Successful stent-assisted coil embolization for a recurrent distal posterior inferior cerebellar artery aneurysm: A case presentation.

Background: Distal posterior inferior cerebellar artery (PICA) aneurysms are exceedingly rare intracranial aneurysms. In the acute phase of rupture, interventions commonly involve parent artery occlusion through endovascular treatment or direct trapping surgery. There is no consensus on the best treatment of chronic ruptured or unruptured aneurysms, and stent-assisted coil embolization has not yet been reported in the chronic phase of rupture.

Olfactory hallucinations caused by an unruptured posterior communicating artery aneurysm improved by clipping: A case report with literature review.

Background: Unruptured cerebral aneurysms that lead to epilepsy are rare and olfactory hallucinations caused by such an aneurysm are extremely rare. Various treatments have been proposed, including wrapping, clipping with or without cortical resection, and coil embolization, but there is no consensus on the best approach.

Case Description: We present a case of a 69-year-old female who experienced olfactory hallucinations caused by a posterior communicating artery aneurysm and was treated with clipping without cortical resection, with a positive outcome.

Hypoperfusion intensity ratio and CBV index as predictive parameters to identify underlying intracranial atherosclerotic stenosis in endovascular thrombectomy.

Background And Purpose: Intracranial atherosclerotic stenosis (ICAS)-related large vessel occlusion (LVO) is difficult to diagnose before endovascular thrombectomy (EVT) in an emergency. We hypothesized that hypoperfusion intensity ratio (HIR) and cerebral blood volume (CBV) index reflect collateral flow and would be useful parameters to predict underlying ICAS.

Materials And Methods: Clinical and perfusion imaging parameters of patients receiving EVT for LVO were reviewed retrospectively.

Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic.

Background: During the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The study's objective was to examine whether subarachnoid haemorrhage (SAH) hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines.

Methods: We conducted a cross-sectional, retrospective, observational study across 6 continents, 37 countries and 140 comprehensive stroke centres.

Meningioma in Down Syndrome.

Background: Down syndrome comprises multiple malformations and is due to trisomy of chromosome 21. There is epidemiologic evidence that individuals with Down syndrome are at decreased risk for solid tumors including brain tumors. It has been suggested that some genes expressed on the extra copy of chromosome 21 act as tumor suppressor genes and contribute to protection against tumorigenesis.

Epstein-Barr virus-associated primary central nervous system lymphoma in a patient with adult T-cell leukemia / lymphoma.

We present a case of Epstein-Barr virus (EBV)-associated primary central nervous system lymphoma (PCNSL) arising from a patient with cutaneous-type adult T-cell leukemia/lymphoma (ATLL). Extranodal sites affected by ATLL include the skin, lung, liver, gastrointestinal tract and central nervous system (CNS). CNS involvement usually occurs as an acute and lymphoma-type ATLL.

Treatment strategy for giant aneurysms in the cavernous portion of the internal carotid artery.

Background: As direct surgery to treat giant aneurysms of the ICA is difficult, ICA occlusion is the conventional treatment in patients with BTO tolerance. To determine whether bypass surgery should be performed after carotid occlusion by trapping or proximal occlusion, we developed a treatment strategy that includes BTO and SPECT.

Methods: We report 19 patients with symptomatic giant aneurysms in the cavernous portion of ICA.

Clinical features of aneurysms of the posterior cerebral artery: a 15-year experience with 21 cases.

Objective: To investigate the characteristic clinical behavior and develop guidelines for the clinical management of posterior cerebral artery aneurysms, we reviewed 21 cases treated during a 15-year period.

Methods: Between 1988 and 2002, we treated 21 patients (10 male, 11 female; mean age, 49.8 yr) with posterior cerebral artery aneurysms at Kumamoto University Hospital and its affiliated hospitals.

Contribution of angiotensin-converting enzyme and angiotensin II to ischemic stroke: their role in the formation of stable and unstable carotid atherosclerotic plaques.

Background: The angiotensin-converting enzyme/angiotensin II (ACE/Ang II) system is a strong contributor to intimal hyperplasia in atherosclerotic lesions. To illuminate its role in ischemic stroke, we examined the expression of ACE/Ang II in stable and unstable carotid atherosclerotic plaques from symptomatic and asymptomatic patients.

Methods: Using immunohistochemical methods, we studied differences between carotid atherosclerotic lesions obtained at carotid endarterectomy (CEA) from symptomatic (n = 36) and asymptomatic (n = 28) patients.

Multimodal treatment of ruptured dissecting aneurysms of the vertebral artery during the acute stage.

Object: The goal of this study was to implement an algorithm for and assess the multimodal (endovascular and microsurgical) treatment of patients with ruptured dissecting aneurysms of the vertebral artery (VA) during the acute stage.

Methods: During a 4-year period, the authors treated 19 ruptured dissecting aneurysms of the VA during the acute stage, within 3 days after the hemorrhage. Factors guiding management decisions were tolerance of the test occlusion and the site of the dissection.

Analysis of mean transit time of contrast medium in ruptured and unruptured arteriovenous malformations: a digital subtraction angiographic study.

Background And Purpose: To clarify hemodynamic risk factors for hemorrhage in arteriovenous malformations (AVMs), the mean transit time (MTT) of feeding arteries and draining veins in AVMs with and without hemorrhage was measured and analyzed.

Methods: Morphological features such as the number and diameter of draining and feeding vessels and the AVM nidus volume were evaluated in 30 patients with supratentorial AVMs. The MTT of feeding arteries and draining veins was measured with the use of time-density curves obtained by digital subtraction angiography.

High-risk age for rebleeding in patients with hemorrhagic moyamoya disease: long-term follow-up study.

Objective: The prevention of rebleeding is one of the most important issues in the successful treatment of moyamoya disease with hemorrhagic onset. However, the natural course of hemorrhagic moyamoya disease and the characteristics of rebleeding remain unclear.

Methods: To study the natural course of the disease in conservatively treated patients, we analyzed long-term follow-up reports on 36 patients (12 male and 24 female) treated without bypass surgery at our hospitals before 1994 (mean follow-up, 12.

Surgical indications to maintain quality of life in elderly patients with ruptured intracranial aneurysms.

Objective: We performed a retrospective study to assess long-term outcomes in very old patients with ruptured intracranial aneurysms. The aim of the study was to develop guidelines for choosing surgical or conservative treatment with the goal of maintaining patients' quality of life.

Methods: Between 1996 and 1999, 76 consecutive patients, aged 80 to 89 years, with ruptured intracranial aneurysms were treated at 18 participating centers.

Pre- and post-treatment MR imaging and single photon emission CT in patients with dural arteriovenous fistulas and retrograde leptomeningeal venous drainage.

Background And Purpose: Dural arteriovenous fistulas (DAVFs) with disturbed regional cerebral blood flow (rCBF) include retrograde leptomeningeal venous drainage (RLVD). We examined rCBF disturbances in patients with DAVFs by studying MR imaging and single photon emission CT (SPECT) changes before and after treatment.

Methods: In 22 patients with DAVFs and RLVD, we studied their symptoms, pre- and post-treatment MR imaging and SPECT findings, and treatment results.

Intrathecal urokinase infusion through a microcatheter into the cisterna magna to prevent cerebral vasospasm: experimental study in dogs.

Background And Purpose: Our preliminary report on intrathecal urokinase (UK) infusion into the cisterna magna (CM) with a microcatheter showed good results in terms of vasospasm prevention in humans. In this study, we evaluated the relationship between different urokinase (UK) infusion sites and their effect on vasospasm prevention by using our canine subarachnoid hemorrhage (SAH) model.

Methods: At 24 hours after SAH induction, we injected 1000 IU/kg UK into the cisterna magna (CM) or lumbar sac (LS) of dogs by using a microcatheter inserted at the lumbar region.

Single blood injection into the ventral cisterna magna through a microcatheter for the production of delayed cerebral vasospasm: experimental study in dogs.

Background And Purpose: We developed an experimental canine subarachnoid hemorrhage (SAH) model in which one-time blood injection by means of a microcatheter into the ventral cisterna magna (CM) is performed without direct CM puncture. We assessed the severity and duration of the vasospasm produced in this model.

Methods: Fresh autologous blood (0.

Angiographic dilatation and branch extension of the anterior choroidal and posterior communicating arteries are predictors of hemorrhage in adult moyamoya patients.

Background And Purpose: The cause of intracranial bleeding in moyamoya disease patients is still unknown. To identify factors that contribute to bleeding, we assessed the angiographic findings of moyamoya disease patients.

Methods: We examined angiograms obtained from 107 moyamoya patients; 70 manifested ischemic and 37 had hemorrhagic lesions.

Successful clipping of a distal posterior inferior cerebellar artery aneurysm located on the anterior surface of the medulla oblongata--case report.

A 55-year-old male presented with a ruptured distal posterior inferior cerebellar artery (PICA) aneurysm manifesting as subarachnoid hemorrhage. Angiography demonstrated a saccular aneurysm arising from the lateral medullary segment of the left PICA and located on the medial side of the left vertebral artery (VA) and the anterior surface of the medulla oblongata. A transcondylar fossa approach was used to ensure a sufficient operating field and to obtain adequate visualization of the aneurysm, the parent artery, and the perforating arteries to the medulla oblongata.

Vertebral artery-posterior inferior cerebellar artery bypass with a superficial temporal artery graft to treat aneurysms involving the posterior inferior cerebellar artery.

Object: In patients with aneurysms that require occlusion of the posterior inferior cerebellar artery (PICA), revascularization of this artery should be performed. A novel surgical method for revascularization of the PICA is presented.

Methods: After a segment of the superficial temporal artery (STA) was harvested, the aneurysm was treated by trapping, followed by placement of a vertebral artery (VA)-PICA bypass in which the STA segment was used as a graft.

Appropriate interval between embolization and surgery in patients with meningioma.

Background And Purpose: The best time for surgery after embolization of meningiomas remains unclear. We used the tumor-softening effect of embolization to determine this time.

Methods: Forty-two patients with intracranial meningiomas that received more than 50% of their blood supply from the external carotid artery underwent embolization before surgery.