Topological data analysis (TDA) enhances bispectral EEG (BSEEG) algorithm for detection of delirium.

Current methods for screening and detecting delirium are not practical in clinical settings. We previously showed that a simplified EEG with bispectral electroencephalography (BSEEG) algorithm can detect delirium in elderly inpatients. In this study, we performed a post-hoc BSEEG data analysis using larger sample size and performed topological data analysis to improve the BSEEG method.

Mechanical Thrombectomy for Basilar Artery Occlusion Compared with Anterior Circulation Stroke.

Objective: To investigate the clinical effectiveness of mechanical thrombectomy (MT) for basilar artery occlusion (BAO) and to ascertain whether outcomes for patients with BAO were comparable to those with anterior circulation large vessel occlusion (ACS).

Methods: A total of 345 patients who underwent MT between 2011 and 2018 were grouped by occlusion site (295 patients with ACS and 50 patients with BAO). Patients' baseline characteristics, procedural times, complications, symptomatic intracranial hemorrhage, modified Rankin Scale score, and mortality at 90 days were analyzed.

Mechanical Thrombectomy of Primary Distal Anterior Cerebral Artery Occlusion: A Case Report.

Objective: Primary anterior cerebral artery (ACA) occlusion is a rare condition and sometimes leads to significant neurological deficits. We herein report on the efficacy of mechanical thrombectomy (MT) in treating the distal ACA occlusion in a clinical setting.

Case Presentation: A 76-year-old woman presented with a sudden onset of right hemiparesis.

A Direct Aspiration First Pass Technique in Japanese Real-World Clinical Setting.

Background: It is debatable whether mechanical thrombectomy has benefits in a real-world setting outside the more rigid and selective clinical trial environment.

Objective: To evaluate clinical outcomes, efficacy, and safety of mechanical thrombectomy in single-center retrospective cohort case series.

Methods: We reviewed prospectively collected data from our large-vessel occlusion stroke database to identify patients undergoing mechanical thrombectomy using Penumbra catheters (Penumbra, Almeida, California) as first-line devices.

Mechanical Thrombectomy for Acute Anterior Cerebral Artery Occlusion.

Background: We sought to examine the presentation, treatment, and outcomes of anterior cerebral artery (ACA) occlusions in patients undergoing mechanical thrombectomy (MT).

Methods: Two-hundred ninety-eight consecutive patients with large-vessel occlusion treated with MT were analyzed to identify all patients with acute ACA occlusion who underwent MT. The primary end point was defined as achieving a thrombolysis in cerebral infarction score ≥2b.

Recurrence in 787 Patients with Chronic Subdural Hematoma: Retrospective Cohort Investigation of Associated Factors Including Direct Oral Anticoagulant Use.

Objective: Chronic subdural hematoma (CSDH) is a highly recurrent disorder. Although some predictors including the use of antithrombotic agents such as aspirin and warfarin have been proposed, the pathogenic mechanism involved remains unclear. Moreover, the link between direct oral anticoagulant (DOAC) agent use and CSDH recurrence has not been reported.

Basilar Artery Occlusion with "Seizures" as a Presenting Symptom: Three Cases Treated Using Mechanical Thrombectomy.

Background: Basilar artery occlusion (BAO) is a rare, potentially fatal cause of ischemic stroke. It is often challenging to diagnose, especially when the presenting symptom is "seizures". We present 3 cases of patients with BAO presenting with seizures.

A case of delayed distal coil migration after coil embolization of an unruptured distal azygos anterior cerebral artery aneurysm: A case report and literature review.

Intraprocedural coil migration during endovascular treatment for an aneurysm that might carry serious ischemic complications is well known. On the other hand, delayed coil migration after endovascular treatment for an aneurysm is very rare. A 77-year-old woman was incidentally diagnosed with unruptured aneurysm associated with distal azygos anterior cerebral artery (ACA).

[Coil Embolization for Very Small Intracranial Aneurysms with Diameter Less than 3mm:A Case Series of 14 Patients and Literature Review].

Introduction: Many studies describe aneurysms measuring ≤3mm as "very small" or "tiny, " with a risk of intraoperative rupture higher than that of most cerebral aneurysms. We evaluated the results of endovascular coil embolization for very small aneurysms with diameter ≤3mm.

Material And Methods: The same interventional neurosurgeon performed coil embolization for 14 tiny aneurysms in 14 patients(8male and 6 females)at our institution between May 2015 and June 2017.

[Five Cases of Neuroendovascular Treatment Using the Goose Neck Snare for Inducing and Holding the Guiding Catheter].

The stabilization of a guiding catheter is a very important factor for successful endovascular treatment. However, it is sometimes difficult to obtain sufficient stabilization because of the tortuosity of the approach route. A Goose Neck Snare is useful for the retrieval of intravascular foreign bodies and can be used to hold the guiding catheter.

A case with coil embolization for ruptured aneurysm associated with fenestration of the posterior inferior cerebellar artery.

An 87-year-old man hospitalized for subarachnoid hemorrhage showed a ruptured aneurysm arising from fenestration of the posterior inferior cerebellar artery. Endovascular treatment was selected and the aneurysm and superior limb were embolized completely using three coils. Fenestration of the posterior cerebellar artery is exceedingly rare.

Mechanical Thrombectomy for Acute Basilar Artery Occlusion in Early Therapeutic Time Window.

Background: The natural history of basilar artery occlusion (BAO) is devastating, with morbidity rates increasing up to 80%. However, the efficacy of recanalization therapy for BAO has not been established as yet.

Objective: We analyzed consecutive cases of BAO treated with mechanical thrombectomy (MT) to evaluate its safety and efficacy and to determine factors associated with the prognosis.

[Usefulness of Edoxaban for Deep Cerebral Venous Sinus Thrombosis with Hemorrhagic Infarction:A Case Report].

We describe a case of deep cerebral venous sinus thrombosis(DCVST)that was successfully treated by oral administration of the Xa inhibitor edoxaban. A 53-year-old man was admitted to our hospital because of a headache and undifferentiated dizziness. Computed tomography(CT)demonstrated a low-density area in the bilateral thalamus and high-density lesions in the internal cerebral veins(ICVs)and vein of Galen.

Optimal thresholds for ischemic penumbra predicted by computed tomography perfusion in patients with acute ischemic stroke treated with mechanical thrombectomy.

Background And Purpose: Optimal thresholds for ischemic penumbra detected by CT perfusion (CTP) in patients with acute ischemic stroke (AIS) have not been elucidated. In this study we investigated optimal thresholds for salvageable ischemic penumbra and the risk of hemorrhagic transformation (HT).

Methods: A total of 156 consecutive patients with AIS treated with mechanical thrombectomy (MT) at our hospital were enrolled.

[A Case of Middle Cerebral Artery Stenosis Presented with Limb-Shaking TIA].

Involuntary movement is a rare clinical manifestation of transient ischemic attack (TIA). However, limb-shaking TIA is well described presentation of carotid occlusive disease. We present the case of a patient who developed limb-shaking TIA associated with high-grade stenosis of middle cerebral artery (M1), which was treated with percutaneous transluminal angioplasty (PTA).

[A Girl with Intraorbital Varix: A Case Report].

We report a case of intraorbital varix. A 16-year-old girl showed sudden left-sided exophthalmos after vomiting. After several episodes of vomiting, she developed complete loss of vision in the left eye, followed by orbital pain, disruption of eye movement, and periorbital swelling.

[Contralateral suboccipital approach for clipping of an unruptured vertebral artery-posterior inferior cerebellar artery aneurysm].

Numerous approaches have been used to access aneurysms of the vertebral artery(VA)-posterior inferior cerebellar artery(PICA)complex for microsurgical clipping. Here, we report the case of a patient with an unruptured aneurysm of the left VA-PICA complex that was successfully treated using a contralateral suboccipital approach. Computed tomography angiography demonstrated a small saccular aneurysm arising from the lateral aspect of the left V4 segment just distal to the PICA origin.

Risk of rebleeding in arteriovenous malformations due to impaired venous drainage after radiosurgery.

A 27-year-old woman presented with rebleeding from an intracranial arteriovenous malformation (AVM) 6 years after radiosurgery. Cerebral angiography demonstrated venous drainage change into a single drainer and cortical reflux due to drainage occlusion into the superior sagittal sinus. During surgery, multiple small feeders thought to be occluded on preoperative angiography caused brain swelling, hindering resection of the AVM border plane.

[A case of petrous ridge meningioma manifested as pneumocephalus followed by Eustachian tube insufflation].

A 50-year-old female, who had a headache after Eustachian tube insufflation for her ear congestion, came to our hospital. CT and MRI revealed pneumocephalus and petrous ridge meningioma which destroyed petrous bone and air cells. Eustachian tube insufflation was considered to make the air coming into the middle ear, mastoid air cell and then into the intracranial space destroying the tumor.

[Four cases of direct surgery for anterior inferior cerebellar artery aneurysms].

Anterior inferior cerebellar artery (AICA) aneurysms are very rare. We carried out four direct operations for AICA aneurysms including two distal AICA aneurysms using lateral suboccipital retrosigmoid approaches (LSRA). We successfully performed the clipping by LSRA.

[Seven cases of posterior cerebral artery aneurysms].

In a period of ten years, since January 1996, we have encountered seven cases of posterior cerebral artery aneurysms (0.58% of surgically treated 1027 aneurysms in our hospital). Six of these cases were females (from 39 years old to 73 years old, average 54.

Sensory aphasia after closed head injury.

A 51-year-old, right-handed male injured his head when drunk. After an initial mute state lasting for several hours, he exhibited fluent aphasia, impaired word finding, some verbal paraphasia and impaired verbal comprehension. A CT scan revealed a contusion in the left anterior temporal lobe.