World Neurosurg
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Although extraparenchymal neurocysticercosis (NCC) is well established, presentation in the suprasellar space is rare. When presenting in the suprasellar space, the imaging characteristics may mimic more common lesions including craniopharyngioma and Rathke cleft cyst depending on the life cycle of the parasite. Although antiparasitic medical therapy may be effective for viable NCC, it is not routinely employed for calcified NCC. ⋯ Regardless of the life cycle stage, endonasal resection offers a minimally invasive approach for suprasellar NCC; treatment can be tailored to the patient's presentation and stage of infection.
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A patient presented with progressive ischemic stroke and received mechanical thrombectomy with a Solitaire FR device 29 days after stroke onset. The occluded V4 segment of the left vertebral artery showed a double rail sign on angiography, which indicated that the occlusion might have been caused by embolism instead of stenosis. The mechanical thrombectomy procedure was a 1-pass success and the patient was functionally independent with a modified Rankin Scale score of 1 at 3-month follow-up. The appearance of the vascular wall (double rail sign) of the occluded cerebral vascular segment on angiography may be a significant feature to identify the character of the occlusion even a long time after onset, which is important when planning further endovascular therapy in patients with ischemic stroke.