Changes in blood and renal function in patients after cerebral digital subtraction angiography.

Objective: Describe the incidence of contrast-induced acute renal injury (CI-AKI) and the changes in hematocrit in a cohort of patients undergoing elective cerebral digital subtraction angiography (DSA).

Methods: In this prospective study, patients undergoing cerebral DSA were assessed for hematocrit level and CI-AKI risk factors before the procedure and for developing CI-AKI 72 h after exposure to the contrast media.

Results: Among 215 patients (109 men, mean age 36.

A Review of the Scientific Contributions of Nepal on COVID-19.

Purpose Of Review: There has been a high influx of publications on the SARS-CoV-2 and COVID-19 worldwide in the recent few months as very little was known about them. Nepal too had a substantial number of publications on the same, and there was a need to track the most relevant and impactful to the scientific community through bibliometric analysis.

Recent Findings: A total of 72 publications were analyzed.

The 2020 research pandemic: A bibliometric analysis of publications on COVID-19 and their scientific impact during the first months.

Background: The outbreak of COVID-19 has created a landslide of publications, from different sources and unequal impact. We considered that the first 3 months are crucial to understand how knowledge has been generated by performing a bibliometric analysis, including the citations to these articles to guide researchers in exploring this field, and to evaluate the relationship between confirmed COVID-19 cases and deaths with the number of papers per country.

Methods: Scientific publications were obtained from PubMed (January-March 2020) and their citations during the first 6 months retrieved from the Scopus database.

A Pilot Study of Facial Nerve Stimulation on Cerebral Artery Vasospasm in Subarachnoid Hemorrhage Patients.

Background: The objective of this pilot study was to assess the safety and efficacy of VitalFlow stimulation in aneurysmal subarachnoid hemorrhage (aSAH) patients with vasospasm for the purpose of guiding the design of larger, controlled studies in vasospasm patients, a largely untreated condition [1].

Methods: Six patients with angiographic vasospasm developing post-aSAH were treated with VitalFlow stimulation. Digital subtraction angiograms were obtained at the time of diagnosis (baseline) and then 30 minutes post-stimulation.

Persistent Primitive Trigeminal Artery Associated With Anterior Communicating Artery Aneurysm and Hypoplastic Vertebral Artery.

The persistent trigeminal artery is one of the presegmental arteries in the embryonic period; in some rare cases, it is associated with cerebral aneurysm but as a cause of subarachnoid hemorrhage (SAH) has not been described in the literature. We report a patient who presented a Fisher IV SAH associated with a ruptured intracranial aneurysm. The performed cerebral angiography demonstrated the presence of aneurysm in the anterior communicating artery associated to hypoplastic vertebral artery on the same side.

Rupture of Persistent Primitive Trigeminal Artery-basilar Artery Aneurysm Managed with Stent-assisted Coiling.

Persistent primitive trigeminal artery (PPTA), a fetal carotid-basilar anastomosis, is the most common embryological vascular remnant persisting into adult age. However, reported cases associated with cerebral aneurysms are rare. A 33-year-old female presented with an extremely rare PPTA-basilar artery (PPTA-BA) aneurysm manifesting as subarachnoid hemorrhage.

Endovascular Management of Intracranial Pial Arteriovenous Fistulas: Experience of Largest Series at a Single Center Over Six Years.

Introduction: Intracranial pial fistulas are an extremely uncommon type of vascular pathology consisting of one or multiple arterial connections to a single venous drainage channel without the presence of an intervening nidus. Due to its typical location and high-flow dynamics, its management is difficult and options include endovascular treatment and open surgical treatment. The arterial supply of these lesions is usually derived from pial or cortical vessels, and commonly such lesions are not localized in the dura mater.

A proposed classification for assessing rupture risk in patients with intracranial arteriovenous malformations.

Background: Whether cerebral arteriovenous malformations (AVMs) should be treated remains an ongoing debate. Nevertheless, there is a need for predictive factors that assist in labelling lesions as low or high risk for future rupture. Our aim was to design a new classification that would consider hemodynamic and anatomic factors in the rapid assessment of rupture risk in patients with AVMs.

Comparative analysis of aneurysm volume by different methods based on angiography and computed tomography angiography.

Endovascular treatment and prognosis of intracranial aneurysms are based on size and volume, which demand more accurate neuroimaging techniques. Aneurysm volume calculation is important to choose endovascular treatment modalities and packing density calculation. Of all these methods, it remains unknown which one is the most accurate to calculate aneurysm volume.

Embolic stroke secondary to spontaneous thrombosis of unruptured intracranial aneurysm: Report of three cases.

Intracranial aneurysms uncommonly present with ischemic stroke. Parent artery occlusion due to local extension of the luminal thrombus, aneurysms ejecting emboli to distal arteries, or increased mass effect have been described as possible pathogenic mechanisms. Guidelines for the management of these patients are absent.

Odontogenic Pain as the Principal Presentation of Vertebral Artery Pseudoaneurysm; a Case Report.

Dissection of the vertebral artery is an important but rare cause of cerebrovascular accidents. Here we report a 48-year-old man with toothache since 4 days before who presented to the emergency department with neck pain and final diagnosis of dissecting right vertebral artery pseudoaneurysm. To our knowledge, this maybe the first report of odontogenic pain as the first manifestation of vertebral artery pseudoaneurysm in the literatures.

Contralateral transvenous approach and embolization with 360° guglielmi detachable coils for the treatment of cavernous sinus dural fistula.

carotid-cavernous fistulas are spontaneours acquired connections between the carotid artery and the cavernous cavernous sinus, being classified as direct or indirect; being usually diagnosed in postmenopausal women, but are also associated with other pathoogies such as pregnancy, sinusitis and cavernous sinus thrombosis. They are clinically characterized by ophthalmological symptoms and pulsatile tinnitus. A 51-year-old woman who started her current condition about 4 years ago with pulsatile tinnitus, to which were added progressively: Pain, conjunctival erythema, right eye proptosis and the occasional headache of moderate intensity.

[Endovascular management of cavernous sinus dural fistulas].

Objective: Describe the outcomes of patients diagnosed with indirect carotid-cavernous fistula treated by endovascular methods.

Design: A retrospective case series.

Participants: Twelve patients with dural cavernous sinus fistula with important ophthalmologic involvement admitted and treated at the National Institute of Neurology and Neurosurgery between February 1990 and January 2005.

[Anatomic variations of the internal carotid artery: implications for the neurologic endovascular therapist].

Tortuosity of the cervical segment of the internal carotid artery (ICA) can hinder navigation intravascular devices for treating intracranial aneurysms and even complex ICA access techniques can fail. Variations in the course of the internal carotid artery are known as coiling, kinking or tortuosity of the vessel. Such failures have clinical relevance.

[Endovascular approach in the management of intracranial aneurysms. Part 2: indications and therapeutic strategy].

The success and stability of the occlusion of intracranial aneurysms can be achieved after an adequate conceptualization and implementation of current endovascular techniques, which in turn should be based on knowledge of available devices and the analysis of the specific characteristics the aneurysm and its parent artery to what we called aneurysmal complex.

[Endovascular approach in the management of intracranial aneurysms. Part 1: basic concepts and devices].

Neurological endovascular therapy is a discipline that has shown effectiveness and safety in the management of intracranial aneurysms, however recanalization persists as one of the most important obstacles to overcome. Precise knowledge of the anatomy and hemodynamics of the aneurysm and the parent artery as well as currently available endovascular devices, are decisive in the analysis and to design a specific treatment plan for each case. In this manner we ensure, as long as possible, success and durability of the treatment.

[Traumatic arteriovenous pial fistula masquerading as a carotid-cavernous fistula: an uncommon disorder with an unusual presentation].

Traumatic intracranial pial arteriovenous fistulae are infrequent lesions. Their cardinal signs have been related to mass effect and hemorrhage, but their clinical manifestations due to venous retrograde flow into ophthalmic veins has never been described. This phenomenon is usually seen in dural arteriovenous fistula draining to the cavernous sinus or carotid-cavernous sinus fistula.

Ten-year follow-up of giant basilar aneurysm treated by sole stenting technique: a case report.

Introduction: The sole stenting technique has emerged as a new tool for the management of intracranial aneurysms. However, several concerns have emerged about the long-term behavior of intracranial stents, particularly their safety and efficacy.

Case Presentation: We present the first case of an intracranial aneurysm intentionally treated with the sole stenting technique.

Management of direct carotid-cavernous sinus fistulas with the use of ethylene-vinyl alcohol (Onyx) only: preliminary results.

Object: So-called direct carotid-cavernous fistulas (CCFs) are commonly treated by detachable balloons or coils to occlude the shunt while sparing the carotid artery. Liquid embolic agents have been rarely used, and in particular, to the authors' knowledge, the use of Onyx as the sole agent has never been reported in an indexed publication.

Methods: The authors describe a case series of 5 patients with posttraumatic CCF in whom embolization with Onyx was prospectively used as the sole strategy of management.

Perianeurysmal abscess and meningitis after endovascular coil placement for an intracranial aneurysm.

Background: Only five cases of infection of the central nervous system attributable to intracranial permanent devices (e.g., coils, cyanacrylate) have been described.

Definition of the key target volume in radiosurgical management of arteriovenous malformations: a new dynamic concept based on angiographic circulation time.

Object: The cumulative experience worldwide indicates complete radiosurgical obliteration rates of brain arteriovenous malformations (AVMs) ranging from 35 to 90%. The purpose of this study was to propose a strategy to increase the obliteration rate for AVMs through the dynamic definition of the key target volume (KTV).

Methods: A prospective series of patients harboring an AVM was assessed using digital subtraction angiography in which a digital counter was used to measure the several stages of the frame-by-frame circulation time.

Use of the sole stenting technique for the management of aneurysms in the posterior circulation in a prospective series of 20 patients.

Object: The use of intracranial stents in stent-assisted coil embolization is now a current neurosurgical practice worldwide. The clinical utility of these stents in the sole stenting (SS) technique, however, has not been thoroughly described, and the published reports of this experience are scarce. This study was designed to evaluate SS treatment of dissecting and nondissecting aneurysms of the posterior circulation.