Scholars@Duke
David Hasan

David Hasan

Professor of Neurosurgery
Neurosurgery
david.hasan@duke.edu
200 Trent Dr, DUMC 3807, Durham, NC 27710
200 Trent Dr, Box 3807, Durham, NC 27710

Selected Publications

Propranolol or Beta-Blockers for Cerebral Cavernous Malformation: a Systematic Review and Meta-analysis of Literature in Both Preclinical and Clinical Studies.

Journal Article Transl Stroke Res · December 2024 Cerebral cavernous malformation (CCM), either sporadic or familial, is a devastating vascular malformation affecting the central nervous system that can present with intracerebral hemorrhage, seizure, and new focal neurologic deficits resulting in substant ... Full text Link to item Cite

Clopidogrel Is Associated with Reduced Likelihood of Aneurysmal Subarachnoid Hemorrhage: a Multi-Center Matched Retrospective Analysis.

Journal Article Transl Stroke Res · October 2024 Maladaptive inflammation underlies the formation and rupture of human intracranial aneurysms. There is a growing body of evidence that anti-inflammatory pharmaceuticals may beneficially modulate this process. Clopidogrel (Plavix) is a commonly used irrever ... Full text Link to item Cite

Balloon-mounting stent versus balloon angioplasty for intracranial arterial stenosis: A systematic review and meta-analysis.

Journal Article J Stroke Cerebrovasc Dis · May 2024 BACKGROUND: Intracranial artery atherosclerotic stenosis (ICAS) is a major cause of stroke, especially in Asian countries. Current treatment options, including balloon-mounted stent (BMS) and balloon angioplasty (BA), lack sufficient evidence to determine ... Full text Link to item Cite

Serum Interleukin-1 Levels Are Associated with Intracranial Aneurysm Instability.

Journal Article Transl Stroke Res · April 2024 Serum interleukin-1 (IL-1) are possibly indicative of the inflammation in the intracranial aneurysm (IA) wall. This study aimed to investigate whether IL-1 could discriminate the unstable IAs (ruptured intracranial aneurysms (RIAs) and symptomatic unruptur ... Full text Link to item Cite

Antithrombotic Therapy in Cerebral Cavernous Malformations: A Systematic Review, Meta-Analysis, and Network Meta-Analysis.

Journal Article J Am Heart Assoc · March 19, 2024 BACKGROUND: Cerebral cavernous malformations are complex vascular anomalies in the central nervous system associated with a risk of intracranial hemorrhage. Traditional guidelines have been cautious about the use of antithrombotic therapy in this patient g ... Full text Link to item Cite

Direct Versus Indirect Revascularization for Moyamoya: a Large Multicenter Study.

Journal Article J Neurol Neurosurg Psychiatry · February 14, 2024 BACKGROUND: Moyamoya is a chronic occlusive cerebrovascular disease of unknown etiology causing neovascularization of the lenticulostriate collaterals at the base of the brain. Although revascularization surgery is the most effective treatment for moyamoya ... Full text Link to item Cite

Revisiting Transcranial Light Stimulation as a Stroke Therapeutic-Hurdles and Opportunities.

Journal Article Transl Stroke Res · December 2023 Near-infrared laser therapy, a special form of transcranial light therapy, has been tested as an acute stroke therapy in three large clinical trials. While the NEST trials failed to show the efficacy of light therapy in human stroke patients, there are man ... Full text Link to item Cite

Symptomatic carotid artery intraluminal thrombus: risk of medical management failure and distal embolization.

Journal Article J Neurointerv Surg · November 24, 2023 BACKGROUND: Carotid artery intraluminal thrombus (ILT), or free-floating thrombus, is an uncommon cerebrovascular entity with considerable equipoise regarding its clinical management. Likewise, in patients treated with medical management (MM), distal embol ... Full text Link to item Cite

Comparative outcomes of middle meningeal artery embolization with statins versus embolization alone in the treatment of chronic subdural hematoma: a systematic review and meta-analysis.

Journal Article Neurosurg Rev · October 3, 2023 Chronic subdural hematoma (cSDH) is common among the elderly, with surgical evacuation as a prevalent treatment, facing recurrence rates up to 30%. Recently, middle meningeal artery embolization (MMAE) has emerged as a promising approach, offering reduced ... Full text Link to item Cite

Volumetric surveillance of brain aneurysms: Pitfalls of MRA.

Journal Article Interv Neuroradiol · October 2023 INTRODUCTION: Untreated brain aneurysms are usually surveilled with serial MR imaging and evaluated with 2D multiplanar measurements. The assessment of aneurysm growth may be more accurate with volumetric analysis. We evaluated the accuracy of a magnetic r ... Full text Link to item Cite

3D aneurysm wall enhancement is associated with symptomatic presentation.

Journal Article J Neurointerv Surg · August 2023 BACKGROUND: Aneurysm wall enhancement (AWE) is a potential surrogate biomarker for aneurysm instability. Previous studies have assessed AWE using 2D multiplanar methods, most of which were conducted qualitatively. OBJECTIVE: To use a new quantitative tool ... Full text Link to item Cite

Haptoglobin Treatment for Aneurysmal Subarachnoid Hemorrhage: Review and Expert Consensus on Clinical Translation.

Journal Article Stroke · July 2023 Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating form of stroke frequently affecting young to middle-aged adults, with an unmet need to improve outcome. This special report focusses on the development of intrathecal haptoglobin supplementation as ... Full text Link to item Cite

Magnetite nanoparticles as a kinetically favorable source of iron to enhance GBM response to chemoradiosensitization with pharmacological ascorbate.

Journal Article Redox Biol · June 2023 Ferumoxytol (FMX) is an FDA-approved magnetite (Fe3O4) nanoparticle used to treat iron deficiency anemia that can also be used as an MR imaging agent in patients that can't receive gadolinium. Pharmacological ascorbate (P-AscH-; IV delivery; plasma levels  ... Full text Link to item Cite

Intraarterial encephalography from an acutely implanted aneurysm embolization device in awake humans.

Journal Article J Neurosurg · March 1, 2023 OBJECTIVE: Endovascular electroencephalography (evEEG) uses the cerebrovascular system to record electrical activity from adjacent neural structures. The safety, feasibility, and efficacy of using the Woven EndoBridge Aneurysm Embolization System (WEB) for ... Full text Link to item Cite

Comprehensive morphomechanical analysis of brain aneurysms.

Journal Article Acta Neurochir (Wien) · February 2023 OBJECTIVE: Brain aneurysms comprise different compartments that undergo unique biological processes. A detailed multimodal analysis incorporating 3D aneurysm wall enhancement (AWE), computational fluid dynamics (CFD), and finite element analysis (FEA) data ... Full text Link to item Cite

Postoperative cognitive dysfunction after endovascular treatments for unruptured intracranial aneurysms: A pilot study.

Journal Article Interv Neuroradiol · August 2022 OBJECTIVE: Post operative cognitive dysfunction (POCD) has been widely observed after major surgery, particularly in elderly patients with general anesthesia (GA). However, a specific unanswered question is whether different approaches to anesthetic manage ... Full text Link to item Cite

Increased Concentrations of Atherogenic Proteins in Aneurysm Sac Are Associated with Wall Enhancement of Unruptured Intracranial Aneurysm.

Journal Article Transl Stroke Res · August 2022 Current MR-vessel wall imaging (VWI) of unruptured intracranial aneurysms (UIAs) permits the visualization of wall structures. Aneurysm wall enhancement (AWE) was associated with atherosclerotic remodeling of the aneurysm wall accompanied by infiltration o ... Full text Link to item Cite

Clipping Could Be the Best Treatment Modality for Recurring Anterior Communicating Artery Aneurysms Treated Endovascularly.

Journal Article Neurosurgery · May 1, 2022 BACKGROUND: The anterior communicating artery (AcoA) is the most common location for intracranial aneurysms. OBJECTIVE: To present occlusion outcomes, complication rate, recurrence rate, and predictors of recurrence in a large cohort with AcoA aneurysms tr ... Full text Link to item Cite

The Woven EndoBridge (WEB) device: feasibility, techniques, and outcomes after FDA approval.

Journal Article J Neurosurg · May 1, 2022 OBJECTIVE: Wide-neck bifurcation cerebral aneurysms have historically required either clip ligation or stent- or balloon-assisted coil embolization. This predicament led to the development of the Woven EndoBridge (WEB) aneurysm embolization system, a self- ... Full text Link to item Cite

Predictors of aneurysm occlusion following treatment with the WEB device: systematic review and case series.

Journal Article Neurosurg Rev · April 2022 The Woven EndoBridge (WEB) device is becoming increasingly popular for treatment of wide-neck aneurysms. As experience with this device grows, it is important to identify factors associated with occlusion following WEB treatment to guide decision making an ... Full text Link to item Cite

Assessing the rate, natural history, and treatment trends of intracranial aneurysms in patients with intracranial dural arteriovenous fistulas: a Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) investigation.

Journal Article J Neurosurg · April 1, 2022 OBJECTIVE: There is a reported elevated risk of cerebral aneurysms in patients with intracranial dural arteriovenous fistulas (dAVFs). However, the natural history, rate of spontaneous regression, and ideal treatment regimen are not well characterized. In ... Full text Link to item Cite

Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR): rationale, design, and initial characterization of patient cohort.

Journal Article J Neurosurg · April 1, 2022 OBJECTIVE: Cranial dural arteriovenous fistulas (dAVFs) are rare lesions, hampering efforts to understand them and improve their care. To address this challenge, investigators with an established record of dAVF investigation formed an international, multic ... Full text Link to item Cite

Recurrence after cure in cranial dural arteriovenous fistulas: a collaborative effort by the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR).

Journal Article J Neurosurg · April 1, 2022 OBJECTIVE: Cranial dural arteriovenous fistulas (dAVFs) are often treated with endovascular therapy, but occasionally a multimodality approach including surgery and/or radiosurgery is utilized. Recurrence after an initial angiographic cure has been reporte ... Full text Link to item Cite

Intervention for unruptured high-grade intracranial dural arteriovenous fistulas: a multicenter study.

Journal Article J Neurosurg · April 1, 2022 OBJECTIVE: The risk-to-benefit profile of treating an unruptured high-grade dural arteriovenous fistula (dAVF) is not clearly defined. The aim of this multicenter retrospective cohort study was to compare the outcomes of different interventions with observ ... Full text Link to item Cite

Dural arteriovenous fistulas without cortical venous drainage: presentation, treatment, and outcomes.

Journal Article J Neurosurg · April 1, 2022 OBJECTIVE: Current evidence suggests that intracranial dural arteriovenous fistulas (dAVFs) without cortical venous drainage (CVD) have a benign clinical course. However, no large study has evaluated the safety and efficacy of current treatments and their ... Full text Link to item Cite

Analysis of Cerebral Aneurysm Wall Tension and Enhancement Using Finite Element Analysis and High-Resolution Vessel Wall Imaging

Journal Article Frontiers in Neurology · December 10, 2021 Biomechanical computational simulation of intracranial aneurysms has become a promising method for predicting features of instability leading to aneurysm growth and rupture. Hemodynamic analysis of aneurysm behavior has helped investigate the complex relat ... Full text Cite

Phase 1/2a Trial of ISPASM.

Journal Article Stroke · December 2021 BACKGROUND AND PURPOSE: Microthrombosis could play a role in delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. Tirofiban has shown promising results in reducing delayed cerebral ischemia in retrospective studies. However, the safety of us ... Full text Link to item Cite

Reversible bilateral optic tract edema following pipeline-assisted coiling of a large ophthalmic aneurysm: A case report.

Journal Article Clin Neurol Neurosurg · December 2021 Edema coursing the optic apparatus has traditionally been associated with sellar and para-sellar tumors. However, postoperative aneurysmal volume expansion following endovascular treatment has been reported to induce cranial neuropathies, such as vision lo ... Full text Link to item Cite

High-resolution vessel wall imaging after mechanical thrombectomy.

Journal Article Neuroradiol J · December 2021 OBJECTIVES: High-resolution magnetic resonance imaging has the potential of characterising arterial wall changes after endovascular mechanical thrombectomy. The purpose of this study is to evaluate high-resolution magnetic resonance imaging features of lar ... Full text Link to item Cite

Insights into the pathogenesis of cerebral fusiform aneurysms: high-resolution MRI and computational analysis.

Journal Article J Neurointerv Surg · December 2021 BACKGROUND: Intracranial fusiform aneurysms are complex and poorly characterized vascular lesions. High-resolution magnetic resonance imaging (HR-MRI) and computational morphological analysis may be used to characterize cerebral fusiform aneurysms. OBJECTI ... Full text Link to item Cite

Melatonin and risk of mortality in subjects with aneurysmal subarachnoid hemorrhage.

Journal Article Clin Neurol Neurosurg · November 2021 BACKGROUND: Delayed cerebral ischemia (DCI) is a cause of morbidity associated with aneurysmal subarachnoid hemorrhage (aSAH). Neuroinflammation contributes to the development of DCI. Melatonin is a sleep-promoting hormone known to have cerebral anti-infla ... Full text Link to item Cite

Metastatic Renal Cell Carcinoma to the Spine: Outcomes and Morbidity: Single-Center Experience.

Journal Article World Neurosurg · October 2021 BACKGROUND: Renal cell carcinoma with metastases to the spine (RCCMS) requires a multidisciplinary approach. We reviewed our institutional experience with RCCMS patients undergoing spinal surgery in order to identify factors that may affect clinical outcom ... Full text Link to item Cite

Aneurysm Wall Enhancement Is Associated With Decreased Intrasaccular IL-10 and Morphological Features of Instability.

Journal Article Neurosurgery · September 15, 2021 BACKGROUND: High-resolution vessel wall imaging plays an increasingly important role in assessing the risk of aneurysm rupture. OBJECTIVE: To introduce an approach toward the validation of the wall enhancement as a direct surrogate parameter for aneurysm s ... Full text Link to item Cite

Semiautomated 3D mapping of aneurysmal wall enhancement with 7T-MRI.

Journal Article Sci Rep · September 15, 2021 Aneurysm wall enhancement (AWE) after the administration of contrast gadolinium is a potential biomarker of unstable intracranial aneurysms. While most studies determine AWE subjectively, this study comprehensively quantified AWE in 3D imaging using a semi ... Full text Link to item Cite

Aneurysmal Subarachnoid Hemorrhage in Patients with Coronavirus Disease 2019 (COVID-19): A Case Series.

Journal Article World Neurosurg · September 2021 OBJECTIVE: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is a pressing public health issue. Although most cases do not result in severe illness requiring hospitalization, there is increasing evidence that SARS-CoV-2-induced infl ... Full text Link to item Cite

Pathophysiology of Delayed Cerebral Ischemia After Subarachnoid Hemorrhage: A Review.

Journal Article J Am Heart Assoc · August 3, 2021 Delayed cerebral ischemia is a major predictor of poor outcomes in patients who suffer subarachnoid hemorrhage. Treatment options are limited and often ineffective despite many years of investigation and clinical trials. Modern advances in basic science ha ... Full text Link to item Cite

Aberrant whole blood gene expression in the lumen of human intracranial aneurysms

Journal Article Diagnostics · August 1, 2021 The rupture of an intracranial aneurysm (IA) causes devastating hemorrhagic strokes. Yet, most IAs remain asymptomatic and undetected until they rupture. In the search for circulating biomarkers of unruptured IAs, we previously performed transcriptome prof ... Full text Cite

A comparative study of transradial versus transfemoral approach for flow diversion.

Journal Article Neuroradiology · August 2021 PURPOSE: Data in neurointerventional literature is extremely limited regarding the safety and efficacy of flow diversion using transradial access (TRA). We aim to demonstrate the safety and efficacy of intracranial aneurysm treatment with the Pipeline Embo ... Full text Link to item Cite

Concentration of Lp(a) (Lipoprotein[a]) in Aneurysm Sac Is Associated With Wall Enhancement of Unruptured Intracranial Aneurysm.

Journal Article Stroke · April 2021 BACKGROUND AND PURPOSE: Atherosclerotic remodeling of the aneurysm wall, which could be detected as aneurysm wall enhancement (AWE) by magnetic resonance-vessel wall imaging, is a part of degenerative change of unruptured intracranial aneurysms (UIAs). The ... Full text Link to item Cite

Impact of Intracerebral Hematoma Evacuation During Decompressive Hemicraniectomy on Functional Outcomes.

Journal Article Stroke · March 2021 BACKGROUND AND PURPOSE: Decompressive hemicraniectomy has been used to treat spontaneous intracerebral hemorrhage, but the benefit of evacuating the hematoma during the procedure is unclear. We aim to evaluate the utility of performing clot evacuation duri ... Full text Link to item Cite

Regional Aneurysm Wall Enhancement is Affected by Local Hemodynamics: A 7T MRI Study.

Journal Article AJNR Am J Neuroradiol · March 2021 BACKGROUND AND PURPOSE: Aneurysm wall enhancement has been proposed as a biomarker for inflammation and instability. However, the mechanisms of aneurysm wall enhancement remain unclear. We used 7T MR imaging to determine the effect of flow in different reg ... Full text Link to item Cite

Predictors of ventriculostomy infection in a large single-center cohort.

Journal Article J Neurosurg · March 1, 2021 OBJECTIVE: External ventricular drain (EVD) placement is a common neurosurgical procedure. While this procedure is simple and effective, infection is a major limiting factor. Factors predictive of infection reported in the literature are not conclusive. Th ... Full text Link to item Cite

Decreased contrast enhancement on high-resolution vessel wall imaging of unruptured intracranial aneurysms in patients taking aspirin.

Journal Article J Neurosurg · March 1, 2021 OBJECTIVE: Inflammation plays an integral role in the formation, growth, and progression to rupture of unruptured intracranial aneurysms (UIAs). Animal and human studies have suggested that, due to its antiinflammatory effect, aspirin (ASA) may decrease th ... Full text Link to item Cite

Objective quantification of contrast enhancement of unruptured intracranial aneurysms: a high-resolution vessel wall imaging validation study.

Journal Article J Neurosurg · March 1, 2021 OBJECTIVE: High-resolution vessel wall imaging (HR-VWI) has emerged as a valuable tool in assessing unruptured intracranial aneurysms (UIAs). There is no standardized method to quantify contrast enhancement of the aneurysm wall. Contrast enhancement can be ... Full text Link to item Cite

Performance of Aneurysm Wall Enhancement Compared with Clinical Predictive Scales: PHASES, ELAPSS, and UIATS.

Journal Article World Neurosurg · March 2021 OBJECTIVE: To correlate the presence of objectively measured wall enhancement on high-resolution vessel wall imaging (HR-VWI) with the clinical predictive scales PHASES, ELAPSS, and UIATS. METHODS: Patients with unruptured intracranial aneurysm (UIAs) pros ... Full text Link to item Cite

Quantitative Assessment of Ventriculostomy-Related Hemorrhage: A Volume-Based Classification System to Predict New Neurological Symptoms.

Journal Article Oper Neurosurg (Hagerstown) · January 13, 2021 BACKGROUND: Hemorrhage is one of the most feared complications following ventriculostomy placement. Current studies have assessed factors associated with increased risk of ventriculostomy-related hemorrhage (VRH). However, the clinical significance of VRH ... Full text Link to item Cite

Aneurysm risk metrics and hemodynamics are associated with greater vessel wall enhancement in intracranial aneurysms

Journal Article Royal Society Open Science · January 1, 2021 Vessel wall enhancement (VWE) in contrast-enhanced magnetic resonance imaging (MRI) is a potential biomarker for intracranial aneurysm (IA) risk stratification. In this study, we investigated the relationship between VWE features, risk metrics, morphology ... Full text Cite

Minimally Invasive Deep Brain Stimulation Using Intracranial Stents

Conference 2021 IEEE International Symposium on Antennas and Propagation and North American Radio Science Meeting, APS/URSI 2021 - Proceedings · January 1, 2021 Deep brain stimulation is a multipurpose therapy indicated for a host of neuropsychiatric disorders including treatment resistant depression, Parkinson's disease, and refractory epilepsy. However, current systems require invasive surgery and have a high ri ... Full text Cite

Safety and feasibility of the Woven EndoBridge device deployment with monitored anesthesia care.

Journal Article Interv Neuroradiol · December 2020 OBJECTIVE: The Woven EndoBridge (WEB) device can be used for complex intracranial aneurysms (IAs), mostly under general anesthesia (GA). However, it remains controversial if anesthetic management could affect procedural outcomes after endovascular treatmen ... Full text Link to item Cite

Effects of patient-level noise abatement orders on sound levels experienced by critically ill subarachnoid hemorrhage patients: an observational study.

Journal Article Hosp Pract (1995) · December 2020 BACKGROUND/OBJECTIVE: Patients with aneurysmal subarachnoid hemorrhage (aSAH) may be at risk for complications related to excessive environmental noise. Our ICU utilizes a variety of universal interventions to minimize ambient noise levels, but patients wi ... Full text Link to item Cite

Detection and Quantification of Symptomatic Atherosclerotic Plaques With High-Resolution Imaging in Cryptogenic Stroke.

Journal Article Stroke · December 2020 BACKGROUND AND PURPOSE: High-resolution vessel wall imaging (HR-VWI) is a powerful tool in diagnosing intracranial vasculopathies not detected on routine imaging. We hypothesized that 7T HR-VWI may detect the presence of atherosclerotic plaques in patients ... Full text Link to item Cite

Aspirin associated with decreased rate of intracranial aneurysm growth.

Journal Article J Neurosurg · November 1, 2020 OBJECTIVE: Aspirin has emerged as a potential agent in the prevention of rupture of intracranial aneurysms (IAs). In this study, the authors' goal was to test if aspirin is protective against aneurysm growth in patients harboring multiple IAs ≤ 5 mm. METHO ... Full text Link to item Cite

In-House Anesthesia and Interventional Radiology Technologist Support Optimize Mechanical Thrombectomy Workflow after Hours.

Journal Article J Stroke Cerebrovasc Dis · November 2020 BACKGROUND AND PURPOSE: Prior literature suggests after-hours delay leads to poor functional outcomes in stroke patients undergoing thrombectomy. We aimed to evaluate the impact of time of presentation on mechanical thrombectomy (MT) metrics and its associ ... Full text Link to item Cite

Combined Transradial and Transfemoral Approach With Ostial Vertebral Balloon Protection for the Treatment of Patients With Subclavian Steal Syndrome

Journal Article Frontiers in Neurology · October 22, 2020 Background: Patients with an obstructive subclavian artery (SA) may exhibit symptoms of vertebrobasilar insufficiency known as subclavian steal syndrome (SSS). Endovascular treatment with stent assisted percutaneous transluminal angioplasty (SAPTA) demonst ... Full text Cite

Tirofiban Protocol Protects Against Delayed Cerebral Ischemia: A Case-Series Study.

Journal Article Neurosurgery · October 15, 2020 BACKGROUND: There has not been any effective prophylaxis for delayed cerebral ischemia delayed cerebral ischemia (DCI) since the introduction of nimodipine. Platelet inhibition may reduce the risk by preventing the formation of microthrombi. Tirofiban has ... Full text Link to item Cite

Quantifying Intra-Arterial Verapamil Response as a Diagnostic Tool for Reversible Cerebral Vasoconstriction Syndrome.

Journal Article AJNR Am J Neuroradiol · October 2020 BACKGROUND AND PURPOSE: There is mounting evidence supporting the benefit of intra-arterial administration of vasodilators in diagnosing reversible cerebral vasoconstriction syndrome. We prospectively quantified the degree of luminal diameter dilation afte ... Full text Link to item Cite

Between-center and between-country differences in outcome after aneurysmal subarachnoid hemorrhage in the Subarachnoid Hemorrhage International Trialists (SAHIT) repository.

Journal Article J Neurosurg · October 1, 2020 OBJECTIVE: Differences in clinical outcomes between centers and countries may reflect variation in patient characteristics, diagnostic and therapeutic policies, or quality of care. The purpose of this study was to investigate the presence and magnitude of ... Full text Link to item Cite

Clinical and Imaging Features of Contrast-Induced Neurotoxicity After Neurointerventional Surgery.

Journal Article World Neurosurg · October 2020 BACKGROUND: Contrast-induced neurotoxicity (CIN) is an infrequent complication of endovascular procedures, and its understanding remains poor. We aimed to study and characterize the clinical and imaging features of a case series of CIN after neurointervent ... Full text Link to item Cite

Multiple intra-aneurysmal WEB devices: Case discussions and operative technique.

Journal Article J Clin Neurosci · October 2020 The Woven Endobridge (WEB, Sequent Medical, Aliso Viejo, California) device has emerged as an FDA approved endosaccular flow diverting alternative for patients with complex aneurysm morphology. We describe for the first time, in patients with dual anti pla ... Full text Link to item Cite

Increased contrast enhancement of the parent vessel of unruptured intracranial aneurysms in 7T MR imaging.

Journal Article J Neurointerv Surg · October 2020 BACKGROUND: Inflammation of the arterial wall may lead to aneurysm formation. The presence of aneurysm enhancement on high-resolution vessel wall imaging (HR-VWI) is a marker of wall inflammation and instability. We aim to determine if there is any associa ... Full text Link to item Cite

Access-Site Complications in Transfemoral Neuroendovascular Procedures: A Systematic Review of Incidence Rates and Management Strategies.

Journal Article Oper Neurosurg (Hagerstown) · September 15, 2020 BACKGROUND: The femoral artery is the most common access route for cerebral angiography and neurointerventional procedures. Complications of the transfemoral approach include groin hemorrhages and hematomas, retroperitoneal hematomas, pseudoaneurysms, arte ... Full text Link to item Cite

Predictors of Complications, Functional Outcome, and Morbidity in a Large Cohort Treated With Flow Diversion.

Journal Article Neurosurgery · September 15, 2020 BACKGROUND: A dramatic improvement in obliteration rates of large, wide-necked aneurysms has been observed after the FDA approved the Pipeline Embolization Device (PED) in 2011. OBJECTIVE: To assess the predictors of complications, morbidity, and unfavorab ... Full text Link to item Cite

Carotid Blowout Management in the Endovascular Era.

Journal Article World Neurosurg · September 2020 BACKGROUND: Carotid blowout syndrome (CBS) is a potential complication of head and neck cancer, and its therapy is associated with high morbidity and mortality. Recent advances in endovascular techniques have improved patient outcomes. In this study, we re ... Full text Link to item Cite

Mechanical Thrombectomy of Acutely Occluded Flow-Diverters - Neuroendovascular Surgical Technique Demonstration: 2-Dimensional Operative Video.

Journal Article Oper Neurosurg (Hagerstown) · August 1, 2020 Flow-diversion with pipeline embolization devices (PED, Medtronic, Dublin, Ireland) is widely used for embolization of complex intracranial aneurysms.1 In-stent thrombosis can be a dreadful complication after PED deployment. Intra-arterial glycoprotein IIb ... Full text Link to item Cite

Preliminary results in the analysis of the immune response after aneurysmal subarachnoid hemorrhage.

Journal Article Sci Rep · July 16, 2020 Cerebral vasospasm (VSP) is a common phenomenon after aneurysmal subarachnoid hemorrhage (aSAH) and contributes to neurocognitive decline. The natural history of the pro-inflammatory immune response after aSAH has not been prospectively studied in human ce ... Full text Link to item Cite

Treatment of Acutely Ruptured Cerebral Aneurysms With the Woven EndoBridge Device: Experience Post-FDA Approval.

Journal Article Neurosurgery · July 1, 2020 BACKGROUND: Coil embolization of ruptured bifurcation aneurysms is challenging and often necessitates adjunctive stenting, which requires antiplatelet therapy in the setting of subarachnoid hemorrhage (SAH). The Woven EndoBridge (WEB; Terumo) device is an ... Full text Link to item Cite

Treatment and diagnosis of cerebral aneurysms in the post-International Subarachnoid Aneurysm Trial (ISAT) era: trends and outcomes.

Journal Article J Neurointerv Surg · July 2020 BACKGROUND: Following publication of the International Subarachnoid Aneurysm Trial (ISAT), treatment paradigms for cerebral aneurysms (CAs) shifted from open surgical clipping to endovascular embolization as primary therapy in a majority of cases. However, ... Full text Link to item Cite

Analysis of the utility of early MRI/MRA in 400 patients with spontaneous intracerebral hemorrhage.

Journal Article J Neurosurg · June 1, 2020 OBJECTIVE: MRI and MRA studies are routinely obtained to identify the etiology of intracerebral hemorrhage (ICH). The diagnostic yield of MRI/MRA in the setting of an acute ICH, however, remains unclear. The authors' goal was to determine the utility of ea ... Full text Link to item Cite

Intracranial Atherosclerosis: A Disease of Functional, not Anatomic Stenosis? How Trans-Stenotic Pressure Gradients Can Help Guide Treatment.

Journal Article Oper Neurosurg (Hagerstown) · June 1, 2020 BACKGROUND: Most trials have assessed intracranial atherosclerotic disease (ICAD) severity based on angiographic stenosis. However, anatomic stenosis might not accurately identify the actual state of functional post-stenotic flow limitation. OBJECTIVE: To ... Full text Link to item Cite

Ethmoidal dural arteriovenous fistulas: endovascular transvenous embolization technique.

Journal Article J Neurointerv Surg · June 2020 Ethmoidal dural arteriovenous fistulas (dAVFs) are rare, accounting for 1–1.5% of all intracranial malformations. However, they may have angiographic features that increase the risk of rupture: cortical venous drainage, venous ectasia, venous stenosis and ... Full text Link to item Cite

Endovascular management of acute large vessel occlusion stroke in pregnancy is safe and feasible.

Journal Article J Neurointerv Surg · June 2020 INTRODUCTION: Stroke is a leading cause of adult death and disability. Although acute ischemic stroke (AIS) in pregnancy is rare, it has devastating consequences on the life of the mother and fetus. Pregnancy was an exclusion criterion in endovascular thro ... Full text Link to item Cite

Transcirculation Approach for Mechanical Thrombectomy in Acute Ischemic Stroke: A Multicenter Study and Review of the Literature

Journal Article Frontiers in Neurology · May 7, 2020 Background: Transcirculation approaches, which consist of primary catheterization of a target artery from the contralateral side or opposite cerebral circulation, provide alternate endovascular routes when anterograde interventions are not feasible. We aim ... Full text Cite

Quantitative susceptibility mapping and vessel wall imaging as screening tools to detect microbleed in sentinel headache

Journal Article Journal of Clinical Medicine · April 1, 2020 Background: MR-quantitative susceptibility mapping (QSM) can identify microbleeds (MBs) in intracranial aneurysm (IA) wall associated with sentinel headache (SH) preceding subarachnoid hemorrhage. However, its use is limited, due to associated skull base b ... Full text Cite

Cognitive and cerebral hemodynamic effects of endovascular recanalization of chronically occluded cervical internal carotid artery: single-center study and review of the literature.

Journal Article J Neurosurg · April 1, 2020 OBJECTIVE: Revascularization of a symptomatic, medically refractory, cervical chronically occluded internal carotid artery (COICA) using endovascular techniques (ETs) has surfaced as a viable alternative to extracranial-intracranial bypass. The authors aim ... Full text Link to item Cite

Novel Treatment of Cerebral Vasospasm Using Solitaire Stent Retriever-Assisted Angioplasty: Case Series.

Conference World Neurosurg · March 2020 BACKGROUND: Endovascular procedures such as intraarterial (IA) vasodilator injection and balloon angioplasty are used to treat medically refractory cerebral vasospasm. The effects of IA therapy may be short lived and thus require multiple treatments. Ballo ... Full text Link to item Cite

Off-Label Use of the WEB Device.

Journal Article World Neurosurg · February 2020 OBJECTIVE: We present our initial experience with the off-label use of the Woven EndoBridge (WEB) device. METHODS: We performed a retrospective study from 2 institutions of patients with intracranial aneurysms who underwent treatment with the WEB device al ... Full text Link to item Cite

Transcirculation Approach for Endovascular Embolization of Intracranial Aneurysms, Arteriovenous Malformations, and Dural Fistulas: A Multicenter Study.

Journal Article World Neurosurg · February 2020 BACKGROUND: Unfavorable anatomy can preclude traditional anterograde endovascular interventions. Transcirculation approaches, which consist of primary catheterization of a target artery from the contralateral side or opposite cerebral circulation, can prov ... Full text Link to item Cite

Safety and efficacy of the use of large bore intermediate suction catheters alone or in combination for the treatment of acute cerebral venous sinus thrombosis: A multicenter experience.

Journal Article Interv Neuroradiol · February 2020 BACKGROUND AND PURPOSE: Systemic anticoagulation is the standard treatment for cerebral venous sinus thrombosis (CVST). Several endovascular techniques have been described as salvage therapy for anticoagulation refractory CVST cases. We aim to evaluate the ... Full text Link to item Cite

Differential Risk Factors and Outcomes of Ischemic Stroke due to Cervical Artery Dissection in Young Adults.

Journal Article Cerebrovasc Dis · 2020 INTRODUCTION: Cervical artery dissection (CeAD) is a major cause of ischemic stroke in young adults. Our understanding of the specific risk factors and clinical course of CeAD is still evolving. In this study, we evaluated the differential risk factors and ... Full text Link to item Cite

Recanalization of the Chronically Occluded Internal Carotid Artery: Review of the Literature

Journal Article World Neurosurgery: X · January 1, 2020 Introduction: We reviewed the literature on interventions for patients with medically refractory chronically occluded internal carotid artery (COICA) to assess the risks and/or benefits after recanalization via an endovascular technique (ET) or hybrid surg ... Full text Cite

Acute ischaemic stroke interventions: large vessel occlusion and beyond.

Journal Article Stroke Vasc Neurol · 2020 Care for acute ischaemic stroke is one of the most rapidly evolving fields due to the robust outcomes achieved by mechanical thrombectomy. Large vessel occlusion (LVO) accounts for up to 38% of acute ischaemic stroke and comes with devastating outcomes for ... Full text Link to item Cite

Safety and Efficacy of the Pipeline Embolization Device Use in the Outside Circle of Willis Located Intracranial Aneurysms: A Single-Center Experience

Journal Article Interventional Neurology · January 1, 2020 Background: The use of Pipeline Embolization Device (PED) is approved by the US Food and Drug Administration (FDA) to treat aneurysms located between the petrous and superior hypophyseal segments of the internal carotid artery. The purpose of this study is ... Full text Cite

Stroke mechanisms and outcomes of isolated symptomatic basilar artery stenosis.

Journal Article Stroke Vasc Neurol · December 2019 BACKGROUND: While diffuse atherosclerotic disease affecting the posterior circulation has been described extensively, the prevalence, natural history and angiographic characteristics of isolated symptomatic basilar artery stenosis (ISBAS) remain unknown. M ... Full text Link to item Cite

The Safety and Efficacy of Continuous Tirofiban as a Monoantiplatelet Therapy in the Management of Ruptured Aneurysms Treated Using Stent-Assisted Coiling or Flow Diversion and Requiring Ventricular Drainage.

Journal Article Neurosurgery · December 1, 2019 BACKGROUND: Hemorrhagic complications are a major concern for aneurysmal subarachnoid hemorrhage patients treated with stenting or stent-assisted coiling and undergoing additional procedures such as shunting, ventriculostomy placement, and craniotomies/cra ... Full text Link to item Cite

Flow diversion for small caliber vessel aneurysms: efficacy, safety, and functional outcome.

Journal Article J Neurosurg Sci · December 2019 BACKGROUND: Flow-diverting stents had gained prominence among neurointerventionalists. Aneurysms originating from distal vessels, particularly dissecting or fusiform, pose more technical challenges. The aim of the following single center large series was t ... Full text Link to item Cite

Computed Tomography Angiogram Derived From Computed Tomography Perfusion Done with Low Iodine Volume Protocol Preserves Diagnostic Yield for Middle Cerebral Artery-M2 Occlusions.

Journal Article J Stroke Cerebrovasc Dis · December 2019 BACKGROUND: Computed tomography angiogram (CTA) derived from computed tomography perfusion (CTP) has been proposed to avoid addition of separate CT perfusion protocol for selection of large vessel occlusion in acute stroke patients. Previous studies have v ... Full text Link to item Cite

Mechanical Thrombectomy of Acutely Occluded Flow Diverters.

Journal Article Oper Neurosurg (Hagerstown) · November 1, 2019 BACKGROUND: Embolization of intracranial aneurysms with the pipeline embolization device (PED; Medtronic, Dublin, Ireland) is a widely used technique. Despite adequate dual antiplatelet therapy and intraprocedural anticoagulation, in-stent thrombosis has b ... Full text Link to item Cite

Bradycardia and Asystole in Patients Undergoing Symptomatic Chronically Occluded Internal Carotid Artery Recanalization.

Journal Article World Neurosurg · November 2019 BACKGROUND: Reports have emerged describing the successful endovascular recanalization of the chronically occluded internal carotid artery (COICA). The impact this restoration of flow has on the sensitive carotid sinus baroreceptors has not been previously ... Full text Link to item Cite

Vessel wall imaging in intracranial aneurysms.

Journal Article J Neurointerv Surg · November 2019 High-resolution vessel wall imaging (HR-VWI) is becoming a useful tool in the characterization and identification of unstable unruptured brain aneurysms. However, it has not been validated for clinical use. The current evidence on HR-VWI techniques for cha ... Full text Link to item Cite

Transradial approach for the treatment of brain aneurysms using flow diversion: feasibility, safety, and outcomes.

Journal Article J Neurosurg Sci · October 2019 BACKGROUND: The aim of this paper is to describe our experience with the transradial approach (TRA) for intracranial aneurysms treatment using the Pipeline Embolization device (PED). We also performed a logistic regression comparing outcomes between TR and ... Full text Link to item Cite

Mechanical Thrombectomy in Distal Vessels: Revascularization Rates, Complications, and Functional Outcome.

Journal Article World Neurosurg · October 2019 INTRODUCTION: Pivotal trials have shown the tremendous efficacy of mechanical thrombectomy in proximal occlusions. However distal occlusions involving second-order branches of the middle cerebral artery and beyond, anterior cerebral and posterior cerebral ... Full text Link to item Cite

Diverse Use of the WEB Device: A Technical Note on WEB Stenting and WEB Coiling of Complex Aneurysms.

Journal Article World Neurosurg · October 2019 The Woven EndoBridge (WEB) device, an intrasaccular flow-diverter that does not require long-term antiplatelet use, has recently emerged as an alternative to embolize complex intracranial aneurysms; however, there are limitations to the WEB device. First, ... Full text Link to item Cite

In vitro accuracy and inter-observer reliability of CT angiography in detecting intracranial aneurysm enlargement.

Journal Article J Neurointerv Surg · October 2019 BACKGROUND AND PURPOSE: To evaluate the accuracy and inter-observer variability when CT angiography is used to identify unruptured intracranial aneurysm growth. METHODS: Two silicone phantom models were used in this study. Each phantom had eight aneurysms ... Full text Link to item Cite

Aspirin and Intracranial Aneurysms.

Journal Article Stroke · September 2019 Full text Link to item Cite

A2, M2, P2 aneurysms and beyond: results of treatment with pipeline embolization device in 65 patients.

Journal Article J Neurointerv Surg · September 2019 BACKGROUND: Intracranial aneurysms located in the distal vessels are rare and remain a challenge to treat through surgical or endovascular interventions. OBJECTIVE: To describe a multicenter approach with flow diversion using the pipeline embolization devi ... Full text Link to item Cite

The Experience With Flow Diverters in the Treatment of Posterior Inferior Cerebellar Artery Aneurysms.

Journal Article Oper Neurosurg (Hagerstown) · July 1, 2019 BACKGROUND: The use of the pipeline embolization device (PED; Medtronic, Dublin, Ireland) in the posterior circulation has been limited and infrequently reported compared to other off-label utilizations. Posterior inferior cerebellar artery aneurysms (PICA ... Full text Link to item Cite

Pipeline Embolization Device for the Treatment of Intracranial Pseudoaneurysms.

Journal Article World Neurosurg · July 2019 BACKGROUND: Intracranial pseudoaneurysms (PSAs) are associated with high rupture and mortality rates and have traditionally been treated by parent vessel sacrifice. There has been recent interest in using flow-diverting devices for treatment of these compl ... Full text Link to item Cite

Absence of Collaterals is Associated with Larger Infarct Volume and Worse Outcome in Patients with Large Vessel Occlusion and Mild Symptoms.

Journal Article J Stroke Cerebrovasc Dis · July 2019 BACKGROUND: Mechanical thrombectomy is the standard of care for patients with large vessel occlusion (LVO) presenting with severe symptoms; however, little is known about the best treatment for patients with LVO and mild symptoms. The absence of good colla ... Full text Link to item Cite

Common Data Elements for Unruptured Intracranial Aneurysms and Aneurysmal Subarachnoid Hemorrhage: Recommendations from the Working Group on Hospital Course and Acute Therapies-Proposal of a Multidisciplinary Research Group.

Journal Article Neurocrit Care · June 2019 INTRODUCTION: The Common Data Elements (CDEs) initiative is a National Institute of Health/National Institute of Neurological Disorders and Stroke (NINDS) effort to standardize naming, definitions, data coding, and data collection for observational studies ... Full text Link to item Cite

Biospecimens and Molecular and Cellular Biomarkers in Aneurysmal Subarachnoid Hemorrhage Studies: Common Data Elements and Standard Reporting Recommendations.

Journal Article Neurocrit Care · June 2019 INTRODUCTION: Development of clinical biomarkers to guide therapy is an important unmet need in aneurysmal subarachnoid hemorrhage (SAH). A wide spectrum of plausible biomarkers has been reported for SAH, but none have been validated due to significant var ... Full text Link to item Cite

Prioritization and Timing of Outcomes and Endpoints After Aneurysmal Subarachnoid Hemorrhage in Clinical Trials and Observational Studies: Proposal of a Multidisciplinary Research Group.

Journal Article Neurocrit Care · June 2019 INTRODUCTION: In studies on aneurysmal subarachnoid hemorrhage (SAH), substantial variability exists in the use and timing of outcomes and endpoints, which complicates interpretation and comparison of results between studies. The aim of the National Instit ... Full text Link to item Cite

Common Data Elements for Unruptured Intracranial Aneurysms and Subarachnoid Hemorrhage Clinical Research: A National Institute for Neurological Disorders and Stroke and National Library of Medicine Project.

Journal Article Neurocrit Care · June 2019 OBJECTIVES: The goal for this project was to develop a comprehensive set of common data elements (CDEs), data definitions, case report forms and guidelines for use in unruptured intracranial aneurysm (UIA) and subarachnoid hemorrhage (SAH) clinical researc ... Full text Link to item Cite

Definition and Prioritization of Data Elements for Cohort Studies and Clinical Trials on Patients with Unruptured Intracranial Aneurysms: Proposal of a Multidisciplinary Research Group.

Journal Article Neurocrit Care · June 2019 INTRODUCTION: Variability in usage and definition of data characteristics in previous cohort studies on unruptured intracranial aneurysms (UIA) complicated pooling and proper interpretation of these data. The aim of the National Institute of Health/Nationa ... Full text Link to item Cite

Common Data Elements for Radiological Imaging of Patients with Subarachnoid Hemorrhage: Proposal of a Multidisciplinary Research Group.

Journal Article Neurocrit Care · June 2019 INTRODUCTION: Lack of homogeneous definitions for imaging data and consensus on their relevance in the setting of subarachnoid hemorrhage and unruptured intracranial aneurysms lead to a difficulty of data pooling and lack of robust data. The aim of the Nat ... Full text Link to item Cite

Common Data Elements for Unruptured Intracranial Aneurysm and Subarachnoid Hemorrhage Clinical Research: Recommendations from the Working Group on Long-Term Therapies.

Journal Article Neurocrit Care · June 2019 OBJECTIVES: The goal for the long-term therapies (LTT) working group (WG) of the Unruptured Intracranial Aneurysm (UIA) and Subarachnoid Hemorrhage (SAH) common data elements (CDEs) was to develop a comprehensive set of CDEs, data definitions, case report ... Full text Link to item Cite

Common Data Elements for Subarachnoid Hemorrhage and Unruptured Intracranial Aneurysms: Recommendations from the Working Group on Subject Characteristics.

Journal Article Neurocrit Care · June 2019 BACKGROUND: The National Institute of Neurological Disorders and Stroke (NINDS) Common Data Elements (CDEs) have been generated to standardize and define terms used by the scientific community. The widespread use of these CDEs promotes harmonized data coll ... Full text Link to item Cite

Common Data Element for Unruptured Intracranial Aneurysm and Subarachnoid Hemorrhage: Recommendations from Assessments and Clinical Examination Workgroup/Subcommittee.

Journal Article Neurocrit Care · June 2019 BACKGROUND: Clinical studies of subarachnoid hemorrhage (SAH) and unruptured cerebral aneurysms lack uniformity in terms of variables used for assessments and clinical examination of patients which has led to difficulty in comparing studies and performing ... Full text Link to item Cite

Feasibility, safety, and changes in systolic blood pressure associated with endovascular revascularization of symptomatic and chronically occluded cervical internal carotid artery using a newly suggested radiographic classification of chronically occluded cervical internal carotid artery: pilot study.

Journal Article J Neurosurg · May 1, 2019 OBJECTIVE: The overall risk of ischemic stroke from a chronically occluded internal carotid artery (COICA) is around 5%-7% per year despite receiving the best available medical therapy. Here, authors propose a radiographic classification of COICA that can ... Full text Link to item Cite

Intracranial EEG for seizure focus localization: evolving techniques, outcomes, complications, and utility of combining surface and depth electrodes.

Journal Article J Neurosurg · April 1, 2019 OBJECTIVE: Intracranial electroencephalography (iEEG) provides valuable information that guides clinical decision-making in patients undergoing epilepsy surgery, but it carries technical challenges and risks. The technical approaches used and reported rate ... Full text Link to item Cite

Detection of microbleeds associated with sentinel headache using MRI quantitative susceptibility mapping: pilot study.

Journal Article J Neurosurg · April 1, 2019 OBJECT: Sentinel headaches (SHs) associated with cerebral aneurysms (CAs) could be due to microbleeds, which are considered a sign that an aneurysm is unstable. Despite the prognostic importance of these microbleeds, they remain difficult to detect using r ... Full text Link to item Cite

Secular Increases in Spontaneous Subarachnoid Hemorrhage during Pregnancy: A Nationwide Sample Analysis.

Journal Article J Stroke Cerebrovasc Dis · April 2019 IMPORTANCE: Understanding of the epidemiology, outcomes, and management of spontaneous subarachnoid hemorrhage (sSAH) during pregnancy is limited. Small, single center series suggest a slight increase in morbidity and mortality. OBJECTIVE: To determine if ... Full text Link to item Cite

Correlation between pre-admission blood pressure and outcome in a large telestroke cohort.

Journal Article J Clin Neurosci · April 2019 BACKGROUND: Telemedicine rapidly connects patients, with acute ischemic stroke symptoms, with neurovascular specialists for assessment to reduce chemical thrombolysis delivery times. Management of AIS includes maintaining target systolic blood pressures (S ... Full text Link to item Cite

Safety of tirofiban and dual antiplatelet therapy in treating intracranial aneurysms.

Journal Article Stroke Vasc Neurol · March 2019 BACKGROUND: Endovascular treatment of intracranial aneurysms usually involves stent-assisted coiling (SAC) and flow diverters. Glycoprotein IIb/IIIa inhibitors such as tirofiban and dual antiplatelet therapy (DAPT) are required to prevent thromboembolic co ... Full text Link to item Cite

Disparities in Inter-hospital Helicopter Transportation for Hispanics by Geographic Region: A Threat to Fairness in the Era of Thrombectomy.

Journal Article J Stroke Cerebrovasc Dis · March 2019 BACKGROUND AND PURPOSE: Mechanical thrombectomy (MT) is a time-dependent therapy that is only available at a limited number of hospitals. As such, patients that live at a considerable distance of those specialized centers often require rapid interhospital ... Full text Link to item Cite

Angiographic Features of Intracranial Aneurysms in Ecuador.

Journal Article J Stroke Cerebrovasc Dis · March 2019 BACKGROUND: Most of the literature describing morphological features of intracranial aneurysms (IAs) is from North-America, East-Asia, and Europe. There is limited data from South-America. We describe the epidemiologic and angiographic features of ruptured ... Full text Link to item Cite

Accuracy of detecting enlargement of aneurysms using different MRI modalities and measurement protocols.

Journal Article J Neurosurg · February 1, 2019 OBJECTIVE: Aneurysm growth is considered predictive of future rupture of intracranial aneurysms. However, how accurately neuroradiologists can reliably detect incremental aneurysm growth using clinical MRI is still unknown. The purpose of this study was to ... Full text Link to item Cite

External Ventricular Drain and Hemorrhage in Aneurysmal Subarachnoid Hemorrhage Patients on Dual Antiplatelet Therapy: A Retrospective Cohort Study.

Journal Article Neurosurgery · February 1, 2019 BACKGROUND: Stenting and flow diversion for aneurysmal sub arachnoid hemorrhage (aSAH) require the use of dual antiplatelet therapy (DAPT). OBJECTIVE: To investigate whether DAPT is associated with hemorrhagic complication following placement of external v ... Full text Link to item Cite

Second generation drug-eluting stents for endovascular treatment of ostial vertebral artery stenosis: A single center experience

Journal Article Frontiers in Neurology · January 1, 2019 Objective: To report a single-center experience using drug-eluting balloon mounted stents (DES) for endovascular treatment of atherosclerotic ostial vertebral artery stenosis (OVAS). Background: Posterior circulation is affected in up to 25% of strokes, 20 ... Full text Cite

Introduction: Microsurgical and endovascular management of intracranial dural arteriovenous fistula

Journal Article Neurosurgical Focus · January 1, 2019 Over the past decade substantial advances in diagnostic imaging, classification, and understanding the natural history of intracranial dural arteriovenous fistula (dAVF) have been made. Paralleling these improvements in patient evaluation and risk assessme ... Full text Cite

Hybrid Surgery for Internal Carotid Artery Revascularization.

Journal Article World Neurosurg · January 2019 OBJECTIVE: The management of chronic complete internal carotid artery (ICA) occlusion (COICA) has been challenging. Endovascular procedures have been performed with variable success and risks, depending on the type of occlusion and distal revascularization ... Full text Link to item Cite

Iron nanoparticle contrast enhanced microwave imaging for emergent stroke: A pilot study.

Journal Article J Clin Neurosci · January 2019 Emergent stroke is mostly evaluated using hospital based imaging. Quick imaging allows for rapid administration of IV thrombolysis and outcome improvement. Microwave imaging (MI) is an emerging portable imaging modality. Iron oxide nanoparticles are known ... Full text Link to item Cite

In vivo evaluation of the new PHIL low viscosity in a swine rete mirabile model.

Journal Article Interv Neuroradiol · December 2018 INTRODUCTION: Few liquid embolic materials are available for treatment of arteriovenous malformations. We describe the in vivo experience with the new PHIL low viscosity (LV) liquid embolic agent in a swine rete mirabile model. METHODS: Eight swine were tr ... Full text Link to item Cite

Low Yield of Cerebral Angiography in Adequately Occluded Aneurysms After Flow Diversion.

Journal Article Neurosurgery · December 1, 2018 BACKGROUND: Flow diversion has emerged as a highly effective treatment for intracranial aneurysms. OBJECTIVE: To assess the yield of further angiographic follow-up in aneurysms that have achieved adequate occlusion after treatment with the Pipeline Emboliz ... Full text Link to item Cite

Pipeline-assisted coiling versus pipeline in flow diversion treatment of intracranial aneurysms.

Journal Article J Clin Neurosci · December 2018 BACKGROUND AND PURPOSE: Flow-diversion therapy (FDT) for large and complex intracranial aneurysms is effective and considered superior to primary coil embolization. Data evaluating common treatment with both FDT and coiling continues to emerge, but informa ... Full text Link to item Cite

The use of alternatives to clopidogrel in flow-diversion treatment with the Pipeline embolization device.

Journal Article J Neurosurg · November 1, 2018 OBJECTIVEThromboembolic complications continue to be encountered with Pipeline embolization devices (PEDs) despite routine clopidogrel/aspirin antiplatelet therapy. This study examined the safety and efficacy of prasugrel in the management of clopidogrel-r ... Full text Link to item Cite

Hemorrhage associated with ventriculoperitoneal shunt placement in aneurysmal subarachnoid hemorrhage patients on a regimen of dual antiplatelet therapy: a retrospective analysis.

Journal Article J Neurosurg · October 2018 OBJECTIVE: Intracranial stenting and flow diversion require the use of dual antiplatelet therapy (DAPT) to prevent in-stent thrombosis. DAPT may significantly increase the risk of hemorrhagic complications in patients who require subsequent surgical interv ... Full text Link to item Cite

Plasma Soluble Human Elastin Fragments as an Intra-Aneurysmal Localized Biomarker for Ruptured Intracranial Aneurysm.

Journal Article J Am Heart Assoc · September 4, 2018 Background Fragmentation of the tunica media is a hallmark of intracranial aneurysm formation, often leading to aneurysmal progression and subsequent rupture. The objective of this study is to determine the plasma level of elastin fragments in the lumen of ... Full text Link to item Cite

Dual antiplatelet therapy in aneurysmal subarachnoid hemorrhage: association with reduced risk of clinical vasospasm and delayed cerebral ischemia.

Journal Article J Neurosurg · September 2018 OBJECTIVE Clinical vasospasm and delayed cerebral ischemia (DCI) are devastating complications of aneurysmal subarachnoid hemorrhage (aSAH). Several theories involving platelet activation have been postulated as potential explanations of the development of ... Full text Link to item Cite

Sex differences in delayed cerebral ischemia after subarachnoid hemorrhage.

Journal Article J Neurosurg · August 2018 OBJECTIVE In this study the authors sought to investigate the sex differences in the risk of delayed cerebral ischemia (DCI), delayed cerebral infarction, and the role of hormonal status. METHODS Ten studies included in the SAHIT (SAH International Trialis ... Full text Link to item Cite

Characteristics of Unruptured Compared to Ruptured Intracranial Aneurysms: A Multicenter Case-Control Study.

Journal Article Neurosurgery · July 1, 2018 BACKGROUND: Only a minority of intracranial aneurysms rupture to cause subarachnoid hemorrhage. OBJECTIVE: To test the hypothesis that unruptured aneurysms have different characteristics and risk factor profiles compared to ruptured aneurysms. METHODS: We ... Full text Link to item Cite

Bone flap elevation for intracranial EEG monitoring: technical note.

Journal Article J Neurosurg · July 2018 Intracranial electroencephalography (iEEG) provides invaluable information in determining seizure focus and spread due to its high spatial and temporal resolution, which are not afforded by noninvasive studies. Electrodes of various types (e.g., grid, stri ... Full text Link to item Cite

Intraventricular extension of an aneurysmal subarachnoid hemorrhage is an independent predictor of a worse functional outcome.

Journal Article Clin Neurol Neurosurg · July 2018 OBJECTIVE: The objective of this study is to determine the impact of intraventricular hemorrhage (IVH) on the cognitive prognosis of subarachnoid hemorrhage (SAH) due to ruptured cerebral aneurysm, independent of the presence of intraparenchymal hemorrhage ... Full text Link to item Cite

A comparison of two stroke cohorts cared for by two different specialties in a practice-based tele-stroke population.

Journal Article Clin Neurol Neurosurg · May 2018 OBJECTIVES: Neurologists have continually led the assessment and management of Acute Ischemic Stroke(AIS) by use of IV-rtPA, anti-platelet therapy, antihypertensives, and other pharmacologic agents. Since the advent of mechanical thrombectomy(MT) and its p ... Full text Link to item Cite

Cigarette Smoke Initiates Oxidative Stress-Induced Cellular Phenotypic Modulation Leading to Cerebral Aneurysm Pathogenesis.

Journal Article Arterioscler Thromb Vasc Biol · March 2018 OBJECTIVE: Cigarette smoke exposure (CSE) is a risk factor for cerebral aneurysm (CA) formation, but the molecular mechanisms are unclear. Although CSE is known to contribute to excess reactive oxygen species generation, the role of oxidative stress on vas ... Full text Link to item Cite

Embolization of palpebral and orbito-frontal fistulas: technical and anatomical considerations in treating high-flow superficial skin lesions with liquid embolics.

Journal Article J Neurointerv Surg · March 2018 The treatment of palpebral and periorbital fistulas may be challenging due to the presence of multiple anastomosis with eloquent ophthalmic and intracranial vascular territories. Moreover, cosmetic and functional characteristics of this area pose unique ch ... Full text Link to item Cite

Development and Evaluation of a Nanometer-Scale Hemocompatible and Antithrombotic Coating Technology Platform for Commercial Intracranial Stents and Flow Diverters

Journal Article ACS Applied Nano Materials · January 26, 2018 An intracranial aneurysm is a local dilation of an artery in the cerebral circulation and can be endovascularly treated with two types of medical devices known as intracranial stents or flow diverters-both are metallic devices that help redirect blood from ... Full text Cite

Development and validation of outcome prediction models for aneurysmal subarachnoid haemorrhage: the SAHIT multinational cohort study.

Journal Article BMJ · January 18, 2018 OBJECTIVE: To develop and validate a set of practical prediction tools that reliably estimate the outcome of subarachnoid haemorrhage from ruptured intracranial aneurysms (SAH). DESIGN: Cohort study with logistic regression analysis to combine predictors a ... Full text Link to item Cite

Update in the Early Management and Reperfusion Strategies of Patients with Acute Ischemic Stroke.

Journal Article Crit Care Res Pract · 2018 Acute ischemic stroke (AIS) remains a leading cause of death and long-term disability. The paradigms on prehospital care, reperfusion therapies, and postreperfusion management of patients with AIS continue to evolve. After the publication of pivotal clinic ... Full text Link to item Cite

Endovascular Treatment of Ruptured Vertebrobasilar Dissecting Aneurysms Using Flow Diversion Embolization Devices: Single-Institution Experience.

Journal Article World Neurosurg · January 2018 OBJECTIVE: Treatment of ruptured posterior circulation dissecting aneurysms is technically challenging with potentially high morbidity and mortality. We sought to assess the safety and feasibility of using a flow-diversion device (FDD) and a specific acute ... Full text Link to item Cite

Surgical Management of Tumors Involving Meckel's Cave and Cavernous Sinus: Role of an Extended Middle Fossa and Lateral Sphenoidectomy Approach.

Journal Article Otol Neurotol · January 2018 OBJECTIVE: To study the indications and outcomes of lateral sphenoidectomy as part of a combined skull base approach in the treatment of tumors involving Meckel's cave (MC) and cavernous sinus (CS). STUDY DESIGN: Retrospective patient series. SETTING: Tert ... Full text Link to item Cite

Sex Differential in 15-Hydroxyprostaglandin Dehydrogenase Levels in the Lumen of Human Intracranial Aneurysms.

Journal Article J Am Heart Assoc · October 17, 2017 BACKGROUND: Aspirin is a promising medical therapy for the prevention of intracranial aneurysm (IA) rupture. Recently, we found that men have a better response to aspirin than women. The purpose of this study was to determine whether a sex differential exi ... Full text Link to item Cite

Safety and Efficacy of a 600-mg Loading Dose of Clopidogrel 24 Hours Before Pipeline Embolization Device Treatment.

Journal Article World Neurosurg · October 2017 BACKGROUND: Clopidogrel/aspirin antiplatelet therapy routinely is administered 7-10 days before pipeline aneurysm treatment. Our study assessed the safety and efficacy of a 600-mg loading dose of clopidogrel 24 hours before Pipeline Embolization Device (PE ... Full text Link to item Cite

Matched Comparison of Flow Diversion and Coiling in Small, Noncomplex Intracranial Aneurysms.

Journal Article Neurosurgery · July 1, 2017 BACKGROUND: Flow diversion is typically reserved for large, giant, or morphologically complex aneurysms. Coiling remains a first-line treatment for small, morphologically simple aneurysms. OBJECTIVE: To compare coiling and flow diversion in small, uncompli ... Full text Link to item Cite

Quantitative Susceptibility Mapping as a Possible Tool to Radiographically Diagnose Sentinel Headache Associated with Intracranial Aneurysm: Case Report.

Journal Article World Neurosurg · July 2017 BACKGROUND: Sentinel headache (SH) occurs before aneurysm rupture in an estimated 15%-60% of cases of aneurysmal subarachnoid hemorrhage (aSAH). By definition, noncontrast computed tomography (CT) scan of the brain and lumbar puncture are both negative in ... Full text Link to item Cite

Comment

Journal Article Operative Neurosurgery · June 1, 2017 Cite

Treatment of Lateral Skull Base and Posterior Cranial Fossa Lesions Utilizing the Extended Middle Cranial Fossa Approach.

Journal Article Otol Neurotol · June 2017 OBJECTIVE: Define the indications and outcomes for subjects undergoing treatment utilizing the extended middle cranial fossa approach (EMCF). STUDY DESIGN: Retrospective records review. SETTING: University-based tertiary referral center. PATIENTS: Subjects ... Full text Link to item Cite

Off-label uses of the Pipeline embolization device: a review of the literature.

Journal Article Neurosurg Focus · June 2017 The Pipeline embolization device (PED) is the most widely used flow diverter in endovascular neurosurgery. In 2011, the device received FDA approval for the treatment of large and giant aneurysms in the internal carotid artery extending from the petrous to ... Full text Link to item Cite

Clinical Aspects of Intraventricular Hemorrhage

Chapter · March 7, 2017 Primary intraventricular hemorrhage (IVH) refers to bleeding directly into the ventricular system. Secondary IVH occurs more frequently and refers to bleeding extending from the parenchyma or subarachnoid space into the ventricular chambers. Aneurysms, art ... Full text Cite

Loss of Consciousness at Onset of Aneurysmal Subarachnoid Hemorrhage is Associated with Functional Outcomes in Good-Grade Patients.

Journal Article World Neurosurg · February 2017 BACKGROUND: Transient loss of consciousness (LOC) is one of the most common presentations of aneurysmal subarachnoid hemorrhage (SAH) and may be an indicator of early brain injury. In this study, we examined the association of LOC and functional outcomes i ... Full text Link to item Cite

Cavernous carotid aneurysms: a new treatment paradigm in the era of flow diversion.

Journal Article Expert Rev Neurother · February 2017 Cavernous carotid aneurysms can cause significant symptomatology through mass effect and may rupture, resulting in carotid-cavernous fistula or epistaxis. Traditional treatment options included endovascular or surgical parent vessel occlusion, or embolizat ... Full text Link to item Cite

Patency of the posterior communicating artery following treatment with the Pipeline Embolization Device.

Journal Article J Neurosurg · February 2017 OBJECTIVE The Pipeline Embolization Device (PED) has become an effective treatment strategy for some cerebral aneurysms. Concerns regarding the patency of branch arteries have been raised. The objective of this study was to assess the patency of the poster ... Full text Link to item Cite

Brain Multimodality Monitoring: A New Tool in Neurocritical Care of Comatose Patients.

Journal Article Crit Care Res Pract · 2017 Neurocritical care patients are at risk of developing secondary brain injury from inflammation, ischemia, and edema that follows the primary insult. Recognizing clinical deterioration due to secondary injury is frequently challenging in comatose patients. ... Full text Link to item Cite

Predictors of Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage with Asymptomatic Angiographic Vasospasm on Admission.

Journal Article World Neurosurg · January 2017 BACKGROUND: Risk of delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH) with asymptomatic angiographic vasospasm on admission is unclear in the literature. The goal of this study is to identify predictors of clinical ... Full text Link to item Cite

Same-Day Discharge After Treatment with the Pipeline Embolization Device Using Monitored Anesthesia Care.

Journal Article World Neurosurg · December 2016 OBJECTIVE: The Pipeline Embolization Device (PED) has been used and shown to be safe under monitored anesthesia care (MAC). We present the results of the first study, to our knowledge, assessing the safety and feasibility of same-day discharge in patients ... Full text Link to item Cite

Short-Term Outcome of Clipping Versus Coiling of Ruptured Intracranial Aneurysms Treated by Dual-Trained Cerebrovascular Surgeon: Single-Institution Experience.

Journal Article World Neurosurg · November 2016 OBJECTIVE: Studies that showed endovascular coiling of ruptured intracranial aneurysms (RAs) to be superior to microsurgical clipping have compared dedicated endovascular interventionists versus open cerebrovascular surgeons. This is the first study to eva ... Full text Link to item Cite

Intervention for A randomized trial of unruptured brain arteriovenous malformations (ARUBA) - Eligible patients: An evidence-based review.

Journal Article Clin Neurol Neurosurg · November 2016 While intervention for ruptured arteriovenous malformations (AVMs) of the brain is typically warranted, the management of unruptured AVMs remains controversial. Despite numerous retrospective studies, only one randomized controlled trial has been conducted ... Full text Link to item Cite

Differential Sex Response to Aspirin in Decreasing Aneurysm Rupture in Humans and Mice.

Journal Article Hypertension · August 2016 We previously found that aspirin decreases the risk of cerebral aneurysm rupture in humans. We aim to assess whether a sex differential exists in the response of human cerebral aneurysms to aspirin and confirm these observations in a mouse model of cerebra ... Full text Link to item Cite

Risk of Venous Thromboembolism in Patients with Large Hemispheric Infarction Undergoing Decompressive Hemicraniectomy.

Journal Article Neurocrit Care · August 2016 BACKGROUND: Deep-venous thrombosis (DVT) and pulmonary embolism (PE) are major causes of morbidity and mortality in patients with acute ischemic stroke. This study is the first to examine the risk of venous thromboembolism in patients with large hemispheri ... Full text Link to item Cite

Alternative access for endovascular treatment of cerebrovascular diseases.

Journal Article Clin Neurol Neurosurg · June 2016 OBJECTIVE: Data regarding the role of alternative access routes in neuro-endovascular interventions is limited. Our aim is to evaluate the safety and efficacy of alternative access in endovascular management of cerebrovascular diseases. METHODS: 29 patient ... Full text Link to item Cite

A New Protocol for Anticoagulation With Tirofiban During Flow Diversion.

Journal Article Neurosurgery · May 2016 BACKGROUND: Flow diversion is increasingly used to treat intracranial aneurysms. In previous reports, patients were pretreated with aspirin and clopidogrel before the intervention for the prevention of thromboembolic complications. OBJECTIVE: To assess the ... Full text Link to item Cite

Pipeline Embolization Device in the Treatment of Recurrent Previously Stented Cerebral Aneurysms.

Journal Article AJNR Am J Neuroradiol · May 2016 BACKGROUND AND PURPOSE: The use of the Pipeline Embolization Device in the management of recurrent previously stented cerebral aneurysms is controversial. The aim of this study was to evaluate the efficacy and safety of the Pipeline Embolization Device in ... Full text Link to item Cite

Molecular Imaging in Neurovascular Diseases: The Use of Ferumoxytol to Assess Cerebral Aneurysms and Arteriovenous Malformations.

Journal Article Top Magn Reson Imaging · April 2016 Inflammation is increasingly being recognized as contributing to the underlying pathophysiology of cerebral aneurysms and brain arteriovenous malformation. Ferumoxytol is being increasingly used for both its prolonged intravascular imaging characteristics ... Full text Link to item Cite

Assessment of image-derived risk factors for natural course of unruptured cerebral aneurysms.

Journal Article J Neurosurg · February 2016 OBJECTIVE: The goal of this prospective longitudinal study was to test whether image-derived metrics can differentiate unruptured aneurysms that will become unstable (grow and/or rupture) from those that will remain stable. METHODS: One hundred seventy-eig ... Full text Link to item Cite

Technology developments in endovascular treatment of intracranial aneurysms.

Journal Article J Neurointerv Surg · February 2016 Advances in the management and endovascular treatment of intracranial aneurysms are progressing at a tremendous rate. Developments in novel imaging technology may improve diagnosis, risk stratification, treatment planning, intraprocedural assessment, and f ... Full text Link to item Cite

In-Pipeline Stenosis: Incidence, Predictors, and Clinical Outcomes.

Journal Article Neurosurgery · December 2015 BACKGROUND: The Pipeline Embolization Device is a widely utilized flow diverter in the treatment of intracranial aneurysms. OBJECTIVE: To assess the incidence, clinical significance, predictors, and outcomes of in-Pipeline stenosis (IPS). METHODS: Angiogra ... Full text Link to item Cite

The Use of the Pipeline Embolization Device in the Management of Recurrent Previously Coiled Cerebral Aneurysms.

Journal Article Neurosurgery · November 2015 BACKGROUND: The biggest downside of cerebral aneurysm coiling is the high rates of recurrence and retreatments. With the increasing number of aneurysm recurrences after failed coiling procedures, the best retreatment strategy remains unknown. OBJECTIVE: To ... Full text Link to item Cite

Preparedness of neurosurgery graduates for neuroendovascular fellowship: a national survey of fellowship programs.

Journal Article J Neurosurg · November 2015 OBJECT: Endovascular interventions have become an essential part of a neurosurgeon's practice. Whether endovascular procedures have been effectively integrated into residency curricula, however, remains uncertain. The purpose of this study was to assess th ... Full text Link to item Cite

Paradoxical Increase in Mortality and Rupture of Intracranial Aneurysms in Microsomal Prostaglandin E2 Synthase Type 1-Deficient Mice: Attenuation by Aspirin.

Journal Article Neurosurgery · October 2015 BACKGROUND: Inflammation plays an important role in formation and rupture of intracranial aneurysms. Expression of microsomal prostaglandin E2 (PGE2) synthase type 1 (mPGES-1) is increased in the wall of intracranial aneurysms in humans. PGE2, a by-product ... Full text Link to item Cite

Fate of the Ophthalmic Artery After Treatment With the Pipeline Embolization Device.

Journal Article Neurosurgery · October 2015 BACKGROUND: Flow diverters have emerged as a major tool in the treatment of cerebral aneurysms. A crucial issue with the use of flow diverters is the patency of side branches covered by the device, most importantly the ophthalmic artery (OA). OBJECTIVE: To ... Full text Link to item Cite

The unruptured intracranial aneurysm treatment score: a multidisciplinary consensus.

Journal Article Neurology · September 8, 2015 OBJECTIVE: We endeavored to develop an unruptured intracranial aneurysm (UIA) treatment score (UIATS) model that includes and quantifies key factors involved in clinical decision-making in the management of UIAs and to assess agreement for this model among ... Full text Link to item Cite

Stratification of a population of intracranial aneurysms using blood flow metrics.

Journal Article Comput Methods Biomech Biomed Engin · August 2015 Indices of the intra-aneurysm hemodynamic environment have been proposed as potentially indicative of their longitudinal outcome. To be useful, the indices need to be used to stratify large study populations and tested against known outcomes. The first obj ... Full text Link to item Cite

Pressure changes within the sac of human cerebral aneurysms in response to artificially induced transient increases in systemic blood pressure.

Journal Article Hypertension · August 2015 Formation and rupture of cerebral aneurysms have been associated with chronic hypertension. The effect of transient increase in blood pressure and its effect on intra-aneurysmal hemodynamics have not been studied. We examined the effects of controlled incr ... Full text Link to item Cite

Smooth Muscle Peroxisome Proliferator-Activated Receptor γ Plays a Critical Role in Formation and Rupture of Cerebral Aneurysms in Mice In Vivo.

Journal Article Hypertension · July 2015 Vascular inflammation plays a critical role in the pathogenesis of cerebral aneurysms. Peroxisome proliferator-activated receptor γ (PPARγ) protects against vascular inflammation and atherosclerosis, whereas dominant-negative mutations in PPARγ promote ath ... Full text Link to item Cite

Elective endovascular treatment of unruptured intracranial aneurysms: a management case series of patient outcomes after institutional change to admit patients principally to postanesthesia care unit rather than to intensive care.

Journal Article Anesth Analg · July 2015 BACKGROUND: Our intention in this case series was to review the postoperative care and neurologic outcomes of patients who had undergone elective endovascular treatment of unruptured intracranial aneurysms. The case series is unique managerially in that a ... Full text Link to item Cite

Safety and efficacy of the Pipeline Embolization Device in 100 small intracranial aneurysms.

Journal Article J Neurosurg · June 2015 OBJECT Flow diverters are increasingly used for treatment of intracranial aneurysms. In most series, the Pipeline Embolization Device (PED) was used for the treatment of large, giant, complex, and fusiform aneurysms. Little is known about the use of the PE ... Full text Link to item Cite

Myeloperoxidase is increased in human cerebral aneurysms and increases formation and rupture of cerebral aneurysms in mice.

Journal Article Stroke · June 2015 BACKGROUND AND PURPOSE: Cerebral aneurysm (CA) affects 3% of the population and is associated with hemodynamic stress and inflammation. Myeloperoxidase, a major oxidative enzyme associated with inflammation, is increased in patients with CA, but whether my ... Full text Link to item Cite

Novel role for endogenous hepatocyte growth factor in the pathogenesis of intracranial aneurysms.

Journal Article Hypertension · March 2015 Inflammation plays a key role in formation and rupture of intracranial aneurysms. Because hepatocyte growth factor (HGF) protects against vascular inflammation, we sought to assess the role of endogenous HGF in the pathogenesis of intracranial aneurysms. C ... Full text Link to item Cite

Prognostic value of premorbid hypertension and neurological status in aneurysmal subarachnoid hemorrhage: pooled analyses of individual patient data in the SAHIT repository.

Journal Article J Neurosurg · March 2015 OBJECT: The literature has conflicting reports about the prognostic value of premorbid hypertension and neurological status in aneurysmal subarachnoid hemorrhage (SAH). The aim of this study was to investigate the prognostic value of premorbid hypertension ... Full text Link to item Cite

Flow-diversion for ophthalmic segment aneurysms.

Journal Article Neurosurgery · March 2015 BACKGROUND: The use of flow-diversion to treat ophthalmic segment aneurysms (OSA) has not been well evaluated. OBJECTIVE: To assess the visual outcomes, the obliteration rate, and the need for retreatment of OSA treated by the pipeline embolization device ... Full text Link to item Cite

Biology of cerebral arteriovenous malformations with a focus on inflammation.

Journal Article J Cereb Blood Flow Metab · February 2015 Cerebral arteriovenous malformations (AVMs) entail a significant risk of intracerebral hemorrhage owing to the direct shunting of arterial blood into the venous vasculature without the dissipation of the arterial blood pressure. The mechanisms involved in ... Full text Link to item Cite

Treatment of ruptured intracranial aneurysms with the pipeline embolization device.

Journal Article Neurosurgery · February 2015 BACKGROUND: The pipeline embolization device (PED) has been used for treatment of unruptured aneurysms. Little is known about the use of the PED in ruptured aneurysms. OBJECTIVE: To assess the safety and efficacy of the PED in ruptured intracranial aneurys ... Full text Link to item Cite

Potential role of aspirin in the prevention of aneurysmal subarachnoid hemorrhage.

Journal Article Cerebrovasc Dis · 2015 BACKGROUND: Inflammation is a key element behind the pathophysiology of cerebral aneurysm formation and rupture. Aspirin is a potent inhibitor of cyclooxygenase-2 (COX), which plays a critical role in the expression of immune modulators known to contribute ... Full text Link to item Cite

Potential role of granulocyte-monocyte colony-stimulating factor in the progression of intracranial aneurysms.

Journal Article DNA Cell Biol · January 2015 Macrophages play a central role in the inflammatory response leading to aneurysm formation, progression, and rupture. The purpose of this study was to determine whether granulocyte-monocyte colony-stimulating factor (GM-CSF) plays a role in the progression ... Full text Link to item Cite

Endovascular Treatment of Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: Complications, Neurological Outcomes, and Radiographic Results.

Journal Article ScientificWorldJournal · 2015 INTRODUCTION: Idiopathic intracranial hypertension (IIH) may result in a chronic debilitating disease. Dural venous sinus stenosis with a physiologic venous pressure gradient has been identified as a potential etiology in a number of IIH patients. Intracra ... Full text Link to item Cite

Comparison of the association of sac growth and coil compaction with recurrence in coil embolized cerebral aneurysms.

Journal Article PLoS One · 2015 BACKGROUND AND PURPOSE: In recurrent cerebral aneurysms treated by coil embolization, coil compaction is regarded as the presumptive mechanism. We test the hypothesis that aneurysm growth is the primary recurrence mechanism. We also test the hypothesis tha ... Full text Link to item Cite

Endovascular stroke intervention in the very young.

Journal Article Clin Neurol Neurosurg · December 2014 OBJECT: This study aims to evaluate the use of endovascular therapy to treat very young (≤ 35 years) patients with acute ischemic stroke from large vessel occlusion. METHODS: We identified from a prospectively maintained database young patients (≤ 35 years ... Full text Link to item Cite

Roles of estrogen in the formation of intracranial aneurysms in ovariectomized female mice.

Journal Article Neurosurgery · December 2014 BACKGROUND: Epidemiological studies have indicated that postmenopausal women have a higher incidence of intracranial aneurysms than men in the same age group. OBJECTIVE: To investigate whether estrogen or estrogen receptors (ERs) mediate protective effects ... Full text Link to item Cite

The Subarachnoid Hemorrhage International Trialists (SAHIT) Repository: advancing clinical research in subarachnoid hemorrhage.

Journal Article Neurocrit Care · December 2014 Researchers and other stakeholders continue to express concern about the failure of randomized clinical trials (RCT) in subarachnoid hemorrhage (SAH) to show efficacy of new treatments. Pooled data may be particularly useful to generate hypotheses about ca ... Full text Link to item Cite

Comparison of techniques for ventriculoperitoneal shunting in 523 patients with subarachnoid hemorrhage.

Journal Article J Neurosurg · October 2014 OBJECTIVE: It is common practice to use a new contralateral bur hole for ventriculoperitoneal shunt (VPS) placement in subarachnoid hemorrhage (SAH) patients with an existing ventriculostomy. At Thomas Jefferson University and Jefferson Hospital for Neuros ... Full text Link to item Cite

A single pipeline embolization device is sufficient for treatment of intracranial aneurysms.

Journal Article AJNR Am J Neuroradiol · August 2014 BACKGROUND AND PURPOSE: The Pipeline Embolization Device has emerged as an important treatment option for intracranial aneurysms. The number of devices needed to treat an aneurysm is uncertain and is the subject of vigorous debate. The purpose of this stud ... Full text Link to item Cite

Microsurgical clipping of large and giant cerebral aneurysms: a single-center contemporary experience.

Journal Article J Clin Neurosci · August 2014 Several treatment strategies are available to manage large and giant cerebral aneurysms, including surgical, endovascular and combined approaches. We present our experience with microsurgical clipping of large and giant aneurysms. A total of 138 patients w ... Full text Link to item Cite

Angiotensin 1-7 reduces mortality and rupture of intracranial aneurysms in mice.

Journal Article Hypertension · August 2014 Angiotensin II (Ang II) stimulates vascular inflammation, oxidative stress, and formation and rupture of intracranial aneurysms in mice. Because Ang 1-7 acts on Mas receptors and generally counteracts deleterious effects of Ang II, we tested the hypothesis ... Full text Link to item Cite

Brainstem melanomas presenting as a cavernous malformation.

Journal Article Neurochirurgie · August 2014 BACKGROUND: Melanoma lesions in the brainstem can be difficult to distinguish radiographically and clinically from cavernous malformations. However, the treatment modalities and clinical course of these two diseases differ considerably. We report two cases ... Full text Link to item Cite

Endovascular treatment of carotid-cavernous fistulas.

Journal Article Neurosurg Clin N Am · July 2014 Endovascular management has become the treatment of choice for carotid-cavernous fistulas regardless of the fistula type. The endovascular method offers numerous options that render it capable of treating each fistula type by choosing an adequate technique ... Full text Link to item Cite

Estrogen protects against intracranial aneurysm rupture in ovariectomized mice.

Journal Article Hypertension · June 2014 Clinical observations suggest that postmenopausal women have a higher incidence of aneurysmal rupture than premenopausal women. We hypothesize that a relative deficiency in estrogen may increase the risks of aneurysmal growth and subarachnoid hemorrhage in ... Full text Link to item Cite

Vascular smooth muscle cells in cerebral aneurysm pathogenesis.

Journal Article Transl Stroke Res · June 2014 Vascular smooth muscle cells (SMC) maintain significant plasticity. Following environmental stimulation, SMC can alter their phenotype from one primarily concerned with contraction to a pro-inflammatory and matrix remodeling phenotype. This is a critical p ... Full text Link to item Cite

Treatment of blister-like aneurysms with the pipeline embolization device.

Journal Article Neurosurgery · May 2014 BACKGROUND: Endovascular vessel reconstruction with the pipeline embolization device (PED) has become common practice. Data on the safety and efficacy of the PED in blister-like aneurysms (BLAs) are limited. OBJECTIVE: To retrospectively present our experi ... Full text Link to item Cite

Multidisciplinary consensus on assessment of unruptured intracranial aneurysms: proposal of an international research group.

Journal Article Stroke · May 2014 BACKGROUND AND PURPOSE: To address the increasing need to counsel patients about treatment indications for unruptured intracranial aneurysms (UIA), we endeavored to develop a consensus on assessment of UIAs among a group of specialists from diverse fields ... Full text Link to item Cite

Medial acoustic neuromas: clinical and surgical implications.

Journal Article J Neurosurg · May 2014 OBJECT: Medial acoustic neuroma is a rare entity that confers a distinct clinical syndrome. It is scarcely discussed in the literature and is associated with adverse features. This study evaluates the clinical and imaging features, pertinent surgical chall ... Full text Link to item Cite

Critical role of TNF-α in cerebral aneurysm formation and progression to rupture.

Journal Article J Neuroinflammation · April 16, 2014 BACKGROUND: Alterations in TNF-α expression have been associated with cerebral aneurysms, but a direct role in formation, progression, and rupture has not been established. METHODS: Cerebral aneurysms were induced through hypertension and a single stereota ... Full text Open Access Link to item Cite

Molecular imaging of cerebrovascular lesions.

Journal Article Transl Stroke Res · April 2014 Inflammation is a key component in the pathogenesis of cerebrovascular lesions. Two agents have emerged as promising possibilities for imaging cerebrovascular lesions. These agents are ferumoxytol and myeloperoxidase (MPO)-specific paramagnetic magnetic re ... Full text Link to item Cite

Tumor necrosis factor-α modulates cerebral aneurysm formation and rupture.

Journal Article Transl Stroke Res · April 2014 Inflammation is a critical process behind cerebral aneurysm formation and rupture. Tumor necrosis factor alpha (TNF-α) is a key immune modulator that has been implicated in cerebral aneurysm pathophysiology. This may occur through TNF-α-mediated endothelia ... Full text Link to item Cite

Endovascular management of cerebral vasospasm following aneurysm rupture: outcomes and predictors in 116 patients.

Journal Article Clin Neurol Neurosurg · March 2014 OBJECTIVE: To retrospectively assess the safety and efficacy of endovascular treatment of cerebral vasospasm with different modalities and assess predictors of outcome. METHODS: Endovascular treatment was indicated in the event of neurological deterioratio ... Full text Link to item Cite

Coiling of large and giant aneurysms: complications and long-term results of 334 cases.

Journal Article AJNR Am J Neuroradiol · March 2014 BACKGROUND AND PURPOSE: Large and giant intracranial aneurysms are increasingly treated with endovascular techniques. The goal of this study was to retrospectively analyze the complications and long-term results of coiling in large and giant aneurysms (≥ 1 ... Full text Link to item Cite

Endovascular stroke intervention in young patients with large vessel occlusions.

Journal Article Neurosurg Focus · January 2014 OBJECT: Endovascular therapy has become a widely used method for achieving arterial recanalization in patients who are ineligible for intravenous thrombolysis or those in whom it is unsuccessful. Young stroke patients with large vessel occlusions may parti ... Full text Link to item Cite

Extending the indications of flow diversion to small, unruptured, saccular aneurysms of the anterior circulation.

Journal Article Stroke · January 2014 BACKGROUND AND PURPOSE: Flow diverters are currently indicated for treatment of large and complex intracranial aneurysms. The purpose of this study was to determine whether the indications of flow diversion can be safely extended to unruptured, small, sacc ... Full text Link to item Cite

Short-term outcome for saccular cerebral aneurysms treated with the Orbit Galaxy Detachable Coil System.

Journal Article J Clin Neurosci · January 2014 Technological advancement within the field of neuroendovascular therapy may lead to safer and more robust treatment options for patients with lesions traditionally not favorable to coil occlusion. We analyze and report our outcomes with the Orbit Galaxy De ... Full text Link to item Cite

Impalement brain injury from steel rod causing injury to jugular bulb: case report and review of the literature.

Journal Article Brain Inj · 2014 BACKGROUND: The management of impalement penetrating brain injuries (IPBI) from non-missile objects is extremely challenging, especially when vascular structures are involved. Cerebral angiography is a crucial tool in initial evaluation to assess for vascu ... Full text Link to item Cite

Advances in neurovascular treatments.

Journal Article Biomed Res Int · 2014 Full text Link to item Cite

Endovascular intervention for acute ischemic stroke in light of recent trials.

Journal Article ScientificWorldJournal · 2014 Three recently published trials, MR RESCUE, IMS III, and SYNTHESIS Expansion, evaluating the efficacy and safety of endovascular treatment of acute ischemic stroke have generated concerns about the future of endovascular approach. However, the tremendous e ... Full text Link to item Cite

Update on intra-arterial chemotherapy for retinoblastoma.

Journal Article ScientificWorldJournal · 2014 The tools for managing retinoblastoma have been increasing in the past decade. While globe-salvage still relies heavily on intravenous chemotherapy, tumors in advanced stage that failed chemotherapy are now referred for intra-arterial chemotherapy (IAC) to ... Full text Link to item Cite

Therapeutic implications of estrogen for cerebral vasospasm and delayed cerebral ischemia induced by aneurysmal subarachnoid hemorrhage.

Journal Article Biomed Res Int · 2014 Cerebral vasospasm (CV) remains the leading cause of delayed morbidity and mortality following aneurysmal subarachnoid hemorrhage (SAH). However, increasing evidence supports etiologies of delayed cerebral ischemia (DCI) other than CV. Estrogen, specifical ... Full text Link to item Cite

Endovascular treatment of distal intracranial aneurysms with Onyx 18/34.

Journal Article Clin Neurol Neurosurg · December 2013 OBJECTIVE: Surgical clipping and coil embolization of distally located intracranial aneurysms can be challenging. The goal of this study was to assess the feasibility, safety and efficacy of treatment of distal aneurysms with the liquid embolic agent Onyx ... Full text Link to item Cite

CT perfusion-guided versus time-guided mechanical recanalization in acute ischemic stroke patients.

Journal Article Clin Neurol Neurosurg · December 2013 OBJECTIVE: Perfusion studies are increasingly used to triage acute stroke patients for endovascular recanalization therapies. We compare the safety and efficacy of CT perfusion (CTP)-guided to time-guided mechanical recanalization in acute ischemic stroke ... Full text Link to item Cite

Preoperative spinal tumor embolization: an institutional experience with Onyx.

Journal Article Clin Neurol Neurosurg · December 2013 BACKGROUND: Preoperative embolization has the potential to decrease intraoperative blood loss and facilitate spinal cord decompression and tumor resection. OBJECTIVE: We report our institutional experience with the embolization of hypervascular extradural ... Full text Link to item Cite

Spontaneous delayed migration/shortening of the pipeline embolization device: report of 5 cases.

Journal Article AJNR Am J Neuroradiol · December 2013 Five patients were found to have spontaneous delayed migration/shortening of their Pipeline Embolization Devices on follow-up angiography. The device migrated proximally in 4 patients and distally in 1 patient. One patient had a subarachnoid hemorrhage and ... Full text Link to item Cite

Inflammation and human cerebral aneurysms: current and future treatment prospects.

Journal Article Future Neurol · November 1, 2013 The formation of cerebral aneurysms and their rupture propensity is of immediate clinical importance. Current management includes observation with expectant management, microsurgical clipping and/or endovascular coiling. The surgical options are invasive a ... Full text Link to item Cite

Risk of hemorrhagic complication associated with ventriculoperitoneal shunt placement in aneurysmal subarachnoid hemorrhage patients on dual antiplatelet therapy.

Journal Article J Neurosurg · October 2013 OBJECT: The use of an intracranial stent requires dual antiplatelet therapy to avoid in-stent thrombosis. In this study, the authors sought to investigate whether the use of dual antiplatelet therapy is a risk factor for hemorrhagic complications in patien ... Full text Link to item Cite

Dual antiplatelet therapy.

Journal Article J Neurosurg · October 2013 Full text Link to item Cite

Stress cardiomyopathy with an "inverse" takotsubo pattern in a patient with acute aneurysmal subarachnoid hemorrhage.

Journal Article Echocardiography · September 2013 BACKGROUND: Subarachnoid hemorrhage (SAH) induced myocardial dysfunction (often labeled neurogenic stunned myocardium) encompasses a spectrum of clinical presentations ranging from an isolated elevation of cardiac enzymes to cardiogenic shock. OBJECTIVE: W ... Full text Link to item Cite

Localized increase of chemokines in the lumen of human cerebral aneurysms.

Journal Article Stroke · September 2013 BACKGROUND AND PURPOSE: Inflammation may play an important role in the formation and rupture of cerebral aneurysms. Chemokines act as chemoattractants for leukocytes directing them toward sites of tissue inflammation. The purpose of this study was to deter ... Full text Link to item Cite

Stenting as monotherapy for uncoilable intracranial aneurysms.

Journal Article Neurosurgery · September 2013 BACKGROUND: Small, blister-like aneurysms (BLAs), by virtue of their unique morphology, are difficult to treat with conventional modalities. The use of oversized self-expanding stents as monotherapy for BLAs is a relatively new and promising concept that w ... Full text Link to item Cite

The emerging role of ferumoxytol-enhanced MRI in the management of cerebrovascular lesions.

Journal Article Molecules · August 13, 2013 Inflammation is increasingly being understood to be a key component to the pathophysiology of cerebrovascular lesions. Ferumoxytol, an iron oxide nanoparticle coated by a carbohydrate shell, has been used in MRI studies as an inflammatory marker because it ... Full text Link to item Cite

Comparison of flow diversion and coiling in large unruptured intracranial saccular aneurysms.

Journal Article Stroke · August 2013 BACKGROUND AND PURPOSE: Flow diversion has emerged as an important tool for the management of intracranial aneurysms. The purpose of this study was to compare flow diversion and traditional embolization strategies in terms of safety, efficacy, and clinical ... Full text Link to item Cite

Carotid and vertebral artery sacrifice with a combination of Onyx and coils: technical note and case series.

Journal Article Neuroradiology · August 2013 INTRODUCTION: Permanent vessel sacrifice has become a routine for the management of aneurysms, pseudoaneurysms, tumors, and carotid blowouts. The purpose of this study is to describe a new technique for carotid and vertebral artery sacrifice using a combin ... Full text Link to item Cite

The Pipeline Embolization Device: learning curve and predictors of complications and aneurysm obliteration.

Journal Article Neurosurgery · July 2013 BACKGROUND: The Pipeline Embolization Device (PED) has emerged as a promising treatment for intracranial aneurysms. OBJECTIVE: To assess the safety and efficacy of the PED, to analyze the effect of operator experience on the complication rate, and to ident ... Full text Link to item Cite

Imaging aspirin effect on macrophages in the wall of human cerebral aneurysms using ferumoxytol-enhanced MRI: preliminary results.

Journal Article J Neuroradiol · July 2013 BACKGROUND AND PURPOSE: Daily intake of aspirin was shown to decrease human cerebral aneurysm rupture by 60%. The feasibility of imaging macrophages in human cerebral aneurysm walls using ferumoxytol-enhanced MRI has been demonstrated. The goal of the pres ... Full text Link to item Cite

Aneurysmal subarachnoid hemorrhage in patients under 35-years-old: a single-center experience.

Journal Article Clin Neurol Neurosurg · June 2013 OBJECTIVE: Aneurysmal subarachnoid hemorrhage (SAH) is relatively uncommon in young adults. There is a paucity of data pertaining to the management of aneurysmal SAH in young patients, especially with endovascular therapy. METHODS: We reviewed all SAH pati ... Full text Link to item Cite

SAHIT Investigators--on the outcome of some subarachnoid hemorrhage clinical trials.

Journal Article Transl Stroke Res · June 2013 Outcome of patients with aneurysmal subarachnoid hemorrhage (SAH) has improved over the last decades. Yet, case fatality remains nearly 40% and survivors often have permanent neurological, cognitive and/or behavioural sequelae. Other than nimodipine drug o ... Full text Link to item Cite

Sensitivity of Quantified Intracranial Aneurysm Geometry to Imaging Modality.

Journal Article Cardiovasc Eng Technol · March 2013 The objective of this study is to assess the sensitivity of intracranial aneurysm geometry to the modality of imaging. Four imaging modalities-3D rotational angiography (3DRA), computed tomography angiography (CTA), contrast enhanced magnetic resonance ang ... Full text Link to item Cite

Evidence that acetylsalicylic acid attenuates inflammation in the walls of human cerebral aneurysms: preliminary results.

Journal Article J Am Heart Assoc · February 22, 2013 BACKGROUND: Inflammatory cells and molecules may play a critical role in formation and rupture of cerebral aneurysms. Recently, an epidemiologic study reported that acetylsalicylic acid (ASA) decreases the risk of aneurysm rupture. The goal of this study w ... Full text Link to item Cite

Clinical prediction models for aneurysmal subarachnoid hemorrhage: a systematic review.

Journal Article Neurocrit Care · February 2013 BACKGROUND: Clinical prediction models can enhance clinical decision-making and research. However, available prediction models in aneurysmal subarachnoid hemorrhage (aSAH) are rarely used. We evaluated the methodological validity of SAH prediction models a ... Full text Link to item Cite

Endovascular treatment of cerebral mycotic aneurysm: a review of the literature and single center experience.

Journal Article Biomed Res Int · 2013 The management of mycotic aneurysm has always been subject to controversy. The aim of this paper is to review the literature on the intracranial infected aneurysm from pathogenesis till management while focusing mainly on the endovascular interventions. Th ... Full text Link to item Cite

Cigarette smoke modulates vascular smooth muscle phenotype: implications for carotid and cerebrovascular disease.

Journal Article PLoS One · 2013 BACKGROUND: The role of smooth muscle cell (SMC) phenotypic modulation in the cerebral circulation and pathogenesis of stroke has not been determined. Cigarette smoke is a major risk factor for atherosclerosis, but potential mechanisms are unclear, and its ... Full text Open Access Link to item Cite

Subarachnoid Hemorrhage International Trialists data repository (SAHIT).

Journal Article World Neurosurg · 2013 The outcome of patients with aneurysmal subarachnoid hemorrhage (SAH) has improved slowly over the past 25 years. This improvement may be due to early aneurysm repair by endovascular or open means, use of nimodipine, and better critical care management. De ... Full text Link to item Cite

Cerebral blood flow dynamics and head-of-bed changes in the setting of subarachnoid hemorrhage.

Journal Article Biomed Res Int · 2013 Head-of-bed (HOB) elevation is usually restricted in patients with aneurysmal subarachnoid hemorrhage (SAH). The goal of this study is to correlate HOB changes (0° and 90°) with cerebral blood flow using transcranial Doppler (TCD) and thermal diffusion pro ... Full text Link to item Cite

Cerebral aneurysm sac growth as the etiology of recurrence after successful coil embolization

Conference ASME 2012 Summer Bioengineering Conference, SBC 2012 · December 1, 2012 Full text Cite

Early change in ferumoxytol-enhanced magnetic resonance imaging signal suggests unstable human cerebral aneurysm: a pilot study.

Journal Article Stroke · December 2012 BACKGROUND AND PURPOSE: The clinical significance of early (ie, within the first 24 hours) uptake of ferumoxytol by macrophages in the wall of human cerebral aneurysms is not clear. The purpose of this study was to determine whether early uptake of ferumox ... Full text Link to item Cite

Incidence of cerebral ischemic events after discontinuation of clopidogrel in patients with intracranial aneurysms treated with stent-assisted techniques.

Journal Article J Neurosurg · November 2012 OBJECT: The optimal antiplatelet medication protocol for prevention of thrombotic complications after stent-assisted coil embolization of cerebral aneurysms is unclear. Early cessation of antiplatelet agents may be associated with an increased risk of cere ... Full text Link to item Cite

Macrophage imbalance (M1 vs. M2) and upregulation of mast cells in wall of ruptured human cerebral aneurysms: preliminary results.

Journal Article J Neuroinflammation · September 21, 2012 BACKGROUND: M1 and M2 cells are two major subsets of human macrophages that exert opposite effects on the inflammatory response. This study aims to investigate the role of macrophage M1/M2 imbalance and mast cells in the progression of human cerebral aneur ... Full text Link to item Cite

Safety and efficacy of tirofiban in stent-assisted coil embolization of intracranial aneurysms.

Journal Article Neurosurgery · September 2012 BACKGROUND: Thromboembolic complications are a major concern in stent-assisted coiling of intracranial aneurysms that may be prevented with adequate antiplatelet therapy. OBJECTIVE: To assess the safety and efficacy of tirofiban in stent-assisted coiling. ... Full text Link to item Cite

Clinical and radiographic predictors of neurological outcome following posterior fossa decompression for spontaneous cerebellar hemorrhage.

Journal Article J Clin Neurosci · September 2012 Spontaneous cerebellar hemorrhage often requires surgical suboccipital decompression and clot evacuation. Predictors of postoperative neurological deficits and outcome are not widely addressed in the literature. A retrospective review was conducted on 37 c ... Full text Link to item Cite

Is packing density important in stent-assisted coiling?

Journal Article Neurosurgery · August 2012 BACKGROUND: Recent reports have shown that stent-assisted coiling (SAC) is associated with lower aneurysm recanalization rates compared with conventional coiling, raising questions about the necessity of achieving high packing density (PD) in stented aneur ... Full text Link to item Cite

Endovascular management of carotid blowout.

Journal Article World Neurosurg · July 2012 OBJECTIVE: To highlight pertinent aspects of emergent endovascular management of carotid rupture, or carotid blowout syndrome (CBS), an emergent, life-threatening complication of head and neck cancer and its treatments. METHODS: A retrospective chart revie ... Full text Link to item Cite

Ferumoxytol-enhanced MRI to Image Inflammation within Human Brain Arteriovenous Malformations: A Pilot Investigation.

Journal Article Transl Stroke Res · July 2012 Inflammation cell infiltration and cytokine expression are seen in the vascular walls and intervening stroma of resected brain arteriovenous malformation (bAVM) specimens, even in unruptured and previously untreated lesions. Macrophages may play a critical ... Full text Link to item Cite

Upregulation of cyclooxygenase-2 (COX-2) and microsomal prostaglandin E2 synthase-1 (mPGES-1) in wall of ruptured human cerebral aneurysms: preliminary results.

Journal Article Stroke · July 2012 BACKGROUND AND PURPOSE: Cyclooxygenase-2 (COX-2) and Microsomal Prostaglandin E2 Synthase-1 (mPGES-1) catalyze isomerization of the cyclooxygenase product PGH2 into PGE2. Deletion of COX-2/mPGES-1 suppresses carotid artery atherogenesis and angiotensin II- ... Full text Link to item Cite

Stent-assisted coiling of wide-necked aneurysms in the setting of acute subarachnoid hemorrhage: experience in 65 patients.

Journal Article Neurosurgery · June 2012 BACKGROUND: Stent-assisted coiling in the setting of subarachnoid hemorrhage remains controversial. Currently, there is a paucity of data regarding the utility of this procedure and the risks of hemorrhagic and ischemic complications. OBJECTIVE: To assess ... Full text Link to item Cite

The superior ophthalmic vein approach for the treatment of carotid-cavernous fistulas: a novel technique using Onyx.

Journal Article Neurosurg Focus · May 2012 OBJECT: Endovascular therapy is the primary treatment option for carotid-cavernous fistulas (CCFs). Operative cannulation of the superior ophthalmic vein (SOV) provides a reasonable alternative route to the cavernous sinus when all transvenous and transart ... Full text Link to item Cite

Macrophage imaging within human cerebral aneurysms wall using ferumoxytol-enhanced MRI: a pilot study.

Journal Article Arterioscler Thromb Vasc Biol · April 2012 OBJECTIVE: Macrophages play a critical role in cerebral aneurysm formation and rupture. The purpose of this study is to demonstrate the feasibility and optimal parameters of imaging macrophages within human cerebral aneurysm wall using ferumoxytol-enhanced ... Full text Link to item Cite

Stent-assisted coil embolization of complex wide-necked bifurcation cerebral aneurysms using the "waffle cone" technique. A review of ten consecutive cases.

Journal Article Interv Neuroradiol · March 2012 Endovascular treatment of complex, wide-necked bifurcation cerebral aneurysms is challenging.  Intra/extra-aneurysmal stent placement, the "waffle cone" technique, has the advantage of using a single stent to prevent coil herniation without the need to del ... Full text Link to item Cite

Cerebral aneurysm sac growth as the etiology of recurrence after successful coil embolization.

Journal Article Stroke · March 2012 BACKGROUND AND PURPOSE: Coil compaction is thought to be the main mechanism for recurrence in cerebral aneurysms with previously successful coil embolization. We hypothesize that sac growth may be equally or more important. The objective was to study the r ... Full text Link to item Cite

Anterior-to-posterior circulation approach for mechanical thrombectomy of an acutely occluded basilar artery using the penumbra aspiration system.

Journal Article World Neurosurg · February 2012 OBJECTIVE: Prompt access to arterial occlusion is the key to successful endovascular revascularization in acute stroke. We present the first reported case utilizing anterior-to-posterior circulation approach for a successful mechanical thrombectomy and che ... Full text Link to item Cite

Treatment of endovascular coil and stent migration using the merci retriever: report of three cases.

Journal Article Case Rep Med · 2012 Background. Coil and stent migration is a potentially catastrophic complication in endovascular neurosurgery, which may lead to cerebral thromboembolism. Techniques for removing migrated coil and stent are not well established. Methods and Results. We pres ... Full text Link to item Cite

Aspirin as a promising agent for decreasing incidence of cerebral aneurysm rupture.

Journal Article Stroke · November 2011 BACKGROUND AND PURPOSE: Chronic inflammation is postulated as an important phenomenon in intracranial aneurysm wall pathophysiology. This study was conducted to determine if aspirin use impacts the occurrence of intracranial aneurysm rupture. METHODS: Subj ... Full text Link to item Cite

Duplication of the internal carotid artery presenting with severe atherosclerotic stenosis.

Journal Article J Clin Neurosci · July 2011 Duplication of the extracranial internal carotid artery is a rare anatomic variant. We present the first patient with unilateral duplication of the cervical internal carotid artery with severe stenosis. Stent-assisted percutaneous transluminal angioplasty ... Full text Link to item Cite

Computed tomography perfusion-based selection of patients for endovascular recanalization.

Journal Article Neurosurg Focus · June 2011 Intravenous and intraarterial recombinant tissue plasminogen activator remains underutilized in the treatment of acute ischemic stroke, largely due to strict adherence to the concept of the therapeutic time window for administration. Recent efforts to expa ... Full text Link to item Cite

Risk of ventriculostomy-related hemorrhage in patients with acutely ruptured aneurysms treated using stent-assisted coiling.

Journal Article J Neurosurg · April 2011 OBJECT: Intracranial stenting has improved the ability to treat wide-neck aneurysms via endovascular techniques. However, stent placement necessitates the use of antiplatelet agents, and the latter may complicate the treatment of patients with acutely rupt ... Full text Link to item Cite

Treatment outcome of aneurysmal subarachnoid hemorrhage in patients aged 70 years and older.

Journal Article Neurosurgery · March 2011 BACKGROUND: The incidence of subarachnoid hemorrhage is increasing, especially in the elderly as life expectancy increases. Aggressive treatment of aneurysms in the elderly is usually avoided because of a presumed poor prognosis. OBJECTIVE: The aim of this ... Full text Link to item Cite

Comparison of imaging modalities in the quantification of cerebral aneurysm geometry

Conference ASME 2010 Summer Bioengineering Conference, SBC 2010 · December 1, 2010 Full text Cite

Anomalous origins of the calcarine and parieto-occipital arteries.

Journal Article J Clin Neurosci · October 2010 Understanding cerebrovascular anatomy and its variations is of utmost importance in treating vascular malformations. The two patients presented here demonstrate yet to be reported anomalous origins of the cortical branches of the posterior cerebral artery. ... Full text Link to item Cite

Direct carotid-cavernous fistula presenting with minimal symptoms and rapid angiographic progression.

Journal Article J Clin Neurosci · September 2010 Most patients with direct carotid-cavernous fistulas (CCFs) present with dramatic symptoms including proptosis, chemosis, and diplopia. We report a patient with a direct/high-flow CCF whose only initial symptom was pulse-synchronous tinnitus. Following dia ... Full text Link to item Cite

Multiple symptomatic vertebral artery loops treated with posterior cervical fusion.

Journal Article J Clin Neurosci · June 2010 Multiple symptomatic vertebral artery (VA) loops are rare and their management is challenging. A 55-year-old man presented with a 5-year history of frequent episodes of presyncope and mild left C5 radiculopathy that was exacerbated by flexion or extension ... Full text Link to item Cite

The efficacy of endovascular stenting in the treatment of supraclinoid internal carotid artery blister aneurysms using a stent-in-stent technique.

Journal Article AJNR Am J Neuroradiol · June 2010 BACKGROUND AND PURPOSE: Blister aneurysms of the supraclinoid ICA represent a rare but well-documented cause of subarachnoid hemorrhage. These aneurysms are difficult to detect, and their surgical treatment is challenging, with high morbidity and mortality ... Full text Link to item Cite

Campomelic dysplasia: a rare cause of congenital spinal deformity.

Journal Article J Clin Neurosci · May 2010 Campomelic dysplasia is a rare autosomal dominant syndrome that often results in congenital spinal deformity. As a result of improvements in respiratory care, some patients survive into childhood, requiring treatment of their spinal deformities. We present ... Full text Link to item Cite

Utility of CT angiography in the identification and characterization of supraclinoid internal carotid artery blister aneurysms.

Journal Article AJNR Am J Neuroradiol · April 2010 BACKGROUND AND PURPOSE: Blister aneurysms of the supraclinoid ICA represent a rare but potentially catastrophic cause of SAH, often presenting both diagnostic and therapeutic dilemmas. We explore the utility of CTA in the identification and characterizatio ... Full text Link to item Cite

Successful management of a simultaneous Aspergillus fumigatus and Absidia corymbifera invasive fungal infection.

Journal Article J Pediatr Hematol Oncol · January 2010 Considering the poor prognosis of pediatric patients with invasive fungal infections due to zygomycosis, we present the case of a female adolescent with acute lymphoblastic leukemia, who successfully completed her chemotherapy despite a disseminated double ... Full text Link to item Cite

Anterior clivectomy: surgical technique and clinical applications.

Journal Article J Neurosurg · November 2008 OBJECT: Midline clival lesions, whether involving the clivus or simply situated anterior to the brainstem, present a technical challenge for adequate exposure and safe resection. The authors describe, as a minimally invasive technique, an anterior clivecto ... Full text Link to item Cite

Management of Cervical Spinal Fractures in Ankylosing Spondylitis

Chapter · January 1, 2006 The first reported case of cervical spine injury in a patient with ankylosing spondylitis (AS) appeared in 1933 (1). Subsequently, numerous publications have shown the incidence of traumatic cervical injury in patients with AS to be appreciably higher than ... Full text Cite

Clinical course and surgical management of massive cerebral infarction.

Journal Article Neurosurgery · July 2004 OBJECTIVE: Acute occlusion of the proximal middle cerebral artery (MCA) can lead to rapid development of fatal brain swelling and ischemic strokes. Decompressive surgery, if performed early in this subpopulation of patients, can reduce mortality and result ... Full text Link to item Cite

Chiari I malformation in the very young child: the spectrum of presentations and experience in 31 children under age 6 years.

Journal Article Pediatrics · December 2002 INTRODUCTION: The entity of hindbrain herniation without myelodysplasia in the very young child has been poorly described. A retrospective analysis of children diagnosed with Chiari I malformation (CM I) before their sixth birthday is presented. METHODS: S ... Full text Link to item Cite