Efficacy of Step-down Infusion Method of a Novel Barbiturate Therapy for Severe Subarachnoid Hemorrhage with Intracerebral Hematoma.

Currently, there is no effective treatment for elevated intracranial pressure in the acute phase of subarachnoid hemorrhage. Recently, we developed "step-down infusion of barbiturate," a therapeutic strategy for severe traumatic brain injury, which decreased intracranial pressure and significantly reduced mortality without serious side effects. This study aimed to examine the efficacy of step-down infusion of barbiturate in patients with severe subarachnoid hemorrhage.

Cough syncope and central sleep apnea caused by CM1 with atlas assimilation in adult: An illustrative case.

Background: Cough syncope, central sleep apnea (CSA), and Chiari type 1 malformations (CM1) with atlas assimilation are very rare in adults.

Case Description: A 48-year-old male taxi driver fainted. He was neurologically intact, but tested positive for mild sleep apnea confirmed by a polysonogram.

Mini-open exoscopic surgery for C1 restenosis 7 years after decompression of Chiari malformation type 1 with atlas assimilation.

Background: Chiari malformation type 1 (CM1) associated with atlas assimilation (AA) is rarely encountered in children without syringomyelia. Here, a 13-year-old child underwent an original foramen magnum decompression (FMD) for a CM1. Seven years after the index surgery, at age 20, the patient required secondary surgery to address recurrent C1 stenosis attributed to CM1/AA performed without a duraplasty.

Cervical lower motor neuron syndrome caused by cervicothoracic dural arteriovenous fistula: illustrative case.

Background: Brachial nerve palsy without sensory impairment is called cervical lower motor neuron syndrome (CLMNS), and differential diagnosis can be difficult.

Observations: A 50-year-old man presented with left brachial nerve palsy (C7, C8, and T1). Neuroradiological imaging findings showed a dural arteriovenous fistula at the cervicothoracic junction.

Temporal Base Transdural Anastomosis in Moyamoya Disease: A Potential Association with Posterior Cerebral Artery Involvement and Clinical Importance.

Moyamoya disease is associated with the formation of collateral pathways, including transdural anastomosis, such as vault and ethmoidal moyamoya. However, temporal base transdural anastomosis remains unrecognized. This study investigates the imaging characteristics and features of temporal base transdural anastomosis in moyamoya disease.

SARS-CoV-2 Did Not Spread Through Dental Clinics During the COVID-19 Pandemic in Japan.

Background: Dental professionals were thought to have the most significant risk of coronavirus infection during the pandemic. Since the first Coronavirus Disease 2019 (COVID-19) patient was detected in Japan in January 2020, Japan has faced several waves of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections. However, no cluster of SARS-CoV-2 infections associated with dental procedures has been reported in Japan.

Intramedullary schwannoma mimicking ependymoma: illustrative case.

Background: Most intramedullary spinal cord tumors are gliomas such as astrocytoma and ependymoma. Intramedullary schwannoma is rare.

Observations: A 73-year-old woman presented with slowly progressive leg numbness and disturbed gait.

The Usefulness of Vascularized Flap Craniotomy for Open-Wound Depressed Skull Fractures.

Background And Importance: Free bone flap craniotomy for open-wound depressed skull fractures poses a high risk of infection due to free bone fragments. This risk escalates in the presence of compound fractures with accompanying dural injuries. The primary objectives in managing depressed skull fractures include infection prevention and the correction of cosmetic deformities.

Impact of Clazosentan on Vasospasm Reduction and Functional Recovery after Aneurysmal Subarachnoid Hemorrhage.

In every hospital in Japan, until 2022, the primary treatment for preventing delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) involved a combination of ozagrel sodium (Oz), fasudil hydrochloride (Fs), cilostazol, and statins. However, with the approval of clazosentan in January 2022, it has been used as a first-choice drug more frequently. Despite this shift, limited evidence exists regarding the use of clazosentan as the first choice for DCI prevention.

Impact of the Coronavirus Pandemic on Patients Requiring Tracheal Intubation by Helicopter Emergency Medical Services: A Retrospective, Single-Center, Observational Study.

: The impacts of the coronavirus disease 2019 (COVID-19) pandemic on patients using helicopter emergency medical services (HEMS) regarding tracheal intubation and patient management remain unclear. Thus, we aimed to investigate this matter in Japan. : In this retrospective, observational study, we analyzed 2277 patients who utilized HEMS in Tochigi Prefecture during 2018-2022.

Leakage Sign Is a Reliable Predictor of Hematoma Expansion in Acute Epidural Hematoma.

Background: Hematoma expansion (H-Ex) in small-/medium-sized acute epidural hematoma (AEDH) cases upon emergency admission is critical. Predicting H-Ex can lead to early surgical interventions, improving outcomes, and eliminating the need to check for expansion via computed tomography (CT). This study aimed to identify the most reliable predictors of AEDH expansion.

A Ruptured Aneurysm of the Transdural Anastomotic Artery Occurring at the Temporal Base in Moyamoya Disease: Case Report and Literature Review.

A 24-year-old woman with hemorrhagic onset moyamoya disease received bilateral indirect bypass surgery 11 years ago. She presented with a life-threatening atraumatic acute right subdural hematoma with temporal lobe intracerebral hemorrhage due to a transdural anastomosis (TDA) aneurysm rupture. We reviewed six cases of rare TDA aneurysms, all of which occurred around the temporal base.

Visual Outcomes and Surgical Approach Selection Focusing on Active Optic Canal Decompression and Maximum Safe Resection for Suprasellar Meningiomas.

The goal of treating patients with suprasellar meningioma is improving or preserving visual function while achieving long-term tumor control. We retrospectively examined patient and tumor characteristics and surgical and visual outcomes in 30 patients with a suprasellar meningioma who underwent resection via an endoscopic endonasal (15 patients), sub-frontal (8 patients), or anterior interhemispheric (7 patients) approach. Approach selection was based on the presence of optic canal invasion, vascular encasement, and tumor extension.

Preoperative Novel Magnetic Resonance Fusion Imaging for Carotid Endarterectomy Patients with Contrast Contraindications: A Pilot Study.

Objective: For carotid endarterectomy (CEA) patients with renal dysfunction and allergies to contrast media, we developed a preoperative novel method of noncontrast 3-dimensional magnetic resonance fusion imaging (NC-3DMRFI) which could describe well blood vessels, plaques, and bony structures even in surgical position. In this study, we examined the usefulness of this method.

Methods: We extracted noncontrast magnetic resonance images of bones, blood vessels, and plaques to create a 3-dimensionalusion image.

Brain Hypothermia Therapy and Targeted Temperature Management for Acute Encephalopathy in Children: Status and Prospects.

In adult intensive care, brain hypothermia therapy (BHT) was reported to be effective in neuroprotection after resuscitation and cardiac arrest. By contrast, in neonatal intensive care, the pathophysiology of brain damage caused by hypoxic-ischemic encephalopathy (HIE) is attributed to circulatory disturbances resulting from ischemia/reperfusion, for which neonatal brain cryotherapy is used. The , 2010, recommends cerebral cryotherapy for HIE associated with severe neonatal pseudoparenchyma death.

Systemic inflammation caused by an intracranial mesenchymal tumor with a EWSR1::CREM fusion presenting associated with IL-6/STAT3 signaling.

Pediatric neoplastic diseases account for about 10% of cases of fever of unknown origin (FUO), and most neoplastic disease cases are leukemia, lymphoma, and neuroblastoma. Brain tumors are rarely reported as the cause of FUO, although craniopharyngioma, metastatic brain tumor, and Castleman's disease have been reported. We report a case of intracranial mesenchymal tumor (IMT) with a FET:CREB fusion gene, which had inflammatory phenotype without neurological signs.

A case of mid-thoracic osteoporotic vertebral fracture with the inability to belch syndrome.

Background: Osteoporotic vertebral fractures (OVF) commonly occur at the thoracolumbar junction, but are less frequently encountered in the mid-thoracic region. Here, a 69-year-old female presented with back pain and the new onset of symptoms characterized by the inability to belch.

Case Description: A 69-year-old female presented with back pain.

Cerebrospinal fluid shunt for normal pressure hydrocephalus patient exacerbates cord symptoms due to spinal tumor.

Background: Normal-pressure hydrocephalus (NPH) and spinal intradural extramedullary benign tumors rarely exist together. Here, a 72-year-old female who presented with NPH symptoms (i.e.

Characteristics of patients who received helicopter emergency medical services in Japan from 2012 to 2019: a retrospective analysis of data from Tochigi Prefecture.

Background: Helicopter Emergency Medical Services (HEMS) has been in operation in Japan since 2001, allowing patients almost anywhere in the nation to receive on-scene emergency treatment from physicians. However, there is insufficient literature on the characteristics of the patients who use Japanese HEMS. Thus, this study aimed to investigate the overall characteristics of patients receiving HEMS care within a single prefecture in Japan.

Transmission of toxigenic infection with airway obstruction from cats to a human.

Background: Infections caused by a zoonotic pathogen, have been reported worldwide. This microorganism is known to produce the diphtheria toxin and cause diphtheria-like illness.

Case Presentation: A 63-year-old woman with a history of diabetes and hypertension developed cold and flu-like symptoms, which gradually progressed into respiratory distress.

Early postoperative prediction of both disease remission and long-term disease control in acromegaly using the oral glucose tolerance test.

Purpose: Transsphenoidal surgery (TSS) is the cornerstone of acromegaly treatment. Two biochemical parameters, growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels, sometimes diverge postoperatively; however, it is important to maintain disease control without further treatment, regardless of whether these parameters converge. This study investigated whether remission and long-term disease control could be predicted using early postoperative GH and IGF-1 levels.

Primary Pituitary Adenoid Cystic Carcinoma: A Rare Salivary Gland-Like Tumor in the Sella.

Adenoid cystic carcinoma (ACC) is a tumor of the exocrine glands that originates primarily from the minor and major salivary glands, nasopharynx, and lacrimal glands. ACC grows slowly but is locally aggressive and prone to recurrence. It is uncommon for ACCs to develop in the pituitary gland as a primary tumor.