Multiple extra-axial calcified lesions and tortuous vessels in a patient with meningioangiomatosis and executive dysfunction.

Meningioangiomatosis (MA) is a rare benign hamartomatous lesion characterized by leptomeningeal and cortical vascular proliferation, and the predominant imaging feature is cerebral calcification. Although the radiological findings of this entity are well known, angiographic characteristics are incompletely understood. This report describes a case of a 54-year-old woman with sporadic MA and lifelong executive dysfunction with novel phase-specific angiographic features.

Comparison of Exoscopic and Microscopic Superficial Temporal Artery to Middle Cerebral Artery Bypass.

Purpose: Exoscopes have been used as a reliable surgical tool in the neurosurgical field. They could improve surgical field visibility with 4K three-dimensional (4K-3D) monitors and provide alleviation for the physical strain by allowing surgeons to maintain a neutral posture. In this study, we report our initial experience with exoscopic superficial temporal artery (STA)-middle cerebral artery (MCA) bypass compared to the conventional microscope at our institution.

Lack of association between chronological age and fisher group and poor outcomes in older patients with severe-grade aneurysmal subarachnoid hemorrhage: a nationwide registry study in Japan.

Older age and Fisher group scores predict poor outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, among aging societies, treatment indications and decisions in older patients with severe-grade aSAH (World Federation of Neurosurgical Societies [WFNS] grade IV or V) remain poorly understood. Therefore, we aimed to identify the risk factors associated with poor outcomes in non-older and older patients with severe-grade aSAH.

Absent right common carotid artery associated with left accessory middle cerebral artery diagnosed by computed tomography angiography.

Purpose: To describe a case involving congenital absence of the right common carotid artery (CCA) associated with a left accessory middle cerebral artery (MCA) that was diagnosed by computed tomography angiography (CTA).

Methods: A 63-year-old woman with a narrow right internal carotid artery (ICA) incidentally detected on magnetic resonance imaging underwent CTA for further vascular evaluation.

Results: CTA revealed absence of the right CCA, with the right external carotid artery (ECA) branching from the brachiocephalic trunk and the right ICA branching from the right subclavian artery.

Histopathological analysis of duragen collagen matrix over time in humans.

DuraGen is a widely used type I collagen matrix derived from bovine Achilles tendon that promotes fibroblast ingrowth and neovascularization. However, it remains unknown the time required for dura regeneration and reabsorption of the graft. We evaluate the histopathological characteristics of implanted DuraGen in humans across multiple time points.

Comparative Effects of Carotid Endarterectomy and Stenting on Visual Recovery in Patients With Carotid Artery Stenosis.

Background And Objectives: Although carotid endarterectomy (CEA) and carotid artery stenting (CAS) reduce the risk of stroke, their efficacy in improving decreased vision is unclear. This study aims to evaluate the effects of CEA and CAS on ocular blood flow (OBF) and visual acuity (VA) in patients with carotid artery stenosis, while also exploring the possible relevance of postoperative microembolisms to visual recovery.

Methods: The results of 78 procedures (CEA, 39; CAS, 39) performed in 76 patients with carotid artery stenosis were prospectively analyzed.

Machine learning validation of a simple prediction model for the correlation between advanced age and clinical outcomes in patients with aneurysmal subarachnoid hemorrhage.

Adverse effects of advanced age and poor initial neurological status on outcomes of patients with aneurysmal subarachnoid hemorrhage (SAH) have been documented. While a predictive model of the non-linear correlation between advanced age and clinical outcome has been reported, no previous model has been validated. Therefore, we created a prediction model of the non-linear correlation between advanced age and clinical outcome by machine learning and validated it using a separate cohort.

Risk factors of short-term poor functional outcomes and long-term durability of ruptured large or giant intracranial aneurysms.

Objective: Aneurysmal subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality rates. In particular, functional outcomes of SAH caused by large or giant (≥ 10 mm) ruptured intracranial aneurysms are worsened by high procedure-related complication rates. However, studies describing the risk factors for poor functional outcomes specific to ruptured large/giant aneurysms are sparse.

Distance from the midline to the aneurysm as simple predictor of ischemic complication with small unruptured middle cerebral artery aneurysm surgery.

Background: This study aimed to clarify the risk factors for postoperative cerebral infarction in surgical clipping for prevalent small middle cerebral artery aneurysms (MCA Ans).

Methods: This retrospective study included 246 patients (mean age, 64.8 ± 10.

A Sudden Unilateral Visual Field Loss in a Recreational Tennis Player: Cervical Internal Carotid Artery Dissection Associated With Low-Impact Sports.

Traumatic cervical internal carotid artery dissection (CICAD) is a rare condition caused by blunt trauma to the neck, often through automobile- or sports-related collisions, assaults, or falls. Herein, we report an unusual case in which engaging in a low-impact sport (tennis) caused CICAD, without a direct injury. A 56-year-old man with hypertension suddenly experienced a visual field loss in his right eye while playing tennis.

Recovery of Oculomotor Nerve Palsy After Surgical and Endovascular Repair of Unruptured Internal Carotid-Posterior Communicating Artery Aneurysms.

Objective: Unruptured posterior communicating artery (Pcom) aneurysms cause oculomotor nerve palsy (ONP). However, the time course of recovery after aneurysm repair remains unclear. We aimed to evaluate the ONP course after clipping and coiling for unruptured Pcom aneurysms.

Intracranial mycotic aneurysm rupture following cupping therapy.

Background: Cupping therapy is an alternative treatment that uses a small glass cup to suck the skin with a needle and has been used to manage skin problems and pain. However, serious complications have been reported. Herein, we describe a case of intracranial mycotic aneurysm rupture after cupping therapy.

Clinical Outcomes in Elderly Patients with Chronic Subdural Hematoma: Validation of Irrigation Assignment Based on Hematoma Characteristics.

The number of elderly patients with chronic subdural hematomas (CSDH) is increasing worldwide; however, there is limited data regarding the clinical outcomes in this population. Our therapeutic method using burr hole evacuation for CSDH is based on the hematoma characteristics, using simple drainage for single-layer lesions and drainage with irrigation for multiple-layer lesions. This study aimed to compare the postoperative outcomes of elderly and younger patients, identify the predictors of outcomes in elderly patients, and verify the validity of our therapeutic methods.

Effect of revascularization surgery on cerebral hemodynamics in adult moyamoya disease.

Objective: Few studies have reported local hemodynamic changes after revascularization surgery. This study aimed to identify regional hemodynamic changes after combined revascularization surgery for moyamoya disease using single-photon emission computed tomography with N-isopropyl-p-I-iodoamphetamine.

Methods: A total of 46 adults with moyamoya disease who underwent combined revascularization surgery from August 2009 to July 2021 at our facility were enrolled.

Frontal Sinus Mucosa Bacteriological Features: Evaluation after Unintentional Opening in Neurosurgery.

 The bacteriological features of the frontal sinus mucosa may impose significant complications in neurosurgery, when breached unintentionally. This study aimed to investigate the bacterial flora in patients undergoing frontal craniotomy for cerebrovascular substrate surgery.  This is a single-center prospective study.

Another cause of treatable dementia: rapid cognitive improvement after carotid endarterectomy. Illustrative case.

Background: Revascularization techniques in cervical internal carotid artery (ICA) stenosis are indicated to prevent the onset or recurrence of ischemic events in the setting of atherosclerotic carotid artery disease. Recent reports, case series, and comparative studies have suggested that revascularization techniques may also improve cognitive outcome in both symptomatic and asymptomatic patients, thus raising the question of whether another surgically treatable dementia has presented itself.

Observations: A 70-year-old right-handed female with a history of hypertension, diabetes, and bilateral silent cerebral infarcts was evaluated for progressive cognitive impairment over a 1-year period, which was associated with a severe left cervical ICA stenosis.

Study of certain easily available biochemical markers in prognostication in severe traumatic brain injury requiring surgery.

Background: This study aimed to identify easily available prognostic factors in severe traumatic brain injury (TBI) patients undergoing craniotomy.

Methods: We retrospectively analyzed the clinical characteristics (age, sex, Glasgow coma scale score, cause of TBI, and oral antithrombotic drug use), laboratory parameters (hemoglobin, sodium, C-reactive protein, D-dimer, activated partial thromboplastin time, prothrombin time-international normalized ratio, and glucose-potassium [GP] ratio), and neuroradiological findings of 132 patients who underwent craniotomy for severe TBI in our hospital between January 2015 and December 2021. The patients were divided into two groups: Those with fatal clinical outcomes and those with non-fatal clinical outcomes, and compared between the two groups.

Disappearance of hemichorea as the initial presentation of moyamoya disease after revascularization surgery regardless of residual hypoperfusion evaluated by quantitative N-isopropyl-p-I-iodoamphetamine SPECT.

Background And Importance: Although hypoperfusion of the basal ganglia or the frontal subcortical matter is suspected, the pathology of chorea in moyamoya disease remains unclarified. Herein, we report a case of moyamoya disease presenting with hemichorea and evaluate pre- and postoperative perfusion using single photon emission computed tomography with N-isopropyl-p-I-iodoamphetamine (I-IMP SPECT).

Clinical Presentation: An 18-year-old woman presented with choreic movement of her left limbs.