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Neurocrit Care 2020 Jul 1. Epub 2020 Jul 1.

Department of Neurosurgery, University of Michigan, 3552 Taubman Center, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.

Objective: Our prior studies have found that intracerebroventricular injection of blood components can cause hydrocephalus and choroid plexus epiplexus cell activation in rats. To minimize the cross-species reaction, the current study examines whether intraventricular injection of acellular components of cerebrospinal fluid (CSF) from subarachnoid hemorrhage patients can cause hydrocephalus and epiplexus macrophage activation in nude mice which lack a T cell inflammatory response.

Methods: Adult male nude mice received intraventricular injections of acellular CSF from subarachnoid hemorrhage patients or a control patient. Read More

World Neurosurg 2020 Jun 25. Epub 2020 Jun 25.

Department of Neurosurgery, University of Illinois at Chicago, Chicago, Il, USA; Department of Neurosurgery, Stony Brook University, Stony Brook, NY, USA.

Background: Secondary intracerebral hemorrhage (SICH) score is used to predict risk of intracranial hemorrhage (ICH) associated vascular lesions. However, it has low clinical utility in identifying patients without need for neurovascular imaging.

Objective: This study aims to develop a modified scoring system to capture patients with low risk of underlying vascular pathology, thereby decreasing need for vascular imaging and its associated morbidity. Read More

J Neurosurg 2020 Jun 26:1-9. Epub 2020 Jun 26.

Objective: Awake surgery is becoming more standard and widely practiced for neurosurgical cases, including but not limited to brain tumors. The optimal selection of patients who can tolerate awake surgery remains a challenge. The authors performed an updated cohort study, with particular attention to preoperative clinical and imaging characteristics that may have an impact on the viability of awake craniotomy in individual patients. Read More

World Neurosurg 2020 Jun 22. Epub 2020 Jun 22.

Department of Neurosurgery, University of Louisville, Louisville, KY.

Background: Intracranial mycotic aneurysms are uncommon, it can occur due extravascular extension or intravascular seeding of the vessel wall. It often results subarachnoid hemorrhage (SAH) with poor prognosis. We present a rare case of ruptured proximal anterior inferior cerebellar artery- posterior inferior cerebellar artery (AICA-PICA) mycotic aneurysm after an episode of bacterial meningitis. Read More

Intern Med 2020 Jun 23. Epub 2020 Jun 23.

Department of Neurology, Tokyo Teishin Hospital, Japan.

Spontaneous intracranial hypotension (SIH) is an important cause of headache mainly associated with spinal cerebrospinal fluid leakage. We herein report the case of a 51-year-old man who developed SIH after swimming. Brain magnetic resonance imaging (MRI) showed a transient high-intensity lesion in the splenium of the corpus callosum (SCC), in addition to bilateral subdural hematomas (SDH) and pseudo-subarachnoid hemorrhage on brain computed tomography. Read More

Am J Case Rep 2020 Jun 24;21:e920606. Epub 2020 Jun 24.

Department of Neurology, Henan Provincial People's Hospital, School of Clinical Medicine, Henan University, Zhengzhou, Henan, China (mainland).

BACKGROUND Cortical subarachnoid hemorrhage (cSAH) is a rare clinical presentation with different causes, but rarely happens along with acute ischemic stroke. Intracranial high-grade stenosis originated from brain has been regarded as an unusual cause of cSAH, especially in young adults. CASE REPORT A case of 33-year-old male presented with mild headache and spontaneous left-sided body weakness. Read More

J Neurol 2020 Jun 22. Epub 2020 Jun 22.

Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, 245 Burgundy Street, Heidelberg, VIC, 3084, Australia.

Background: Cerebral venous thrombosis (CVT) is associated with intracranial hemorrhage.

Aim: To identify clinical and imaging features of CVT-associated intracranial hemorrhage. We hypothesized that higher clot burden would be associated with a higher risk of intracranial hemorrhage. Read More

J Neurointerv Surg 2020 Jun 22. Epub 2020 Jun 22.

Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada

We report the case of a patient with subarachnoid hemorrhage and three aneurysms arising from the posterior communicating artery (Pcomm)-P1 complex, treated with endovascular coiling and competitive flow diversion. The largest and likely ruptured Pcomm aneurysm was treated with traditional coiling. Two smaller potentially ruptured aneurysms arose from the distal right posterior cerebral artery (PCA) P1 segment. Read More

Stroke Vasc Neurol 2020 Jun 22. Epub 2020 Jun 22.

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

Background And Purpose: There is limited nationwide evidence about the standard management characteristics of stroke types and prognosis in China. This study aimed to assess clinical characteristics, in-hospital and after-discharge management characteristics and prognosis for stroke types in China.

Methods: A nationwide registry recruited 14 244 imaging-confirmed first-ever incident strokes from 132 hospitals across 31 provinces of China during 2007-2008, recording presenting characteristics, diagnostic procedures and in-hospital treatment. Read More

World Neurosurg 2020 Jun 16. Epub 2020 Jun 16.

Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address:

Background: Andexanet alfa, a novel anticoagulation reversal agent for Factor Xa inhibitors, was recently approved. Traumatic intracranial hemorrhage presents a prime target for this drug. The ANNEXA-4 study established the efficacy of andexanet alfa in reversing Factor Xa inhibitors. Read More

J Neurosurg 2020 Jun 19:1-9. Epub 2020 Jun 19.

1Division of Neurosurgery, University of Stellenbosch; and.

Objective: While high-velocity missile injury (gunshot) is associated with kinetic and thermal injuries, non-missile penetrating head injury (NMPHI) results in primary damage along the tract of the piercing object that can be associated with significant secondary complications. Despite the unique physical properties of NMPHI, factors associated with complications, expected outcomes, and optimal management have not been defined. In this study, the authors attempted to define those factors. Read More

Surg Neurol Int 2020 30;11:128. Epub 2020 May 30.

Department of Neurosurgery, Kanazawa Medical Center, Shimoishibikimachi, Kanazawa, Ishikawa, Japan.

Background: Reversible cerebral vasoconstriction syndrome (RCVS) presents with characteristic clinical, brain imaging, and angiographic findings. The most common clinical feature of RCVS is a severe acute headache, which is often referred to as a thunderclap headache due to the nature of its presentation. It may occur spontaneously or may be provoked by various precipitating factors. Read More

J Neurointerv Surg 2020 Jun 16. Epub 2020 Jun 16.

Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA

Background: Ruptured aneurysms of the intracranial vertebral artery (VA) or posterior inferior cerebellar artery (PICA) are challenging to treat as they are often dissecting aneurysms necessitating direct sacrifice of the diseased segment, which is thought to carry high morbidity due to brainstem and cerebellar stroke. However, relatively few studies evaluating outcomes following VA or proximal PICA sacrifice exist. We sought to determine the efficacy and outcomes of endovascular VA/PICA sacrifice. Read More

Neurol Med Chir (Tokyo) 2020 Jun 12. Epub 2020 Jun 12.

Department of Neurosurgery, Graduate School of Medicine, Nagoya University.

An isolated fourth ventricle (IFV) is characterized by fourth ventricular dilation due to obstruction of its inlet and outlet. A disproportionately large communicating fourth ventricle (DLCFV) is a rare subtype of IFV, characterized by dilation of the fourth ventricle, regardless of the size of the lateral ventricles, with no apparent obstruction of the cerebral aqueduct. To our knowledge, this is the first case series describing endoscopic diagnosis and treatment strategy for DLCFV. Read More

Anaesth Rep 2020 Jan-Jun;8(1):40-43. Epub 2020 Jun 5.

SCDU Anestesia Rianimazione Torino Italy.

Spinal subarachnoid haemorrhage is a rare complication of spinal anaesthesia, especially following atraumatic lumbar puncture and in the absence of coagulopathies. The initial presentation of spinal subarachnoid haemorrhage is variable and paraplegia with full recovery within a few hours is rare. Bleeding can extend into the intracranial subarachnoid space, but there are only a few reports of symptomatic intracranial and spinal subarachnoid haemorrhage after spinal anaesthesia. Read More

Stroke 2020 Jul 10;51(7):2103-2110. Epub 2020 Jun 10.

Department of Neurology (T.Y.C., D.W.J.D., B.R.), Erasmus MC - University Medical Center, Rotterdam, the Netherlands.

Background And Purpose: The prevalence of unruptured intracranial aneurysms (UIAs) in the adult population is ≈3%. Rupture of an intracranial aneurysm can have devastating consequences, which emphasizes the importance of identification of potentially modifiable determinants for the presence and size of UIAs. Our aim was to study the association of a broad spectrum of potential determinants with the presence and size of UIAs in a general adult population. Read More

Neurosurg Rev 2020 Jun 6. Epub 2020 Jun 6.

Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China.

Determining the rupture source is imperative in patient with aneurysmal subarachnoid hemorrhage (SAH). About one third of SAH cases with multiple intracranial aneurysms cannot be certain of the rupture source according to the hemorrhage pattern. This study aims to identify of the rupture source in patients with multiple intracranial aneurysms by fusing SAH data and computed tomography angiography (CTA) data. Read More

BMJ Open 2020 Jun 4;10(6):e036404. Epub 2020 Jun 4.

Department of Neurosurgery, University Medical Center Groningen, Groningen, The Netherlands.

Introduction: We developed a zero-dimensional (0D) model to assess the patient-specific haemodynamics in the circle of Willis (CoW). Similar numerical models for simulating the cerebral blood flow (CBF) had only been validated qualitatively in healthy volunteers by magnetic resonance (MR) angiography and transcranial Doppler (TCD). This study aims to validate whether a numerical model can simulate patient-specific blood flow in the CoW under pathological conditions. Read More

J Neurosurg Pediatr 2020 Jun 5:1-7. Epub 2020 Jun 5.

Objective: Postoperative pain can limit the recovery of children undergoing craniotomy for tumor resection, and pain management is highly variable between institutions and practitioners. Nonsteroidal antiinflammatory drugs (NSAIDs) are effective in treating postoperative pain following craniotomy, but their use has been limited by concerns about postoperative hemorrhage. The risk of postoperative hemorrhage is not insignificant in patients undergoing craniotomy for tumor resection. Read More

BMJ Case Rep 2020 Jun 3;13(6). Epub 2020 Jun 3.

Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada

We report the case of a patient with subarachnoid hemorrhage and three aneurysms arising from the posterior communicating artery (Pcomm)-P1 complex, treated with endovascular coiling and competitive flow diversion. The largest and likely ruptured Pcomm aneurysm was treated with traditional coiling. Two smaller potentially ruptured aneurysms arose from the distal right posterior cerebral artery (PCA) P1 segment. Read More

J Neurol 2020 Jun 3. Epub 2020 Jun 3.

Department of Radiology, Bichat Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.

Aim: To assess: (1) the prevalence of convexity subarachnoid hemorrhage (cSAH) in infective endocarditis (IE); (2) its relationship with IE features; (3) the associated lesions; (4) whether cSAH is a predictor of future hemorrhage; (5) whether cSAH could cause cortical superficial siderosis (cSS).

Methods: We retrospectively evaluated the MRI data in 240 IE-patients: At baseline, the location of cSAH and associated lesions; at follow-up, the occurrence of new lesions and of cSS. Patients with and without cSAH were compared. Read More

Surg Neurol Int 2020 16;11:108. Epub 2020 May 16.

Department of Neurosurgery, Montefiore Medical Center, Bronx, New York, United States.

Background: In recent years, the role of ABO blood type moved into focus through the discovery of different hemostaseologic properties with importance in many diseases including subarachnoid hemorrhage (SAH). However, the role of ABO blood type in delayed cerebral ischemia (DCI) onset, clinical progress, and outcome after SAH is to date largely unexplored. Our aim was to explore the role of ABO blood group in DCI and clinical outcomes after aneurysmal SAH (aSAH). Read More

World Neurosurg 2020 May 31. Epub 2020 May 31.

Department of Neurological Surgery, Rush University Medical Center, Chicago, IL, USA.

The natural history of unruptured dissections of the intracranial vertebral artery (VA) is not well delineated. The dissected VA may heal spontaneously or may be associated with ischemic events. The literature on medical management for intracranial VA dissections is also limited. Read More

World Neurosurg 2020 May 29. Epub 2020 May 29.

Division of Diagnostic and Therapeutic Neuroradiology, Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, Canada; Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Canada.

Dtsch Arztebl Int 2020 Apr;117(14):235-242

Department of Neurosurgery, UMC Mannheim, Medical Faculty, Ruprecht-Karls-Universität Heidelberg; Department of Neuroradiology, University Hospital Erlangen, University of Erlangen-Nuremberg; Department of Neurology, Center of Neurology and Neurosurgery, Universitätsklinikum Goethe- Universität Frankfurt.

Background: About 2 million adults in Germany harbor an unruptured intracranial aneurysm (IA). Rupture can lead to a life-threatening subarachnoid hemorrhage. If an IA is detected incidentally in cranial imaging, it must be decided how to proceed. Read More

World Neurosurg 2020 May 10. Epub 2020 May 10.

Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.

Background: Intracranial arterial dissection (IAD) is known to exhibit various patterns of arterial imaging features such as stenosis and dilation; however, the genetic background of IAD has not been elucidated so far. RNF213 was recently identified as a susceptibility gene for moyamoya disease (MMD) and intracranial artery stenosis (ICAS). More recently, RNF213 p. Read More

World Neurosurg 2020 May 11;140:229-232. Epub 2020 May 11.

Department of Neurosurgery, Acıbadem University Atakent Hospital, Istanbul, Turkey.

Background: Reports of cerebral aneurysm and aneurysm rupture during pregnancy are rare in the literature. Aneurysms might rupture and cause intracranial hemorrhage during or after pregnancy. Aneurysmal subarachnoid hemorrhage during pregnancy presents a challenge regarding treatment and management. Read More

Cureus 2020 Apr 16;12(4):e7694. Epub 2020 Apr 16.

Neurological Surgery, The University of Toledo Medical Center, Toledo, USA.

We present our experience following a unique case of coincident intracranial hemorrhage and comminuted fractures of both the squamous temporal bone and zygomaticofrontal orbit. Surgical techniques and outcome for this presentation have yet to be sufficiently described. A 55-year-old male presented following trauma with Glasgow Coma Scale score of 7. Read More

Brain Sci 2020 May 15;10(5). Epub 2020 May 15.

Epileptology Center, Medical Faculty, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.

: Though Todd's phenomenon (TP) is a relatively rare occurrence, its correct identification is of key diagnostic and therapeutic importance as a stroke mimic. Here we describe a case of isolated gaze palsy as a manifestation of TP, discuss periictal gaze abnormalities as lateralizing sign involving the frontal eye field (FEF), and present a narrative literature review. : We reviewed the main features of the case and conducted a structured literature search of TP and gaze palsy using PubMed. Read More

Semin Intervent Radiol 2020 Jun 14;37(2):166-174. Epub 2020 May 14.

Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado.

Neuroangiography (NA) is a minimally invasive procedure used to diagnose patients with neurovascular diseases. Noninvasive imaging has improved dramatically in recent years and is utilized more frequently; however, further evaluation with NA is still required in certain cases. NA indications include intracranial (cerebral aneurysms, arteriovenous malformations, dural arteriovenous fistula, cerebral vasculitis, cerebral vasospasm, ischemic stroke, nontraumatic subarachnoid hemorrhage, intracerebral hemorrhage, Moyamoya, vein of Galen malformation, intracranial tumors, and pseudotumor cerebri) and extracranial (internal and common carotid artery stenosis, vertebral artery stenosis, carotid artery blowout, vertebral artery blowout, epistaxis, oropharyngeal bleeding, and carotid body tumor) pathologies which can help with diagnosis and potential subsequent endovascular treatment. Read More

Br J Neurosurg 2020 May 18:1-2. Epub 2020 May 18.

Department of Neurology, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejing, China.

Acute methanol intoxication can occur as accidental ingestion of adulterated spirits. We report a 51-year-old male patient with high anion-gap metabolic acidosis (pH 6.71, HCO4. Read More

Front Neurol 2020 28;11:283. Epub 2020 Apr 28.

Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, South Korea.

Accurate diagnosis of the presence and severity of neural injury in patients with subarachnoid hemorrhage (SAH) is important in neurorehabilitation because it is essential for establishing appropriate therapeutic strategies and developing a prognosis. Diffusion tensor imaging has a unique advantage in the identification of microstructural white matter abnormalities which are not usually detectable on conventional brain magnetic resonance imaging. In this mini-review article, 12 diffusion tensor imaging studies on SAH-related brain injury were reviewed. Read More

World Neurosurg 2020 May 12;140:219-223. Epub 2020 May 12.

Department of Neurosurgery, Rouen University Hospital, Rouen, France; Department of Interventional Neuroradiology, Rouen University Hospital, Rouen, France; University of Limoges CNRS XLIM UMR 7252, Limoges, France; Laboratory of Microvascular Endothelium and Neonate Brain Lesions, Normandie University, UNIROUEN, INSERM U1245, Rouen, France. Electronic address:

Background: Intracranial aneurysms (IAs) are exceptional in neonates accounting for less than 2% of all IAs occurring during the first decade of life. Little is known about this pathology in this specific population. Because of its scarcity and this specific age at onset, the treatment of IA in neonates is challenging. Read More

Medicine (Baltimore) 2020 May;99(19):e20013

Department of Neurosurgery, Fuzong Clinical Medical College of Fujian Medical University, 900th Hospital.

Introduction: Clinically, anterior communicating artery complex fenestration combined with fenestration-related aneurysms is rare, and combination of this condition with tandem aneurysms is even rarer.

Patient Concerns: A case of a 43-year-old man with spontaneous subarachnoid hemorrhage.

Diagnosis: A computed tomography angiography examination revealed a fenestrated anterior communicating artery complex combined with 2 aneurysms. Read More

Oper Neurosurg (Hagerstown) 2020 May 4. Epub 2020 May 4.

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.

Anterior communicating artery (ACoA) aneurysms are prone to rupture even at smaller sizes. The surgical management of ACoA aneurysms is highly dependent on the spatial orientation of the saccular projection, categorized as inferior, superior, anterior, or posterior. Superior projecting aneurysms constitute approximately one-third of all aneurysms involving the ACoA. Read More

Rom J Intern Med 2020 Apr 30. Epub 2020 Apr 30.

Department of Neurology, University Emergency Hospital Bucharest.

Cardiac abnormalities are frequently reported in acute subarachnoid hemorrhage (SAH) patients. However, frank ST-elevation and myocardial dysfunction mimicking acute coronary syndrome is a rare occurrence. Systemic and local catecholamine release mediate myocardial injury and may explain raised troponin levels, concordant regional wall motion abnormalities and systolic dysfunction. Read More

Am J Case Rep 2020 May 1;21:e923289. Epub 2020 May 1.

Department of Neurosurgery, Pediatric Hospital of Athens, Agia Sophia, Athens, Greece.

BACKGROUND Cerebral arteriovenous malformations (AVMs) are considered to be abnormalities of congenital origin, presumably arising due to a disorder in the process of embryogenesis, in the phase of differentiation of premature vascular domes into mature arteries, capillaries, and veins. The end result of that process is the formation of direct arteriovenous communications, without intervening capillary beds. CASE REPORT We report the case of a 6-year-old female who suffered an abrupt deterioration of her level of consciousness due to a subarachnoid hemorrhage located in the basal cisterns. Read More

Spinal Cord Ser Cases 2020 Apr 28;6(1):29. Epub 2020 Apr 28.

Rehabilitation Center SGR Group, Willemstad, Curaçao.

Introduction: Ecstasy is a commonly used party drug and is the second most popular drug after marijuana among youngsters. Serious health hazards have been described including cardiac diseases, neurological complications, multi-organ failure, and even death. Spinal cord injury/dysfunction (SCI/D) is rarely described as a result of ecstasy ingestion. Read More

World Neurosurg 2020 06 25;138:e955-e960. Epub 2020 Apr 25.

Department of Neurosurgery, Baylor Scott & White Medical Center, Temple, Texas, U.S.A.; Department of Surgery, Texas A&M University College of Medicine, Temple, Texas, U.S.A.

Objective: The novel coronavirus disease 2019 (COVID-19) pandemic poses a substantial threat to the health of health care personnel on the front line of caring for patients with COVID-19. The Centers for Medicare and Medicaid Services have announced that all nonessential planned surgeries and procedures should be postponed until further notice and only urgent procedures should proceed. Neurologic surgeries and procedures should not be delayed under the circumstance in which it is essential at saving a life or preserving functioning of the central nervous system. Read More

World Neurosurg 2020 Apr 25;139:440-444. Epub 2020 Apr 25.

Department of Vascular Surgery, Aichi Medical University, Nagakute, Aichi, Japan.

Background: Cerebrospinal fluid (CSF) drainage during the treatment of aortic disease is commonly performed to prevent spinal cord ischemia. Spinal subdural hematoma (SDH) has never been reported after CSF drainage during thoracic endovascular aortic repair (TEVAR). We present a case of concurrent intracranial subarachnoid hemorrhage (SAH) and spinal SDH after CSF drainage tube removal in a patient with TEVAR. Read More

Emerg Med Clin North Am 2020 May;38(2):523-537

Surgery, Larner College of Medicine at the University of Vermont, 111 Colchester Avenue, EC 2, Burlington, VT 05401, USA. Electronic address:

A careful history and thorough physical examination are necessary in patients presenting with acute neurologic dysfunction. Patients presenting with headache should be screened for red-flag criteria that suggest a dangerous secondary cause warranting imaging and further diagnostic workup. Dizziness is a vague complaint; focusing on timing, triggers, and examination findings can help reduce diagnostic error. Read More

J Neuroradiol 2020 Apr 23. Epub 2020 Apr 23.

Department of Radiology, Mayo Clinic, 200 1(st) St SW, 55905 Rochester, MN, USA. Electronic address:

Intracranial artery dissections (IAD) are uncommon entities associated with high rates of morbidity and mortality. Certain ethnic groups and patients with underlying connective tissue disorders may be at a higher risk of developing IAD, but these relationships are unclear due to the condition's rarity. Patients often present with a prodromal headache followed by subarachnoid hemorrhage (SAH) or ischemic stroke. Read More

Brain Sci 2020 Apr 20;10(4). Epub 2020 Apr 20.

Department of Neurology, Juntendo University School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.

Cerebral artery fenestration is a rare variant of the vascular architecture, but its existence is well documented. The common site of fenestration is the vertebra-basilar artery and it may be found incidentally with subarachnoid hemorrhage. However, fenestration-related cerebral infarction is rare. Read More

Mol Diagn Ther 2020 Jun;24(3):351-364

Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bengaluru, 560029, India.

Introduction: Diagnosis of the rupture of an intracranial aneurysm (IA) relies on sophisticated neuro-imaging studies, and molecular biomarkers to identify an IA or predict its rupture are still unavailable.

Objective: Our objective was to determine the plasma microRNA (miRNA) expression profile in patients with ruptured IA presenting as aneurysmal subarachnoid hemorrhage (aSAH) and identify potential biomarkers of aneurysmal rupture.

Methods: Plasma miRNA profiling was carried out using quantitative real-time polymerase chain reaction (qRT-PCR) in 20 patients with aSAH and 20 age- and sex-matched healthy controls. Read More

NMC Case Rep J 2020 Apr 24;7(2):75-79. Epub 2020 Mar 24.

Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

The diagnosis and treatment of patients with ruptured basilar artery dissection (rBAD) are often difficult. We present a case of rBAD diagnosed with magnetic resonance vessel wall imaging (MR-VWI) and treated with coil embolization with overlapping low-profile visualized intraluminal support (LVIS) stents. The case is of a 49-year-old woman with subarachnoid hemorrhage. Read More

Neurocrit Care 2020 Apr 21. Epub 2020 Apr 21.

Neuroscience Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Background: Intracranial pressure (ICP) monitoring is essential after subarachnoid hemorrhage (SAH) to prevent secondary brain insults and to tailor individualized treatments. Optic nerve sheath diameter (ONSD), measured using ultrasound (US), could serve as a noninvasive bedside tool to estimate ICP, avoiding the risks of hemorrhage or infection related to intracranial catheters. The aims of this study were twofold: first, to explore the reliability of US for measuring ONSD; second, to establish whether the US-ONSD can be considered a proxy for ICP in SAH patients early after bleeding. Read More

IEEE J Transl Eng Health Med 2019 26;7:1800707. Epub 2019 Sep 26.

4National Center for Medical Imaging and Instrumentation ResearchUniversidad Autónoma Metropolitana-IztapalapaMexico City04257Mexico.

Background: The objective of this pilot study was to assess the safety and efficacy of VitalFlow stimulation in aneurysmal subarachnoid hemorrhage (aSAH) patients with vasospasm for the purpose of guiding the design of larger, controlled studies in vasospasm patients, a largely untreated condition [1].

Methods: Six patients with angiographic vasospasm developing post-aSAH were treated with VitalFlow stimulation. Digital subtraction angiograms were obtained at the time of diagnosis (baseline) and then 30 minutes post-stimulation. Read More

AMIA Annu Symp Proc 2019 4;2019:848-856. Epub 2020 Mar 4.

Department of Biomedical Informatics, Emory School of Medicine, Atlanta, GA, USA.

The goal of this study was to investigate the application of machine learning models capable of capturing multiplica tive and temporal clinical risk factors for outcome prediction inpatients with aneurysmal subarachnoid hemorrhage (aSAH). We examined a cohort of 575 aSAH patients from Emory Healthcare, identified via digital subtraction angiog- raphy. The outcome measure was the modified Ranking Scale (mRS) after 90 days. Read More

Radiol Case Rep 2020 Jun 11;15(6):757-760. Epub 2020 Apr 11.

Department of Diagnostic Radiology, School of Medicine, Tohoku University, 1-1 Seiryo-cho Aoba-ku, Sendai, Japan.

Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple organ systems. Cerebral aneurysm formation is a rare central nervous system manifestation of SLE and tends to present as subarachnoid hemorrhage. Here, we report a 34-year-old woman with SLE complicated by a thrombosed aneurysm that had arose at the origin of a perforating artery, thereby causing obstruction of the artery and subsequent development of pontine infarction. Read More

World Neurosurg 2020 Jun 2;138:e913-e921. Epub 2020 Apr 2.

Department of Neurosurgery, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany. Electronic address:

Objective: To analyze angiographic characteristics of cerebral vasospasm (CVS) after spontaneous subarachnoid hemorrhage (sSAH) and their potential impact on secondary infarction and functional outcome.

Methods: Demographic, clinical, and imaging data of sSAH patients with angiographic CVS admitted over a 6-year period were retrospectively analyzed.

Results: A total of 85 patients were included in the final analysis. Read More