Initial experience with Pipeline embolization of intracranial pseudoaneurysms in pediatric patients.

Objective: Flow-diverting devices have been used successfully for the treatment of complex intracranial vascular injuries in adults, but the role of these devices in treating iatrogenic and traumatic intracranial vascular injuries in children remains unclear. The authors present their experience using the Pipeline embolization device (PED) for treating intracranial pseudoaneurysms in children.

Methods: This single-center retrospective cohort study included pediatric patients with traumatic and iatrogenic injuries to the intracranial vasculature that were treated with the PED between 2015 and 2021.

A combined approach for stabilization and endoscopic/ endonasal odontoid and clivus resection for treatment of basilar invagination.

Background: Basilar invagination (BI) is a complex condition characterized by prolapse of the odontoid into the brain stem/upper cervical cord. This lesion is often associated with Chiari malformations, and rheumatoid arthritis (RA). Treatment options for BI typically include cervical traction, an isolated anterior transoral odontoidectomy, anterior endonasal odontoidectomy, an isolated posterior fusion, or combined anterior/ posterior surgical approach.

Prolactinoma extension as a contributing factor in dopamine agonist-induced CSF rhinorrhea: a systematic review of the literature.

Background: Dopamine agonist-induced cerebrospinal fluid (CSF) rhinorrhea is an uncommon treatment-related complication arising in 6.1% of prolactinoma patients treated with dopamine agonists. Locally invasive prolactinomas may create CSF fistulae through formation of dural and osseous skull base defects.

Treatment of unusually located traumatic intracranial aneurysms and severe vasospasm following a gunshot wound to the head: A case report.

Background: Traumatic intracranial aneurysms (TICAs) represent up to 1% of all intracranial aneurysms. They can be the result of non-penetrating and penetrating brain injury (PBI). Approximately 20% of TICA are caused by PBI.

C1 Transverse Process Resection for Management of Jugular Stenosis.

Background And Importance: Idiopathic intracranial hypertension, also known as pseudotumor cerebri, often presents with severe headache and associated vision loss. Venous outflow obstruction has been noted as a prominent etiologic factor in many cases, and previous anatomic studies have shown that the internal jugular (IJ) vein at the skull base can be prone to compression by the neighboring bony structures.

Clinical Presentation: We present a case of 13-yr-old male with a multifactorial intracranial hypertension including compression of the IJ vein by the transverse process of C1.

Restrictive cerebral cortical venopathy: A new clinicopathological entity.

We present a case of a novel restrictive cerebral venopathy in a child, consisting of a bilateral network of small to medium cortical veins without evidence of arteriovenous shunting, absence of the deep venous system, venous ischemia, elevated intracranial pressure, and intracranial calcifications. The condition is unlike other diseases characterized by networks of small veins, including cerebral proliferative angiopathy, Sturge-Weber syndrome, or developmental venous anomaly. While this case may be the result of an anatomic variation leading to the congenital absence of or early occlusion of the deep venous system, the insidious nature over many years argues against this.

Complicated Mild Traumatic Brain Injury and the Need for Imaging Surveillance.

Objective: To evaluate the need for repeat head computed tomography (CT) in patients with complicated mild traumatic brain injury (TBI) determined nonoperative after the first head CT.

Methods: A total of 380 patients with mild TBI and a positive head CT not needing surgery were included. Changes between first and second head CT were categorized as decreased, increased, or stable.

Preinjury warfarin, but not antiplatelet medications, increases mortality in elderly traumatic brain injury patients.

Background: Previous studies of traumatic brain injury (TBI) outcomes in elderly patients on oral antithrombotic (OAT) therapies have yielded conflicting results. Our objective was to examine the effect of premorbid OAT medications on outcomes among elderly TBI patients with intracranial hemorrhage.

Methods: We performed a retrospective analysis of elderly TBI patients (≥65 years) with closed head injury and evidence of brain hemorrhage on computed tomography scan from 2006 to 2010.

Manual aspiration thrombectomy for basilar infarction in the setting of a persistent primitive hypoglossal artery: Case report and review of the literature.

Background: Persistent primitive hypoglossal artery (PPHA), a remnant of embryonal circulation, is a rare variant of the posterior cerebral circulation. Seven prior cases of posterior circulation stroke in the setting of PPHA have been described in the literature, with all but one case being attributable to atherosclerotic embolization from the internal carotid artery (ICA) through the PPHA.

Case Description: We report a unique case of a young male with a PPHA presenting with a "top of the basilar" syndrome following the repair of his atrial septal defect who underwent emergent revascularization via endovascular mechanical aspiration thrombectomy.

Enterocutaneous fistula in the setting of ventriculoperitoneal shunt extrusion through the skin and perforation through the small bowel.

The authors report a case of a 2-year-old boy with postinfectious hydrocephalus, managed with a ventriculoperitoneal (VP) shunt and complicated by shunt extrusion through the cranial skin. The shunt was removed due to concern for infection, and the child was found to have an enterocutaneous fistula (ECF) communicating along the shunt track between the small bowel and a clavicular sinus. Self-closure of the ECF was anticipated.

Predicting the likelihood of an isocitrate dehydrogenase 1 or 2 mutation in diagnoses of infiltrative glioma.

Background: Several variables are associated with the likelihood of isocitrate dehydrogenase 1 or 2 (IDH1/2) mutation in gliomas, though no guidelines yet exist for when testing is warranted, especially when an R132H IDH1 immunostain is negative.

Methods: A cohort of 89 patients was used to build IDH1/2 mutation prediction models in World Health Organization grades II-IV gliomas, and an external cohort of 100 patients was used for validation. Logistic regression and backward model selection with the Akaike information criterion were used to develop prediction models.

A review of therapeutic uses of mirtazapine in psychiatric and medical conditions.

Objective: To review the literature examining the use of mirtazapine with an emphasis on its therapeutic benefits for psychiatric patients with comorbid medical conditions.

Data Sources: MEDLINE, PsycINFO, Global Health, and AGRICOLA were searched using the terms mirtazapine OR Remeron. Limits were English language, human, year 1980-2012, treatment and prevention, and therapy.

Addicted to constructs: science in reverse?

Advancement in science requires clarity of constructs.Like other fields in behavioral science, addiction research is being held back by researchers' use of different terms to mean similar things (synonymy) and the same term to mean different things (polysemy). Journals can help researchers to stay focused on novel and significant research questions by challenging new terms introduced without adequate justification and requiring authors to be parsimonious in their use of terms.

How molecular testing can help (and hurt) in the workup of gliomas.

Advances in genetics research have greatly expanded our ability to accurately diagnose gliomas and provide more useful prognostic information. Herein specific examples are used to show how high-yield targets such as EGFR, 1p/19q, IDH1/2, MGMT, and BRAF can expand the power of the surgical neuropathologist. To avoid errors, however, the significance and controversies associated with each test must be thoroughly understood.