Perioperative Management of Carotid Blowout Syndrome After Head and Neck Cancer Treatment: A Retrospective Case Series.

Background: Carotid blowout syndrome (CBS) is a life-threatening emergency involving the rupture of the carotid arteries and/or branches, often following surgery and radiotherapy for head and neck cancer. Our case series aimed to describe airway management strategies, endovascular and surgical approaches, perioperative resuscitation management, and clinical outcomes in a cohort of patients with CBS at a tertiary referral academic health center.

Methods: We retrospectively identified patients presenting with CBS between 2017 and 2021.

Progressive Disseminated Histoplasmosis with Primary Adrenal Insufficiency in Immunocompetent Person: A Case Report.

Histoplasmosis, also referred to as Darling's disease, is mainly caused by the thermally dimorphic fungus Histoplasma capsulatum. It is usually contracted by inhaling fungal spores found in soil contaminated with bat or bird droppings, often during activities like cave exploration. Although endemic in certain regions of India, such as the eastern part, and sporadically in southern and northern states, histoplasmosis can manifest with varied clinical presentations, ranging from asymptomatic to severe disseminated disease affecting multiple organs.

Long-Term Outcomes of Neoadjuvant Intraarterial Chemotherapy for Locally Invasive Lacrimal Gland Carcinoma ex Pleomorphic Adenoma.

Purpose: There is no current standard treatment regimen for carcinoma ex pleomorphic adenoma (CXPA) of the lacrimal gland. Neoadjuvant intraarterial cytoreductive chemotherapy (IACC) followed by multimodal therapy has achieved good locoregional control in adenoid cystic carcinoma of the lacrimal gland. The authors reviewed their experience with neoadjuvant IACC followed by multimodal therapy for CXPA of the lacrimal gland.

Unveiling FDA-approved Drugs and Formulations in the Management of Bladder Cancer: A Review.

Urological cancers are one of the most prevalent malignancies around the globe. Specifically, bladder cancer severely threatens the health of humans because of its heterogeneous and aggressive nature. Extensive studies have been conducted for many years in order to address the limitations associated with the treatment of solid tumors with selective substances.

Neuronavigation-Guided Transcranial Histotripsy (NaviTH) System.

Objective: The goal of the work described here was to develop the first neuronavigation-guided transcranial histotripsy (NaviTH) system and associated workflow for transcranial ablation.

Methods: The NaviTH system consists of a 360-element, 700 kHz transmitter-receiver-capable transcranial histotripsy array, a clinical neuronavigation system and associated equipment for patient-to-array co-registration and therapy planning and targeting software systems. A workflow for NaviTH treatments, including pre-treatment aberration correction, was developed.

Focused update to guidelines for endovascular therapy for emergent large vessel occlusion: basilar artery occlusion patients.

Background: Endovascular therapy (EVT) dramatically improves clinical outcomes for patients with anterior circulation emergent large vessel occlusion (ELVO) strokes. With recent publication of two randomized controlled trials in favor of EVT for basilar artery occlusions, the Society of NeuroInterventional Surgery (SNIS) Standards and Guidelines Committee provides this focused update for the existing SNIS guideline, 'Current endovascular strategies for posterior circulation large vessel occlusion stroke.'

Methods: A structured literature review and analysis of studies related to posterior circulation large vessel occlusion (basilar or vertebral artery) strokes treated by EVT was performed.

MR Imaging-based Biomarker Development in Hemorrhagic Stroke Patients Including Brain Iron Quantification, Diffusion Tensor Imaging, and Phenomenon of Ultra-early Erythrolysis.

This review article discusses the role of MR imaging-based biomarkers in understanding and managing hemorrhagic strokes, focusing on intracerebral hemorrhage (ICH) and aneurysmal subarachnoid hemorrhage. ICH is a severe type of stroke with high mortality and morbidity rates, primarily caused by the rupture of small blood vessels in the brain, resulting in hematoma formation. MR imaging-based biomarkers, including brain iron quantification, ultra-early erythrolysis detection, and diffusion tensor imaging, offer valuable insights for hemorrhagic stroke management.

Characterization of Blood-Brain Barrier Opening Induced by Transcranial Histotripsy in Murine Brains.

Objective: Transcranial histotripsy has shown promise as a non-invasive neurosurgical tool, as it has the ability to treat a wide range of locations in the brain without overheating the skull. One important effect of histotripsy in the brain is the blood-brain barrier (BBB) opening (BBBO) at the ablation site, but there is a knowledge gap concerning the extent of histotripsy-induced BBBO. Here we describe induction of BBBO by transcranial histotripsy and use of magnetic resonance imaging (MRI) and histology to quantify changes in BBBO at the periphery of the histotripsy ablation zone over time in the healthy mouse brain.

Case of postoperative mitral and tricuspid valve repair with large vessel occlusion ischaemic stroke: successfully treated with mechanical thrombectomy extracting subocclusive thrombus containing foreign material.

A woman in her 60s with a history of prior ischaemic stroke developed acute onset slurring of speech, left-sided facial droop and left-sided weakness and was found on CT angiography to have a subocclusive thrombus multiple days after undergoing mitral and tricuspid valve repair surgery. A stent retriever and aspiration catheter were used to successfully remove the subocclusive material which was identified as 'foreign material' on histology. Ultimately, the patient demonstrated clinical improvement.

The interplay among a dental procedure, infective endocarditis, and an acute ischemic stroke.

Background: This case report highlights the rare association among a dental procedure, infective endocarditis, and an acute ischemic stroke.

Case Description: A 54-year-old woman who experienced an acute ischemic stroke 5 weeks after a tooth extraction is described. The initial symptoms of this patient included mild to moderate word-finding difficulty and right facial droop.

Scleral ectasia stabilization following intra-arterial chemotherapy in an eye with recurrent retinoblastoma.

Purpose: To report a case of recurrent retinoblastoma following transpupillary thermotherapy (TTT) with development of scleral ectasia, as well as their successful treatment with intra-arterial chemotherapy.

Observations: A 15-month-old girl with bilateral retinoblastoma presented with recurrent retinoblastoma and associated scleral ectasia with concern for extraocular extension after receiving multiple round of systemic chemotherapy and TTT. Given her negative systemic evaluation, decision was made to pursue intra-arterial chemotherapy.

Genetic Enhancement of Cereals Using Genomic Resources for Nutritional Food Security.

Advances in genomics resources have facilitated the evolution of cereal crops with enhanced yield, improved nutritional values, and heightened resistance to various biotic and abiotic stresses. Genomic approaches present a promising avenue for the development of high-yielding varieties, thereby ensuring food and nutritional security. Significant improvements have been made within the omics domain, specifically in genomics, transcriptomics, and proteomics.

The potential of 3D models and augmented reality in teaching cross-sectional radiology.

What was the educational challenge?The complexity and variability of cross-sectional imaging present a significant challenge in imparting knowledge of radiologic anatomy to medical students.What was the solution?Recent advancements in three-dimensional (3D) segmentation and augmented reality (AR) technology provide a promising solution. These advances allow for the creation of interactive, patient-specific 3D/AR models which incorporate multiple imaging modalities including MRI, CT, and 3D rotational angiography can help trainees understand cross-sectional imaging.

Transcranial histotripsy parameter study in primary and metastatic murine brain tumor models.

Objective: This study investigated the effect of various histotripsy dosages on tumor cell kill and associated bleeding in two murine brain tumor models (glioma [Gl261] and lung metastasis [LL/2-Luc2]).

Methods And Materials: GL261 or LL/2-Luc2 cells were cultured and implanted into the brains of C57BL/6 mice. Histotripsy (1-cycle pulses, 5 Hz PRF, 30 MPa-P) was performed using a 1 MHz transducer for five different dosages for each cell line: 5, 20 or 200 pulses per location (PPL) at a single treatment point, or 5 or 10-20 PPL at multiple treatment points.

Successful retrieval of ethylene vinyl alcohol (EVOH) from the left middle cerebral artery during preoperative embolization of a juvenile nasopharyngeal angiofibroma (JNA).

Preoperative embolization of a juvenile nasopharyngeal angiofibroma (JNA) using ethyl vinyl alcohol (EVOH) is an effective adjunctive treatment prior to surgical resection. While liquid embolic agents are safe to use, we present a unique case involving the migration of EVOH into the left middle cerebral artery (MCA) through an external carotid artery-internal carotid artery (ECA-ICA) collateral during preoperative embolization using a dual-lumen balloon catheter. A 16-year-old male presented with left-sided nasal congestion, new nasal intonation in voice, and epistaxis.

Histotripsy Treatment of Murine Brain and Glioma: Temporal Profile of Magnetic Resonance Imaging and Histological Characteristics Post-treatment.

Objective: Currently, there is a knowledge gap in our understanding of the magnetic resonance imaging (MRI) characteristics of brain tumors treated with histotripsy to evaluate treatment response as well as treatment-related injuries. Our aim was to bridge this gap by investigating and correlating MRI with histological analysis after histotripsy treatment of mouse brain with and without brain tumors and evaluating the evolution of the histotripsy ablation zone on MRI over time.

Methods: An eight-element, 1 MHz histotripsy transducer with a focal distance of 32.

Comparing internal versus external carotid artery branch delivery of intraarterial chemotherapy for the treatment of retinoblastoma.

Purpose: The goal of this study was to compare the efficacy of intraarterial chemotherapy (IAC) for retinoblastoma delivered via the ophthalmic artery (OA) division of the internal carotid artery (ICA) versus alternative branches of the external carotid artery (ECA).

Methods: We performed a retrospective chart review of patients receiving IAC for retinoblastoma at a single institution. Subjects were divided into three groups: those that received IAC solely through the OA branch of the ICA, those that initially received IAC through the OA branch of the ICA but were later switched to the ECA, and those that only received IAC through the ECA.

Newer Updates in Pediatric Vascular Diseases.

Pediatric neurovascular pathology directly involves or is in close proximity to the central nervous system (CNS). These vascular pathologies can occur in isolation or in association with broader syndromes. While some vascular pathologies are unique to the pediatric population, the full spectrum of adult neurovascular lesions can also affect children however, may present differently both clinically and on diagnostic imaging.

Neuroendovascular Procedures in Patients with Ehlers-Danlos Type IV: Multicenter Case Series and Systematic Review.

Background: Ehlers-Danlos type IV or vascular Ehlers-Danlos syndrome (vEDS) is a rare inherited disorder characterized by profound vascular fragility resulting from defective production of type III procollagen. Cerebrovascular diseases including spontaneous dissections, cerebral aneurysms, and cavernous carotid fistulae are common. Endovascular therapies in this patient population are known to be higher risk, although many studies (before 2000) involved older techniques and equipment.