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Intracranial OR Aneurysm Neuro*

Vivek Sudhakar, Amin Mahmoodi, John R Bringas, Jerusha Naidoo, Adrian Kells, Lluis Samaranch, Massimo S Fiandaca, Krystof S Bankiewicz
OBJECTIVESuccessful convection-enhanced delivery of therapeutic agents to subcortical brain structures requires accurate cannula placement. Stereotactic guiding devices have been developed to accurately target brain nuclei. However, technologies remain limited by a lack of MRI compatibility, or by devices' size, making them suboptimal for direct gene delivery to brain parenchyma. The goal of this study was to validate the accuracy of a novel frameless skull-mounted ball-joint guide array (BJGA) in targeting the nonhuman primate (NHP) brain...
February 15, 2019: Journal of Neurosurgery
Zongze Li, Junlin Lu, Li Ma, Chunxue Wu, Zongsheng Xu, Xiaolin Chen, Xun Ye, Rong Wang, Yuanli Zhao
OBJECTIVEPostoperative neurological deficits impair the overall outcome of revascularization surgery for patients with moyamoya disease (MMD). dl-3-n-butylphthalide (NBP) is approved for the treatment of ischemic stroke in China. This pilot study evaluated the effect of NBP on perioperative stroke and neurological deficits in patients with MMD.METHODSThe authors studied cases in which patients underwent combined revascularization surgery for MMD at their institution, with or without NBP administration. The overall study group included 164 patients (213 surgically treated hemispheres), including 49 patients who received NBP (25 mg twice daily) for 7 postoperative days...
February 15, 2019: Journal of Neurosurgery
Goji Fushihara, Tomoya Kamide, Tatsuki Kimura, Ririko Takeda, Toshiki Ikeda, Yuichiro Kikkawa, Ryuichiro Araki, Hiroki Kurita
OBJECTIVE: The aim of the study was to better define the incidence of and risk factors for early seizures after repair of unruptured intracranial aneurysms in modern microsurgical techniques. PATIENTS AND METHODS: The medical records of 414 consecutive patients who underwent neck clipping of unruptured intracranial aneurysms in our institution over a 5-year period were retrospectively reviewed. Clinical and neuroimaging variables were analyzed to investigate putative predictors of perioperative seizures using multivariate logistic regression analysis...
February 8, 2019: Clinical Neurology and Neurosurgery
Richard Voldřich, Martin Májovský, Martin Chovanec, David Netuka
BACKGROUND: Pneumocephalus is commonly associated with cranial trauma including surgical interventions. Spontaneous pneumocephalus on the other hand is a rare diagnosis. Reported cases were predominantly unilateral. We report unique case of a bilateral spontaneous pneumocephalus probably related to bilateral tegmen defect related to repeated Politzer maneuvers. CASE DESCRIPTION: A 78-year-old man suffered from vertigo, tinnitus, instability and mild expressive aphasia...
February 13, 2019: World Neurosurgery
Philip A Sosa, Phillip Matar, Isabel T Gross
BACKGROUND: Extracranial carotid aneurysms in children are extremely rare but carry a high mortality and morbidity. For pediatric patients, they are often complications of pharyngeal infections and surgical trauma but can also arise from congenital and inflammatory diseases. They have a wide range of presentation from an asymptomatic mass to a rapidly fatal hemorrhage. CASE: A 10-year-old boy presented to the emergency department with complaints of a neck mass and residual cough from a recent upper respiratory infection...
February 13, 2019: Pediatric Emergency Care
Alexander Lilja-Cyron, Morten Andresen, Jesper Kelsen, Trine Hjorslev Andreasen, Kåre Fugleholm, Marianne Juhler
BACKGROUND: Decompressive craniectomy (DC) is used in cases of severe intracranial hypertension or impending intracranial herniation. DC effectively lowers intracranial pressure (ICP) but carries a risk of severe complications related to abnormal ICP and/or cerebrospinal fluid (CSF) circulation, eg, hygroma formation, hydrocephalus, and "syndrome of the trephined." OBJECTIVE: To study the long-term effect of DC on ICP, postural ICP regulation, and intracranial pulse wave amplitude (PWA)...
February 15, 2019: Neurosurgery
Krista J Spiller, Guo-Hua Bi, Yi He, Ewa Galaj, Eliot L Gardner, Zheng-Xiong Xi
BACKGROUND AND PURPOSE: Endocannabinoids are critically involved in brain reward functions. This is generally believed to be mediated by activation of CB1 receptors, in large part due to their high density in the brain. However, the recent discovery of CB2 receptors (CB2 R) in the brain, particularly in midbrain dopamine neurons, has challenged this view and inspired us to re-examine the roles of both CB1 R and CB2 R in the effects of cannabis. EXPERIMENTAL APPROACH: In the present study, we used the electrical intracranial self-stimulation (ICSS) paradigm to evaluate the effects of various cannabinoid drugs on brain reward in laboratory rats, and the roles of CB1 R and CB2 R activation in brain reward function(s)...
February 14, 2019: British Journal of Pharmacology
Vinita Gupta, Kirti Aggarwal, Prateek Nishant, Rajnish Kumar Arora
We hereby report a case of metastatic Ewing's sarcoma presenting with rapid-onset total ophthalmoplegia, optic atrophy, and right temporal hemianopia. Comprehensive ophthalmic and neurological evaluation with targeted radioimaging revealed a tumor mass centered over the sella, compressing optic chiasma, extending to involve the left cavernous sinus and the left orbital apex. Whole-body imaging revealed the evidence of multifocal lung and mediastinal metastasis with focal lytic defect in the left femoral head...
January 2019: Journal of Neurosciences in Rural Practice
Chin Taweesomboonyat, Thara Tunthanathip, Sakchai Sae-Heng, Thakul Oearsakul
Background: With the advancement of neuronavigation technologies, frameless stereotactic brain biopsy has been developed. Previous studies proved that frameless stereotactic brain biopsy was as effective and safe as frame-based stereotactic brain biopsy. The authors aimed to find the factors associated with diagnostic yield and complication rate of frameless intracranial biopsy. Materials and Methods: Frameless stereotactic brain biopsy procedures, between March 2009 and April 2017, were retrospectively reviewed from medical records including imaging studies...
January 2019: Journal of Neurosciences in Rural Practice
Anil C Anand, Pankaj Singh
Neurologic dysfunction characterised by Hepatic Encephalopathy (HE) and cerebral oedema are the most dramatic presentations of Acute Liver Failure (ALF) and signify poor outcome. Improved critical care and wider availability of emergency Liver Transplantation (LT) has improved survivability in ALF. In most cases absence of clinically overt encephalopathy after spontaneous recovery from ALF or after LT is thought to indicate complete neurologic recovery. Recent data suggests that neurologic recovery may not always be complete...
January 2019: Journal of Clinical and Experimental Hepatology
Martin Seeber, Lucia-Manuela Cantonas, Mauritius Hoevels, Thibaut Sesia, Veerle Visser-Vandewalle, Christoph M Michel
Subcortical neuronal activity is highly relevant for mediating communication in large-scale brain networks. While electroencephalographic (EEG) recordings provide appropriate temporal resolution and coverage to study whole brain dynamics, the feasibility to detect subcortical signals is a matter of debate. Here, we investigate if scalp EEG can detect and correctly localize signals recorded with intracranial electrodes placed in the centromedial thalamus, and in the nucleus accumbens. Externalization of deep brain stimulation (DBS) electrodes, placed in these regions, provides the unique opportunity to record subcortical activity simultaneously with high-density (256 channel) scalp EEG...
February 14, 2019: Nature Communications
Wei-Ting Wu, Hsiu-Yung Pan, Kuan-Han Wu, Yi-Syun Huang, Chien-Hung Wu, Fu-Jen Cheng
BACKGROUND: Subarachnoid hemorrhage (SAH) is a serious cause of headaches. The Ottawa subarachnoid hemorrhage (OSAH) rule helps identify SAH in patients with acute nontraumatic headache with high sensitivity, but provides limited information for identifying other intracranial pathology (ICP). OBJECTIVES: To assess the performance of the OSAH rule in emergency department (ED) headache patients and evaluate its impact on the diagnosis of intracranial hemorrhage (ICH) and other ICP...
February 7, 2019: American Journal of Emergency Medicine
Suwarna Chakraborty, Sunil Jamuna Tripathi, B N Srikumar, T R Raju, B S Shankaranarayana Rao
BACKGROUND: Major depressive disorder (MDD) is a multifactorial disease which often coexists with cognitive deficits. Depression-induced cognitive deficits are known to be associated with aberrant reward processing, neurochemical and structural alterations. Recent studies have shown that chronic electrical stimulation of brain reward areas induces a robust antidepressant effect. However, the effects of repeated electrical self-stimulation of lateral hypothalamus - medial forebrain bundle (LH-MFB) on depression-induced cognitive deficits and associated neurochemical and structural alterations in the prefrontal cortex (PFC) are unknown...
January 31, 2019: Brain Stimulation
Mindy X Wang, Garrett Smith, Mehmet Albayram
Spinal cord watershed ischemia is a rare phenomenon often associated with cardiac arrest, prolonged hypotension, and atherosclerotic disease. It can manifest as central necrosis with peripheral sparing in the transverse axis, and central lesion with rostral and caudal sparing in the longitudinal axis. Few reports provide detailed imaging findings of spinal cord watershed ischemia lesions. We present a patient who experienced watershed infarcts of the brain and spinal cord following prolonged hypotension due to blood loss after an aortic aneurysm repair...
January 31, 2019: Clinical Imaging
Sher-Lyn Tham, Yuxin Guo, Jack Kian Chng
BACKGROUND: Axillary artery aneurysms necessitate repair due to potential neurovascular complications. With increasing endovascular interventions for these uncommon lesions, there is a need to evaluate their usage against conventional open repair. CASE: We discuss the management of two patients with symptomatic axillary artery aneurysms who presented to our institution. The first case is a 52 year-old lady with an enlarging left pulsatile mass, later found to be an axillary artery aneurysm, who underwent an open aneurysmal resection and interposition grafting...
February 11, 2019: Annals of Vascular Surgery
Liang Jiang, Yu-Chen Chen, Hong Zhang, Mingyang Peng, Huiyou Chen, Wen Geng, Quan Xu, Xindao Yin, Yuehu Ma
PURPOSE: Fluid-attenuated inversion recovery vascular hyperintensity (FVH) is frequently found in stroke patients after intracranial arterial occlusion, but the prognostic value of FVH findings is unclear. We assessed whether FVH is associated with cerebral collateral status and functional outcome in patients with acute stroke patients receiving endovascular therapy. METHODS: FVH score, American Society of Interventional and Therapeutic Neuroradiology (ASITN) grade, the functional outcome at 3 months (modified Rankin Scale (mRS)), and other clinical data were collected for 37 acute stroke patients with large vessel occlusion (LVO) receiving MRI before and after endovascular therapy...
February 14, 2019: European Radiology
Jae W Song, Emmanuel C Obusez, Scott B Raymond, Samuel D Rafla, Pamela W Schaefer, Javier M Romero
BACKGROUND AND PURPOSE: We hypothesized that vessel wall MR imaging (VWI) with 3D-time-of-flight magnetic resonance imaging (3D-TOF-MRA) together increases the ability to detect abnormal intracranial vessel segments compared to 3D-TOF-MRA alone. METHODS: Ninety-three consecutive subjects with a clinical history of suspected vasculopathy imaged with both VWI and 3D-TOF-MRAs were retrospectively reviewed. The 3D-TOF-MRAs were reviewed by two independent neuroradiologists classifying arterial segments as normal or abnormal based on caliber changes...
February 13, 2019: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Anna Tölli, Charlotte Höybye, Bo-Michael Bellander, Jörgen Borg
OBJECTIVE: To explore associations between pituitary dysfunction and clinical outcome at 12 months after traumatic brain injury and aneurysmal subarachnoid haemorrhage. METHODS: Prospective cohort study of 82 patients with traumatic brain injury and 45 with aneurysmal subarachnoid haemorrhage, included at 1 neurointensive care unit. Baseline data comprised age, sex, Glasgow Coma Scale (GCS) score, S100B and pupil light reactions. Hormone data were collected in the neurointensive care unit and 3, 6 and 12 months...
February 14, 2019: Journal of Rehabilitation Medicine
Zhaoqiang Li, Yang Hua, Jie Yang, Jingzhi Li
Stylocarotid artery syndrome (SAS) is a type of Eagle syndrome, which is caused by the compression of the internal or external carotid artery (along with their perivascular sympathetic fibers) by an elongated styloid process, resulting in neurological symptoms including transient ischemic attack (TIA) and cervicofacial pain along the distribution of the artery. The authors describe the case of a 56-year-old man with a history of TIA of unknown origin, who underwent color Doppler flow imaging (CDFI) that detected an elongated styloid process and transcranial Doppler (TCD) monitoring that revealed changes in intracranial blood flow when turning his head...
2019: Frontiers in Neurology
Kyung-Ah Park, Sei Yeul Oh, Ju-Hong Min, Byoung Joon Kim, Yikyung Kim
PURPOSE: To describe the causes of third, fourth, and sixth cranial nerve palsies in children and adolescents. METHODS: In this retrospective case series, a total of 66 patients aged 0-19 years with third, fourth, and sixth cranial nerve palsies seen in strabismus and neuro-ophthalmic practice from 2010 to 2017 were included. Causes of palsies were determined based on clinical assessment, high-resolution magnetic resonance imaging (MRI), and laboratory work-up. RESULTS: Thirty-five patients had sixth cranial nerve palsy, 14 patients had third cranial nerve palsy (7 partial, 7 complete), 13 patients had fourth cranial nerve palsy, and 4 patients had combined cranial nerve palsies in this study...
February 13, 2019: Eye
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