Journal of Vascular and Interventional Neurology

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The TNF-α antagonists are the drugs used for the treatment of ulcerative colitis (UC). Nontraumatic convexity subarachnoid hemorrhage is an infrequent nonaneurysmal subtype of subarachnoid bleeding caused mainly by reversible cerebral vasoconstriction syndrome (RCVS), cerebral amyloid angiopathy, and posterior reversible encephalopathy syndrome (PRES). We present a 26-year-old female patient with a diagnosis of UC taking Adalimumab. She received her last doses the same day she was admitted to our hospital for an acute severe UC exacerbation...

Objective: We report a case of dural arteriovenous fistula (dAVF) presenting as isolated cerebral aqueduct hemorrhage. Result: A 73-year-old man with a history of hypertension and chronic alcoholism presented with altered mental status and gait difficulties, bilateral fronto-occipital headaches, and intermittent dizziness. He had bilateral upward gaze restriction. Computerized tomography scan showed hyperdensity in the cerebral aqueduct and dilation of the lateral and third ventricles...

Background and Purpose: Cervical artery dissections, which may be traumatic or spontaneous, account for a significant proportion of strokes in the young. Antithrombotic therapy is the mainstay of treatment, but new oral anticoagulants could be an alternative treatment to the optimal strategy of anticoagulation followed by antiplatelet drugs. Summary of Case: We report the case of a 40-year-old patient with a spontaneous vertebral artery dissection who developed a cerebellar ischemic stroke, who had a favorable outcome and complete vessel recanalization after three months of treatment with the oral factor Xa inhibitor rivaroxaban...

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Purpose: Head and neck arteriovenous malformation (AVM) and fistulae treatment without reflux and with nidal penetration are challenging. We describe a case series including adult and pediatric patients utilizing a specific two-microcatheter technique using Onyx with strategic embolization of small feeding branches prior to dominant branch embolization. We aim to demonstrate the safety and efficacy of this technique. Methods: <AbstractText Label="Patient Selection" NlmCategory="UNASSIGNED">Head and neck vascular malformation cases were reviewed from 2010 to 2017...

Orthognathic surgeries such as Le Fort I are widely used in clinical practice. Postoperative internal maxillary artery pseudoaneurysm is a very rare complication, which can lead to significant postoperative bleeding. In this article, we report a case of early postoperative bleeding secondary to pseudoaneurysm following Le Fort I surgery with a novel endovascular treatment approach.

OBJECTIVE: To assess the effectiveness of cilostazol, a selective inhibitor of phosphodiesterase type III, in preventing cerebral ischemia related to cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH). METHODS: A total of six clinical studies met the inclusion criteria and were included in the meta-analysis. We calculated pooled risk ratios (RR) and 95% confidence intervals (CI) using random-effects models. The primary endpoint was cerebral ischemia related to vasospasm...

Background: Hereditary multiple exostoses (HME) is an inherited genetic condition, characterized by the formation of multiple osteochondromas, developing throughout childhood and into puberty. Vascular complications associated with HME are uncommon. Methods: A case of a patient with HME who was admitted to hospital with subarachnoid hemorrhage (SAH), as a result of acute rupture of a basilar tip aneurysm (BTA), will be presented. Relevant literature on this topic will be systematically reviewed...

An anomalous origin of the right vertebral artery is rare. The left vertebral artery from the aortic arch is where most of the anomalies occur. The next is an origin of the right vertebral artery from the right common carotid artery in association with the aberrant right subclavian artery. However, independent anomalous origin of the right vertebral artery from the right common carotid artery has not been well known in the previous literature. We present this anomaly, and able to understand the mechanism of the occurrence by embryological knowledge...

Purpose: We evaluated carotid cavernous fistula (CCF) cases which were treated with various vascular routes and different embolization agents. Our aim was to present endovascular treatment procedures, clinical and radiological findings, and to discuss the safety and clinical efficacy of the treatment. Materials and Methods: The demographic information, presenting symptoms and clinical findings of 25 CCF cases in 23 patients treated with endovascular route were reviewed...

INTRODUCTION: Dabigatran is one of the nonvitamin K antagonist oral anticoagulants. Thrombolytic treatment with intravenous recombinant tissue plasminogen activator is contraindicated in patients taking a DOAC. Idarucizumab was recently approved for dabigatran-activity reversing in severe bleeding, emergency surgery, or urgent procedures, but many attempts have been made to use idarucizumab in patients presenting with acute ischemic stroke in order to be eligible for thrombolysis. CASE: Our patient was an 89-year-old woman with severe aphasia who was treated with dabigatran for nonvalvular atrial fibrillation...

Background: Thrombectomy has become established as a successful treatment strategy for ischemic stroke, and consequently, more patients are undergoing this procedure. Due to comorbid conditions, chronic disease states, and advanced age, many patients have anatomy which complicates revascularization, specifically difficult aortic arch anatomy, or tortuous common and internal artery anatomy, or both. Methods: In the present study, these unfavorable anatomic parameters were analyzed for 53 patients undergoing acute thrombectomy for ischemic stroke...

Background: Recognition of stroke warning signs and risk factors reduces prehospital delay and increases stroke survival. The goal of this study was to evaluate the public knowledge of stroke warning signs and risk factors in a rural area in Central Pennsylvania. Materials and Methods: In this study, the 2016 Sullivan County Health Fair attendees in central Pennsylvania answered a structured close-ended multiple choice questionnaire about stroke warning signs and risk factors...

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Background: Stroke ranks as the second leading cause of death and the leading cause of morbidity worldwide. Large intracranial arterial stenosis (ICAS) is a major cause of stroke. Methods: This study investigated the prevalence and associated vascular risk factors of ICAS in a high-risk population in Qalyeubia Governorate, Egypt. A cross-sectional pilot survey using transcranial Doppler (TCD) was conducted at Toukh Central Hospital and Aghore El-qubra primary healthcare units in the Qalyeubia Governorate from 1 January 2016 until the end of June 2016...

We described an 88-year-old woman presented with large aneurysm on the carotid siphon of the right internal carotid artery (ICA). Digital subtraction angiography showed extravasation from the distal cervical segment of the right ICA due to positioning a guiding catheter for intra-aneurysmal coil embolization. Transoral carotid ultrasonography (TOCU) showed arrested bleeding and a pseudolumen in the distal cervical segment of the right ICA. We originally described that TOCU was useful for evaluating iatrogenic extravasation and extracranial ICA dissection during neurointervention...

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Objective: To test the effectiveness of topical EMLA cream (lidocaine 2.5% and prilocaine 2.5%) for pain control during femoral artery catheterization for neuro-endovascular procedures in adult patients. Methods: The body habitus overlying the femoral arterial pulsation was graded as: (1) pubic symphysis and iliac crest bone protuberances visualized; (2) Pubic Symphysis and Iliac Crest bone protuberances not seen but easily palpable; (3) Pubic Symphysis and Iliac Crest bone protuberances palpable with considerable difficulty; and (4) abdominal layers fold over the femoral region...

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