Natural course of the acute unruptured intracranial vertebral artery dissections which show pearl-and-string sign.

Introduction: Ruptured vertebral artery dissections frequently exhibit pearl-and-string signs, a characteristic also observed in many unruptured dissections. This study examines the natural course of 50 unruptured acute vertebral artery dissections presenting with pearl-and-string signs and compares them to 10 ruptured dissections of the same morphological pattern.

Methods: We reviewed 633 radiology reports of head and neck imaging studies that included the keyword 'dissection'.

Efficacy of Coil Embolization in Small, Anterior Circulation Aneurysms in Patients Less Than 40 Years Old.

Ruptured and unruptured aneurysms are less common in younger individuals compared to older patients. Endovascular treatment has gained popularity over surgical options in the general population, but surgery remains the primary treatment for younger patients due to concerns about higher recurrence rates with endovascular procedures. This study compared the immediate and long-term outcomes of endovascular treatment in patients under 40 years with those aged 41-60.

Acute hemicranial pain accompanied with a pearl and string type dissection of intracranial vertebral artery: Consideration for the time when to finish the medical observation.

The International Classification of Headache Disorder (ICHD) clearly guides the suspicion of intracranial vertebral artery dissection (ICVAD) in headache patients, but guidelines on how observational or imaging studies should be performed to detect dangerous progression early are unclear. Fifty-six cases with pearl and string type intracranial vertebral artery dissection were divided into 3 groups: 39 in the headache group, 6 in the infarction group, and 11 in the hemorrhagic group. Clinical and angiographic data were analyzed and compared.

Collateral estimation by susceptibility-weighted imaging and prediction of functional outcomes after acute anterior circulation ischemic stroke.

To determine the value of susceptibility-weighted imaging (SWI) for collateral estimation and for predicting functional outcomes after acute ischemic stroke. To identify independent predictors of favorable functional outcomes, age, sex, risk factors, baseline National Institutes of Health Stroke Scale (NIHSS) score, baseline diffusion-weighted imaging (DWI) lesion volume, site of steno-occlusion, SWI collateral grade, mode of treatment, and successful reperfusion were evaluated by multiple logistic regression analyses. A total of 152 participants were evaluated.

Collateral and permeability imaging derived from dynamic contrast material-enhanced MR angiography in prediction of PH 2 hemorrhagic transformation after acute ischemic stroke: a pilot study.

Purpose: To evaluate the role of collateral and permeability imaging derived from dynamic contrast material-enhanced magnetic resonance angiography to predict PH 2 hemorrhagic transformation in acute ischemic stroke.

Methods: The secondary analysis of a published data from participants with acute ischemic stroke. The multiphase collateral map and permeability imaging were generated by using dynamic signals from dynamic contrast material-enhanced magnetic resonance angiography obtained at admission.

Multiphase MR Angiography Collateral Map: Functional Outcome after Acute Anterior Circulation Ischemic Stroke.

Background Collateral circulation determines tissue fate and affects treatment result in acute ischemic stroke. A precise method for collateral estimation in an optimal imaging protocol is necessary to make an appropriate treatment decision for acute ischemic stroke. Purpose To verify the value of multiphase collateral imaging data sets (MR angiography collateral map) derived from dynamic contrast material-enhanced MR angiography for predicting functional outcomes after acute ischemic stroke.

Thrombocytopenia during intravenous valproic acid therapy in the neurological intensive care unit.

What Is Known And Objective: Thrombocytopenia is a common laboratory abnormality among critically ill patients under neurological intensive care unit (NCU) care. Valproic acid (VPA), a widely used antiepileptic drug, is one of the common causes of drug-induced thrombocytopenia. The purpose of this study was to estimate the incidence and risk factors of thrombocytopenia after intravenous VPA therapy among the patients admitted to NCU.

Complications Following Burr Hole Craniostomy and Closed-System Drainage for Subdural Lesions.

Objective: Burr hole craniostomy and closed-system drainage (BCD) is a common surgical procedure in the field of neurosurgery. However, complications following BCD have seldom been reported. The purpose of this study was to report our experiences regarding complications following BCD for subdural lesions.

Simple Coiling versus Stent-Assisted Coiling of Paraclinoid Aneurysms: Radiological Outcome in a Single Center Study.

Objective: Paraclinoid aneurysms are a group of aneurysms arising at the distal internal carotid artery. Due to a high incidence of small, wide-necked aneurysms in this zone, it is often challenging to achieve complete occlusion when solely using detachable coils, thus stent placement is often required. In the present study, we aimed to investigate the effect of stent placement in endovascular treatment of paraclinoid aneurysms.

Traumatic Pseudoaneurysm Related to Calcified Nodules of Cerebral Convexity Dura Mater in an American College Football Player.

Repeated concussion is common among football players; however, these minor blunt head trauma rarely result in serious complications. We report a case of a young college football player who presented acute subdural hematoma, cerebral edema, and seizure due to pseudoaneurysm rupture. The pseudoaneurysm, located at the cortical branch of the middle cerebral artery, was speculated to be formed by dural calcification and adhesion with the underlying brain, possibly due to repeated concussions.

Relationship between Gyrus Rectus Resection and Cognitive Impairment after Surgery for Ruptured Anterior Communicating Artery Aneurysms.

Objective: The gyrus rectus (GR) is known as a non-functional gyrus; hence, its resection is agreed to be a safe procedure frequently practiced to achieve a better surgical view during specific surgeries. This study aimed at comparing the cognitive outcomes following GR resection in patients who underwent surgery for ruptured anterior communicating artery (ACoA) aneurysms.

Materials And Methods: From 2012 to 2015, 39 patients underwent surgical clipping for ruptured ACoA aneurysms.

Association between genetic variation in the dopamine system and motor recovery after stroke.

Background: The dopamine system plays a key role in motor learning and neuroplasticity. Several studies have studied the efficacy of dopaminergic drugs in enhancing motor recovery after stroke, but the effects are controversial. Although genetic variations in plasticity-related genes influence each individual's capacity for recovery after stroke, limited studies have investigated the effects of polymorphism of dopamine-related genes.

Safety, Tolerability, and Pharmacokinetics of Fosphenytoin Loading in Patients With Subarachnoid Hemorrhage.

Objective: Fosphenytoin is frequently used for the rapid delivery of phenytoin in subarachnoid hemorrhage (SAH) patients. The present study was performed to investigate the safety, tolerability, and pharmacokinetic profiles of rapid intravenous loading of fosphenytoin in SAH patients.

Methods: Fosphenytoin was administered intravenously as a single loading dose of 20 mg phenytoin-equivalent/kg at an infusion rate of 150 mg PE/min to 30 adult patients with SAH, who experienced seizures or had a clinical suspicion of nonconvulsive seizures.

Enhanced efficacy of human brain-derived neural stem cells by transplantation of cell aggregates in a rat model of Parkinson's disease.

Objective: Neural tissue transplantation has been a promising strategy for the treatment of Parkinson's disease (PD). However, transplantation has the disadvantages of low-cell survival and/or development of dyskinesia. Transplantation of cell aggregates has the potential to overcome these problems, because the cells can extend their axons into the host brain and establish synaptic connections with host neurons.

Clinical characteristics of cerebral venous thrombosis in a single center in Korea.

Objective: The purpose of this study is to investigate the clinical characteristics of cerebral venous thrombosis (CVT) in a single center in Korea.

Methods: A total of 36 patients were diagnosed with CVT from August 2005 to May 2013. The patient data regarding age, sex, disease stage, pathogenesis, location, laboratory findings, radiological findings, and treatment modalities were retrospectively collected.

Post-carotid stenting reperfusion injury with blood-brain barrier disruption on gadolinium-enhanced FLAIR MRI.

Background: Following carotid revascularization, an abrupt increase in cerebral blood flow may disrupt the blood-brain barrier, resulting in reperfusion injury. This damage to the blood-brain barrier may be reflected by subarachnoid enhancement on FLAIR MRI after gadolinium injection.

Case Presentation: The authors present two cases of post-carotid stenting reperfusion injury that showed hyperintensity in the subarachnoid spaces on FLAIR MRI after gadolinium injection.

Atherosclerotic arterial wall change of non-stenotic intracracranial arteries on high-resolution MRI at 3.0T: Correlation with cerebrovascular risk factors and white matter hyperintensity.

Objective: Prior to detecting intracranial arterial stenosis, atherosclerotic wall change or plaque with positive remodeling can be evaluated with high-resolution MRI (HRMRI). We prospectively evaluate atherosclerotic arterial wall change in patients without intracranial stenosis using HRMRI at 3.0T and correlate the atherosclerotic change, cerebrovascular risk factors, and white matter hyperintensity (WMH).

Glomus tumor in the femoral nerve.

The glomus tumor of the peripheral nerve is one of the mesenchymal tumors originating in the epineurium, and is extremely rare. A 56-year-old man presented complaining of lancinating pain on the left thigh, which was provoked by pressure or exercise. Subsequent image study revealed a mass in the femoral nerve.

Galeal tack-up sutures to prevent subgaleal cerebrospinal fluid collection.

Objective: Postoperative subgaleal cerebrospinal fluid (CSF) collection is considered as one of the common minor surgical complication which can lead to prolonged hospitalization. We introduce "galeal tack-up suture" to prevent postoperative subgaleal CSF collection.

Methods: Galeal tack-up suture consists of various surgical techniques which aim to fix galea to cranium in order to prevent CSF pooling in subgaleal space.

Long-term outcome of vertebral artery origin stenosis in patients with acute ischemic stroke.

Background: Vertebral artery origin (VAO) stenosis is occasionally observed in patients who have acute ischemic stroke. We investigated the long-term outcomes and clinical significance of VAO stenosis in patients with acute ischemic stroke.

Methods: We performed a prospective observational study using a single stroke center registry to investigate the risk of recurrent stroke and vascular outcomes in patients with acute ischemic stroke and VAO stenosis.

Comparative Results of the Patients with Intracerebral and Intra-sylvian Hematoma in Ruptured Middle Cerebral Artery Aneurysms.

Objective: To clarify the prognosis of the patients with intra-sylvian hematoma (ISH) and intracerebral hematoma (ICH) in ruptured middle cerebral artery (MCA) aneurysms.

Methods: We categorized hematoma into ISH and ICH by the presence of intra-hematomal contrast enhancing vessel (IHCEV) on computed tomography angiography (CTA). Forty-four ruptured MCA aneurysm patients with ICH or ISH were grouped by the grading system proposed by the authors in our previous study.

Multimodal CT: favorable outcome factors in acute middle cerebral artery stroke with large artery occlusion.

Background: We investigated which parameters of multimodal computed tomography (CT) or their combinations might be useful as additional imaging predictors for favorable outcomes in acute stroke patients with large artery occlusion.

Methods: The parameters of multimodal CT, including non-enhanced CT, CT angiography, perfusion CT parameters, CT angiography source image (CTA-SI), and collateral flow, were analyzed in 66 consecutive patients with acute middle cerebral artery stroke with large artery occlusion. For favorable outcomes at the 3-month follow-up, odds ratios of multimodal CT parameters with an optimum predictive cut-off Alberta Stroke Program Early CT Score (ASPECTS) were assessed.

Eosinophilic myelitis in the cervical cord mimicking intramedullary cord tumor.

Eosinophilic myelitis (EM) or atopic myelitis is a rare disease characterized by a myelitic condition in the spinal cord combined with allergic process. This disease has specific features of elevated serum IgE level, active reaction to mite specific antigen and stepwise progression of mostly the sensory symptoms. Toxocariasis can be related with a form of EM.

Grading of intracerebral hemorrhage in ruptured middle cerebral artery aneurysms.

Objective: To propose grading of intracerebral hemorrhage (ICH) in ruptured middle cerebral artery (MCA) aneurysms, which helps to predict the prognosis more accurately.

Methods: From August 2005 to December 2010, 27 cases of emergent hematoma evacuation and aneurysm clipping for MCA aneurysms were done in the author's clinic. Three variables were considered in grading the ICH, which were 1) hematoma volume, 2) diffuse subarachnoid hemorrhage (SAH) that extends to the contralateral sylvian cistern, and 3) the presence of midline shifting from computed tomography findings.