World Neurosurg
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Encephaloduroarteriosynangiosis (EDAS) as a form of indirect revascularization has been recently proposed as a potentially promising alternative for patients with intracranial atherosclerotic disease (ICAD). The object of this study was to compare the prognostic roles between isolated EDAS and medical therapy in patients with atherosclerotic middle cerebral artery occlusion (MCAO). ⋯ In the long-term, isolated EDAS can be considered effective and safe for patients with atherosclerotic MCAO, whereas it may need additional medical therapy support in the short-term.
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Hematoma expansion (HE) is closely related to poor outcome in spontaneous intracerebral hemorrhage (sICH). Island sign (IS) is a novel HE predictor based on noncontrast computed tomography (NCCT). This study is aimed to confirm the accuracy of IS for predicting HE and compare it to the spot sign (SS) on computed tomography angiography (CTA). ⋯ IS is independently associated with HE. Although the accuracy of IS for predicting HE is lower than SS, it can be an alternative predictor if CTA cannot be performed.
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To report a single-center experience with endovascular treatment of ruptured proximal posterior inferior cerebellar artery (PICA) aneurysms. ⋯ Ruptured proximal PICA aneurysms may be effectively treated with endovascular coil embolization. A variety of coil embolization techniques are required to obliterate an aneurysm without parent artery occlusion. Given that recurrence is possible, follow-up is required. Surgical clipping can be performed for recurrence with a relatively low risk of complications, because the aneurysm is unruptured. Coil embolization of a proximal PICA aneurysm in the acute phase can be a good treatment modality with good patient outcomes.
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Gastroparesis following resection of a fourth ventricle tumor has never been reported in the literature. We report a unique case of gastroparesis following resection of a fourth-ventricle ependymoma in a child. ⋯ We report, to our knowledge, the first case of gastroparesis following resection of a fourth-ventricle ependymoma in a child. Gastroparesis can recover spontaneously, which we suspect may be due to reversible injury of the dorsal motor nucleus of the vagus.
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Meningioma growing into an arachnoid cyst is an extremely rare event. Only 3 cases are reported in the literature. In 2 of them, an operative procedure in or near the arachnoid cyst preceded tumor growth. ⋯ We discuss the possible pathogenesis in light of the scarce published literature, as well as the differential diagnosis of this rapidly growing tumor.