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Neurohospitalist 2021 Jul 10;11(3):251-254. Epub 2020 Dec 10.

Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Moyamoya disease (MMD) is a rare, progressive occlusive disease characterized by bilateral internal carotid artery hypoplasia that often presents with ischemic stroke and intracerebral hemorrhage (ICH). Although MMD-related ICH is generally managed similarly to spontaneous ICH, we present a case in which standard management strategies may have led to an unprecedented devastating outcome. A 37-year-old female without any previous medical history presented with headache and right-sided weakness. Read More

Front Neurol 2021 7;12:669828. Epub 2021 Jun 7.

Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Identification of ischemic stroke patients at high risk of developing life-threatening malignant infarction at an early stage is critical to consider more rigorous monitoring and further therapeutic measures. We hypothesized that a score consisting of simple measurements of visually evident ischemic changes in non-enhanced CT (NEMMI score) predicts malignant middle cerebral artery (MCA) infarctions (MMI) with similar diagnostic power compared to other baseline clinical and imaging parameters. One hundred and nine patients with acute proximal MCA occlusion were included. Read More

Brain Nerve 2021 Jun;73(6):715-724

Department of Neurology, Teikyo University School of Medicine.

Magnetic resonance imaging (MRI) is widely employed in the diagnosis of lumbar spine disorders, such as lumbar spinal stenosis or lumbar disc herniation. However, incomplete specificity is a definite drawback, given that MRI abnormalities are frequently identified in aged control subjects. Relying solely on MRI without considering clinical symptoms/signs or electrodiagnosis may lead to misdiagnosis. Read More

J Neurotrauma 2021 Jun 9. Epub 2021 Jun 9.

University of Cincinnati, 2514, Neurology and Rehabilitation Medicine, Cincinnati, Ohio, United States;

Subdural hematomas (SDHs) are increasingly common and can cause ischemic brain injury. Prior work has suggested that this is driven largely by vascular compression from herniation, although this work was done prior to the era of magnetic resonance imaging (MRI). We thus sought to study SDH-related ischemic brain injury by looking at patterns of cytotoxic edema on diffusion-weighted MRI. Read More

J Curr Ophthalmol 2021 Jan-Mar;33(1):88-90. Epub 2021 Mar 26.

Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Purpose: To report a case of progressive Chiari malformation type I (CIM) in a patient with unilateral sporadic retinoblastoma (RB) treated with intra-arterial chemotherapy (IAC) and enucleation.

Methods: A 5-year-old male patient with a history of RB in his left eye treated with IAC and enucleation presented to our clinic for routine RB surveillance. Radiotherapy had not been used for the treatment of his RB. Read More

J Matern Fetal Neonatal Med 2021 Jun 1:1-7. Epub 2021 Jun 1.

FETALMED - Maternal-Fetal Diagnostic Center, Fetal Imaging Unit, Santiago, Chile.

Objective: To study the prevalence of abnormalities of the septi pellucidi (SP) in a cohort of fetuses with open spinal dysraphism (OSD) and to determine whether this condition is secondary to obstructive ventriculomegaly and, therefore, part of the natural history of prenatal intracranial hypotension (PICH) syndrome.

Methods: Magnetic resonance imaging (MRI) studies from fetuses with OSD were analyzed. The SP were assessed using axial and coronal T2-weighted images of the fetal brain and classified as intact, partially absent, or completely absent. Read More

Case Rep Neurol 2021 Jan-Apr;13(1):246-250. Epub 2021 Apr 19.

Department of Neurology, Haga Hospital, The Hague, The Netherlands.

Spontaneous intracranial hypotension (SIH) is caused by spinal leakage of cerebrospinal fluid (CSF) and typically causes orthostatic headache which is relieved by lying in a recumbent position. We describe the case of a 44-year-old male suffering from orthostatic headaches accompanied by symptomatic cervical disc herniation, for which he had an anterior cervical discectomy and fusion (ACDF). Computerized tomography of the brain at the emergency department 1 week after this procedure showed bilateral subacute subdural hematomas. Read More

Exp Ther Med 2021 Jul 13;22(1):757. Epub 2021 May 13.

Department of Neurosurgery, Faculty of Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.

In the present study, we aimed to assess and analyze the predictive factors of 30-day mortality in patients with acute subdural hematoma (ASDH) who underwent surgical intervention after traumatic brain injury (TBI). We conducted a retrospective study, which included a cohort of 135 consecutive patients diagnosed with ASDH who required surgical evacuation. We assessed the demographic and clinical data, the imaging data of the hematoma described by preoperative computed tomography (CT) and the type of neurosurgical intervention for hematoma evacuation via either craniectomy or craniotomy. Read More

J Pediatr Genet 2021 Jun 21;10(2):131-138. Epub 2020 Apr 21.

Human Cytogenetics Department, Human Genetics and Genome Research Division, National Research Centre, Cairo, Egypt.

Paternal microduplication of 11p14.3-p15.5 causes the clinical manifestations of Beckwith-Wiedemann syndrome (BWS), while microdeletion of 18q23-ter is clinically characterized by short stature, congenital malformations, and developmental delay. Read More

J Stroke Cerebrovasc Dis 2021 Jul 1;30(7):105830. Epub 2021 May 1.

Department of Neurology, Medical College of Georgia, Augusta University, Augusta, 1120 15th Street BI3076, GA, United States.

Objective: Decompressive craniectomy (DC) improves functional outcomes in selected patients with malignant hemispheric infarction (MHI), but variability in the surgical technique and occasional complications may be limiting the effectiveness of this procedure. Our aim was to evaluate predefined perioperative CT measurements for association with post-DC midline brain shift in patients with MHI.

Methods: At two medical centers we identified 87 consecutive patients with MHI and DC between January 2007 and December 2019. Read More

World Neurosurg 2021 May 1. Epub 2021 May 1.

Department of Neurosurgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; Neurosciences Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Background: Epidural hematoma causing brain herniation is a major cause of mortality and morbidity after severe traumatic brain injury, even if surgical treatment is performed quickly. Decompression may be effective in decreasing intracranial pressure, but its effect on outcomes remains unclear.

Methods: A retrospective analysis of deeply comatose patients (Glasgow Coma Scale score 3-5) who underwent surgical treatment during a 12-year period, either via osteoplastic craniotomy (OC) or decompressive craniectomy, was carried out. Read More

Neuroradiology 2021 May 1. Epub 2021 May 1.

School of Biomedical Engineering & Imaging Sciences (BMEIS), King's College London, London, UK.

Purpose: A retrospective study was performed to study the effect of fetal surgery on brain development measured by MRI in fetuses with myelomeningocele (MMC).

Methods: MRI scans of 12 MMC fetuses before and after surgery were compared to 24 age-matched controls without central nervous system abnormalities. An automated super-resolution reconstruction technique generated isotropic brain volumes to mitigate 2D MRI fetal motion artefact. Read More

J Neuroimaging 2021 Apr 30. Epub 2021 Apr 30.

Division of Neuroradiology, Department of Radiology, Medstar Georgetown University Hospital, Washington, DC, USA.

Background And Purpose: Colloid cysts are relatively rare intracranial lesions located in the rostral aspect of third ventricle. They may produce acute hydrocephalus, brain herniation, and death. On conventional MRI, the appearance of a colloid cyst varies depending on its composition. Read More

Brain Sci 2021 Apr 2;11(4). Epub 2021 Apr 2.

Medical Physics Department, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.

Congenital diaphragmatic hernia (CDH) is a severe pediatric disorder with herniation of abdominal viscera into the thoracic cavity. Since neurodevelopmental impairment constitutes a common outcome, we performed morphometric magnetic resonance imaging (MRI) analysis on CDH infants to investigate cortical parameters such as cortical thickness (CT) and local gyrification index (LGI). By assessing CT and LGI distributions and their correlations with variables which might have an impact on oxygen delivery (total lung volume, TLV), we aimed to detect how altered perfusion affects cortical development in CDH. Read More

Medicine (Baltimore) 2021 Apr;100(17):e25751

Department of Neurology.

Abstract: Disrupted blood-brain barrier (BBB) in patients with ischemic stroke plays a critical role in malignant middle cerebral artery infarction (MMI) development.Cerebral white matter changes (WMC), particularly in the deep subcortical area or in severe one, may be also underlain by disrupted BBB. It is unclear whether the presence of WMC with potential premorbid disruption of BBB makes patients susceptible to MMI. Read More

N Z Vet J 2021 Jul 28;69(4):247-254. Epub 2021 Apr 28.

The Nest Te Kōhanga, Wellington Zoo, Wellington, New Zealand.

Case History: A kākāpō () chick hatched on an off-shore island of New Zealand with a small white mass protruding through the cranial skin of the head. The chick's growth followed a normal pattern for kākāpō but at 3 weeks of age the cranium mass was non-reducible and fixed in place and the chick was removed from the island for diagnostic imaging and hand-rearing.

Clinical Findings And Treatment: A computed tomography (CT) examination revealed a full-thickness circular defect in the central cranium with suspected herniation of brain and dura. Read More

Oper Neurosurg (Hagerstown) 2021 Apr 16. Epub 2021 Apr 16.

Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

Background: Encephaloceles are herniations of intracranial neural tissue and meninges through defects in the skull. Basal encephaloceles are rare anterior skull base defects incident in 1 in 35,000 live births. Sphenoethmoidal encephaloceles are even more uncommon, with an incidence of 1 in 700,000 live births. Read More

J Neurotrauma 2021 May 13. Epub 2021 May 13.

Neuroscience and Mental Health Research Program, Hospital for Sick Children, Toronto, Ontario, Canada.

The identification of children with traumatic brain injury (TBI) who are at risk of death or poor global neurological functional outcome remains a challenge. Magnetic resonance imaging (MRI) can detect several brain pathologies that are a result of TBI; however, the types and locations of pathology that are the most predictive remain to be determined. Forty-two critically ill children with TBI were recruited prospectively from pediatric intensive care units at five Canadian children's hospitals. Read More

Interv Neuroradiol 2021 Mar 28:15910199211003451. Epub 2021 Mar 28.

Medical Imaging, The Canberra Hospital, Australian Capital Territory, Australia.

Brain herniation into a dural venous sinus is a rare entity of unknown clinical significance without a clear relationship to raised intracranial pressure. There are yet to be detailed reports of interventional neuroradiology procedures involving sinus stenting across brain herniations. The authors of this paper present the first case of a stent placed across a large brain herniation into the transverse sinus in a patient with a tectal plate lesion and features of chronically raised intracranial pressure. Read More

J Clin Neurosci 2021 Apr 11;86:211-216. Epub 2021 Feb 11.

Department of Neuroanesthesia, National Institute of Neurology and Neurosurgery "Manuel Velasco Suarez" (INNN), 3877 Insurgentes Sur Av, La Fama, Tlalpan, 14269 Mexico City, Mexico. Electronic address:

The incidence of primary brain tumors during pregnancy is uncommon. The etiology of these can range from different genetic syndromes such as Li Fraumeni, neurofibromatosis type I, and hormonal associated tumors. The number of meningiomas gradually tends to increase during pregnancy, suggesting a relationship between non-malignant meningiomas and hormonal changes. Read More

Indian J Radiol Imaging 2020 Oct-Dec;30(4):517-520. Epub 2021 Jan 13.

Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Herniation of brain parenchyma outside its normal enclosure (also known as encephalocele) has long been known to occur at certain classic sites and is classified accordingly. With widespread use of modern neuroimaging, the previously unknown atypical and rare sites of encephalocele have now been identified. Brain herniation into a dural venous sinus is one such recently described entity with case reports extending only upto the earlier part of this decade. Read More

Childs Nerv Syst 2021 Mar 14. Epub 2021 Mar 14.

Department of Radiology, Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, Guizhou, People's Republic of China.

Growing skull fracture (GSF) is a rare complication of pediatric head trauma. It usually arises from a linear fracture with an underlying dural tear, which results in herniation of the intracranial contents. In rare cases, the herniated intracranial contents can be restricted in the diploe, resulting in an expanded diploic cavity. Read More

Ann Maxillofac Surg 2020 Jul-Dec;10(2):495-500. Epub 2020 Jul 2.

School of Dentistry, University Center of Patos de Minas, Patos de Minas, Minas Gerais, Brazil.

Trauma in the face region has a very varied etiology and can be associated with several important structures. Isolated fractures in the orbit region correspond to about 4 to 16% of all facial fractures and this incidence increases to 30 to 55% if we take into account fractures that expand to extraorbital regions. The present clinical report aims to describe the case of a male patient, 21-years-old, victim of a motorcycle accident with facial trauma and traumatic brain injury due to frontal collision. Read More

J Craniofac Surg 2021 Mar-Apr 01;32(2):e191-e195

Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan.

Objective: To explore the clinical effect of sellar floor bone flap with a pedicled nasoseptal flap in endoscopic transnasal pituitary adenoma surgery for skull base reconstruction.Method: This was a retrospective clinical analysis of 30 patients with pituitary adenoma operated by the same neurosurgical team from June 2015 to June 2018. All patients were diagnosed with pituitary adenoma by pituitary magnetic resonance imaging, and the authors confirmed that the sellar floor bone was intact using sphenoid sinus computed tomography. Read More

Zhonghua Yi Xue Za Zhi 2021 Mar;101(9):620-623

Emergency Department, the Affiliated Wuxi No.2 Hospital of Nanjing Medical University, Wuxi 214002, China.

To explore the efficacy and safety of intraoperative ultrasound-assisted neuroendoscopy for treating hypertensive intracerebral hemorrhage (HICH) via lateral fissure and insula approach. The clinical data of 66 patients with HICH in basal ganglia who underwent intraoperative ultrasound-assisted neuroendoscopy via lateral fissure and insula approach for hematoma evacuation were retrospectively analyzed, including operative data and follow-up results. All patients had no brain hernia before operation. Read More

Crit Care 2021 02 23;25(1):78. Epub 2021 Feb 23.

Division of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.

Purpose: To study variation in, and clinical impact of high Therapy Intensity Level (TIL) treatments for elevated intracranial pressure (ICP) in patients with traumatic brain injury (TBI) across European Intensive Care Units (ICUs).

Methods: We studied high TIL treatments (metabolic suppression, hypothermia (< 35 °C), intensive hyperventilation (PaCO < 4 kPa), and secondary decompressive craniectomy) in patients receiving ICP monitoring in the ICU stratum of the CENTER-TBI study. A random effect logistic regression model was used to determine between-centre variation in their use. Read More

Brain Dev 2021 Jun 15;43(6):719-723. Epub 2021 Feb 15.

Center for Integrated Human Brain Science, Brain Research Institute, University of Niigata, Japan. Electronic address:

Background: Acute encephalopathy with acute brain swelling (ABS) is a recently proposed disease of unknown etiology, characterized by rapid progression to whole-brain swelling. To our knowledge, we reported the first case of a patient with acute encephalopathy with ABS wherein brain magnetic resonance imaging (MRI) abnormalities were noted prior to the diffuse brain swelling onset.

Case Presentation: An 11-year-old boy was admitted to our unit owing to prolonged disturbance of consciousness following febrile status epilepticus. Read More

Insights Imaging 2021 Feb 11;12(1):14. Epub 2021 Feb 11.

Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy.

Objective: To promote a better radiological interpretation of spine degeneration, a consistent standardization of the acquisition, interpretation and description of Magnetic Resonance Imaging (MRI) l findings.

Materials And Methods: In order to achieve this objective, a consensus among experts in imaging of degenerative spine disease (DSD) from Italian radiological societies (SIRM-Italian Society of Radiology, AINR-Italian Association of Neuroradiology) was achieved. The representatives of the Italian inter-societal working group examined the literature produced by European/American task forces on optimizing the study sequences, classification of degenerative disc changes, spondylo-arthrosis, osteochondrosis, synovial and ligament pathologies of the spinal column, and on canal and foraminal stenosis. Read More

Front Neurol 2020 21;11:594954. Epub 2021 Jan 21.

Regenerative Bioscience Center, University of Georgia, Athens, GA, United States.

The Stroke Therapy Academic Industry Roundtable (STAIR) has recommended that novel therapeutics be tested in a large animal model with similar anatomy and physiology to humans. The pig is an attractive model due to similarities in brain size, organization, and composition relative to humans. However, multiple pig breeds have been used to study ischemic stroke with potentially differing cerebral anatomy, architecture and, consequently, ischemic stroke pathologies. Read More

Chin Neurosurg J 2021 Feb 3;7(1):12. Epub 2021 Feb 3.

The Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining, 810000, Qinghai Province, China.

Background: Civilian gunshot wounds to the head refer to brain injury caused by projectiles such as gun projectiles and various fragments generated by explosives in a power launch or explosion. Gunshot wounds to the head are the deadliest of all gun injuries. According to literature statistics, the survival rate of patients with gunshot wounds to the head is only 9%. Read More