Ruptured distal anterior inferior cerebellar artery aneurysm years after stereotactic radiosurgery for vestibular schwannoma: A case report and literature review.

Background: Aneurysmal formation after stereotactic radiosurgery (SRS) for vestibular schwannoma (VS) is a rare complication. Its characteristics and the best treatment strategies remain controversial, and the clinical course is especially unknown because reported aneurysms are first incidentally detected, or aneurysmal rupture occurs suddenly, and they are treated immediately.

Case Description: A 68-year-old man who underwent SRS for VS 20 years ago presented with subarachnoid hemorrhage (SAH) due to rupture of a radiation-induced fusiform anterior inferior cerebellar artery aneurysm.

[A case of recurrent stroke with carotid-web despite dabigatran treatment successfully treated by carotid endarterectomy].

We present a case of a 41-year-old female presenting with recurrence of ischemic stroke on subtherapeutic doses of dabigatran. She had a history of embolic stroke of undetermined sources at the age of 40, and underwent implantable cardiac monitor implantation and had started dabigatran. One year after the first ischemic stroke, she presented with sudden dysarthria and left hemiparesis and was admitted to our hospital.

[A Case of Radiation Necrosis in the Right Occipital Lobe Accompanied with Massive Hemorrhage:Histopathological Analysis].

Radiation necrosis with massive hemorrhage is a rare complication of radiotherapy. We report the case of a male patient who had undergone radiotherapy therapy 18 years earlier and presently underwent gamma knife radiosurgery for a metastatic brain tumor in his right occipital lobe. The patient showed aberrant behavior with left homonymous hemianopsia and a gradual deterioration of cognitive function after radiotherapy.

Safety and Feasibility of Carotid Artery Stenting with Dual-Echo Technique to Minimize Iodinated Contrast Dose.

Background: The aim of this study was to evaluate the safety and feasibility of carotid artery stenting (CAS) employing dual-ultrasound technique and administering a minimal contrast agent in patients with renal insufficiency.

Methods: Between September 2009 and July 2013, 63 consecutive patients underwent CAS at our institution: dual-echo carotid artery stenting (DECAS) in 7 patients with renal insufficiency and standard carotid artery stenting (STCAS) in the remaining 56 patients. Periprocedural adverse events and outcomes were compared between the 2 groups.

[Surgical Outcome of Acute and Subacute Subdural Hematoma with Endoscopic Surgery].

Acute subdural hematoma (ASDH) and subacute subdural hematoma(SASDH)evacuations are commonly performed through a large craniotomy or with external decompression surgery to avoid secondary brain injury. In the field of head trauma, minimally invasive surgeries performed with neuroendoscopy were recently reported. We report 12 patients with ASDH( n=9) and SASDH (n=3)w ho underwent endoscopic hematoma evacuation via a small craniotomy between November 2013 and May 2015.

White-collar sign as a predictor of outcome after endovascular treatment for cerebral aneurysms.

OBJECTIVE The white-collar sign (WCS) is known as a thick neointimal tissue formation at the aneurysm neck after endovascular coil embolization of cerebral aneurysms, which may prevent aneurysm recanalization. The purpose of this study was to evaluate factors involved in the appearance of WCS and to identify radiological and clinical outcomes of treated aneurysms with WCS. METHODS The study included 140 patients with 149 aneurysms in which it was possible to confirm the aneurysm neck between the aneurysm sac and parent artery by using conventional angiography.

[Stent-assisted embolization for ruptured vertebral artery dissection involving the origin of the posterior inferior cerebellar artery:a case report of staged strategy].

We report a ruptured vertebral artery dissection (VAD) involving the origin of the posterior inferior cerebellar artery(PICA)treated by a staged strategy with stent-assisted coil embolization. A 52-year-old woman was admitted with a ruptured right VAD involving the origin of the developed PICA. Endovascular internal trapping of the enlarged distal VAD was performed (Stage 1).

[Intraorbital schwannoma arising from the supraorbital nerve].

A 67-year-old man presented a three-month history of double vision and slight numbness at his right forehead. Neurological examination on admission demonstrated diplopia at lower gaze and mild hypesthesia at right frontal. MRI disclosed an extraconal cystic mass, centered over the superior rectus muscle, in the superior part of the right orbit.

[A case of transorbital penetrating brain injury by a blunt metal rod].

This report presents a case of a transorbital penetrating brain injury caused by a metal rod. A 47-year-old male injured his left lower eyelid with no witness during working hours. The two days later, he presented with a right hand tremor and abnormal behavior, and was admitted to the hospital.

[Vertebral arteriovenous fistula presenting with subarachnoid hemorrhage: a case report].

We report a rare case of a vertebral arteriovenous fistula presenting with subarachnoid hemorrhage (SAH). A 60-year-old man was admitted to our hospital with a sudden onset of headache and neck pain. A neurological examination showed no abnormalities.

[Successful trans-arterial occlusion of a vertebral arteriovenous fistula with aid of intra vascular ultra sound (IVUS) and balloon catheter].

We report a case of spontaneous vertebral arteriovenous fistula manifesting pulsating tinnitus with left cervical bruit. A 50-year-old woman presented with pulsatile tinnitus of unknown duration. Angiography revealed a simple and direct fistula between the second segment of the left vertebral artery and the epidural venous system.

Endovascular treatment for cervical carotid artery stenosis presenting with progressing stroke: three case reports.

Background: Progressing stroke is said to occur when symptoms and signs worsen in cases of ischemic stroke. Although conservative methods using volume expansion with antithrombotic or anticoagulative agents are widely used for progressing stroke, in some hospitals, emergency carotid endarterectomy (CEA) has been performed for carotid stenosis, with mixed results. Here we report three cases with progressing ischemic stroke that were managed by endovascular surgical intervention.

Characterization of the supermirror hard-x-ray telescope for the InFOCmuS balloon experiment.

A hard-x-ray telescope is successfully produced for balloon observations by making use of depth-graded multilayers, or so-called supermirrors, with platinum-carbon (Pt/C) layer pairs. It consists of four quadrant units assembled in an optical configuration with a diameter of 40 cm and a focal length of 8 m. Each quadrant is made of 510 pieces of coaxially and confocally aligned supermirrors that significantly enhance the sensitivity in an energy range of 20-40 keV.

[A case of basilar artery stenosis treated by stent placement].

Symptomatic basilar artery stenosis invariably has poor prognosis owing to limited treatment options. Modernized stent system delivery technology has paved the way for treating tortuous vascular segments of intracranial system. The authors hereby report on the use of intracranial stent to treat basilar artery stenosis.

Depicting cerebral veins by three-dimensional CT angiography before surgical clipping of aneurysms.

Background And Purpose: Cerebral veins show wide variation, and unexpected veins occasionally limit surgical procedures for clipping of cerebral aneurysms. This study was undertaken to assess the utility of three-dimensional CT angiography (3D-CTA) in the evaluation of venous anatomy before surgical clipping of cerebral aneurysms.

Methods: 3D-CTA was performed in 19 patients before pterional craniotomy.