What does computational fluid dynamics tell us about intracranial aneurysms? A meta-analysis and critical review.

Despite the plethora of published studies on intracranial aneurysms (IAs) hemodynamic using computational fluid dynamics (CFD), limited progress has been made towards understanding the complex physics and biology underlying IA pathophysiology. Guided by 1733 published papers, we review and discuss the contemporary IA hemodynamics paradigm established through two decades of IA CFD simulations. We have traced the historical origins of simplified CFD models which impede the progress of comprehending IA pathology.

The challenging case of a primigravid Bedouin woman with a dormant neck nodule that grew explosively during her pregnancy.

A Desmoid tumor in the neck is a rare tumor in an even more unusual site. Our patient was an 18-year-old primigravid Bedouin woman from northwest Egypt. She presented with a dormant neck nodule that grew explosively during her first pregnancy and stopped abruptly after delivery.

Evidence for non-Newtonian behavior of intracranial blood flow from Doppler ultrasonography measurements.

Computational fluid dynamics (CFD) studies of intracranial hemodynamics often use Newtonian viscosity model to close the shear rate term in the Navier-Stokes equation. This is based on a commonly accepted hypothesis which state that non-Newtonian effects can be neglected in intracranial blood flow. This study aims to examine the validity of such hypothesis to guide future CFD studies of intracranial hemodynamics.

Endovascular Management of Microcerebral Aneurysms with Diameter Smaller than 3 mm: Is It Feasible and Safe?

Background: The neurosurgical management of microcerebral aneurysms with diameter smaller than 3 mm remains a great challenge as many complications can occur.

Aim: Our target was to assess the efficacy and usefulness of endovascular treatment of these lesions.

Methods: We did a prospective and retrospective gathering of the results of endovascular treatments for a group of 16 patients with 16 microcerebral aneurysms.

Proposed Parent Vessel Geometry Based Classification of Anterior Communicating Artery-Located Aneurysms.

Background And Objectives: The present study is focused on correlation of parent vessels and neck diameters with anterior communicating artery (AComA) aneurysmal depth and growth direction. The study principally aims to suggest a new classification of AComA-located aneurysms based on the physical characteristics of parent vessels.

Methods: A retrospective analysis was performed of 155 patients with ruptured AComA-located aneurysms.

Association of alirocumab therapy with inflammatory lesions of the vocal folds: A case report.

Therapeutic monocolonal antibodies (MAbs) are a new, rapidly growing class of medications that frequently have poorly characterized side-effect profiles. We present a patient who developed inflammatory lesions of the vocal folds in temporal relation to the initiation of alirocumab. Lesions of the vocal folds represent a previously unreported adverse effect of alirocumab therapy, making it the second MAb documented with such a side effect.

Infantile Dural Arteriovenous Fistula of the Transverse Sinus Presenting with Ocular Symptoms, Case Reports and Review of Literature.

Dural arteriovenous fistula (DAVF) of the transverse sinus with ophthalmic manifestations in young children are rare. We reviewed two cases of direct AVF of the transverse sinus with ocular manifestations managed at our institution. The first, a 2.

The value of preoperative embolization in large and giant solid cerebellar hemangioblastomas.

Background: Solid cerebellar hemangioblastomas are highly vascular lesions and may cause catastrophic hemorrhage during excision.

Methods: This retrospective study enrolled 10 patients (7 men and 3 women, with a mean age of 38.2 ± 12.

Endovascular Modalities for the Treatment of Cavernous Sinus Arteriovenous Fistulas: A Single-Center Experience.

Background: Cavernous sinus (CS) fistulas are classified into traumatic and spontaneous. Traumatic carotid-cavernous fistulas (CCFs) are usually direct internal carotid artery (ICA) high-flow fistulas; whereas spontaneous CCFs are usually dural, low-flow fistulas and generally possess less severe symptoms than direct carotid-cavernous fistulas.

Methods: This study involved 34 patients who were classified into 2 groups: Group A included 26 patients with direct carotid-cavernous fistula; and Group B included 8 patients with indirect dural cavernous fistula.

Management of spinal dural arterio-venous fistulas. Report of 12 cases and review of literature.

Introduction: Spinal cord arteriovenous malformations and fistulae are rare vascular lesions than can lead to myelopathy that is at many instances overlooked during diagnosing the cause of progressive myelopathy and weakness. Treatment options involve either endovascular embolization, surgical disconnection or a combination of both. This study aims to evaluate various treatment methods for sDAVFs and the outcome of these methods.

Carotid artery occlusion for the treatment of symptomatic giant carotid aneurysms: a proposal of classification and surgical protocol.

Giant intracranial aneurysms are rare disorders that represent only 5% of all intracranial aneurysms; they have a wide variety of presentations including rupture, embolic effects, and mass effect symptoms that can mislead the diagnosis to tumors rather than aneurysms. Their treatment is difficult and carries higher morbidity and mortality than usual aneurysms due to their complex nature. This study involved retrospective analysis of data of 28 patients, managed between 2006 and 2012, suffering from giant internal carotid artery (ICA) aneurysms with various presenting symptoms, none of which was hemorrhage.

Religious attitudes in adolescents with Obsessive Compulsive Symptoms OCS and disorder OCD.

Background: Mental health professionals observed booming in prevalence of obsessive compulsive symptoms among children and adolescents. Our epidemiological study aims at estimating the prevalence of obsessive symptoms and obsessive compulsive disorder among secondary school students and, as a secondary research objective, to assess religious attitudes among those patients.

Materials: The study is cross sectional conducted on 1299 secondary school students, adequate sample size estimated on a prevalence of 2% for Obsessive Compulsive Disorder (OCD) in literature.

Successful endovascular management of brain aneurysms presenting with mass effect and cranial nerve palsy.

Aneurysms presented with mass effect are traditionally treated by surgical clipping to decompress their mass effect. The aim of this work is to discuss the efficiency of endovascular techniques in treating 47 patients with variable sizes of intracranial aneurysms presented with mass effect and/or cranial nerve palsy. There were 47 patients with 47 unruptured aneurysms.

Effect of magnesium sulfate therapy on patients with aneurysmal subarachnoid hemorrhage using serum S100B protein as a prognostic marker.

Magnesium, one of the essential trace elements, plays important roles in maintaining both normal cellular and body functions. S100 calcium-binding protein B (S100B) has been used as a marker of glial damage in several neurological disorders. Thirty patients with ruptured intracranial aneurysms treated by clipping are included.

The adverse effects of flow-diverter stent-like devices on the flow pattern of saccular intracranial aneurysm models: computational fluid dynamics study.

Background: Stent deployment across the aneurysmal neck has been established as one of the endovascular methods to treat intracranial aneurysms with or without coils.

Objective: The purpose is to study the possible adverse effects of deployment of the new flow-diverter stent-like devices (FD) on the flow characteristics of saccular aneurysm models.

Methods: Numerical simulations of the blood flow patterns in the artificial models of three aneurysms were studied.

Vein of Galen aneurysms: presentation and endovascular management.

Background: We present our experience with managing 13 cases of vein of Galen aneurysm with a special focus on endovascular strategies. This clinical review deals with the multivariable clinical presentation of vein of Galen aneurysms and the role of transarterial endovascular treatment.

Methods: Thirteen patients diagnosed with vein of Galen aneurysms have been reviewed.

Influence of parent vessel dominancy on fluid dynamics of anterior communicating artery aneurysms.

Background: Parent vessel plays an important role in aneurysm formation and rupture. The diameter of either the A1 arteries is the peculiar key controlling the flow of the anterior communicating artery (ACOMA) aneurysms (ANs).

Objective: The purpose is to study the effect of parent vessel dominancy, that is, the diameter of the A1 artery, on the flow characteristics of the ACOMA ANs.

The coronary sinus conduit function: anatomical study (relationship to adjacent structures).

Background: The mitral valve annulus (MVA) is anchored antero-medially to the aorta. Dilatation of the MVA primarily affects its postero-lateral aspect, which is related to the coronary sinus (CS). The CS and its tributaries have been used for pacing the left ventricle in patients with intractable heart failure.

Intraoperative electrophysiologic identification of the nervus intermedius.

Objective: Although enormous attention has been directed to the localization and preservation of the facial nerve in acoustic neuroma surgery, the nervus intermedius has largely been ignored. In this article, we describe a method for intraoperative electrophysiologic identification of the nervus intermedius.

Study Design: Retrospective case review.

Presumed periorbital lupus vulgaris with ocular extension.

Objective: To report an unusual case of lupus vulgaris that spread to the left anterior ocular surface.

Design: Case report.

Participant: An 18-year-old woman presented with an 8-month history of an infiltrative skin lesion affecting the left lower eyelid and cheek area, left globe, right lacrimal sac area, together with a cystic lesion in the foot area.

Topical levocabastine for the treatment of perennial allergic rhinitis.

The ultrastructure of the nasal mucosa following the use of intranasal levocabastine was studied in 20 patients suffering from perennial allergic rhinitis. The patients received twice daily 0.05 per cent levocabastine spray with a treatment duration of four weeks.

Comparative studies on urethral function.

Urethral pressure profiles (in vivo), opening pressures, and flow rates at opening pressure (in vitro) were determined for female, male, pregnant, ovariectomized (OVX), OVX and then estrogen-treated, and OVX and then progesterone-treated rabbits. Using the isolated whole-urethra preparation, we determined the opening pressures and flow rates as well as the effects of 250 microM phenylephrine, 250 microM bethanechol, and 120 mM KCl on the urethral opening pressure and flow rate. The results demonstrated that (1) the urethral pressure profiles were similar for male and female rabbits, (2) ovariectomy and pregnancy decreased the urethral pressure profiles, (3) estrogen therapy partially reversed the effect of ovariectomy on the urethra, and (4) progesterone therapy had little effect on the urethral pressure profile.