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Headache 2019 Apr 15. Epub 2019 Apr 15.

Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Background: Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by thunderclap headaches and transient segmental cerebral arterial vasoconstriction. Many drugs have been identified as triggers of RCVS. However, RCVS induced by methotrexate (MTX), an antimetabolite agent, has never been reported. Read More

J Biophotonics 2019 Apr 15:e201800408. Epub 2019 Apr 15.

RWTH Aachen University, Faculty of Medicine, Translational Neurosurgery and Neurobiology, Department of Neurosurgery, Aachen, Germany.

Aneurysmal Subarachnoid Hemorrhage (aSAH) is a severe medical condition associated with a significant cause of mortality throughout the world. Cisterna Magna Injection Model is accepted widely to mimic clinical aSAH and is performed on small animal models to study aSAH during neurosurgery. Coherent light scattered from the surface of the rat brain is used to infer information about the variations in blood flow during this condition. Read More

Neurosurgery 2019 May;84(5):E272-E273

Introduction: Subarachnoid hemorrhage from a ruptured intracranial aneurysm poses a significant health hazard due to its high rates of mortality and disability. The 2 most commonly used treatment modalities of intracranial aneurysms are neurosurgical clipping and endovascular coiling. Through the decision on which treatment option should be chosen in every case is made based on medical indication, nevertheless, due to high socioeconomic burden of subarachnoid hemorrhage, it is also important to compare the healthcare expenditures, caused by clipping and coiling. Read More

Neurosci Lett 2019 Apr 10. Epub 2019 Apr 10.

Department of Anatomazy and Histology, School of Basic Medical Sciences, Peking University, Beijing, 100191, China; Beijing Key Lab of Magnetic Resonance Imaging Technology, Beijing, 100191, China. Electronic address:

Background: In this study, the protective effects of 3,4-dihydroxyphenyl lactic acid (DLA) on blood-brain barrier (BBB) injury following subarachnoid hemorrhage (SAH) has been explored.

Methods: Male Sprague-Dawley rats (weight 300-350 g) were used to establish the SAH model using the endovascular perforation method. The animals were randomly divided into four groups: sham (n = 40), SAH (n = 46), SAH + vehicle (n = 44), and SAH + DLA (n = 40) treatment groups. Read More

Clin Neurol Neurosurg 2019 Mar 11;180:111-116. Epub 2019 Mar 11.

Department of Radiology and Biomedical Imaging, Yale School of Medicine, Box 208042, Tompkins East 2, 333 Cedar St, New Haven, CT, 06520-8042, United States. Electronic address:

Objectives: Isolated perimesencephalic subarachnoid hemorrhage is an uncommon, distinct subtype of subarachnoid hemorrhage with a more benign prognosis. A negative computed tomographic angiogram has been shown to be reliable in excluding aneurysmal rupture as the underlying etiology. However, some studies continue advocating for more imaging to determine a vascular cause in perimesencephalic subarachnoid hemorrhage. Read More

Front Neurol 2019 26;10:246. Epub 2019 Mar 26.

Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States.

The neuropathology of traumatic brain injury (TB) is diverse, including primary injury to neurons, axons, glial cells, vascular structures, and secondary processes, such as edema and inflammation that vary between individual patients. Traumatic microvascular injury is an important endophenotype of TBI-related injury. We studied patients who sustained a TBI requiring ER evaluation and had an MRI performed within 48 h of injury. Read More

J Clin Neurosci 2019 Apr 3. Epub 2019 Apr 3.

Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Surgery, University of Melbourne, Victoria, Australia.

We report a case of a right-handed Caucasian woman who developed mirror writing following a non-aneurysmal, non-traumatic subarachnoid haemorrhage. The patient was unaware of having this phenomenon, and it was detected by clinical staff when the patient was writing a card to a family member. Serial imaging has ruled out a stroke as well as an underlying vascular abnormality. Read More

Behav Brain Res 2019 Apr 3;367:194-200. Epub 2019 Apr 3.

Department of Radiology, West China Hospital, Sichuan University, Chengdu, China. Electronic address:

Subarachnoid hemorrhage (SAH) may lead to brain atrophy and cognitive dysfunction. This study aimed to compare the efficacy of nimodipine and deferoxamine on these sequelae of SAH. A rat model of SAH was established by the double-hemorrhage method. Read More

J Neurosurg 2019 04 5:1-12. Epub 2019 Apr 5.

Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona.

Objective: Anterior communicating artery (ACoA) aneurysms are common intracranial aneurysms. Despite advances in endovascular therapy, microsurgical clipping remains an important treatment for aneurysms with broad necks, large size, intraluminal thrombus, complex branches, or previous coiling. Anatomical triangles identify safe corridors for aneurysm access. Read More

BMJ 2019 Apr 4;365:k1933. Epub 2019 Apr 4.

Eastbourne District General Hospital, East Sussex Healthcare NHS Trust, Eastbourne, UK.

Circ Res 2019 Apr 5. Epub 2019 Apr 5.

Hans Berger Department of Neurology, University Hospital Jena.

Rationale: Delayed ischemic neurological deficit is the most common cause of neurological impairment and unfavorable prognosis in subarachnoid hemorrhage (SAH) patients. Despite the existence of neuroimaging modalities that depict the onset of the accompanying cerebral vasospasm, preventive and therapeutic options are limited and fail to improve outcome owing to an insufficient pathomechanistic understanding of the delayed perfusion deficit. Previous studies have suggested that bilirubin oxidation products (BOXes), originating from released heme surrounding ruptured blood vessels, are involved in arterial vasoconstriction. Read More

Asian J Neurosurg 2019 Jan-Mar;14(1):245-248

Department of Neurosurgery, Medicine School of Tunis, National Institute of Neurology, University of Tunis-El Manar, Tunis, Tunisia.

Cauda equina paragangliomas are rare neuroendocrine benign and slow-growing tumors. Acute paraplegia, occurring because of sudden intratumoral hemorrhage, represents an extremely rare clinical picture of this disease. We report the case of a 64-year-old male presenting with a 5-day acute lower back pain, sciatica, and leg weakness. Read More

World Neurosurg 2019 Mar 28. Epub 2019 Mar 28.

Division of Neurosurgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.

Introduction: Radiculo-medullary arteries aneurysms are rare, with only few cases previously reported.

Case Report: We report the case of a 54-year-old woman with sudden onset of upper thoracic back pain. MRI/MRA of the spine showed a cervico-thoraco-lumbar hematoma, with no evidence of underlying vascular malformations. Read More

World Neurosurg 2019 Mar 27. Epub 2019 Mar 27.

Department of Neurosurgery, Ajou University Hospital, Suwon, South Korea. Electronic address:

Objective: This study aimed to investigate the characteristics of A1 aneurysms according to their locations and to compare their imaging appearances in order to identify factors associated with their rupture.

Methods: We retrospectively reviewed the medical records of 31 patients harboring 32 A1 aneurysms diagnosed and treated between March 2009 and September 2018 at our institute.

Results: Thirteen (41. Read More

Mayo Clin Proc 2019 Mar 25. Epub 2019 Mar 25.

Department of Neurology, Mayo Clinic, Rochester, MN.

Objective: To determine how brain magnetic resonance imaging (MRI) findings impact clinical outcomes in patients with infective endocarditis (IE) and to propose a management algorithm for patients with neurologic symptoms who are candidates for valve surgery (VS).

Patients And Methods: Data from our center were retrospectively reviewed for patients hospitalized with IE between January 1, 2007, and December 31, 2014. Outcomes were postoperative intracerebral hemorrhage (ICH), 6-month mortality, and functional outcome at last follow-up as described by the modified Rankin Scale (mRS) score. Read More

Neuroscience 2019 Mar 22. Epub 2019 Mar 22.

Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address:

Lipoxin A4 (LXA4) has been reported to reduce inflammation in experimental subarachnoid hemorrhage (SAH), but the mechanism remains unclear. In this study, we investigated the role of LXA4 in inflammation-mediated cerebrovascular endothelial dysfunction and the potential mechanism after SAH. SAH was induced by endovascular perforation in male Sprague-Dawley rats, and recombinant LXA4 was injected intracerebroventricularly 1. Read More

Front Med (Lausanne) 2019 8;6:38. Epub 2019 Mar 8.

Department of Neurology, Duke University, Durham, NC, United States.

Clopidogrel is a commonly prescribed antiplatelet drug in patients with stents and histories of arterial vascular disease. It generally has a favorable side effect profile with increasing bleeding risk as the main concern as an adverse event. A 19-year-old previously healthy male presented to the neurological intensive care unit with a subarachnoid hemorrhage requiring a flow diverting stent to secure the aneurysm. Read More

J Neuroradiol 2019 Mar 20. Epub 2019 Mar 20.

CHU de Henri-Mondor, Créteil, AP-HP, service de neuroradiologie diagnostique et thérapeutique, 94000 Créteil, France.

Introduction: The neurological complications of Sickle Cell Disease (SCD) include cerebral infarction and haemorrhage with rarely subarachnoid haemorrhage due to cerebral aneurysms.

Materials And Methods: In our interventional department, working with SCD referral department, we reported our experience concerning management of adult's patients with cerebral aneurysms. We identified 26 adults with 48 intracranial aneurysms documented by imaging. Read More

Eur Radiol Exp 2019 Mar 21;3(1):13. Epub 2019 Mar 21.

Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.

Background: To study hippocampus subfield volumes in patients after microsurgical clipping (MC) and/or endovascular coiling (EC) of intracranial aneurysms.

Methods: Hippocampus subfield volumetry was performed using FreeSurfer v6.0 in 51 patients (35 females, mean age 54. Read More

J Stroke Cerebrovasc Dis 2019 Mar 18. Epub 2019 Mar 18.

Department of Stroke Medicine, Kawasaki Medical School, Okayama, Japan. Electronic address:

A 48-year-old woman spontaneously developed occipital pain, without any other neurological deficit. A brain magnetic resonance angiography showed narrowing, irregular dilatation, and aneurysmal formation in both the vertebral arteries (VA). According to these findings and the clinical course, we diagnosed the patient with spontaneous VA dissection. Read More

Am J Emerg Med 2019 Mar 10. Epub 2019 Mar 10.

Department of Emergency Medicine, Jackson Memorial Health System, Miami, FL 33136, USA.

Introduction: In the catastrophic neurologic emergency, a complete neurological exam is not always possible or feasible given the time-sensitive nature of the underlying disease process, or if emergent airway management is indicated. As the neurologic exam may be limited in some patients, the emergency physician is reliant on the assessment of brainstem structures to determine neurological function. Physicians thus routinely depend on advanced imaging modalities to further investigate for potential catastrophic diagnoses. Read More

World Neurosurg 2019 Feb 25;122:e546-e552. Epub 2018 Oct 25.

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China. Electronic address:

Objective: The purpose of this study is to introduce our initial experience with the evaluation of the feasibility of using Willis covered stents (WCSs) in the treatment of complicated ophthalmic artery (OA) segment aneurysms.

Methods: Of the 162 patients with OA segment aneurysms treated by endovascular techniques in West China Hospital from January 2015 to August 2017, a total of 26 patients treated with WCSs were included in the study.

Results: Twenty-six patients with 26 aneurysms were included (mean age, 57. Read More

Radiology 2019 May 19;291(2):411-417. Epub 2019 Mar 19.

From the Departments of Radiology and Biomedical Imaging (A.M., X.W., H.P.F., C.C.M.), Economics (H.P.F.), Management (H.P.F.), Public Health (H.P.F.), and Neurosurgery (C.C.M.), Yale School of Medicine, 333 Cedar St, Box 208042, Tompkins East 2, New Haven, CT 06520-8042; Harvey L. Neiman Health Policy Institute, Reston, VA (D.R.H.); Department of Radiology, University of Maryland School of Medicine, Baltimore, MD (D.G.); and Department of Radiology, Northwell Health, Manhasset, NY (P.S.).

Background Unruptured intracranial aneurysms (UIAs) are relatively common and are being increasingly diagnosed, with a significant proportion in older patients (˃ 65 years old). Serial imaging is often performed to assess change in size or morphology of UIAs since growing aneurysms are known to be at high risk for rupture. However, the frequency and duration of surveillance imaging have not been established. Read More

World Neurosurg 2019 Mar 11. Epub 2019 Mar 11.

Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA. Electronic address:

This case is a presentation of technical tenets for the microsurgical clipping of a ruptured posterior inferior cerebellar artery (PICA) aneurysm. The patient described in this case was a 19-year old male with a history of polysubstance abuse who presented from an outside hospital after being found unresponsive and admitted for a subarachnoid hemorrhage seven days earlier. Noninvasive vascular imaging completed at the outset hospital showed no clear intracranial aneurysm except some irregularity of left PICA proximally. Read More

Clin Neuroradiol 2019 Mar 13. Epub 2019 Mar 13.

Department of Neuroradiology, Pitié-Salpêtrière Hospital, 47 Boulevard de l'Hôpital, 75013, Paris, France.

Purpose: Non-traumatic acute subdural hematomas (SDH) are rare and have seldom been reported in ruptured brain arteriovenous malformations (BAVM). The aim of this study was to report the frequency of acute SDH in BAVM-related hemorrhage and to determine the relationship of SDHs with BAVM angioarchitectural features.

Methods: This was a retrospective monocentric study of patients admitted for BAVM rupture between 2003 and 2017. Read More

Case Rep Vasc Med 2019 5;2019:3185023. Epub 2019 Feb 5.

Medical Officer, Department of Neurosurgery, College of Medical Sciences-Teaching Hospital, Bharatpur-10, Chitwan, Nepal.

Background: Aneurysmal subarachnoid hemorrhage may be associated with different cranial nerve palsies, with oculomotor nerve palsy (ONP) being the most common. ONP is especially associated with posterior communicating artery aneurysms, due to the anatomical proximity of the nerve to the aneurysmal wall. Anterior communicating artery (Acom) aneurysms are very unlikely to produce ONP due to the widely separated anatomical locations of Acom and oculomotor nerve. Read More

Front Neurol 2019 21;10:136. Epub 2019 Feb 21.

Department of Neurosurgery, RWTH Aachen University, Aachen, Germany.

The implementation of rescue efforts for delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage remains largely empirical for a lack of supporting evidence, while the associated risk profile is also unclear. The present study evaluates the safety and efficacy of endovascular rescue treatment (ERT, continuous intraarterial nimodipine; IAN, transcutaneous balloon angioplasty, TBA). In this prospective observational study, we assessed periprocedural complications and side effects in context of ERT. Read More

Brain 2019 Mar 8. Epub 2019 Mar 8.

Department of Anaesthesiology and Pain Medicine, Laboratory for Perioperative Outcomes Analysis and Research, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Although unruptured intracranial aneurysms are increasingly being diagnosed incidentally, perioperative rupture risk of unruptured intracranial aneurysm in patients undergoing cardiovascular surgery remains unclear. Therefore, we conducted an observational study to assess the prevalence and perioperative rupture risk of unruptured intracranial aneurysm in patients undergoing cardiovascular surgery. Adult patients (n = 4864) who underwent cardiovascular surgery between January 2010 and December 2016 were included. Read More

World Neurosurg 2019 Mar 5. Epub 2019 Mar 5.

University of Miami, Department of Neurological Surgery, Florida, USA.

Background: Intracranial pseudoaneurysms (PSA) are associated with high rupture and mortality rates and have traditionally been treated by parent vessel sacrifice. There has been recent interest in utilizing flow-diverting devices for treatment of these complex lesions while preserving flow through the parent artery.

Objective: Examine the safety and efficacy of these devices in the treatment of intracranial PSA. Read More

Neurol Sci 2019 Mar 7. Epub 2019 Mar 7.

Neurology Service and Stroke Unit, Department of Neuroscience, AO Brotzu, Cagliari, Italy.

Background: Intracranial hypotension has been associated with a wide spectrum of neurological conditions including chronic non-aneurysmal and acute aneurysmal subarachnoid hemorrhage.

Case: A 59-year-old man presented with a non-aneurysmal subarachnoid hemorrhage in a perimesencephalic pattern after a mild physical exertion. In the course of the disease, a magnetic resonance imaging of head and spine displayed intracranial hypotension that resolved spontaneously. Read More

Neuroradiol J 2019 Mar 6:1971400919834692. Epub 2019 Mar 6.

1 Division of Neurosurgery, University of Toronto, Canada.

Flow diverters have emerged as a safe and effective treatment option for patients with complex unruptured cerebral aneurysms. Their utilisation in patients with ruptured aneurysms poses significant challenges, most notably the need for periprocedural dual antiplatelet medication. We describe the use of the pipeline embolisation device with shield technology in an 88-year-old patient with a complex ruptured posterior communicating artery aneurysm not amenable to microsurgical clipping or coiling alone. Read More

J Neurosurg 2019 Mar 1:1-11. Epub 2019 Mar 1.

2Department of Epidemiology, MD Anderson Cancer Center, University of Texas, Houston, Texas.

OBJECTIVEAs imaging technology has improved, more unruptured intracranial aneurysms (UIAs) are detected incidentally. However, there is limited information regarding how UIAs change over time to provide stratified, patient-specific UIA follow-up management. The authors sought to enrich understanding of the natural history of UIAs and identify basic UIA growth trajectories, that is, the speed at which various UIAs increase in size. Read More

BMJ Case Rep 2019 Feb 27;12(2). Epub 2019 Feb 27.

Department of Neurosurgery, University Hospital of Wales, Cardiff, UK.

Spinal arachnoid cysts (SAC) are rare in isolation and the exact aetiology is still debated. Primary (congenital) cysts are caused by structural abnormalities in the arachnoid layer and largely affect the thoracic region. Secondary cysts are induced by a multitude of factors, infection, trauma or iatrogenic response, and can affect any level of the spinal cord. Read More

World Neurosurg 2019 Feb 26;122:e612-e618. Epub 2018 Oct 26.

Department of Neuroscience/Neurosurgery, Uppsala University, Uppsala, Sweden.

Background: Inflammatory processes play a key role in the pathophysiology of subarachnoid hemorrhage (SAH). This study evaluated whether different temporal patterns of intrathecal and systemic inflammation could be identified in the acute phase after SAH. The intensity of the inflammation was also assessed in clinical subgroups. Read More

Medicine (Baltimore) 2019 Feb;98(8):e14184

Department of Rehabilitation Medicine, Dongguk University Ilsan Hospital, Goyang, Korea and Dongguk University, Seoul, Korea.

Rationale: Most perineural cysts are asymptomatic and discovered incidentally at the time of imaging. Although enlargement of the perineural cyst (PC) through a ball-valve mechanism and resultant compression of the adjacent neural or bony structures are known to be a source of pain in PCs, the reason why asymptomatic PCs become symptomatic is unclear. The authors report a case of PC, which was presumed to become symptomatic after subarachnoid hemorrhage without enlargement of the pre-existing PC. Read More

Interv Neuroradiol 2019 Feb 25:1591019919828657. Epub 2019 Feb 25.

3 St Paul Radiology, St Paul, USA.

A 50-year-old female patient with hyperimmunoglobulin E syndrome (HIES) presented initially at the age of 48 years with subarachnoid hemorrhage (SAH) from a ruptured left middle cerebral artery (MCA) bifurcation aneurysm, which was treated successfully with coiling and microsurgical clipping. Angiography and cross-sectional imaging did not indicate evidence of any additional intracranial aneurysm. However, the patient presented two years later with SAH secondary to a new ruptured right MCA bifurcation aneurysm, which was treated successfully with microsurgical clipping. Read More

J Neurosurg 2019 Feb 22:1-11. Epub 2019 Feb 22.

1Division of Neurosurgery, Toronto Western Hospital, Krembil Brain Institute, University Health Network, and Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

OBJECTIVEThe evolution of microsurgical and endoscopic techniques has allowed the development of less invasive transcranial approaches. The authors describe a purely endoscopic transpterional port craniotomy to access lesions involving the cavernous sinus and the anterolateral skull base.METHODSThrough single- or dual-port incisions and with direct endoscopic visualization, the authors performed an endoscopic transpterional port approach (ETPA) using a 4-mm straight endoscope in 8 sides of 4 formalin-fixed cadaveric heads injected with colored latex. Read More

Case Rep Ophthalmol 2019 Jan-Apr;10(1):11-18. Epub 2019 Jan 16.

Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Background: Invasive aspergillosis is often fatal. Here, we report a patient with invasive aspergillosis primarily involving the optic nerve diagnosed on autopsy.

Case Presentation: A 77-year-old female with underlying diabetes mellitus, hyperlipidemia, and hypertension presented with disc swelling of the left eye. Read More

Neurocrit Care 2019 Feb 21. Epub 2019 Feb 21.

Department of Emergency Medicine, Stanford University Medical Center, Palo Alto, USA.

Background And Aims: Spontaneous subarachnoid hemorrhage (SAH) from a brain aneurysm, if untreated in the acute phase, leads to loss of functional independence in about 30% of patients and death in 27-44%. To evaluate for SAH, the American College of Emergency Physicians (ACEP) Clinical Policy recommends obtaining a non-contrast brain computed tomography (CT) scan followed by a lumbar puncture (LP) if the CT is negative. On the other hand, current evidence from prospectively collected data suggests that CT alone may be sufficient to rule out SAH in patients who present within 6 h of symptom onset while anecdotal evidence suggests that CT angiogram (CTA) may be used to detect aneurysms, which are the probable cause of SAH. Read More

Surg Neurol Int 2019 15;10. Epub 2019 Jan 15.

Department of Neurosurgery, Ube-kohsan Central Hospital, 750 Nishikiwa, Ube, Yamaguchi, Japan.

Background: We present a case of tentorial dural arteriovenous fistula (TDAVF) causing subarachnoid hemorrhage with mass effect of large venous pouches, which was struggling to diagnosis and management due to complex vasculature and severe general condition.

Case Description: A 43-year-old man was transferred to our hospital due to sudden consciousness disturbance. A neurological examination revealed tetraparesis and pupil dilatation with no light reflex. Read More

Ann Thorac Surg 2019 Feb 11. Epub 2019 Feb 11.

Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio; Department of Neurology, NYU School of Medicine, New York, NY. Electronic address:

Background: Little data exists regarding reversal and resumption of antithrombotics following left ventricular assist device (LVAD)-associated intracranial hemorrhage (ICH).

Methods: Prospectively collected data of LVAD patients with ICH was reviewed. Coagulopathy reversal agents, antithrombotic regimens and thrombotic (venous thromboembolism, ischemic stroke, myocardial infarction) and hemorrhagic (recurrent ICH, gastrointestinal bleed, anemia requiring transfusion) complications were recorded. Read More

J Clin Med 2019 Feb 12;8(2). Epub 2019 Feb 12.

TENSOR-Team of NeuroSurgery-Oriented Reaserch, Jagiellonian University Medical College, 31-008 Kraków, Poland.

Tortuosity of blood vessels is a common angiographic finding that may indicate systemic disease and can be correlated with vascular pathologies. In this work, we determined whether patients with and without internal carotid artery (ICA) aneurysm presented with differences in its tortuosity descriptors. We retrospectively analysed data of 298 patients hospitalized between January 2014 and June 2018. Read More

Eur J Case Rep Intern Med 2018 28;5(8):000912. Epub 2018 Aug 28.

Vascular Neurology Department, Instituto Nacional de Neurologia y Neurocirugia, Mexico City, Mexico.

Background: Bilateral third cranial nerve palsy has only been reported in a handful of conditions including some with inflammatory, tumoural and vascular causes. An urgent imaging study is mandatory to rule out vascular aetiology, mainly aneurysmal subarachnoid haemorrhage (aSAH).

Case Presentation: A 28-year-old Hispanic woman presented to the emergency department with a 21-day history of a sudden-onset and severe headache that on three occasions was accompanied by transient loss of awareness, the last episode occurring a week previously. Read More

Eur J Case Rep Intern Med 2018 28;5(11):000961. Epub 2018 Nov 28.

Department of Internal Medicine, Centro Hospitalar do Meio Tejo, EPE, Tomar, Portugal.

Non-traumatic haematomyelia is a rare finding of acute onset, which in most cases is the result of arteriovenous malformations (AVM), tumours, coagulation disorders or autoimmune conditions, but may also be secondary to treatment with anticoagulants and radiotherapy. We present the case of a 58-year-old woman with sudden onset cervical pain, followed by asymmetric diminution of strength in the upper limbs with reduced pain sensitivity. The diagnosis of AVM at the C7 and D1 levels was made following cervico-dorsal magnetic resonance imaging and angiography. Read More

Crit Care 2019 Feb 11;23(1):42. Epub 2019 Feb 11.

Department of Anaesthesiology and Critical Care Medicine, INT (Institut de Neurosciences de la Timone), University Hospital Timone, Aix Marseille University, Marseille, France.

Background: Several lipid metabolites in cerebrospinal fluid are correlated with poor outcomes in aneurysmal subarachnoid haemorrhage. Most of these metabolites bind to ubiquitous thromboxane-prostaglandin (TP) receptors, causing vasoconstriction and inflammation. Here, we evaluated terutroban (TBN), a specific TP receptor antagonist, for the prevention of post-haemorrhage blood-brain barrier disruption, neuronal apoptosis and delayed cerebral hypoperfusion. Read More

J Clin Neurosci 2019 May 4;63:122-129. Epub 2019 Feb 4.

Neuroradiologische Klinik, Neurozentrum, Klinikum Stuttgart, Germany; Medical Faculty, University Duisburg-Essen, Germany.

Basilar perforator artery aneurysms (BAPA's) are an under-recognised cause of sub-arachnoid haemorrhage (SAH). We present our single centre experience of BAPA's and review of the literature. We performed a retrospective review of our prospectively maintained database to identify all BAPA's that presented acute SAH between February 2009 and February 2018. Read More

Neurosci Lett 2019 Apr 31;699:64-70. Epub 2019 Jan 31.

Neurosciences and Mental Health, SickKids Research Institute, Toronto, Canada; Division of Neurology, The Hospital for Sick Children, University of Toronto, Canada. Electronic address:

Recent evidence suggests that good neurological outcome in subarachnoid hemorrhage (SAH) does not equate to good neuropsychological and cognitive outcome. These individuals continue to face cognitive difficulties in tasks involving mental flexibility, short-term memory and attention, resulting in decreased independence in daily living and reduced ability to return to work. In the current study, we examined the functional connectivity profiles using magnetoencephalography (MEG) in SAH patients, versus controls, during a visual short-term memory, 1-back, task. Read More

J Stroke Cerebrovasc Dis 2019 May 31;28(5):1192-1199. Epub 2019 Jan 31.

Department of Neurosurgery, Fukuoka University, Fukuoka Japan.

Background: There are limited clinical studies of bilateral vertebral artery dissection (VAD).

Objective: To compare the characteristics, imaging findings, and treatments between patients with bilateral and unilateral VAD.

Methods: Between February 2007 and May 2017, 31 (mean age: 53. Read More

J Neurol Surg A Cent Eur Neurosurg 2019 May 1;80(3):228-232. Epub 2019 Feb 1.

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

Background:  Intracranial chondromas are extremely rare and represent only 0.2% of all intracranial primary neoplasms. The histologic appearance lacks nuclear atypism and mitoses, and it usually shows low growth potential, although these benign features do not necessarily imply a good prognosis. Read More

World Neurosurg 2019 Jan 29. Epub 2019 Jan 29.

Department of Neurology, Neurosurgery and Radiology, Rutgers University - Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA; Department of Neurology and Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, New York, USA. Electronic address:

Background: Intrathecal (IT), intraventricular (IVt), and intracisternal administration of nicardipine deliver treatment directly into the central nervous system. This route of drug delivery is being investigated as a potential treatment of vasospasm following aneurysmal subarachnoid hemorrhage (aSAH).

Objective: The authors reviewed the existing literature regarding the direct administration of nicardipine into the intracranial space for the treatment of vasospasm following aSAH. Read More