Internal carotid artery (ICA) injury is a rare but severe complication of transsphenoidal surgery. A 69-year-old woman presented with progressive visual disturbance secondary to pituitary adenoma. The patient underwent subtotal tumor resection through endoscopic residual in the cavernous sinus gradually enlarged over next 3 years. During second surgical intervention, an inadvertent scratch, worn-out tip micro-suction device, on partially calcified medial wall C4 segment resulted ICA rupture,...

Background Traumatic posterior inferior cerebellar artery (PICA) aneurysms are rare. Fractures of the occipital condyles (OCs) have been reported to cause delayed hypoglossal nerve (HN) palsy possibly. Case Description A 67-year-old man fell while hiking on a mountain. On initial presentation at local hospital, patient exhibited right abducens and hoarseness. Cranial computed tomography (CT) revealed multiple intracranial air densities, with no remarkable hemorrhages detected in cerebral...

Background Various brainstem pathologies cause hiccups. Case Description A 45-year-old man with cerebral cavernous malformation (CCM) in the pons, identified at age of 25 years, experienced an exacerbation left hemiparesis. The patient presented oculomotor and facial nerve paresis, trigeminal pain, swallowing disturbances, though hiccups were not observed. Cerebral magnetic resonance imaging revealed a hemorrhagic mass occupying dorsal predominantly on right side, along multiple hemosiderin...

A 74-year-old man presented with persistent hiccups and headache persisting for 2 days. An anticoagulant was administered his coronary heart disease. Cranial computed tomography (CT) revealed an intracerebral hemorrhage (ICH) located in the right occipital lobe, without any abnormal findings around brainstem. The patient underwent endoscopic hematoma evacuation via a burr hole, resulting immediate resolution of hiccups. Following uneventful postoperative course, experienced recurrent on 47th...

Purpose To investigate the length variation of posterior auricular artery and propose a novel classification based on angiographical appearance. Patients Methods A series 234 consecutive patients who had undergone conventional cerebral angiography was analyzed. The examined lateral projection external carotid or common arteriography. classified into four groups by length, using auditory canal top helix as radiographical landmarks. Our proposed is follows: Type A, terminates between its...

Accessible summary Consumer gender and age, nurse influenced the perception of overall severity aggressive incidents, in addition to aggression data provided by Staff Observation Aggression Scale – Revised (SOAS‐R) scores. The factors influencing assessments incident can be identified from scores concurrently conducting objective (i.e. SOAS‐R) visual analogue scale) assessments. Abstract aim this study is investigate associated with judgements as ward nurses, using Japanese‐language version...

There are only a few case reports in which cholesterol crystals were found the thrombus retrieved by mechanical thrombectomy for cryptogenic stroke, leading to definitive diagnosis. We herein report of aortogenic embolic stroke diagnosed presence rich and review previously reported cases. A woman her 80s was transferred as an emergency due consciousness disturbance, right conjugate deviation, severe left hemiparesis. Magnetic resonance imaging showed occlusion middle cerebral artery (MCA)...

Pelizaeus-Merzbacher disease (PMD) is a rare X-linked dysmyelinating disorder of the CNS resulting from abnormalities in proteolipid protein (PLP) gene. Exonic mutations PLP gene are present 10 to 25% all cases. In investigating genotype-phenotype correlations, we screened five Japanese families with PMD for and compared their clinical manifestations. We identified two novel nucleotide substitutions exon 5, at V208N P210L, families. remaining three families, there were no detected. Although...

Lateral wall paraclinoid aneurysms (LPA) are a rare type of aneurysm located on the lesser curve side internal carotid artery (ICA) bend, at level anterior clinoid process. The objective this study was to assess influence flexion ICA morphology and outcome endovascular treatment. Between 2003 2018, we treated 643 cases unruptured with therapy in our institution. Of those cases, projecting laterally preoperative angiography were defined as LPA. degree bending (ICA angle) measured...

Abstract A 70-year-old man, who had previously undergone surgical resection of left parasagittal meningioma involving the middle third superior sagittal sinus (SSS) two times, presented with recurrence tumor. We performed removal tumor combined SSS as Simpson grade II. After removal, since a dominant bilateral chronic subdural hematoma (CSDH) appeared, it was treated by burr hole surgery. However, because CSDH rapidly and repeatedly recurred eventually changed to acute hematoma, elimination...

A 53-year-old woman presented with a 2-week history of headache and vertigo. Computed tomography revealed hyperdense tumor, measuring 30 × 31 36 mm in diameter, the anteromedial parts cerebellar hemispheres. Cerebral magnetic resonance imaging 10 days later an apparent extra-axial tumor broad attachment to medial tentorium cerebelli rapid growth diameter 40 41 46 mm. angiography no obvious feeding vessels or stains. The patient underwent biopsy through left occipital transtentorial route....

A 43-year-old, previously healthy man experienced a decreased sensation in the left lower extremity without preceding spinal trauma. At presentation, patient exhibited slight motor weakness extremity, addition to pain below ipsilateral T7. Spinal magnetic resonance imaging (MRI) revealed abnormal findings consistent with idiopathic thoracic cord herniation (ITSCH) at T5/6 level. Computed tomography (CT) small vertebral erosion T5. The patient's symptoms gradually progressed over next 3...

A 50-year-old man presented with headache and left hemiparesis. No noticeable preceding head trauma was observed. Computed tomography (CT) scans revealed a compressive chronic subdural hematoma (CSDH). The patient underwent burr-hole irrigation, during which he considerably restless. In addition, extensive avulsion found in the parietal dura mater posterior to burr hole. CT performed immediately after surgery emergence of thick epidural (EDH) located burr-hole. During emergency craniotomy...

A 73-year-old man who previously underwent transsphenoidal surgery for a Rathke's cleft cyst presented with headache and fever. Ophthalmological examination revealed the progression of visual impairment. Cerebral magnetic resonance imaging cystic mass in sellar suprasellar regions rim-like enhancement. An intralesional hyperintense area temporal enlargement was identified using serial diffusion-weighted imaging. Lumbar cerebrospinal fluid tap findings indicated bacterial meningitis. The...

Orbital schwannomas arising from the frontal nerve are a rare but distinct entity.

Arachnoid cysts (ACs) complicated by chronic subdural hematoma (CSDH) are a rare but distinct entity.

Objective: Pipeline Embolization Device (PED; Medtronic, Minneapolis, NM, USA) is the first and currently only flow diversion device approved by Ministry of Health, Labour Welfare in Japan. The PED able to embolize unruptured intracranial aneurysm (UIA) due disruption blood into sac while preserving normal parent surrounding branch vessels. One drawbacks embolization require coil when aneurysms are deemed be high-risk delayed rupture.

A 65-year-old man presented with coma. The cranial computed tomography (CT) revealed a massive hematoma in the left cerebral hemisphere, accompanied by intraventricular hemorrhage (IVH) and ventriculomegaly. Contrast examination ectatic superior ophthalmic veins (SOVs). patient underwent emergent evacuation. CT performed on postoperative day (POD) 2 showed remarkable reduction diameters of both SOVs. second patient, 53-year-old man, consciousness disturbance right hemiparesis. large...