Combined Treatment of Large Fusiform A2 Aneurysm with End-to-Side Extended Superficial Temporal Artery-A3 Bypass Using Contralateral Superficial Temporal Artery Interposition Graft and Endovascular Aneurysm Trapping: A Case Report and Literature Review.

A2 fusiform aneurysms present certain management difficulties with conventional microsurgical or endovascular approaches due to the circumferential morphology, deep location within the interhemispheric fissure, and narrow surgical corridor. We present a case of a large (>10 cm) fusiform aneurysm in the right A2 segment treated with a combined method consisting of an extended superficial temporal artery to A3 bypass using a contralateral superficial temporal artery interposition graft and subsequent endovascular trapping of the aneurysm. To treat the aneurysm, endovascular trapping following revascularization was planned.

Additive Manufacturing of Si-Added 7075 Aluminum Alloys: Microstructural, Mechanical, and Electrochemical Properties via Heat Treatment.

Al 7075 alloy (AA7075) exhibits excellent strength yet poses significant challenges for additive manufacturing (AM) due to its complex composition and propensity for defects during rapid solidification. To address these issues, this study introduces a novel AA7075 containing a small amount of Si fabricated by selective laser melting (SLM). Despite concerns about reduced melt-pool stability at low Si content, the alloy was successfully processed into defect-minimized samples.

Efficacy of Anti-Adhesive Substitute and Step-by-Step Techniques in Decompressive Craniectomy and Subsequent Cranioplasty.

Objective: Dural substitutes have been widely used in decompressive craniectomy to prevent adhesion, and have significantly reduced blood loss and operation time. However, there are only limited studies providing information regarding detailed techniques and the specific operation time that is associated with good prognoses. In this study, we evaluate the effectiveness of using a dural substitute as an anti-adhesive material during cranioplasty, focusing on technical details and operation time from incision to bone closure.

Comparison of Surgical and Endovascular Treatments for Partially Thrombosed Intracranial Aneurysms : Insights into Recurrence and Residual Lesions.

Objective: Partially thrombosed intracranial aneurysms (PTIAs) are known to occur for both large and small aneurysms; however, standardized treatment guidelines remain undefined. This study aimed to evaluate and compare the efficacy of surgical and endovascular strategies for managing PTIAs to identify the optimal treatment approach.

Methods: A retrospective analysis was performed on patients diagnosed with PTIAs who underwent surgical or endovascular treatment at our institution from January 2005 to December 2022.

Antegrade horizontal stenting for endovascular coiling of wide-neck aneurysms in the basilar tip: Two case reports.

Rationale: Endovascular coil embolization for wide-neck intracranial aneurysms is technically challenging and requires supporting devices. Intracranial stents are widely used as a buttress for compact coil filling and preventing coil protrusion into the parent artery. Horizontal stenting has been developed to maximize coil insertion and reduce the risk of thromboembolism.

Futile recanalization after endovascular treatment in acute ischemic stroke with large ischemic core.

Background: Endovascular therapy (EVT) is the treatment of choice for acute ischemic stroke (AIS) with large vessel occlusion. However, in many patients, successful EVT recanalization does not correspond to a clinical improvement, called futile recanalization (FR). We aimed to identify stroke risk factors and patient characteristics associated with FR in AIS with large core infarct (LCI).

Surgical Results with Low-Grade Arteriovenous Malformations : A Single Center 14-Year Experience.

Objective: Advancements in AVM surgical techniques for cerebral arteriovenous malformation (AVM) underscore its efficacy. Our research aims to showcase the positive outcomes of treating low-grade AVMs surgically, focusing on safety and effectiveness.

Methods: We retrospectively reviewed 55 patients (36 males and 19 females; average age 37.

Spontaneous intracranial hypotension presenting with bilateral subdural hematoma: Decision-making and treatment strategies.

Background: The timing and decision to drain subdural hematoma (SDH) in spontaneous intracranial hypotension (SIH) remains a dilemma. We reviewed our experience of bilateral SDH secondary to SIH, focusing on decision making and treatment strategies.

Methods: We retrospectively reviewed bilateral SDH secondary to SIH between March 2010 and September 2021.

Intracranial-intracranial bypass strategies for the treatment of complex intracranial aneurysms: anatomical characteristics and surgical intervention.

Objective: The effectiveness of revascularization for complex aneurysms is well-established. This study aimed to describe the technical characteristics and clinical efficacy of intracranial-to-intracranial (IC-IC) bypass for the treatment of complex intracranial aneurysms.

Methods: We retrospectively reviewed all patients with aneurysms who underwent a preplanned combination of surgical or endovascular treatment and IC-IC bypass at our institution between January 2006 and September 2023.

Microsurgical strategies for small unruptured dorsal internal carotid artery aneurysms.

Objective: This study aimed to develop microsurgical strategies based on the anatomical relationship between dorsal internal carotid artery (ICA) aneurysms, the falciform ligament (FL), and the anterior clinoid process (ACP).

Methods: Between 2017 and 2022, 25 patients with unruptured dorsal ICA aneurysms (less than 4 mm in diameter) underwent microsurgical direct clipping. These cases involved the left ICA (n=17) and the right ICA (n=8), with a mean aneurysm size of 3.

Minimally invasive fibrinolytic treatment and drainage in patients with acute subdural hemorrhage and underlying comorbidities.

The incidence of acute subdural hemorrhage (ASDH), which is often caused by head trauma, is steadily increasing due to an increase in the elderly population and the use of anticoagulants. Urgent surgical treatment is recommended if the patient has impaired consciousness, worsening neurological symptoms, or brain midline shift (MLS) due to large hematomas on brain computed tomography (CT). Although large craniotomy is traditionally recommended for ASDH removal, old age, comorbidities, and antiplatelet drugs are considered risk factors for surgical complications, many neurosurgeons hesitate to perform aggressive surgical procedures in these patients.

Microstructural Evolution and Mechanical Properties of Non-Equiatomic (CoNi)CrFeC High-Entropy Alloy.

In this study, we manufactured a non-equiatomic (CoNi)CrFeC high-entropy alloy (HEA) consisting of a single-phase face-centered-cubic structure. We applied in situ neutron diffraction coupled with electron backscattered diffraction (EBSD) and transmission electron microscopy (TEM) to investigate its tensile properties, microstructural evolution, lattice strains and texture development, and the stacking fault energy. The non-equiatomic (CoNi)CrFeC HEA revealed a good combination of strength and ductility in mechanical properties compared to the equiatomic CoNiCrFe HEA, due to both stable solid solution and precipitation-strengthened effects.

Direct Removal of Fourth Ventricle Hematoma in Massive Intraventricular Hemorrhage.

Various grading systems and surgical techniques have been developed for the treatment of intraventricular hemorrhage (IVH); however, little attention has been paid to the fourth ventricle hematoma. Nonetheless, hemorrhagic dilation of the fourth ventricle may lead to catastrophic consequences for patients with massive IVH. We present two cases of massive IVH accompanied by massive fourth ventricle hematoma which was successfully removed with combination of suboccipital craniotomy for fourth ventricle hematoma and intraventricular fibrinolysis for supratentorial hematoma.

Systemic macrophage depletion attenuates infarct size in an experimental mouse model of stroke.

Objective: Macrophages have been shown to play important roles in various pathophysiological processes of the central nervous system via neuroinflammation, leading to an increased interest in macrophage biology. Circulating blood monocytes are among the first cells to infiltrate the brain after ischemic stroke; however, the role of innate immune cells such as monocytes and macrophages remains to be elucidated. Here, we investigated the association between blood monocytes and infarct size following ischemic stroke.

Correlation between high hair cortisol level and intracranial aneurysm rupture.

Measurement of cortisol in hair is a reliable method for determining long-term cortisol exposure reflecting chronic stress. Research using hair cortisol concentration has been limited to mainly cardiometabolic diseases. The association between hair cortisol concentration and aneurysmal rupture has not yet been studied.

Modified Suturing Techniques in Carotid Endarterectomy for Reducing the Cerebral Ischemic Time.

Objective: Carotid endarterectomy (CEA) is an effective surgical procedure for treating symptomatic or asymptomatic patients with carotid stenosis. Many neurosurgeons use a shunt to reduce perioperative ischemic complications. However, the use of shunting is still controversial, and the shunt procedure can cause several complications.

Bevacizumab-refractory radiation necrosis with pathologic transformation of benign meningioma following adjuvant gamma knife radiosurgery: A rare case report.

Rationale: Bevacizumab has shown good efficacy in radiation necrosis (RN) following gamma knife radiosurgery (GKRS) and associated peritumoral edema. However, few studies have reported bevacizumab failure. Moreover, the pathologic transformation of benign meningioma following GKRS has never been reported.

Acute Parent Artery Occlusion in Thrombosed Middle Cerebral Artery Aneurysm Presenting with Ischemic Stroke.

Background: Thrombosed intracranial aneurysms are complex and unstable lesions that are especially associated with ischemic stroke. Although acute parent artery occlusion manifesting with ischemic stroke is very rare, it can lead to catastrophic consequences.

Case Description: This study presents 2 cases of acute parent artery occlusion in thrombosed large and giant middle cerebral artery bifurcation aneurysms manifesting with ischemic stroke.

Vasa Vasorum Densities in Human Carotid Atherosclerosis Is Associated with Plaque Development and Vulnerability.

Objective: The extensive vasa vasorum network functions as a conduit for the entry of inflammatory cells or factors that promote the progression of angiogenesis and plaque formation. Therefore, we investigated the correlation between the carotid vasa vasorum activities and carotid plaque vulnerability using indocyanine green video angiography (ICG-VA) during carotid endarterectomy (CEA).

Methods: Sixty-nine patients who underwent CEA were enrolled prospectively from September 2015 to December 2017.

Staged, Combined Management of Ruptured Vertebral Artery Dissecting Aneurysms Involving the Posterior Inferior Cerebellar Artery: Report of 4 Cases and Review of the Literature.

Background: Ruptured vertebral artery dissecting aneurysms (VADAs) involving the posterior inferior cerebellar artery (PICA) are the most difficult to treat among variations of VADAs but require prompt treatment. The major challenge is to preserve the PICA while occluding the aneurysm. Despite advances in the management of ruptured VADAs involving the PICA, each treatment, whether it is combined or not, is associated with a significant degree of risk.

Microsurgical Management of Ruptured Blood Blister Aneurysms of the Internal Carotid Artery without Bypass: A Retrospective Single-Center Study of 36 Patients over 20 Years.

Background: Microsurgical management of blood blister aneurysms of the internal carotid artery is challenging because of the special characteristics of these aneurysms. We reviewed our diverse surgical methods with long-term clinical and radiologic follow-up.

Methods: We retrospectively reviewed all patients with blood blister aneurysms presenting with subarachnoid hemorrhage that were treated with microsurgical obliteration between 1993 and 2017.

Contralateral Brain Atrophy in Conservatively Treated Primary Intracerebral Hemorrhage.

Background: In patients with intracerebral hemorrhage (ICH), brain volume loss can occur in the hemisphere ipsilateral to the hematoma. However, contralateral hemispheric volume change after ICH is not well known. The present study aimed to investigate contralateral brain volume changes in patients with ICH who had not undergone surgery.