Proposed imaging assessment score for aneurysmal subarachnoid hemorrhage correlated with prognosis: Shinshu Aneurysmal subarachnoid hemorrhage score.

Background: Aneurysmal subarachnoid hemorrhage (aSAH) imaging has been shown to correlate with prognosis. However, no numerical index of bleeding severity has been established. This study aimed to propose a new simple scoring system for computed tomography imaging of aSAH and to confirm its effectiveness in retrospective and prospective studies.

Single-lane clipping technique for a ruptured aneurysm of A1 fenestration of the anterior cerebral artery: a case report and literature review.

Fenestration of the A1 segment of the anterior cerebral artery is a rare vascular anomaly with a high risk of saccular aneurysm at the proximal end of the A1 fenestration. These aneurysms have a high risk of rupture. However, conventional surgical clipping can be technically challenging due to the anatomical characteristics.

Correlations Among Consistency, Computed Tomography Values, and Histopathological Subtypes of Spinal Meningioma.

The consistency of spinal meningiomas is important to consider when performing tumor removal surgery. This study evaluated the correlations between spinal meningioma consistency and both preoperative computed tomography (CT) values and histopathological subtypes. Fifteen consecutive patients who underwent surgical resection of spinal meningioma at our institution were identified, and preoperative CT values and the signal intensity of T2-weighted magnetic resonance images of the tumor were determined retrospectively.

Calcified ectopic TSH-secreting pituitary adenoma mimicking craniopharyngioma: a rare case report and literature review.

Among pituitary adenomas, which are relatively common brain tumors, elements of ectopic, thyroid-stimulating hormone (TSH) secretion, and intratumoral calcification are unusual. Here, we present an extremely rare case of a calcified ectopic TSH-secreting pituitary adenoma arising from the pars tuberalis mimicking craniopharyngioma based on neuroimaging findings. To our knowledge, this is the first case report of calcified ectopic TSH-secreting pituitary adenoma without symptoms of excessive thyroid hormone secretion.

Evaluation of Metallic Artifacts Caused by Nonpenetrating Titanium Clips in Postoperative Neuroimaging.

Background: Nonpenetrating titanium clips create no suture holes and thereby reduce cerebrospinal fluid leakage after dural closure. However, no data exist regarding metallic artifacts caused by these clips during postoperative neuroimaging. We aimed to evaluate clip-related artifacts on postoperative magnetic resonance (MR) images of 17 patients who underwent spinal surgery.

Surgery for ventral intradural thoracic spinal tumors with a posterolateral transpedicular approach.

Background: Surgery for ventrally seated thoracic tumors requires an anatomically specific approach that is distinct from cervical or lumbar spinal cord surgery as the narrower spinal canal of the thoracic spinal cord makes it sensitive to surgical procedures. However, reports describing this operative technique are few. To obtain a wide operative field and minimize thoracic spinal cord retraction, we employed a posterolateral transpedicular approach in ventral-located tumors and investigated the efficacy and limitations of this technique.

Long Segment Spinal Dural Cyst: A Case Report.

Background: Spinal meningeal cysts are a rare benign disease that can cause myelopathy. In most cases, spinal meningeal cysts consist of an arachnoid membrane. To the best of our knowledge, few articles have report on intradural spinal meningeal cyst consisting of dura mater.

Usefulness of needle holder with a function of fine forceps for bypass surgery in both hands.

Background: In bypass surgery, a single-handed needle holder is usually used with other handed fine forceps. Recently, a needle holder with the function of fine forceps has been developed.

Methods: In this technical note, usefulness of newly developed needle holders in both hands is presented in bypass surgery.

Usefulness of a device for body support during operations performed while standing.

During microsurgical procedures, manipulations are often performed using a foot switch while the surgeon stands on one foot. This position can easily result in body axis instability and greater musculoskeletal loading. To support the surgeon's posture, we have developed a tool called the "Surgeon's Body Support Device.

Early changes in tissue perfusion after tissue plasminogen activator administration in hyperacute ischemic stroke: initial experiences with arterial spin labeling perfusion magnetic resonance imaging.

Cerebral perfusion monitoring is an important component of hyperacute stroke treatment. Arterial spin labeling (ASL) perfusion magnetic resonance (MR) imaging provides a noninvasive method of cerebral perfusion observation. Rapid changes in cerebral perfusion were demonstrated in two patients admitted one hour after onset of hyperacute stroke who underwent recombinant tissue plasminogen activator (rt-PA) treatment.

Clip blade scissoring with titanium bayonet clip in aneurysm surgery. Two case reports.

Scissoring of the cerebral aneurysm clip blades is a rare but potentially devastating complication of clipping surgery and results in aneurysm neck injury inducing rupture and/or cerebral infarction. Scissoring has been reported using titanium straight clips. Here we present two unusual cases of crossing of the blades of titanium bayonet clips by a scissors-like mechanism during surgery.

Cerebral aneurysm clips in the 3-tesla magnetic field. Laboratory investigation.

Object: The aim of this study was to evaluate cerebral aneurysm clips, and to know in more detail the characteristics of currently available clips in the 3-T magnetic field.

Methods: According to the protocol recommended by the American Society for Testing and Materials (ASTM), the authors conducted quantitative evaluation for displacement force and qualitative evaluation for torque in 52 aneurysm clips and 48 samples of raw materials in the 3-T environment.

Results: The largest displacement force occurred near the bore opening, and the force was directed to the isocenter.

Local brain herniation after partial membranectomy for organized chronic subdural hematoma in an adult patient: case report and review of the literature.

Objective: Local brain herniation after removal of chronic subdural haematoma is extremely rare, especially in adult patients. This study reports a case of local brain herniation after partial membranectomy for organized chronic subdural haematoma.

Case Report: A 77-year-old man presented with dysarthria and dysphasia caused by local brain herniation of the right frontal lobe through a defect of the inner membrane.

Overdrainage of cerebrospinal fluid caused by detachment of the pressure control cam in a programmable valve after 3-tesla magnetic resonance imaging.

The authors report a rare case of overdrainage of the CSF caused by the malfunction of a Codman-Hakim programmable valve (CHPV) following a 3-T MR imaging procedure. Nine years ago this 72-year-old woman underwent ventriculoperitoneal shunt placement with a CHPV system for hydrocephalus due to subarachnoid hemorrhage. The postoperative course was uneventful and the system functioned well.

Anatomical study of the trigeminal and facial cranial nerves with the aid of 3.0-tesla magnetic resonance imaging.

Object: Neuroimages often reveal that the trigeminal or facial nerve comes in contact with vessels but does not produce symptoms of trigeminal neuralgia (TN) or hemifacial spasm (HFS). The authors conducted this study to determine how often the trigeminal and facial nerves came in contact with vessels in individuals not suffering from TN or HFS. They also investigated the correlation between aging and the anatomical measurements of the trigeminal and facial nerves.

Investigation of radiofrequency-induced temperature elevation of aneurysm clips in a 3.0-tesla magnetic resonance environment.

Objective: Burn injuries associated with excessive heating of medical metallic devices have been reported, but a definite mechanism for magnetic resonance imaging-induced heating remains unresolved. The aim of this study is to evaluate temperature elevation of metallic wires, aneurysm clips, and clips attached to metallic wires under 3.0-T magnetic resonance imaging.

Description and first clinical application of AirWay Scope for tracheal intubation.

We have developed a novel airway apparatus, AirWay Scope, which we have used in the orotracheal intubation of 10 consecutive patients requiring general anesthesia before neurosurgical procedures. The characteristic shape of the introducer (INTLOCK), the tube guiding function and the sighting device of the AirWay Scope has possibility to facilitate tracheal intubation. Here, we report the first clinical application of this system and describe potential advantages of the apparatus.