Objectives: This study evaluates the feasibility, safety, and efficiency of using a balloon guide catheter (BGC) through transradial access (TRA) for mechanical thrombectomy (MT) in patients with anterior circulation strokes.
Methods: A retrospective case series of patients who underwent MT using BGC through TRA for acute ischemic stroke in the anterior circulation was conducted. Data collected included procedural times (from puncture to revascularization), technical success, complication rates, and clinical outcomes.
Background: The concurrent presentation of meningioma and intracranial aneurysm (IA) poses diagnostic and therapeutic challenges, with no standardized management protocol available. This study aims to address this through an updated systematic review, delineating optimal strategies for managing this dual pathology.
Methods: A systematic review was conducted across PubMed, Web of Science, and Embase databases.
Background: Endothelial dysfunction, induced by high shear stress from increased nidal blood flow, may promote a cycle of inflammation, possibly leading to instability and cerebral arteriovenous malformations (AVMs) rupture. Macrophages, identified with Cluster of Differentiation 68, are key inflammatory components in AVM pathology. We aim to evaluate the relationship of inflammation with AVM flow and hemosiderin.
View Article and Find Full Text PDFIdiopathic intracranial hypertension (IIH) is traditionally characterized by elevated intracranial pressure without an identifiable cause, primarily affecting obese women. However, recent evidence suggests that venous sinus stenosis may play a significant role in the pathophysiology of IIH, challenging its designation as "idiopathic." This editorial discusses the limitations of the current nomenclatures and diagnostic criteria, highlighting the importance of routine venography in detecting venous sinus abnormalities, irrespective of a patient's demographic profile.
View Article and Find Full Text PDFIntroduction: Reversible cerebral vasoconstriction syndrome (RCVS) can present with hemorrhage, ischemia, or both. We aim to compare the differences in presentation and outcomes between patients with RCVS.
Methods: The hemorrhagic presentation group had 58 patients, and the non-hemorrhagic presentations had 30 patients.
Objective: Extracranial-intracranial (EC-IC) bypass has been well described in chronic vaso-occlusive cerebrovascular diseases, including both moyamoya disease (MMD) and atherosclerotic disease (AD). This study aimed to compare factors associated with bypass occlusion between these two diseases.
Methods: An institutional database of 357 patients with intracranial bypass procedures performed between August 2001 and May 2022 was retrospectively reviewed.
Introduction: Cerebral venous sinus stenting (CVSS) is an effective treatment for idiopathic intracranial hypertension (IIH) secondary to dural venous sinus stenosis. Traditional selection of patients for CVSS has been made by microcatheter manometry, but pressure measurements are often equivocal. Here we present the results of a series of cases in which venous flat-panel CT (FP-CT) was used as an adjunct to microcatheter manometry to improve decision making and precise stent placement during CVSS.
View Article and Find Full Text PDFFrench-American neurointerventionalist and pioneer, Dr Gerard Debrun, laid the groundwork for treatments which have become irreplaceable in neurointerventional surgery today. This article aims to outline the career of Dr Debrun while highlighting his accomplishments and contributions to the field of neurointerventional surgery. We selected relevant articles from PubMed authored or co-authored by Dr Debrun between 1941 and 2023.
View Article and Find Full Text PDFThe detachable balloon catheter (DBC) was a revolutionary technique for the treatment of cerebrovascular pathologies. It was used to treat carotid cavernous fistulas (CCFs), vertebro-jugular fistulas, arteriovenous malformations (AVMs), and aneurysms. The DBC became the foundation for neurointerventional techniques, leading to the development of coil embolization and bioactives.
View Article and Find Full Text PDFBackground: The transcallosal retroforniceal transchoroidal approach represents an advanced neurosurgical technique that allows access to lesions located within the posterior third ventricle and mesencephalon. It relies on a comprehensive understanding of microsurgical anatomy and embryology, integrating modern neurosurgical operative techniques to minimize retraction and injury to the normal neuronal structures.
Methods: We report the cases of 2 patients undergoing treatment via this approach, one presenting with a thalamic cavernoma and the other with cystic low-grade glioma of the midbrain.
Objective: Neurosurgery is one of the most competitive specialties, and navigating the match process is often challenging for aspiring applicants. Here, we analyze insights from the National Resident Matching Program Director Surveys, illustrating evolving trends in applicant selection for interviews and for the ranking process, and providing a comparison with other specialties.
Methods: We evaluated 7 surveys administered from 2012 to 2022.
Glioblastoma is the most common malignant primary central nervous system tumor and one of the most debilitating cancers. The prognosis of patients with glioblastoma remains poor, and the management of this tumor, both in its primary and recurrent forms, remains suboptimal. Despite the tremendous efforts that are being put forward by the research community to discover novel efficacious therapeutic agents and modalities, no major paradigm shifts have been established in the field in the last decade.
View Article and Find Full Text PDFSynovial cysts of the spine are degenerative cystic lesions that can lead to severe symptoms secondary to compression of the spinal cord, individual nerve roots, and/or the cauda equina. Some believe the etiology of this entity is related to increased motion across the facet joint and instability. We report a case of a lumbar synovial cyst located at the same level as a previously inserted spinous process fusion device.
View Article and Find Full Text PDFThe widespread use of magnetic resonance imaging (MRI) has led to an increase in incidental findings in the central nervous system. Radiologically isolated syndrome (RIS) is a condition where imaging reveals lesions suggestive of demyelinating disease without any clinical episodes consistent with multiple sclerosis (MS). The prognosis for RIS patients is uncertain, with some remaining asymptomatic while others progress to MS.
View Article and Find Full Text PDFIntroduction: The Montreal Cognitive Assessment (MoCA), a neuropsychological tool for cognitive decline screening is widely used. In the absence of normative data in Lebanon, this study offers normative data for the MoCA in Lebanese community-dwelling older people and compare scores to those of other countries.
Methods: 164 literate subjects aged 60 and above were recruited to complete the MoCA.