Ischemic stroke patients with low DWI ASPECTS scores require puncture to recanalization within 30 min for large vessel occlusion.

Background: The clinical benefits of faster recanalization in acute large vessel occlusion are well recognized, but the optimal procedure time remains uncertain. The aim of this study was to identify patient characteristics that necessitate puncture-to-recanalization (P-R) time within 30 min to achieve favorable outcome.

Methods: We evaluated the patients from a prospective, multicenter, observational registry of acute ischemic stroke patients.

Retroperitoneal hematoma: A rare complication of percutaneous pedicle screw in an osteoporotic patient.

Background: Percutaneous pedicle screw (PPS) placement is an established technique for minimally invasive surgery. However, life-threatening hematomas may occur in osteoporotic patients undergoing percutaneous screw placement.

Case Description: An 80-year-old female with an osteoporotic T10 chance fracture developed a life-threatening hematoma following a T8-L3 posterior fusion performed with PPS.

Optimal Treatment of C3 Lamina in Cervical Laminoplasty.

Study Design: Results of C4-C6 laminoplasty with C3 laminectomy and C3-C6 laminoplasty were compared retrospectively.

Objectives: To clarify the difference between C3 laminectomy and C3 laminoplasty in cervical laminoplasty.

Summary Of Background Data: Intraoperative damage to the semispinalis cervicis has been shown to lead to postoperative axial symptoms and reduced range of motion (ROM).

"Dual Internal Shunts Technique" for Carotid Endarterectomy with Carotid Vertebral Anastomosis: Technical Note.

In revascularization of internal carotid stenosis with carotid vertebrobasilar anastomoses, attention should be paid not only to the anterior circulation but also to the posterior circulation cerebral infarction. A 74-year-old man was referred for treatment of carotid artery stenosis; NASCET 75% stenosis in the right internal carotid artery and acute cerebral infarction were confirmed. Occlusion of the left subclavian artery and vascular anastomosis between the right external carotid artery and the vertebral artery were indicated, such that the right external carotid artery may maintain blood flow to the vertebrobasilar artery.

Detection of Atrial Fibrillation Using Insertable Cardiac Monitors in Patients With Cryptogenic Stroke in Japan (the LOOK Study): Protocol for a Prospective Multicenter Observational Study.

Background: Paroxysmal atrial fibrillation (AF) is a probable cause of cryptogenic stroke (CS), and its detection and treatment are important for the secondary prevention of stroke. Insertable cardiac monitors (ICMs) are clinically effective in screening for AF and are superior to conventional short-term cardiac monitoring. Japanese guidelines for determining clinical indications for ICMs in CS are stricter than those in Western countries.

[Three cases of mechanical thrombectomy in patients over 100 years old].

Background: While several cases involving mechanical thrombectomy in patients >90 years old have been reported, only 1 case involving a patient >100 years old has been described. We herein report 3 cases of mechanical thrombectomy performed in patients >100 years old, along with a review of the literature.Case 1: A 102-year-old woman with a National Institute of Health Stroke Scale (NIHSS) score of 20 and diffusion weighted imaging (DWI)-Alberta Stroke Program Early Computed Tomography Score (ASPECTS) of 8 points showed M1 occlusion.

Spinal subarachnoid hemorrhage after percutaneous kyphoplasty: a case report and literature review.

Background: Spinal intradural (subdural and subarachnoid) hematoma following percutaneous kyphoplasty is an extremely rare complication. In this report, we describe a case of subarachnoid hemorrhage with delayed paralysis after kyphoplasty and review the literature on similar cases to describe the complications of kyphoplasty and vertebroplasty (VP).

Case Description: An 80-year-old man underwent percutaneous kyphoplasty at a local hospital an osteoporotic vertebral fracture (OVF) at the T12 and L1 level.

Closure of a dural defect as a cause of superficial siderosis: does early dural repair lead to a better outcome? Illustrative case.

Background: Superficial hemosiderosis (SS) of the central nervous system is a rare condition that is caused by chronic, repeated hemorrhage into the subarachnoid space. The subsequent deposition of hemosiderin in the brain and spinal cord causes neurological deterioration. In this report, the authors describe a repair procedure for SS associated with a dural defect in the thoracic spine.

Primary results of mechanical thrombectomy for acute ischemic stroke: The K-NET registry in the Japanese metropolitan area.

Background: Endovascular treatment (EVT) for acute large vessel occlusion has proven to be effective in randomized controlled trials. We conducted a prospective cohort study to evaluate the real-world efficacy of EVT in a metropolitan area with a large number of comprehensive stroke centers and to compare it with the results of other registries and randomized controlled trials (RCTs).

Methods: We analyzed the Kanagawa Intravenous and Endovascular Treatment of Acute Ischemic Stroke registry, a prospective, multicenter observational study of patients treated by EVT and/or intravenous tissue-type plasminogen activator (tPA).

A Surgical Case of Bow Hunter's Syndrome Diagnosed by Cervical Rotational MRA.

Bow hunter's syndrome is an ischemic manifestation of vertebrobasilar artery (VA) insufficiency due to stenosis or occlusion of the contralateral VA at the bony elements of the atlas and axis during neck rotation. In early reports, VA stenosis at the craniovertebral junction was the main cause, but later, symptoms due to VA occlusion at the middle and lower cervical vertebrae were also included in this pathology. Although the confirmed diagnosis is usually determined by dynamic digital subtraction angiography (DSA), we have experienced a method of minimally invasive MR angiogram (MRA) that provides the same diagnostic value as DSA and would like to present it here.

Dysphagia after occipital cervical fusion for retro-odontoid pseudotumor with ossification of the anterior longitudinal ligament.

Background: Ossification of the anterior longitudinal ligament (OALL) of the cervical spine is a relatively rare disease. If patients present with dysphagia, hoarseness, and/or dyspnea, they may require surgery.

Case Description: Over a 7-month period, a 55-year-old female with a history of cerebral palsy developed a progressive quadriparesis accompanied by diffuse sensory loss (i.

COVID-19 Countermeasures in Acute Stroke.

The impact of coronavirus disease 2019 (COVID-19) is continuing, and the most important issue facing medical staff is how to provide medical care while preventing nosocomial infections. Since acute stroke treatment, particularly mechanical thrombectomy, is urgent, infection protection measures may not always be followed, which increases the risk of infection exposure. The measures and methods for patient screening, transport, zoning, and use of personal protective equipment (PPE) employed to prevent nosocomial infections of COVID-19 at our facility are described herein.

Hybrid procedure combining clip on wrapping and stent placement for ruptured supraclinoid blood blister-like aneurysm of the internal carotid artery.

Blood blister-like aneurysms of the supraclinoid portion of the internal carotid artery are rare, fragile, and thin-walled lesions with a higher rate of rebleeding. Our case underwent a hybrid procedure combining direct surgical and endovascular approach.

[A Case of Juvenile Cerebral Infarction due to Reversible Cerebral Vasoconstriction Syndrome].

A 19-year-old woman had a thunderclap headache, followed by left hemiparesis and left homonymous hemianopsia. Laboratory tests showed no signs of infection and immunological test results were unremarkable. MRI revealed a cerebral infarction in the right posterior cerebral artery territory, and digital subtraction angiography(DSA)showed right posterior cerebral artery stenosis on day 2.

Induction of autophagic cell death and radiosensitization by the pharmacological inhibition of nuclear factor-kappa B activation in human glioma cell lines.

Object: The intrinsic radioresistance of certain cancer cells may be closely associated with the constitutive activation of nuclear factor-kappa B (NF-kappaB) activity, which may lead to protection from apoptosis. Recently, nonapoptotic cell death, or autophagy, has been revealed as a novel response of cancer cells to ionizing radiation. In the present study, the authors analyzed the effect of pitavastatin as a potential inhibitor of NF-kappaB activation on the radiosensitivity of A172, U87, and U251 human glioma cell lines.

Malignant transformation of supratentorial clear cell ependymoma.

Recurrence of clear cell ependymoma is not a rare condition, but malignant transformation of clear cell ependymoma has not yet been well presented. The authors report a 44-year-old man who presented with progressive right hemiparesis. A brain tumor in the left frontal premotor area was removed and an initial pathological diagnosis of oligodendroglioma was made.

Prognostic factors in elderly patients with supratentorial malignant gliomas.

The prognostic factors were retrospectively analyzed in 30 patients aged 70 years or over with supratentorial malignant gliomas treated by surgery in our hospital. The histological diagnosis was confirmed as grade 3 in 13 patients and grade 4 in 17. Seventeen patients received adjuvant radiation therapy.

Malignant transformation of oligoastrocytoma: a case report.

We report a case of oligoastrocytoma resembling dysembryoplastic neuroepithelial tumor (DNT) with malignant transformation. A 35-year-old woman presented with headache and generalized convulsion in May 2003. Magnetic resonance imaging (MRI) revealed an extensive left temporal lobe tumor.

Malignant transformation of clival chordoma after gamma knife surgery - case report - .

A 54-year-old woman presented a midline clival tumor manifesting as right abducens palsy in May 1997. Magnetic resonance (MR) imaging revealed a midline clival tumor. She underwent surgery twice with the transsphenoidal approach and gamma knife surgery for residual tumor.

Impact of anomalous origin of the ophthalmic artery from the middle meningeal artery on selection of surgical approach to skull base meningioma.

Background: Ectopic sites of origin of the ophthalmic artery from the MMA are associated with visual complications of surgery directed along the sphenoidal wing or embolization of the MMA.

Case Description: Three cases of skull base meningioma in which retinal blood supply originated from the MMA are presented. In one case, the patient experienced transient blindness during selective angiography of the external carotid artery.

Parietal intradiploic encephalocele--case report.

A 66-year-old man presented with a parietal intradiploic encephalocele manifesting as dizziness in June 2001. Skull radiography showed lytic change involving the right parietal bone. Computed tomography with bone window showed bone destruction associated with the right frontal lesion.