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https://www.readbyqxmd.com/read/28919136/pilocytic-astrocytoma-mimicking-cavernous-angioma-imaging-features-and-histological-characteristics
#1
M Gaha, F Bouzayen, Y Limam, M Mokni, H Jemni-Gharbi, K Tlili-Graiess
Pilocytic astrocytoma (PA) commonly occurs during the first two decades of life. Typical locations include cerebellum, optic nerve, optic chiasm/hypothalamus and brainstem. PA should be considered in the differential diagnosis of patients with brain tumors manifesting with hemorrhagic onset. We report a case of a hemorrhagic onset of cerebellar PA in a young adult with imaging findings mimicking cavernous angioma. We also discuss imaging features and histological characteristics with a focus on the etiology of the hemorrhagic onset...
September 15, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28899830/simple-lateral-suboccipital-approach-and-modification-for-vertebral-artery-aneurysms-a-study-of-52-cases-over-10-years
#2
Mardjono Tjahjadi, Behnam Rezai-Jahromi, Joseph Serrone, Ville Nurminen, Joham Choque-Velasquez, Riku Kivisaari, Hanna Lehto, Mika Niemelä, Juha Hernesniemi
INTRODUCTION: Complex skull base approaches are frequently used to treat intracranial vertebral artery (VA) and proximal posterior inferior cerebellar artery (PICA) aneurysms. These complex procedures are associated with higher risk of neurovascular injury. Hence, a less invasive surgical approach is needed to improve treatment's efficacy and safety. MATERIAL AND METHODS: A retrospective analysis was conducted on clinical and radiological data from surgeries where simple lateral suboccipital and "lateral enough" approaches were used to clip VA aneurysms in the Department of Neurosurgery at Helsinki University Central Hospital from 2000 - 2009...
September 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28893126/a-case-with-coil-embolization-for-ruptured-aneurysm-associated-with-fenestration-of-the-posterior-inferior-cerebellar-artery
#3
Kazushi Maeda, Ryota Motoie, Satoshi Karashima, Ryosuke Otsuji, Nice Ren, Shintaro Nagaoka, Yoshiaki Ikai, Junji Uno, Hidefuku Gi
An 87-year-old man hospitalized for subarachnoid hemorrhage showed a ruptured aneurysm arising from fenestration of the posterior inferior cerebellar artery. Endovascular treatment was selected and the aneurysm and superior limb were embolized completely using three coils. Fenestration of the posterior cerebellar artery is exceedingly rare. In addition, we present a first case of aneurysm as fenestration of the posterior inferior cerebellar artery that was definitively identified as a cause of bleeding.
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28891898/vascular-anomalies-of-posterior-fossa-and-their-implications
#4
Rajani Singh, Raj Kumar, Arushi Kumar
Posterior fossa houses very vital and sensitive structures namely midbrain, pons, medulla, and cerebellum. These structures are irrigated by vertebral, posterior inferior cerebellar, anterior inferior cerebellar, and superior cerebellar arteries. Parts of brain located in posterior fossa control important parts of body so any variation pertaining to stenosis, atresia, hypoplasia, fenestration, agenesis, and duplication in the arteries supplying these parts alter the irrigation pattern culminating into various morbid and mortal neurologic disorders...
September 7, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28885973/hemorrhagic-stroke-in-a-young-healthy-male-following-use-of-pre-workout-supplement-animal-rage-xl
#5
Brandon F Harris, Coty Winn, Thomas B Ableman
So-called "pre-workout" supplements are substances marketed as natural dietary supplements with claims of helping athletes achieve more focused and intense workouts. The use of such products remains popular among American youth as a whole, but is especially high among active duty service members. Supplements are minimally regulated by the Food and Drug Administration (FDA), and unlike pharmaceuticals, supplements are often brought to market without any testing to show neither efficacy nor safety. Several case reports have documented serious adverse events and raise the question of whether supplement use was a causative factor...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28882465/remote-cerebellar-hemorrhage-caused-by-undetected-dural-tear-after-lumbar-spinal-surgery
#6
Estela Val-Jordán, Pilar Seral-Moral, Beatriz Novo-González
Remote cerebellar haemorrhage is a rare but serious complication after spinal surgery. Although the mechanism is not well known, it always occurs after loss of cerebrospinal fluid due to dural tear, not always identified, which produces remote venous bleeding. Prognosis depends largely on the severity of this bleeding. We report a case of 67-year-old female who suffered a cerebellar and subarachnoid haemorrhage and subdural haematoma after elective lumbar fusion surgery and eventually required decompressive craniectomy...
September 4, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28870822/radiological-features-and-surgical-strategy-of-hemangioblastomas-with-enhanced-cyst-wall
#7
Qiguang Wang, Si Zhang, Jian Cheng, Wenke Liu, Xuhui Hui
OBJECT: Hemangioblastomas with enhanced cyst wall represent a rare radiologic presentation of hemangioblastomas with poor understandings. We aimed to summarize the clinical and radiological features, important differential diagnosis, surgical strategy and clinical outcome of this rare entity. METHODS: From June 2008 to March 2017, twelve patients suffered from cystic hemangioblastomas presenting with enhanced wall thickness on MRI were treated in our department...
September 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28862551/isolated-abducens-nerve-palsy-associated-with-subarachnoid-hemorrhage-a-localizing-sign-of-ruptured-posterior-inferior-cerebellar-artery-aneurysms
#8
Jan-Karl Burkhardt, Ethan A Winkler, George F Lasker, John K Yue, Michael T Lawton
OBJECTIVE Compressive cranial nerve syndromes can be useful bedside clues to the diagnosis of an enlarging intracranial aneurysm and can also guide subsequent evaluation, as with an acute oculomotor nerve (cranial nerve [CN] III) palsy that is presumed to be a posterior communicating artery aneurysm and a surgical emergency until proven otherwise. The CN VI has a short cisternal segment from the pontomedullary sulcus to Dorello's canal, remote from most PICA aneurysms but in the hemodynamic pathway of a rupturing PICA aneurysm that projects toward Dorello's canal...
September 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28852709/ataxia-pancytopenia-syndrome-with-samd9l-mutations
#9
Sorina Gorcenco, Jonna Komulainen-Ebrahim, Karin Nordborg, Maria Suo-Palosaari, Sten Andréasson, Johanna Krüger, Christer Nilsson, Ulrika Kjellström, Elisa Rahikkala, Dominik Turkiewicz, Mikael Karlberg, Lars Nilsson, Jörg Cammenga, Ulf Tedgård, Josef Davidsson, Johanna Uusimaa, Andreas Puschmann
OBJECTIVE: We describe the neurologic, neuroradiologic, and ophthalmologic phenotype of 1 Swedish and 1 Finnish family with autosomal dominant ataxia-pancytopenia (ATXPC) syndrome and SAMD9L mutations. METHODS: Members of these families with germline SAMD9L c.2956C>T, p.Arg986Cys, or c.2672T>C, p.Ile891Thr mutations underwent structured interviews and neurologic and ophthalmologic examinations. Neuroimaging was performed, and medical records were reviewed...
October 2017: Neurology. Genetics
https://www.readbyqxmd.com/read/28799869/predictive-factors-of-medullary-infarction-after-endovascular-internal-trapping-using-coils-for-vertebral-artery-dissecting-aneurysms
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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...
September 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
#16
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
#17
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
#18
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
#19
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
#20
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
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