressure or brain edema. Therefore, endovascular treatment of the ruptured VADA may be a better technique.

Monitoring of hemodynamic change in patients with carotid artery stenosis during the tilt test using wearable near-infrared spectroscopy.

Transient ischemic attack (TIA) is a major complication in patients with carotid artery stenosis. Patients with severe stenosis sometimes complain of orthostatic dizziness, such as syncope. The purpose of this study was to examine the usefulness of near-infrared spectroscopy (NIRS) for evaluating cerebral circulation in patients with carotid artery stenosis during head-up tilt test (HUTT).

[Stent-assisted angioplasty using the proximal protection method for intracranial internal carotid artery stenosis].

Percutaneous transluminal angioplasty (PTA) with stenting (PTA/stenting) for intracranial atherosclerotic stenoses is usually performed without any embolic protection devise (EPD). However, we have encountered ischemic complications when performing PTA/stenting without EPD for symptomatic intracranial internal carotid artery stenosis. We report here a case of symptomatic intracranial artery stenosis, which was treated by stenting under proximal protection without ischemic complications.

[A case of dural arteriovenous fistula mimicking isolated transverse-sigmoid sinus successfully treated via the transvenous route].

A 66-year-old man was admitted to our hospital suffering from a left temporo-occipital intracerebral hematoma with bilateral thin subdural hematomas. Neurological examinations revealed slightly decreased cognitive function. Cerebral angiography demonstrated a left transverse-sigmoid dural arteriovenous fistula (TS-DAVF) with cortical venous reflux.

[Case of symptomatic epilepsy presenting with focal high intensity on diffusion-weighted image prior to initial convulsive seizure].

It has been reported that high intensity on diffusion-weighted image (DWI) in magnetic reasonance imaging (MRI) accompanying a reduction of the apparent diffusion coefficient (ADC) can be detected at the ictal or postictal stage of epileptic seizure. However, it remains unclear whether such a change results from persisting systemic convulsive seizure or from certain physiological changes such as recurrent epileptic discharge prior to the occurrence of obvious convulsion. We report here a case of symptomatic epilepsy displaying a high intensity area on DWI in MRI before convulsive seizure was initiated.