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https://www.readbyqxmd.com/read/28799869/predictive-factors-of-medullary-infarction-after-endovascular-internal-trapping-using-coils-for-vertebral-artery-dissecting-aneurysms
#1
Masanori Aihara, Isao Naito, Tatsuya Shimizu, Masahiro Matsumoto, Ken Asakura, Naoko Miyamoto, Yuhei Yoshimoto
OBJECTIVE The first choice of treatment in cases of vertebral artery dissecting aneurysms (VADAs) is endovascular internal trapping (EIT) of the dissecting segment using coils. However, this procedure carries the risk of medullary infarction, and the risk factors for this complication are not well understood. This study investigated the risk factors causing medullary infarction. METHODS One hundred patients who underwent EIT for VADAs were included in this study. Ninety-three patients presented with subarachnoid hemorrhage...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28790218/-an-extracranial-aneurysm-in-the-distal-posterior-inferior-cerebellar-artery-located-at-the-tonsillomedullary-segment-case-report-and-review-of-the-literature
#2
Nao Shimooka, Shigenori Taketsuna, Shiromaru Ishida, Kensaku Senda, Masato Kawai
We report a rare case of subarachnoid hemorrhage(SAH)due to ruptured extracranial aneurysm originating at the caudal loop of the left posterior inferior cerebellar artery(PICA). A 50-year-old woman presented with severe headache and mild consciousness disturbance. Computed tomography(CT)revealed SAH and intraventricular hemorrhage. Vertebral angiography showed an extracranial aneurysm located on the tonsillomedullary segment of the left PICA. During the surgery, no vessel branches were confirmed near the aneurysm, and the aneurysm was successfully clipped through suboccipital craniotomy with C1 laminectomy...
August 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28790216/-a-case-of-tentorial-dural-arteriovenous-fistula-treated-with-transvenous-embolization-using-nbca
#3
Hirokazu Nishiyama, Hiroyuki Matsumoto, Yoshiaki Tetsuo, Hideki Takemoto, Naoyuki Nakao
We report a case of tentorial dural arteriovenous fistula(dAVF)treated with transarterial and transvenous embolization using n-butyl-2-cyanoacrylate(NBCA). A 70-year-old man presented with dysarthria and trunk ataxia. Computed tomography(CT)on admission revealed right cerebellar hemorrhage. Right external carotid angiography demonstrated a tentorial dAVF fed by the marginal tentorial artery, petrosquamous branch of the middle meningeal artery, ascending pharyngeal artery, and artery of foramen rotundum. Right internal carotid angiography demonstrated a shunt fed by the meningohypophyseal trunk...
August 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28756984/a-55-year-old-female-with-leukoencephalopathy-with-cerebral-calcifications-and-cysts-case-report-and-radiopathologic-description
#4
Jorge Novo, Diana Lin, Megan Shanks, Mehmet Kocak, Leonidas Arvanitis
Adult-onset leukoencephalopathies with increased cerebral volume can present a potentially challenging diagnosis for the pathologist. We present the case of a patient with a rare adult-onset disease called Leukoencephalopathy with cerebral Calcifications and Cysts (LCC). A 55-year-old woman with a history of morning headaches, mild memory loss, diabetes, and hypertension presented to the emergency department with acute onset altered mental status. CT scan revealed multiple small hypodense lesions in the white matter with calcifications in the bilateral cerebral hemispheres, basal ganglia, pons, and cerebellar hemispheres...
July 6, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28744689/pediatric-cerebellar-giant-cavernous-malformation-case-report-and-review-of-literature
#5
Javier Villaseñor-Ledezma, Marcelo Budke, Juan-Antonio Alvarez-Salgado, María-Angeles Cañizares, Luis Moreno, Francisco Villarejo
BACKGROUND AND IMPORTANCE: Giant cavernous malformations (GCM) are low flow, angiographically occult vascular lesions, with a diameter >4 cm. Cerebellar GCMs are extremely rare, with only seven cases reported based on English literature. These lesions are most commonly seen in the pediatric age group, which is known to have an increased risk of hemorrhage, being surgery clearly recommended. CLINICAL PRESENTATION: An 18-month-old girl presented with a 6-month history of cervical torticollis and upper extremities clumsiness...
July 25, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28742248/biallelic-col3a1-mutations-result-in-a-clinical-spectrum-of-specific-structural-brain-anomalies-and-connective-tissue-abnormalities
#6
Denise Horn, Eberhard Siebert, Ulrich Seidel, Imma Rost, Karin Mayer, Rami Abou Jamra, Diana Mitter, Uwe Kornak
Vascular Ehlers-Danlos syndrome (type IV) is an autosomal dominant disorder caused by heterozygous variants of COL3A1. We identified biallelic COL3A1 variants in two unrelated families. In a 3-year-old female with developmental delay the nonsense variant c.1282C>T, p.(Arg428*) was detected in combination the c.2057delC, p.(Pro686Leufs*105) frame shift variant. Both compound heterozygous variants were novel. This patient was born with bilateral clubfoot, joint laxity, and dysmorphic facial features. At the age of 2 years she developed an aneurysmal brain hemorrhage...
July 25, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28741720/alteplase-for-acute-ischemic-stroke-after-heparin-reversal-with-protamine-a-case-report-and-review
#7
Gabriel V Fontaine, Shawn M Smith
BACKGROUND: Few patients presenting with acute ischemic stroke (AIS) are eligible for alteplase, especially those receiving ongoing anticoagulation. We describe the first reported case of a patient receiving full-dose intravenous (IV) alteplase for AIS after heparin reversal with protamine. CASE: A 73-year-old male presented with AIS. He was treated with IV heparin, tirofiban, loading-dose prasugrel, and aspirin prior to percutaneous coronary intervention (PCI) for placement of a right coronary artery stent...
July 25, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28735123/surgery-for-cerebellar-hemorrhage-a-nsqip-database-analysis-of-patient-outcomes-and-factors-associated-with-30-day-mortality-and-prolonged-ventilation
#8
Gregory D Arnone, Darian R Esfahani, Matt Wonais, Prateek Kumar, Justin K Scheer, Ali Alaraj, Sepideh Amin-Hanjani, Fady T Charbel, Ankit I Mehta
OBJECTIVE: Primary cerebellar hemorrhage accounts for 10% of all intracranial hemorrhages. Given the confined space of the posterior fossa, cerebellar hemorrhage management sometimes necessitates suboccipital decompression and hematoma evacuation. In this study, we examine outcomes following surgery for primary cerebellar hemorrhage, and identify risk factors associated with adverse outcomes. METHODS: A retrospective review of the 2005-2014 ACS-NSQIP database was performed, with CPT Code 61315 (suboccipital craniectomy or craniotomy for evacuation of cerebellar hemorrhage) queried between 2005 and 2014...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28728535/endovascular-occlusion-of-pial-arteriovenous-macrofistulae-using-pcanvas1-and-adenosine-induced-asystole-to-control-nbca-injection
#9
P Lylyk, J Chudyk, C Bleise, C Serna Candel, M Aguilar Pérez, H Henkes
Background In large-caliber pial macrofistulae (pMF), the combination of high blood flow velocity and large efferent artery diameter makes control over the endovascular vessel occlusion difficult and may result in the inadvertent venous passage of occlusive devices or embolic agents. Case descriptions Patient 1: A 27-year-old man presented with headache and ataxia. An infratentorial pMF supplied by both superior cerebellar arteries with venous ectasia was found. The first treatment attempt using balloons and coils failed since the position of either device could not be controlled because of a distal diameter of the feeding artery of 8 mm...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28727900/head-midline-position-for-preventing-the-occurrence-or-extension-of-germinal-matrix-intraventricular-hemorrhage-in-preterm-infants
#10
REVIEW
Olga Romantsik, Maria Grazia Calevo, Matteo Bruschettini
BACKGROUND: Preterm birth is known to constitute the major risk factor for development of germinal matrix-intraventricular hemorrhage (GM-IVH). Head position may affect cerebral hemodynamics and thus may be involved indirectly in development of GM-IVH. Turning the head toward one side may functionally occlude jugular venous drainage on the ipsilateral side while increasing intracranial pressure and cerebral blood volume. Thus, it has been suggested that cerebral venous pressure is reduced and hydrostatic brain drainage improved if the patient is in supine midline position with the bed tilted 30°...
July 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28720746/-a-rare-case-of-ruptured-internal-carotid-posterior-communicating-artery-aneurysm-associated-with-contralateral-delayed-oculomotor-nerve-palsy
#11
Chika Somagawa, Yutaka Fukuda, Shota Yoshimura, Kei Satoh, Takeshi Hiu, Tomonori Ono, Ryujirou Ushijima, Keisuke Toda, Keisuke Tsutsumi
A 55-year-old man presented with difficulty breathing, chest pain, and disturbance of consciousness, and was transferred to our hospital. Initial whole body CT revealed a diffuse subarachnoid hemorrhage(SAH)with severe pulmonary edema that was considered neurogenic in origin. He received controlled ventilation under sedation and conservative care for the SAH. One day after the onset of the SAH, his left pupil suddenly became dilated to 6mm, with no reaction to light. Head CT showed no new bleeding. Subsequent CT angiogram revealed a right internal carotid-posterior communicating artery aneurysm(IC-PC AN)with a posterior-lateral projection; however, no vessel abnormality was observed in the left anterior or posterior circulations...
July 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28713626/recurrent-hemorrhage-in-hemangioblastoma-involving-the-posterior-fossa-case-report
#12
Eric Marvin, Asad S Akhter, Jeroen R Coppens
BACKGROUND: Hemangioblastomas (HGBs) are the most common primary intra-axial posterior fossa tumor in adults. Although spontaneous hemorrhage of these tumors is exceedingly rare, despite their vascular nature, we describe a case of recurrent hemorrhage with associated tonsillar herniation, and demonstrate that a surgical approach can provide a suitable outcome. CASE DESCRIPTION: A 54-year-old female with von Hippel-Lindau (VHL) syndrome presented with acute loss of consciousness and Glasgow Coma Scale (GCS) was 4...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28712903/multimodality-treatment-of-posterior-inferior-cerebellar-artery-aneurysms
#13
Justin R Mascitelli, Kurt Yaeger, Daniel Wei, Christopher P Kellner, Thomas J Oxley, Reade A De Leacy, Johanna T Fifi, Aman B Patel, Thomas P Naidich, Joshua B Bederson, J Mocco
OBJECT: Posterior inferior cerebellar artery (PICA) aneurysms are heterogeneous, uncommon lesions that can be treated in many fashions. Many previous series have focused on a specific aneurysm subset or treatment paradigm. The aim of this study was to present a comprehensive approach for all PICA aneurysms and analyze outcomes by PICA location. METHODS: All PICA aneurysms treated from 2012 until present were reviewed retrospectively and classified by location. Angiographic and clinical outcome were assessed...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28711532/an-intraoperative-look-at-a-residual-recurrent-tentorial-dural-arteriovenous-fistula
#14
Bradley A Gross, Andrew F Ducruet, Brian T Jankowitz, Paul A Gardner
BACKGROUND: Dural arteriovenous fistulas (dAVFs) often are treated via transarterial or transvenous embolization. Incomplete penetration of the draining vein/occult residual often will become apparent on follow-up angiography, requiring repeat embolization, or at times, surgical resection. CASE DESCRIPTION: A 41-year-old woman presented with cerebellar hemorrhage from a tentorial dAVF treated with transvenous coil embolization. Follow-up angiography disclosed a residual/recurrent fistula treated with transvenous Onyx embolization...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28706504/hypertrophic-olivary-degeneration-and-palatal-or-oculopalatal-tremor
#15
REVIEW
Caroline Tilikete, Virginie Desestret
Hypertrophic degeneration of the inferior olive is mainly observed in patients developing palatal tremor (PT) or oculopalatal tremor (OPT). This syndrome manifests as a synchronous tremor of the palate (PT) and/or eyes (OPT) that may also involve other muscles from the branchial arches. It is associated with hypertrophic inferior olivary degeneration that is characterized by enlarged and vacuolated neurons, increased number and size of astrocytes, severe fibrillary gliosis, and demyelination. It appears on MRI as an increased T2/FLAIR signal intensity and enlargement of the inferior olive...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28700676/imaging-features-of-intracerebral-hemorrhage-with-cerebral-amyloid-angiopathy-systematic-review-and-meta-analysis
#16
Neshika Samarasekera, Mark Alexander Rodrigues, Pheng Shiew Toh, Rustam Al-Shahi Salman
BACKGROUND: We sought to summarize Computed Tomography (CT)/Magnetic Resonance Imaging (MRI) features of intracerebral hemorrhage (ICH) associated with cerebral amyloid angiopathy (CAA) in published observational radio-pathological studies. METHODS: In November 2016, two authors searched OVID Medline (1946-), Embase (1974-) and relevant bibliographies for studies of imaging features of lobar or cerebellar ICH with pathologically proven CAA ("CAA-associated ICH")...
2017: PloS One
https://www.readbyqxmd.com/read/28696174/bilateral-lateral-ventricular-subependymoma-with-extensive-multiplicity-presenting-with-hemorrhage
#17
F M Moinuddin, Novita Ikbar Khairunnisa, Hirofumi Hirano, Tomoko Hanada, Tsubasa Hiraki, Mari Kirishima, Kiyohisa Kamimura, Kazunori Arita
This 48-year-old-man who had undergone right thyroid lobectomy for undifferentiated thyroid carcinoma nine years earlier developed generalized seizures. His cerebrospinal fluid was xanthochromic with elevation of total protein. Computed tomography (CT) showed mixed-density bilateral ventricular masses. Magnetic resonance imaging (MRI) revealed multiple nodules in both lateral ventricles; they were heterogeneously enhanced by gadolinium. Diffuse hyperintensity in the right medial temporal lobe and bilateral subependymal area was noted on fluid-attenuated inversion recovery images...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28680780/immediate-remote-cerebellar-hemorrhage-and-seizure-following-revision-lumbosacral-fusion
#18
Alvin Y Chan, Jeffrey P Mullin, Edward Benzel, William Bingaman
Cerebellar hemorrhage (CH) is a rare but devastating complication following spine surgery. It is associated with a compromise to dura integrity and typically has a delayed post-operative onset. Here, we describe a patient who suffered a CH that presented with a generalized tonic-clonic (GTC) seizure immediately after a revision lumbar fusion. The patient did not regain consciousness from anesthesia prior to the hemorrhage. There are no reports indicating that CHs can occur abruptly following a spine surgery...
May 30, 2017: Curēus
https://www.readbyqxmd.com/read/28674367/neuromyelitis-optica-spectrum-disorder-with-recurrent-intracranial-hemorrhage
#19
Hiroaki Yaguchi, Yasunori Mito, Ikkei Ohashi, Taichi Nomura, Ichiro Yabe, Yasutaka Tajima
The patient was a woman without hypertension who had previously experienced intracranial hemorrhage twice at 48 and 56 years of age. At 59 years of age, she was diagnosed with neuromyelitis optica spectrum disorder (NMOSD) based on the presence of a brain stem lesion and the detection of anti-aquaporin 4 (AQP4) antibodies. After 5 months of continuous treatment with prednisolone (15 mg/day), she presented with optic neuritis and intracranial bleeding. A recurrent attack of NMOSD and intracranial hemorrhage were concurrently diagnosed...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28664015/central-hypoventilation-syndrome-complicated-with-lateral-medullary-infarction-after-endovascular-treatment-of-the-vertebral-artery-dissecting-aneurysm-a-case-report
#20
Katsuhiro Tanaka, Hideki Kanamaru, Atsunori Morikawa, Kenji Kawaguchi
Lateral medullary infarction rarely leads to central hypoventilation syndrome (CHS). CHS is a life-threatening disorder characterized by hypoventilation during sleep. We report the first case of CHS as a complication of lateral medullary infarction after endovascular treatment. A 65-year-old man presented twice with severe headache. Computed tomography revealed subarachnoid hemorrhage and cerebral angiography showed a right vertebral dissecting aneurysm involving the posterior inferior cerebellar artery. After emergent endovascular patent artery occlusion, he developed Wallenberg syndrome and experienced apnea and a conscious disturbance episode due to CHS on postoperative days 6 and 16...
October 2016: NMC Case Rep J
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